James Damsere-Derry began his research career sitting on the side of Ghana's busiest highway, pointing a radar gun at passing traffic. He found that well over 90 percent of drivers were speeding and simply ignoring the 30 mph speed limits in small towns and villages close to the Accra-Kumasi road.
As economic conditions improved in Ghana, so had its roads - triggering faster driving speeds through settlements. Crossing the roadway accounted for more than 70 percent of all pedestrian deaths - a toll augmented by hawkers selling wares along roadways.
Photo courtesy WHO
Fogarty's trauma program trainees have
documented Ghana's road injury issues
leading to seat belt laws and other
Today, thanks to a grant from Fogarty's Trauma and Injury Research Program that enabled Damsere-Derry to train at the University of Washington, he is working at the Building and Roads Research Institute (BRRI) in Ghana where, as a leading proponent and researcher of speed control, he has helped increase public awareness and overseen the installation of speed calming measures along the heavily traveled highway.
UW's Dr. Charles Mock, who along with co-principal investigator Dr. Beth Ebel, has directed the grant, said that seven years of capacity building has paid great dividends for the West African nation.
"In most of Africa and the developing world generally there is an explosion of disability from road traffic crashes as an ongoing injury problem," said Mock. "We’ve placed key people at institutions like BRRI and the National Road Safety Commission, and one of our graduates is working on surveillance of injuries at the Komfo Anokye teaching hospital at Kwame Nkrumah University of Science and Technology."
The program offers long-term training of one to three years at UW for two trainees per year and shorter attachments of several weeks geared to specific skills for larger groups. They also offer week-long courses on injury control in Ghana. The latter program included a one-day workshop on road safety and trauma care attended by 25 members of the Ghanian parliament.
"These lawmakers were very prominent people," said Mock, "and the workshop seems to have increased the political will and understanding of road safety and trauma care issues."
New laws mandate seat belt use after a survey by Damsere-Derry and others revealed fewer than one in five drivers used belts and only five percent usage among front-right passengers. Other requirements include driving tests for licenses and helmets for motorcyclists.
At a recent international conference, Ebel was gratified to hear Ghana described as a model country for its ability to gather data to provide a picture of how injury is affecting people in the developing world. "We now have decent data to guide policy and that's really exciting," Ebel explained. "Road injury is not well counted and Ghana now has one of the best information systems. That’s how we know the burden of injury is about four percent of GDP in Ghana."
Ebel and Mock have also been working on data collection to impress upon trainees the importance of tracking the causes of injury. "Before we started working here, the leading diagnosis of an injury fatality was ‘brought in dead’," Ebel recalled.
Mock, who has 30 years of experience of working with Ghana, said that Fogarty's trauma program "was the first major investment in injury control research … it really helped put injury and injury research on the map globally," adding "the emphasis is where it ought to be on institutional capacity building and research for policy and practice changes, but the problem is so big it warrants more in the way of investment."
Damsere-Derry's work and that of others in important Ghanaian institutions, as well as their publications in scientific journals, have led to heightened awareness of the road injury problem and its economic consequences, the importance of good data collection and improvements in trauma care.
"There's a much better understanding that road injury is preventable and treatable," said Ebel.
Adapted from the May / June 2011 Global Health Matters article Driving Ghana to a safer future.