BMJ  2004;328:1260 (22 May), doi:10.1136/bmj.328.7450.1260-a

Letter

Aid may make roads more dangerous than landmines

EDITOR—Roberts and Abbasi highlight disproportionately low spending on preventing road injuries compared with more popular investment areas.¹ Perel et al address gaps in road safety in developing countries where risks are high since protective clothing, road rules, driver training, and speed limits are often absent.²

Annual injuries and deaths from road traffic crashes overtook those related to unexploded ordnance and landmines in Cambodia after 1998 (figure). Crashes continued to rise in number and severity—a disturbing trend when Cambodia ranks high for the number of landmines per head.

View larger version (34K): [in this window] [in a new window]   Numbers of deaths and injuries on roads and from landmines and unexploded ordnance in Cambodia. Sources: Ministry of Public Works and Transport (roads) and Cambodian Red Cross (CRC) and Handicap International (mines)

 

One aid donor, Japan, has funded bridges and road rebuilding from the 1992 ceasefire until the present, repairing damage from fighting and torrential rain.³ Japan holds a virtual monopoly in automobile sales in Cambodia, so the integration of aid and investment is convenient. Recently, roads have become more efficient and faster whereas public transport systems (trains) have decayed. Roads are also more efficient at killing.⁴

Handicap International Belgium and the Cambodian Red Cross have worked to incorporate road safety into Cambodian culture. However, donor countries that inadvertently contribute to deaths on such a massive scale should also be made to contribute: enforcing road rules, financing safety equipment and training, and designing roads to protect slower road users. This would involve a tiny fraction of countries' profits. Unexploded ordnance, landmines, and infectious diseases are a more attractive option to donors, especially when the cost of their investments is so seldom understood.

69 Peel Street, Macclesfield, Cheshire SK11 8BL Greg.Rose{at}northstaffs.nhs.uk

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GR was formerly health development adviser to WHO Cambodia.

Competing interests: None declared.

References

1. Roberts I, Abbasi K. War on the roads: two years on. BMJ 2004;328: 845. (10 April.)[Free Full Text]
2. Perel P, McGuire M, Eapen K, Ferraro A. Research on preventing road traffic injuries in developing countries is needed. BMJ 2004;328: 895. (10 April.)[Free Full Text]
3. Borton J. Japanese aid brings dividends, division. Asia Times Online 2003 Aug 20.
4. Reed M. Picking up speed: as Cambodia's traffic levels increase, so too does the road death toll. Cambodia Daily WEEKEND 2002 Mar 9-10.

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