Re-thinking global road safety


Photo: Riders for Health
Photo: Riders for Health

by Barry Coleman

Barack Obama (President of the USA) must have received many phone calls he will never forget. But one in particular probably stands out: the one that told him that his father had been killed in a road accident.

Since the invention and development of the motor car, millions of people have received the same news. One reaction many people will have will be the sense of pointlessness; the overwhelming sense that the accident could so easily have been avoided.

But what is an ‘accident’? When it comes to road accidents, why are we often so complacent about them? Why are we afraid of diseases and yet apparently unafraid of the bits of steel and glass that speed around us. Why, as drivers or passengers, are we so sure that the glass and steel ‘protect’ us rather than kill or injure us?

The devastation brought about by poor maintenance of vehicles and driving standards is a serious and dangerous matter everywhere, but particularly in the South.

The situation in Africa

Africa appears to be the continent most affected by road deaths and injuries. Lesotho was for many years the world’s most dangerous country in terms of accidents and deaths per vehicle kilometre travelled. The Nairobi-Mombasa highway in Kenya is considered the most dangerous road in the world and in South Africa, which has a population of 45 million, more than 20,000 people die in road accidents each year.

Poor maintenance of vehicles and poor driving skills lead to more accidents in African countries. The numbers of people killed in accidents are often disproportionate because they involve crowded or over-crowded vehicles. If two buses collide, 80 or even 100 lives may be lost.

What can we do?


For many years Riders for Health has taught people in Africa how to drive cars and trucks, and ride motorcycles safely. The people they have taught have very good safety rates. They are constantly working on ways to improve this record and to share their outlook and techniques with more and more people. Every time they do so, more lives are saved.

What is an ‘accident’? Riders for Health teaches people that there is no such thing as an ‘accident’. There are only deliberate actions that people took and intended to take, mad as they are. For example, someone drives out in front of you and you hit them because you did not have time to stop. That is not an ‘accident’. It was a ‘deliberate action’. In fact it was two ‘deliberate actions’. They deliberately drove out in front of you, and you were deliberately driving too fast to stop.

So the first change of assumptions concerns passivity. If we are passive about road accidents, we will continue to have them. We must believe that all events on the road can be controlled and we must do all that we can to achieve this. If everyone did that, there would be no accidents.

Maintenance Secondly, there is the question of maintenance of the vehicle. Uncompromising, perfect maintenance for aircraft is imperative for air travel. Furthermore air-travellers assume that it is being carried out. Are the same standards applied to cars, trucks and motorcycles? No, they are not. For some reason we believe, against all the most obvious evidence, that if we are on the ground nothing will happen to us. We fear the plane far more than the car even though we are far more likely to die driving to the airport.

Everywhere, but particularly in the developing world because of the higher risks, we must maintain vehicles as if they were planes. We must also drive them as carefully as the most careful pilot would fly.

Protection Another assumption which is important to challenge is that our vehicle ‘protects’ us. Somehow drivers feel invulnerable behind the steering wheel and the powerful engine. In fact the opposite is true. If you are in collision with another vehicle it is your own vehicle that will harm you. The steering column will pierce your chest and, if the impact is hard enough, the engine will crush you. It is your own common sense and awareness that protects you, not the vehicle you are travelling in.

Simple solutions, such as using seat belts in cars and wearing helmets when riding motor cycles and bicycles, will improve your chances of survival following a collision.

High speeds Another assumption is that only high speed kills or injures. Ask someone who believes this to hit the back of their hand on a rough wall at 20 km an hour. They will not do it. Deep down they know that an impact of 20 km an hour will be dangerous and hurt them. But once behind that steering wheel, all such instinctive understanding seems to vanish.


We must advocate for big improvements in road safety, including vehicle maintenance and driving skills. Advocacy for improved road safety is weak compared to other issues such as HIV and malaria. Even advocacy for issues such as forced marriages and guinea worm, that affect far fewer people, is much better organised that it is for road safety. The World Health Organisation campaigns against road deaths and injuries, arguing that they are a major threat to global health and well-being, and would benefit from more support.


As well as more forceful advocacy, we need more and better thinking. People laugh now when they learn that someone used to run in front of the early cars with a red flag to warn people that a car was coming. But there was a serious reason behind it. A car coming down the road was extremely dangerous. The horn is probably the direct descendent of the red flag – it should be used to warn people ahead of potential situations. Even though, in many African countries, drivers are compelled by law to have one, it is almost never used for the benefit of other road users. Many people use it to show how angry they are after an incident has happened! Therefore, the horn becomes part of the problem and is no help in the solution.


When we have changed our assumptions and decided what we will and will not tolerate by way of vehicle-related death and injury, it will actually be quite easy to do the training and the maintenance.

Barry Coleman is the Co-founder and Executive Director of Riders for Health.

Riders for Health is an award-winning social enterprise dedicated to the effective management of vehicles used for delivering health care in hostile conditions. For more information:

3 New Street, Daventry, Northamptonshire, NN11 4BT, United Kingdom.

Tel: +44 (0)1327 300 047
Fax: +44 (0)1327 308 760

Basic vehicle safety

  • always wear a seat belt 
  • obey the speed limits and do not drive too close to the vehicle in front
  • do not use a mobile phone whilst driving
  • do not drive after having consumed alcohol 
  • slow down when driving near pedestrians, animals and cyclists 
  • carry out regular maintenance checks