INJURIES ARE PART OF US BUT WE STRIVE TO REDUCE THEIR IMPACT!

By Tony Luggya Stone

“If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do you have to keep moving forward.”  This quote by Martin Luther King Jr

Ring ring…., ring, ring, ring, the rather unwelcome sound of my alarm going off,  on the 12^th day of January 2015, at 6am to the dot. I hit on snooze to catch some more minutes of sleep seeing that previous night was my mates pre-wedding send off  and I was on leave. An hour later I awake in excitement and haste as I remember I have to be in Munyonyo by 9am. Why?

Because the Main risk factors for road traffic accidents, that have become a public health concern, include the following:

•      Demographic factors (explained with the UBOS statistics below)

•      Rapid motorization

•      Transport, land use and road network planning

•      Increased need for travel

•      Choice of less safe forms of travel

With our national statistical analysis showing exponential population growth with expectations thought to be at 100 million by 2050 (see Figure 1 below).

Figure 1: Population projections Uganda

Furthermore Uganda Bureau of Statistics 2012 analysis showed that the majority of our Ugandan population is the youth below 18 years making up  56% of the total population The above population explosion comes with various challenges to societies, governments and resources. But in this case primarily they will need to move to many places, from and to work, from villages and to urban centres, plus other movements such visiting, functions etc.

Total Population	100%	35,356,900
Children (below 18 years)	56%	19,799,864
Adolescents and youth (10 – 24 years)	34.7%	12,268,844
Orphans (for children below 18 years)	10.9%	3,853,902
Infants (below one year)	4.3%	1,520,347
Children below 5 years	19.5%	6,894,596
Women of reproductive age (15 – 49 years)	23%	8,132,087

According to Uganda Revenue Authority new vehicle registration Imported Motor cycles in 2012 were 12,000:5,000 cars however over the past 10 years now the motorcycles are 85,000:6000 cars shown below

  

Figure 2: New vehicle registration (URA)

 

Figure 2: New vehicle registration (URA)

With this large young population comes grave challenges for the stake holders in attempting to have them mature so as to accomplish their full potential. Consequently, focus has been placed on the infectious diseases plus maternal and child health and kudos to them as they are making progress. However, this 56% of the Ugandan population has still been left at risk.

With haste I finally arrived at Munyonyo for the second annual Uganda Injury Forum, a brain child of Makerere University School of public health (MUKSPH) and John Hopkins University. This  joint collaboration brings together stake holders in government, private and private not-for-profit organisations that are leading to discuss local statistics, ways of improving emergency services, fostering inter-organisational partnerships and among other things all in trying to reduce the burden of trauma and injuries which make for an alarming statistic in mortality – almost  epidemic proportions.

The ministry of health represented by Dr Mubikire accompanied by Uganda National Ambulance Service (UNAS) group with Dr Kalanzi Joseph discussing what national policies and injury prevention the ministry of health has embarked on. This was followed up with their approach to significantly improving trauma care and injury data collection including but not limited to including trauma on the Health Management Information Systems (HMIS).

MUKSPH gave a detailed presentation about the statistics and significant epidemiological issues road traffic accidents are causing and significance of good data to keep track of developments. They also highlighted need for partnerships in this endeavour. The first TRAID trauma track masters research was presented and of significance was a Jinja study on capture recapture data of accidents that showed a significant gap or missed data between what the traffic police had and what was recorded at hospitals for admitted injury patients.

Next up was Uganda police represented by Dr Kasiima (PHD) who gave their annual statistics with updates on road use, abuse of drugs and how the police is trying to curb the perpetrators, including a planned police study tour to Australia where a breatherlizer is used for non-alcoholic drug abusers on the road. 

Quite remarkable was the fact that the Uganda Police had signed an MOU with Nakasero Hospital, a private for profit hospital, to stabilize accident victims for free for the first few hours before transfer to a free facility. Kudos to Uganda Police and NHL!

Fire preventions officer Mr Piriyo Robert supplemented this with the Police emergency numbers which are:

1. 0421222 (yes correct number and no digits missing here)
2. 0711042193
3. 0712144799- director

KCCA was represented by their director of health services who explained the authority’s plans for a better Kampala with mapping of streets by hovering helicopters that we may have seen, to ease pick emergency pickups by ambulances. Emergency evacuations, even by putting helipads and HDU beds, have been catered for in the two upcoming hospitals in Kawempe and Kirudu.

We had meal breaks in between and after lunch a breakaway into working groups of three to we could discuss:

1. Preventing Road Traffic Injuries chaired by Police
2. Emergency Response for Road Traffic Injuries chaired by  MOH and Red cross
3. Road Traffic Data Quality and Use = MUKSPH, MULAGO

After this, we emerged for the penultimate plenary sessions which had all the stakeholders representatives as below:

1. Mulago = Dr Alex Bangirana, Head Accident and Emergency
2. Police = Mr Emoit Anthony, head traffic operations
3. Makerere University college of health sciences= chair Dr Sempepwa
4. MOH= Mr Stanley Mubikire
5. Red cross
6. John Hopkins

Each stake holder gave commitment from their respective organisations to bring this burden of mortality down with full length discussions and questions from the house.

Before long it was 4.30PM and the day was ending just as fast as it had began, with Dr Olive Kobusingye giving closing remarks highlighting the primary take home message as:

• What data is there and how is its quality?
• We should receive updated knowledge on status of Road traffic injuries
• How do we all move forward to digest and implement these out comes in our various organisations.

With that brought the close of the 2015 Uganda Injury Forum conference.

But like Martin Luther King Jr said ‘…. whatever you do you have to keep moving forward.”