Road crashes: A huge cost to healthcare

On December 7, two people were confirmed dead on the spot, with several others injured at Namboole roundabout on the outskirts of Kampala after the driver of a Fuso truck rammed into 13 other cars and two motorcycles.
The accident continued a pattern where thousands of Ugandans have been forced into poverty either because they have been crippled and unable to fend for themselves or the breadwinners have been killed.

The latest Kampala Capital City Authority Road Safety Report released this week indicates that 425 fatalities were registered in 2022, representing a 1 percent increase.
At the global stage, the World Health Organisation (WHO) put the deaths resulting from road crashes in Uganda at a staggering 7,315 annually, almost twice the figures reported to police, which stands at 4,159 in 2022.

While the police annual traffic and crime report for 2021 put the percentage of males who died of crashes at 81 percent and 19 percent females, WHO put the figures at 95 percent males and 5 percent females while the deaths per 100,000 population is estimated to be at 16 for every 100,000 people.

Data from the police traffic and safety directorate for the last 10 months indicates that 1,277 road crash deaths involving motorcycle riders were registered, with 513 passengers perishing. A total of 4,442 riders and 2,568 passengers also sustained serious injuries.
Dr Olive Kobusingye, a senior research fellow at Makerere University School of Public Health, and head of the Trauma, Injury, and Disability Unit, said the situation needs urgent intervention.

She said the rampant road crashes have added a huge cost to healthcare delivery, diverting resources needed for other emergency services.
“It’s the minor and serious injuries that will come to the healthcare system that will need an emergency medical service, which in Uganda is [underdeveloped]. We are still struggling to even get people to understand what it’s about,” Dr Kobusingye said.

“Majority of citizens don’t have access to an ambulance because most of them are stationed at hospitals and owned by hospitals or in the city by private companies that will only evacuate if somebody can pay,” she added.
A 2022 report authored by Dr Charles Ayume, the Koboko Municipality MP, and the chairperson of the Health Committee in Parliament, placed the burden of road crash victims’ treatment in government regional referral hospitals across the country at Shs236.3 million daily.

The government spends Shs86.2b on treatment every financial year, which is a big percentage of the national health budget. Dr Ayume said injuries caused by road accidents are costly health-wise, socially, and economically.

He said the accidents occur in a poorly regulated transport and justice sector yet health bears the brunt of these inefficiencies. “I have raised this issue in Parliament that these two sectors must be fixed. It takes anywhere between Shs2m to Shs3m to treat a critically injured patient and if he/she goes to ICU, that’s another Shs3m per day. No amount of budget allocation to emergency medical services will address these gaps if we don’t fix the upstream issues in the transport and law and justice sectors,” he said.

Govt action
Ms Maria Nkalubo, the principal operations officer at the Emergency Medical Services Department at Ministry of Health, said they are working with other stakeholders to reduce the burden. She, however, acknowledged challenges in post-crash management, especially with emergency services in health facilities. 

“We still have challenges because of big population and fewer personnel to handle them. However, we are working hard to address this. We are setting up call and dispatch centres, we have increased the number ambulances, though they are still few, but we shall reach there,” Ms Nkalubo said. She added that the ministry has developed policies, strategies and other legislations aimed at improving national emergency response and ensure that Ugandans are adequately attended to in health facilities.