Boda bodas: A good transport mode but a silent killer

It is about 8:36pm, a 17-year-old male (names withheld on consent) is rushed in  semi-conscious state, with signs of multiple trauma, he had been involved in a boda boda accident 18 hours back, immediately primary and secondary surveys are done and the patient receives initial care to save his life.

After a few minutes, the doctors realise the patient is sliding into hemorrhagic shock, and immediately a Focused assessment with sonography reveal the patient has a ruptured spleen with massive intra-abdominal hemorrhage, the patient quickly goes in for an ex-lap with splenectomy and two litres of blood are drained from the abdomen all this as he is fighting for his dear life.

One thing he has in common with dozens of trauma patients who flock the causality ward daily is that a boda boda was involved in their cause for trauma(accident).

For those who wonder what boda boda is, this is the motorcycle form of taxi used throughout Uganda and particularly at a higher rate in Kampala since it provides a faster way to move through the ever slow or static traffic around Kampala

Every minute of the day, at the causality ward (emergency room) of Mulago National Referral Hospital, numerous ambulances and police patrols are ever flocking in with trauma patients of every kind, from accidents, beatings and stabs from thugs and fights, the causality ward is ever full to brim as usual with the number of patients ever at some point exceeding the number of beds, available, and some will have to painfully wait on the floor, or outside the ward.

As a medical student, something continued to strike my mind every time I had to review a fresh patient about the cause of trauma, it was amazing to find out that one word was very common among a great deal of patients coming in and that was, “a boda boda was involved somewhere and I decided to carry out a study research and the results will amaze you.

Between January and February 2022, (a period of one month) 622 trauma patients were studied. Out of the 622 cases, 336 of these were from road traffic crashes (RTCs). Out of the 336 cases, 252 of these had a boda boda directly involved, which accounts for 75 percent of all the 336 RTCs and approximately 41 percent  of all 622 trauma cases. Hence from our study, boda bodas directly contributed to 41 percent of all causality admissions.

One should take note that this only caters for direct accidents, there are also patients coming in with indirect boda boda involvements, for example some are boda boda riders who are severely beaten by passengers they carried and their motorcycles robbed, some were passengers who were assaulted by riders and their belongings stolen along a ride, in some cases it was an RTC where a car driver intended to drift past a boda boda rider and ended up crashing in another car or pedestrians, etc.

Therefore, when we included the indirect boda boda involvements, we discovered that boda bodas were involved in more than 50 percent of all casualty admissions, meaning boda boda causes alone bring in more cases than all other emergency causes combined. This data also doesn’t include those that pass away on spot.

On further study, I discovered that on average boda boda accidents kill at least 10 people daily in Kampala alone and this costs the government Ugandan Shs4.4 trillion annually. I believe this calls for some action to remedy the situation.

With more study, I found five cardinal reasons for this high rate of boda boda accidents, including negligence of road safety rules, competition for passengers with fellow riders and other public transport operators, inadequate helmet usage, drug use and lastly reckless driving.

To a larger percentage, these are behavioural causes. Since boda bodas serve such a great purpose, we can’t do away with them but we can increase safety for both the passengers and riders through the following: digitalisation; we conducted a study and discovered that only 4 percent of the boda boda accidents involve digitalised riders with the rest being the non-digitalised. Massive sensitisation of riders about road safety,  use of protective equipment by both the riders and passengers.

Boda boda accidents can be lowered to negligible level, saving lives and at the same time lowering the burden on the Ugandan health system. I have a detailed scheme on how boda boda accidents can be lowered by approximately 80 percent in three years with partnership from interested individuals.

It hurts to see people getting permanent disabilities daily, people losing lives, increasing orphan and widow numbers many of whom remain helpless due to deaths or permanent disability of their breadwinners. So, anyone who may wish to come to Uganda, look out for this “silent killer”.

  Joshua Matsiko ,                              [email protected]