Road traffic accidents as a public health problem

In 1963, President John F. Kennedy told the Congress and the American people, 'Traffic accidents are one of the greatest, perhaps the greatest of the nation's public health problems." In 2004, the World Health Organization nominated health day as road safety day. Given the rate of Road Traffic Accidents (RTAs) in Dominica today, the government and opposition leadership, the commander of the Police Traffic Branch and I suppose, the Minister of Tourism, could echo the same dire concerns as the late American President did many decades ago.

RTAs in Dominica have emerged as an important public health issue which needs to be tackled not just by the police but needs a multi-disciplinary approach. The number of fatal and disabling road accidents that are occurring is increasing almost daily. It has become not only a law enforcement issue but a real public health challenge.

The approach to enforce the rules and regulations available to prevent road accidents in Dominica's is often ineffective and half-hearted. Public Health awareness educations, strict implementation of traffic rules among others, are the needs of the 'hour' to prevent this public health issue from becoming a catastrophe. There needs to be an urgent and heightened awareness among health professionals, law enforcement and communities about the various modalities that are at their disposal to prevent and mitigate road accidents. An immediate public health along with a law enforcement road safety campaign is desperately needed to inculcate a sense of responsibility to reverse that disturbing trend.

Some of the contributing factors most often responsible for RTAs are due to the human error. Reckless and speedy driving and not obeying or following traffic rules contribute significantly to this problem. Some drivers continue to act like maniacs in a tearing hurry which leads to errors in judgment. The attitudes of the "right of the mighty" bigger vehicles toward the smaller vehicles, overtaking, poor maintenance of the vehicles and probably in some areas, the appalling conditions of the already chocked roads with its hair-pin turns contribute to this issue.

Consequently, road safety has become a major public health issue in Dominica. For every one killed, injured, or disabled by a RTA, there are countless others deeply affected by the cost of prolonged medical care, loss of a family bread winner, or the extra funds needed to care for the people with disabilities. RTA survivors, their families, friends, and other care givers often suffer adverse social, physical, and psychological effects. If the current trends continue, the number of people killed and injured on Dominica's roads will rise significantly.

Effective and results oriented preventive measures to reduce RTAs can be implemented in Dominica to mitigate RTAs. Working in conjunction with law enforcement, a wide range of effective public health road safety interventions can be implemented to achieve a system approach to road safety in order to tackle the problem and clearly identify solutions. This approach should examine closely interactions between vehicles, road users, enforcement and road infrastructure.

Vehicles should be well-maintained with good breaks, lighting, tires etc. that will reduce accidents. Seat belts and other traffic rules should be strictly enforced by the police. Training on First Aid should be nationwide along with public health and traffic education for the general public. The importance of the "Golden Hour" in giving adequate treatment to the accident victims in saving the injured should be highlighted to both the health personals and the community. The government should look into the provision of medical care/first aid care facilities on highways and busy roads in the countryside.

"Road Safety Weeks" should be observed throughout the island at least three times annually in order to highlight and emphasize the need for safe roads by taking up activities to promote the concept. Prevention of RTAs is a responsibility of various agencies and requires an effective multi-agency concerted, focused and cooperative effort. It will also require effective community participation as well.

Road safety problems represent a significant domestic, social and economic problem. They are preventive problems that can be ill afforded in places like Dominica were scarce resources should not be wasted on avoidable accidents. Also, road accidents often cause injuries that need long periods of rehabilitation as well as permanent injuries. Therefore, it is imperative that everyone understands, believes and adopts the mindset that road safety is everybody's business in Dominica.