A REVIEW OF THE CAUSES, TRENDS, IMPACT AND MITIGATION OF MOTORCYCLE ACCIDENTS WITH SPECIFIC REFERENCE TO KENYA

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1 Abstract A REVIEW OF THE CAUSES, TRENDS, IMPACT AND MITIGATION OF MOTORCYCLE ACCIDENTS WITH SPECIFIC REFERENCE TO KENYA By Mamboleo Dennis and Wakhungu Jacob Masinde Muliro University of Science and Technology It is estimated that slightly over 1.2 million people die annually across the world from road accidents while between million people sustain injuries. The youths from the low and middle income countries of the world are the most affected. Human and environmental errors are the some of the causes of road accidents globally. Kenyan roads claim about 10 lives every day and the trend seem to be surging upwards with the entry of motorcycles into the passenger transport sector. Individuals, families and institutions experience socio-economic, physical and psychological problems. Preventive and adoption of tried and successful measures of reducing road accidents and injuries may help solve the problem. By the end of 2010, Kenya had registered over 200,000, implying that motor cycle crashes, deaths and injuries will probably double from what it was in Scholars, transport stakeholders and other institutions need to do research in this industry so as to determine the causes, trends, and the impact of motorcycle accidents in the country. Such findings may also establish mitigation measures on motor cycle accidents. It is important to note that motor cycle accidents are preventable; adoption of motor cycle traffic policies that have been successful in some parts of the world by Kenya can make the industry to prosper. Key words: motorcycle crashes, causes, trends, deaths, disability, poverty, legislation laws Introduction Road carnage is a global health problem and its magnitude is worrying in both the developed and developing world (WHO, 2010a). About 3,300 lives are lost daily due to road crashes globally, with an estimated million sustaining injuries annually (WHO, 2009; WHO, 2010b). Road traffic injuries are the leading killer of the most economically productive group (15-25 years) in the world (WHO, 2007; WHO, 2008; WHO, 2009). Most of the world s accidents occurred in low-income and middle-income countries of the world whereby public transport vehicles, private cars, three and two-wheeled vehicles and pedestrians significantly contributed to road accidents in one way or the other (WHO, 2009). It was projected that by the year 2030, the road traffic injuries will be ranked fifth overall in deaths globally up from ninth position in 2004 (WHO, 2009). Of the total traffic deaths reported in the following countries in 2007, global motorcycle mortality rates were highest in Thailand, Cambodia, Indonesia, Malaysia, France, USA and México at 70, 63, 61, 58, 25, 11, and 6% respectively (Odera, 2009). In the East African region, two-wheel automobiles have recently become a popular mode of public transport, and statistics have revealed that motor cycle accidents are claiming many lives. In 2007, 16% of Rwanda s 1

2 total road accident deaths were due to motorcycles accidents, while in Uganda and Tanzania, 7% of the total deaths were attributed to motorcycle crashes (Odera, 2009). The causes of motor cycle accidents are human, environmental errors and defective vehicles (Haworth, 2010; WHO, 2010). Motorcycle mortality rates in Kenya have been surging upwards with records showing that between 2005 and 2009, motor cycle deaths excluding passengers rose from 1.7% to 6.1% in the same period (Odera, 2009). The consequences of these accidents include premature deaths, prohibitive treatment costs, disability and other psychological problems (Simiyu et al, 2010, WHO, 2010b). Increased deaths and injuries will most likely hamper the realization of global millennium development goals of fighting hunger, and accessing education and eradicating poverty by half by 2015, (UNDP, 2010; WHO, 2009). Urgent interventions to prevent more deaths and injuries need to be identified and examined so as to reduce the carnage (WHO, 2009; WHO, 2010), which has mostly affected the youths who have secured employment in the sector, which is viewed as cheap, reliable and the quickest means of transport in the rural, sub-urban and urban areas (Odera, 2009). The purpose of this article was to review and discuss the causes, trends and impact of motor cycle accidents, and also at look at some successful mitigation measures in some parts of the world that would be applicable in Kenya. Causes of motorcycle accidents in Kenya Kenya s roads are characterized by many observable, unprofessional driving behaviors such as over-speeding, driving on the wrong lanes, careless overtaking, overloading, carrying wide loads and making turns at inappropriate points without proper turning signals (Odera, 2009), have all been cited as causes of motor cycle accidents in Kenya. A research study conducted in Los Angeles, USA by Hurt et al. (1981) on Motorcycle Accident Cause Factors and Identification of Countermeasures found that most motor cycle accidents were as a result of collisions with other passenger automobiles, or some stationery objects (Hurt et al., 1981). It was also observed that over-speeding while negotiating sharp corners resulted to the rider sliding and falling out of the moving motorcycle (Hurt et al. 1981; Haworth, 2007; Haworth 2010). Other causes included poor road network planning, where roads were shared by both the motor cyclists and four-wheeled vehicles (Hurt et al. 1981; McCarthy et al., 2007). In other instances, some vehicles were found violating the right of way of the motorcyclists (Hurt et al., 1981, Samaha, 2010). The inability of vehicle drivers to detect and recognize motorcycles while in the traffic was another cause; some motorists were found to be deliberately obstructing motorcyclists, hence causing accidents (Hurt et al., 1981; Samaha et al., 2010). Road junctions were death spots where traffic lights were often ignored (Hurt et al., 1981; Samaha et al 2010). Also, inconspicuity of motorcyclists by motorists; majority of the motorcycle drivers did not undergo formal training, while some lacked the legal riding street experience of three years (Hurt et al. 1981; Haworth, 2010). The study also established that some 2

3 motorcyclists did not concentrate on driving, and some used alcohol while they were at work (Hurt et al., 1981; Samaha, 2010). Trend of motor cycle accidents The trend of road traffic deaths and injuries in Kenya attributed to motorcycles were on the increase as the deaths caused by motorcycle accidents in Kenya between were nearly five times more in 2009 than it was in 2006 (Odera, 2009). In 2010, about 9,000 motorcycles entered into the transport sector every month and by December 2010, the registered number of motorcycles had soared to nearly 200,000 from 91,151 in December 2009 (KNBS, 2010). Haworth (2010) also noted that a large number of motor cycles that entered the market led to increased deaths and injuries. As indicated, the large numbers of motor cycles that enter the market imply that the number of crashes associated with them will increase as well. Impact of motorcycle accidents Over-speeding in most cases ends tragically with deaths and severe injuries being reported (WHO, 2007). Rune et al. (2004) asserted that Despite the complexity of the relationship between impact speed and the probability of sustaining injuries of a given severity, there is no doubt at all that the probability of sustaining fatal or serious injury increases dramatically as impact speed increases. Facial disfigurement is usually expected once an accident occurs, especially when a fullface helmet is not used (Hurt et al. 1981, Odera, 2009; Samaha 2010); muscle tears at the elbows, shoulders, hips, knees and wrists, fingers, spine and neck if the rider had not put on the riding protective clothing, which are abrasion resistant in design (Rome, 2006). Fatal accidents usually result into disability. Disability can be a physical ailment, mental, intellectual or sensory malfunctioning REF which inhibits one from performing the daily living activities in persons who were once independent WHO, 2010d). Disability may be defined as a person s lack of capacity in functioning at the body, person, or societal levels, in one or more life domains, as experienced by an individual with a health condition in interaction with contextual factors (WHO, 2010d). One example among many other many disabilities is the traumatic brain injury which renders the survivor completely dependent (Emejulu et al., 2010). With these incapacitations, patients have to stay in hospital for long periods of time to undergo surgery and receive medications. In the long run, the hospital bills become so huge that they overwhelm most families and at the same time put a strain on national health resources (WHO, 2007; Odera, 2009; WHO, 2009). Other consequences associated with road traffic injuries are the indirect costs for individuals, such as the loss of both employment and property (WHO, 2010b). Estimates show that most countries of the world lose between 1% 2% of its gross national product in direct costs (WHO, 2010b). The Kenyan economy spends over US$ 50 million on accidents, and this estimate does not take into account the lost lives (WHO, 2004). 3

4 The accident survivors experience several emotional problems such as acute, moderately severe emotional distress and acute stress syndrome characterized by mood disturbance and horrific memories of the accident (Richard et al. 1993). Poverty is also a consequence of road crashes, for example, many households in India, Bangladesh, Bangalore and Vietnam became victims of poverty after road crashes (WHO, 2008). Motorcycle accident mitigation measures The Hurt Report (1981) noted that of the 900 cases they investigated in Los Angeles, USA, 59.7% sustained injuries because they were not wearing helmets. Failure to wear approved helmets when riding contributed significantly to more injuries (UN, 2010; WHO, 2010b), a situation that is most conspicuous with a large percentage of Kenyan riders (Odera, 2009). To enhance conspicuity of motorcyclists by motorists, motorcyclists must make use of motorcycle headlamps during the day; wear bright colored clothing such as yellow, orange or bright red jackets whenever riding as this significantly reduced involvement in accidents while on the road (Hurt et al. 1981). These measures that lack in Kenya especially with majority of motor cycle passengers (Odera, 2009). The Iran government enforced some traffic interventions such as the motorcycle helmet law, which made the use of helmets compulsory in all 28 provinces in By 2007, fatalities per 100,000 inhabitants decreased from 38.2 to 31.8 (WHO, 2010b). These measures lack in the Kenyan system which has not enforced laws that govern motor cycle business (Odera, 2009). The governments of Iraq and Cambodia trained members of the public on how to offer firstaid to accident victims at the scenes of accidents. Coupled with good hospital and rehabilitation care where none existed, many lives were saved in northern Iraq villages (WHO, 2008). In Kenya, similar road safety strategies that have not been legislated (Odera, 2009) to deal with vast numbers of motor cycles that enter the market (KNBS, 2010). Legislation by governments can be a valuable tool that can greatly benefit the citizenry if they are provided with the necessary human and physical resources. The governments of Romania and Cambodia availed qualified medical personnel and emergency medical services to the injured, measures which saved many lives than before (WHO, 2008). The use of helmets by both the motorcycle riders and the passengers is the best way to prevent severe injuries (Hinds, 2007). Helmet use reduces severe injuries from70% to 40% (WHO, 2010b). WHO reports on road safety advocate that governments enforce laws that require the mandatory use of standard helmets (WHO, 2010b) and protective clothing by motorcycle riders and passengers (Rome, 2006; WHO, 2009). In Kenya, pillion passengers ride without safety riding gears such as helmets or reflective clothing. Building separate roads for non-motorized vehicles, pedestrians and cyclists and motorized vehicles will be a preventive measure for motorcycle accidents because many road users are vulnerable because of lack of proper planning of roads (WHO, 2007; WHO, 2010b). In Kenya, the road network system has not been properly developed; both non-motorized and motorized vehicles share the same roads and the same lanes. 4

5 There is need for the government to implement specific actions aimed at preventing road traffic crashes and minimize injuries. Such measures include the enforcement of speed limits and at the same time ensure reduced drunk-driving (UN, 2010; WHO, 2010b). Research has shown that pedestrians have 90% chances of surviving car crashes of 30kph or less and 50% survival chances at 45kph (WHO, 2010b). In Kenya, motor cycle traffic laws have not been enforced and the operations of the sector are haphazardly conducted. The allocation of sufficient financial and qualified human resources by the government will effectively deal with the road carnage. It will help in the enforcement of the legislated road safety strategies such as erection of proper road signs, regularly mark and maintain the zebra crossings and regulate driving speed (WHO, 2008; WHO; 2009; WHO, 2010b). The government needs to urgently assess the road traffic injuries problem, enact road safety policies and delegate particular responsibilities to specific institutions which will ensure that safety for all is given the priority (WHO, 2009). The government and those delegated with the responsibility must ascertain that all motorcycle drivers are formally trained and licensed, understand the risks all road users are exposed to, and acquire a mandatory driving experience (Hurt 1981). Majority of motor cycle drivers in Kenya are not formally trained and therefore operate without driving licenses, endangering their own and others safety. Road carnage is a worldwide disaster and more investment in terms of research resources needs to be invested so as to look for ways which can prevent and or reduce road crashes (WHO, 2009). So far the East Asian countries have given much attention to research on road traffic injury (WHO, 2010ab). In Kenya, negligible research has been done on the gravity of motor cycles accidents and injuries, and at the same time research funds which may help make motor cycle transport business safer and profitable need to be priorized. Pre-hospital care worked well in Cambodia, Iraq, Ghana and Mexico where ambulances were availed on crash sites; training standards for medical staff were defined and prompt response to emergency calls adhered to by both medical personnel and trained members of the public (WHO, 2010a). This is an effort that the Kenya government needs to try and help the injured before they can reach the hospitals for further medical care. Trauma patients were professionally attended to by a team of experts such as surgeons, medical doctors, nurses and pharmacists. Social workers who were handy in hospitals especially during accident peak times prevented and reduced many deaths from occurring as witnessed in Thailand, Qatar and Vietnam (WHO, 2010a). There is need for rehabilitation teams stationed at various hospitals in Kenya to offer consultancy services to the seriously injured persons and their families on admission. These teams have helped save many lives in countries like Brazil and India (WHO, 2010a). National improvements in terms of pre-hospital care for accident persons at the accident scenes by medical personnel and inter-hospital transfers for specialized treatment for the severely injured persons reduced the mortality rate from 52% in 1990 to 8% in 1998 (WHO, 2010a). This measure if adopted by Kenya will reduce the high death rates currently witnessed on the roads. 5

6 General Discussion About 3,300 persons perish every day from road accidents globally with the youths aged15-25 years claiming the leading position, yet they are the most economically productive group in the society (WHO, 2009). This trend if not checked will be disastrous especially to the developing world where global population traffic deaths by income against percentage of registered vehicles show that low and middle-income countries traffic deaths stand at 91.5% against 48 % of the registered vehicles (WHO, 2009). With the increasing entry of motor cycles into the market for use as a means of public transport, accidents shall remain to be high (Haworth, 2010; WHO, 2010c). Kenya loses about eight lives every day due to road accidents (Odera, 2009; WHO, 2010c) and the situation may worsen with the introduction of motorcycles into the transport sector. Between 2006 and 2009 alone, the deaths from motorcycle accidents rose by five times (Odera 2009). By the end of 2009, there were 91,151 motorcycles and by December 2010 there were slightly over 100,000 new motorcycles in the market (KNBS, 2010). This implies that the deaths from motorcycle accidents in 2010 most probably doubled up from Many motorcycle accidents on roads can be partially attributable to non-experienced drivers as revealed in a study conducted (Hurt et al., 1981). It also found that majority of the motorcycle operators were not trained or licensed (Haworth, 2010). The Kenyan situation is similar to the above. This shows why majority of the drivers flout crucial traffic rules such as overtaking at sharp corners, overlapping within lanes despite having vehicles on both lanes, overloading where in some instances a rider can carry up to more than two passengers, carrying very wide loads on busy roads and over-speeding (Odera, 2009). Age of motor cycle drivers in Kenya is also a contributing factor because some are apparently less than the mandatory driving age as it has been reported in other countries (Haworth, 2010). This is the group that is often indecisive in making informed traffic choices. It is also suspected that many of the Kenyan operators are under the influence of alcohol whenever they are at work while others can be seen plying without using the recommended safety riding gears such as reflective jackets and helmets which are crucial in preventing injuries and fatal accidents. This confirms reports of researchers from other countries ((Hurt 1981; Rome, 2006; Odera, 2009; WHO, 2009; Samaha, 2010). The trends of motor cycle accidents were on the increase between 2006 and 2009 in Kenya (Odera, 2009). The pattern was likely to remain the same with the average entry of about 9,000 new motor cycles in the market per month in 2010 (KNBS, 2010). Coupled with recklessness and inexperience of motor cycle drivers, this situation in Kenya is predictable (Odera, 2009; UN, 2010; WHO 2010c). Kenyan accident survivors and their families suffer from severe stress while others are traumatized which is I n conformity with research findings elsewhere (Rune et al. 2004; Hinds et al., 2007; WHO, 2007). Individuals are temporarily or permanently disabled; poverty creeps into most households as a result of the deaths of bread winners, disposal of family properties, the 6

7 government spends so many resources in terms of money and medical personnel in taking care of accident persons (WHO, 2010b). Preventive and precautionary measures are crucial in preventing and reducing the severity of injuries resulting from road crashes such as use of helmets, putting on headlights whenever riding (Hurt 1981 et al., WHO 2008). These measures have not been enforced in Kenya. Policies aimed at putting in place safety mechanisms for all road users by the government, ensuring their legislation, allowed to drive only if licensed, no drunk-driving (Hurt et al. 1981; WHO 2009; WHO, 2010b); the traffic law must not be lenient on errant motorcyclists as is the current situation in Kenya. The government in collaboration with other stakeholders such as the Automobile Association (AA) need to plan for research funds aimed at improving the road safety, training members of the public and medical personnel on how to deal with accident victims at crash sites and sensitizing the public on safe use of the roads. This has been implemented in other countries e.g. Iraq and Cambodia, Ghana and Mexico (Hurt et al., 1981; WHO, 2009; WHO, 2010a). Organizing seminars on the proper use of roads by both motorcyclists and motorists, police enforcement of traffic rules, motor cycle traffic legislation and enactment laws, and erecting proper road signs in particular spots especially schools and markets may reduce accidents on the roads (UN, 2010; WHO, 2008; WHO, 2009; WHO, 2010b). These rules and set ups have not been realized in Kenya. Conclusions i. Research has pointed out that the major causes of accidents by the two-wheel motorized vehicles are human, environmental errors and mechanically faulty motor cycles. ii. The pattern of motor cycle accidents in Kenya is likely to surpass the death toll given the large number of motor cycles that entered the market in Research has shown that increased crashes, deaths and disability are as a result of increased motor cycles in the market. iii. The consequences of road crashes include deaths, disability, poverty, loss of jobs, emotional distress and strain on family and national resources in the care and treatment of the injured. iv. It is noted the government has not put in place the required legislation, enactment and enforcement of motor cycle safety laws to regulate the industry. Recommendations i. Motor cycle drivers must undergo formal training where they learn safety riding rules; regularly service their vehicles as this will prevent and reduce traffic crashes, deaths and injuries ii. The government needs to regulate the number of motor cycles it registers annually as this will curb and or reduce the recently witnessed increasing death tolls due to motor cycle accidents. 7

8 iii. iv. Legislation, enactment and enforcement of motor cycle traffic laws by the government will minimize accidents and other psychosocial and economic effects related to motor cycle carnage. The government of Kenya and other stakeholders need to inject funds into research projects aimed making the sector safer and profitable. Additionally, adoption and implementation of WHO successful road safety programmes by the government and also involve other multi-sectoral organizations in addressing road safety issues. References Emejulu, J.K.C., Isiguzo C.M., Agbasoga C.E., Ogbuagu C.N. (2010) Traumatic Brain Injury in the Accident and Emergency Department of a Tertiary Hospital in Nigeria, East and Central African Journal of Surgery, Vol. 15, No. 2, Haworth, Narelle L. and Rowden, Peter J. (2010) Challenges in improving the safety of learner motorcyclists. In: Proceedings of 20th Canadian Multidisciplinary Road Safety Conference, 6-9 June, 2010, Niagara Falls, Ontario. Haworth, Narelle L. and Nielson, Angela L. (2008) Motor scooters and mopeds-are increasing sales translating into increasing crashes?. In Proceedings TRB 87 th Annual Meeting, Washington DC. Hinds John D., Gareth Allen, Craig G. Morris (2007) (Review) Trauma and motorcyclists; born to be wild, bound to be injured Injury, International Journal of the Care of the Injured 38, Hurt H.H., Quellet J.V., Thom D.R. (1981 Motorcycle Accident Cause Factors and Identification of Countermeasures Volume 1: Technical Report K.N.B.S. (2010) Leading Economic Indicators. Government of Kenya McCarthy M.G., Hutchins L.K., Tong R., Keigan M. (2007) Comparative analysis of Motor Cycle Accidents from OTS and MAIDS, Published Project Report PPR 168 Odera Wilson (2009) Motorcycle Injuries in East Africa: Magnitude, Risk Factors and Prevention. RTIRN Regional Workshop, Accra, Ghana, December 2. Richard Mayou, Bridget Bryant, Robert Duthie (1993) Psychiatric consequences of road traffic accidents. BMJ 307, Rome de Liz (2006) The injury reduction benefits of motor cycle protective clothing. NTSB Motor cycle Safety Forum, September, Sydney, Australia Rune Elvik, Peter Christensen, Astrid Amundsen (2004) Speed and road accidents An evaluation of the Power Model. TOI report 740/2004 Rune Elvik, Alena Hoye, Truls Vaa, Michael Sorensen (2009) The Handbook of Road Safety Measure, 2 nd Edition, Emerald Publishing Limited Samaha Randa Radwan, Kazuyoshi Kuroki, Kennerly Digges (2007) Opportunities for Safety Improvements in Motorcycle Crashes in the United States: National Crash Analysis Center, The George Washington University 8

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