ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010 3

than the changed perspectives that emerged from the Enlightenment era itself. Here, I believe, anthropological thinking, rather than anthropology, can and will have a crucial role to play.

Anthropological studies that explore negative impacts and unintended consequences of development projects provide important pathways into the negotiation of new ways of moving forward. They are good to think with rather than useful for building an action agenda using the existing development premises. They provide different perspectives and thus enrich understanding of coping mechanisms – informal ways in which people negotiate with outsiders and/or sustain their livelihoods despite rather than because of development interventions in the name of the state. Examples of this approach can be found in the work of Norman Long, James Scott, James Ferguson and Keith Hart.

Similarly, there is the approach informed by the new cosmopolitan anthropology that involves the ethnographic analysis of banking institutions themselves as well as of development agencies – an investigation of the ‘tribal’ cul-tures within financial institutions (see Gillian Tett’s recent book), or the history of the development and deployment of ‘social development specialists’ in the World Bank by scholars such as David Mosse. Annelise Riles’ work on the ethnography of international human rights is also note-worthy in this regard.

The role of such institutions as the World Bank, and of the bases on which the ‘dismal science’ of economics has been promoted, have acquired greater prominence through the global banking crash, the failure of the ‘devel-opment project’ and the need to renegotiate what is seen as being of ‘value’. More fundamentally, this reconsid-

eration reflects an evolving cross-disciplinary concern to transcend the nature/culture divide, to recognize and incorporate complexity thinking, and to rethink dominant modes of interpretation. This involves crafting our ways through complex engagements and networks, weaving a tapestry that acknowledges and incorporates multiple threads that link the hand to the head, the mind to the body. Anthropology could be much more central to this new engagement because it has been able to negotiate between the lines drawn by other disciplines.

This requires the transcendence of the disciplinary boundaries that currently constrain us (and all the social sciences), and which have only emerged in the last hundred years. It also means a greater focus on particular histories and contexts that can then be jointly crafted into emergent paths. For me, that is what anthropology has always been about. I think we need to legitimize ‘anecdotes’ and ‘value judgements’ by foregrounding ‘storytelling’ and identi-fying the (often implicit) values in all e-value-ations.

* * *These threads can be successfully woven together by

telling one’s own story – the inevitable compromises that have had to be made, the misrepresentation of mes-sages, the negotiations with ‘stakeholders’, the developing encounters with different peoples and ideas, the personal contexts and compromises that rarely get included in the explicit record, but which inform one’s own ramblings through an evolving set of landscapes. We need to develop the ability to read between the lines and create opportu-nities, to combine the personal with the political in the pursuit of more sustainable outcomes, and to recreate the bases for building trust and more empathic connections.l

Mosse, David (forthcoming). Social analysis as corporate product: Non-economists/anthropologists at work in the World Bank in Washington DC. In Mosse, D. (ed), Adventures in Aidland: The anthropology of professionals in international development. New York/Oxford: Berghahn.

Rifkin, J. 2009. The empathic civilization: The race to global consciousness in a world in crisis. Cambridge: Polity Press.

Riles, A. 2000. The network inside out. Chicago: University of Michigan Press.

Sennett, R. 2008. The craftsman. London: Penguin.

Scott, J.C. 2009. The art of not being governed. London: Yale University Press.

Strathern, M. (ed.) 2000. Audit cultures: Anthropological studies in accountability, ethics and the academy. London: Routledge.

Taleb, N. 2010. The black swan: The impact of the highly improbable. London: Random House.

Tett, G. 2009. Fool’s gold. London: Little, Brown.

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2011 marks the beginning of a UN Decade of Action for Road Safety. Its scope is ambitious: to save five million lives and prevent 50 million injuries by the end of the ‘decade’ in 2020. According to statistics published and defended by the World Health Organization (WHO), a major participant in the global road safety lobby, some 1.3 million people die every year in road crashes, with up to 20 million more disabled for life. WHO’s slogan, ‘Road safety is no accident’, represents a shift in thinking about road crashes, with an organizational turn towards public health interventions and, more specifically, a construction of the perceived problem as one of violence and injury prevention.

Framing road safety in terms of public health has led to the medicalization of the problem, with the WHO endorsing catchphrases describing road deaths and inju-ries as an ‘epidemic on wheels’ or a ‘disease of develop-ment’. In some instances, the preventative focus of the WHO’s interventions has called for novel ways of looking at wearing seat-belts or helmets as prophylactic, speaking of these as ‘vaccines’ and raising confidence that a public health approach to this global problem will be effective. The global road safety campaign is, however, multi-faceted in its concerns and works with bodies outside of public health, including lobbies representing the interests of the automotive industries, some elements of which pro-vide funding for the safety campaign.

A major source of funds is the Fédération Internationale de l’Automobile (FIA), which partially finances the

Commission for Global Road Safety. Initially set up in 2006, this organization has extensive ties with the auto-motive industries and motor sport, such as Formula One. The WHO’s relationship with the FIA was, at one time, a focus of media attention when the FIA supported tobacco companies’ application to represent and sponsor motor sporting events, even permitting British American Tobacco to become involved with Formula One and exercise adver-tising rights. The FIA’s sponsorship of road safety has also generated criticism from some public health professionals and epidemiologists (see Roberts 2007), principally because many members of the FIA’s Global Road Safety Commission are executives of major corporations in the automotive and petroleum industries. Through its recent collaboration with the international financial institutes (IFIs), high finance and insurers, the commission stands

Mark LamontMark Lamont is a lecturer in anthropology, at Goldsmiths, University of London. His current research is on the cultural history of health and safety in eastern Africa. His email is: m.lamont@gold.ac.uk.

Fig. 1. Sticker encouraging matatu commuters to challenge dangerous drivers, Eastern Province, Kenya (2008).

An epidemic on wheels? Road safety, public health and injury politics in Africa

4 ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010

to exercise considerable behind-the-scenes influence over global transport policy (Roberts 2007).

Justifications for the World Bank’s involvement in this lobby stress the economic costs of road death and injury measured against gross national product, estimating that states indebted to the International Monetary Fund (IMF) and World Bank lose more income to road crashes than they generate from development ‘aid’, tallied at a total of some $US 65 billion annually. This work of translating the horror of individual cases of death and injury into abstract financial aggregates, or mind-boggling statistics, domi-nates most of the knowledge production directed at this yet-to-happen UN decade of action.

As some observers have noted, road safety is a tech-nocratic knowledge, involving the idea of ‘knowledge transfer’ in the fields of the ‘three Es’: engineering, enforcement and education (King 1999). In contrast to the cultural history of health and safety initiatives in countries with an advanced industrial automotive complex, where road safety emerged as a concern of public health pro-fessionals, medics, engineers, consumer rights lobbyists and insurers, the global road safety lobby is characterized more by the international politics of lending and indebted-ness, a politics medical and social researchers have been at pains to make public (Roberts and Mohan 2001).

Running concurrently with several other UN ‘decades’, whatever ‘action’ is to take place should be of interest to anthropologists, principally because the World Bank’s rec-ommendations argue for the state to be the central organ-izer of road safety measures through the establishment of national governing bodies funded by IFI loans. In the context of IFI-indebted states, ‘action’ is an apt metaphor for the expansion of transnational governance, with public health and safety as the professional vehicle for its influ-ence on national transport policy.

As Carol MacLennan (1988) observed with regard to the history of automobile-related injuries in the USA, the politics of public health is directly related to the problem of state power. As an exercise in transnational govern-ance, the UN Decade of Action for Road Safety is further defined by its tacit exclusion of the ‘West’ from the global road safety lobby’s targets, an ideological stance that reproduces a strong developmentalist logic in its proposed interventions. In this article, I focus on the lobby’s appeal to the language of public health, especially the descrip-tion of road death and injury as an ‘epidemic on wheels’, and argue that, in Africa, such an approach depoliticizes the contexts of road safety interventions, and objectifies injury politics in ways that disempower those seeking compensation.

Public health and the doctrine of responsibilityI am broadly interested in the cultural history of health and safety as a mutable form of governance, and recently began an ethnographic study of the global road safety lobby through an engagement with road death and injury politics in Kenya. Kenya suffers in excess of 3000 road

deaths every year, a number said to be on the rise owing to the larger volume of imported second-hand vehicles and the growing availability of consumer credit.

I first became involved in this project through wit-nessing road crashes, being involved in them, and through bereavement. But road safety is an urgent issue for all African countries: as I write, during South Africa’s hosting of the FIFA World Cup, a major news story breaks about the road deaths, in separate crashes, of three young British tourists and the great-granddaughter of Nelson Mandela. It need not be overstated, but these cases become news-worthy because of the highly inflated coverage of the road deaths of foreigners and celebrities in the African media. South Africa sees some ten thousand road deaths annu-ally, casting a gargantuan shadow over these few reported cases. Africa’s ‘road carnage’, as it is often called, is in danger of being essentialized, and the ongoing tragedies almost certainly trivialized (see Roberts 2007).

Radical epidemiologists involved in road safety, from William Haddon Jr in the 1960s to Ian Roberts today, make very clear how they liken road crashes to infectious disease, seeing both as stemming from environmental causes. This is a methodological issue that public health educators fail to clarify. This move has precedent in the USA, where the shift to an epidemiological stance towards road crashes emerged out of a ‘tolerance’ of road death and injury, an ideological position, MacLennan suggests, ‘radically different from our concern with diseases such as cancer and AIDS, which are characterized by a strong public demand for a cure’ (MacLennan 1988: 233).

This comment by an anthropologist raises several issues in relation to the distinction between ‘road safety’ in Africa – or other ‘developing nations’ worldwide – and the more recent concern with ‘automotive safety’ in the USA and other vehicle manufacturing nations. The key lies in the notion of a ‘cure’, and where this may be brought about. The global road safety lobby is not principally concerned with questioning the deep assumptions of automobility, but rather with extending it as an ideology and making automotive transport a necessity of everyday practice well into the future.

In the USA, ‘automotive safety’ has emerged out of a long and protracted struggle between consumer activists, scientists, government agencies and the automotive indus-tries over questions of design and tort law (Jain 2004). It focuses on the harm that car, lorry and motorcycle design can do to the soft machine of the human body.

‘Road safety’, in Africa, begins from the assumption that automobility is not a problem – in fact, it can be a solution to many problems of development – but that road users are. The larger context of road safety in Africa incorpo-rates concerns that 20 years ago were subsumed under the category ‘good governance’, exemplified by campaigns to ‘eradicate’ corruption. Road safety in Africa is not about automobiles to the same extent as ‘automobile safety’ is in the USA, but rather about fixing decrepit road infrastruc-tures, reforming insurance loopholes, delivering efficient licensing and proficient drivers, and reducing illicit prac-tices between drivers and traffic police. That the public health idiom has come to pervade the rising focus on road safety in Africa surely raises questions about the direction this lobby is taking in different parts of the world.

A brief period of fieldwork with taxi drivers in Dar es Salaam, Tanzania, brought to the fore how road safety campaigns in eastern Africa appropriated the language of public health, arguing that road crashes were a disease, epidemiologically on par with malaria or tuberculosis. This medicalization of the public health and education component of the global road safety lobby was further illuminated through discussions with colleagues in South Africa, who had for some time noted the way recent road

Ferguson, James 1990. The anti-politics machine: ‘Development,’ depoliticization, and bureaucratic power in Lesotho. Cambridge: Cambridge University Press.

Jain, Sarah 1999. The prosthetic imagination: Enabling and disabling the prosthesis trope. Science, Technology and Human Values 24(1): 31-54.

— 2004. ‘Dangerous instrumentality’: The bystander as subject in automobility. Cultural Anthropology 19(1): 61-94.

King, Mark 1999. Transferring road safety knowledge and techniques to South East Asia: Contexts and challenges. In Proceedings of the 21st Conference of the Australian Institutes of Transport Research. Available at: http://eprints.qut.edu.au/11308/1/11308.pdf.

MacLennan, Carol 1988. From accident to crash: The auto industry and the politics of injury. Medical Anthropology Quarterly 2(3): 233-250.

Miyazaki, Hirokazi 2004. The method of hope: Anthropology, philosophy and Fijian knowledge. Stanford: Stanford University Press.

Mohan, Dinesh and Roberts, Ian 2001. Global road safety and the contribution of big business: Road safety policies must be based on evidence. British Medical Journal 323(7314): 648.

Moodie, Ellen 2006. Microbus crashes and Coca-Cola cash: The value of death in ‘free market’ El Salvador. American Ethnologist 32(1): 63-80.

Roberts, Ian 2007. Formula One and global road safety. Journal of the Royal Society of Medicine 100: 360-362.

Vaughan, Megan 1991. Curing their ills: Colonial power and African illness. Stanford: Stanford University Press.

Fig. 2. ’Look out for bicyclists’: road safety signage on the Arusha-Dar es Salaam road, sponsored by Vodacom. Tanzania, 2008.

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ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010 5

safety campaigns borrowed from HIV/AIDS activism. One cited a public-service radio advertisement for buckling up that centred on a conversation where a woman urged her partner to wear a seat belt (Rebekah Lee, personal com-munication). This particular advertisement ended with the challenge: ‘If you love your partner, you’ll wear a seat belt.’ In the South African context there is a not-so-very subtle reference in place, where the substitution of ‘seat belt’ for ‘condom’ tells a similar story about a new sub-jectivity of (inter)personal responsibility in looking after one’s own health and safety amid quite threatening struc-tural insecurity.

Personal responsibility is a hallmark of the global road safety lobby’s educational and enforcement campaigns. Targeting individual behaviour is widely viewed as the only way to reduce road fatalities and injuries. At the exclusion of structural considerations, like the poverty that forces water-cart operators and street hawkers to jostle for space with cross-continent fuel tankers and presidential convoys, personal responsibility and the notion of a ration-ally calculating and obedient subject run fluidly through the discourse of road safety campaigns.

In 2009 Costa Rica’s transport minister, Karla Gonzales, was presented with a prize by the ‘Make Roads Safe’ cam-paign – the road safety NGO that meets with the auto-motive industry’s approval – for her introduction of new seat-belt legislation and an extensively mediated public awareness campaign for buckling up, with the slogan ‘Por amor’ (‘For love’). The campaign logo, a cartoon heart being buckled up, signals the idea of (inter)personal responsibility for one’s own safety.

A bold theory of human agency is inflected through much of the global road safety lobby’s assumptions. The ‘Make Roads Safe’ campaign ideologically supports other campaigns that stress human error as the reason behind road crashes. Hardly ever are cheap transport costs, unsafe lorry fleets, or even the ideology of automobility itself brought into conversations about the rising rates of death and injury. Arriving at this ideological conclusion that accidents are caused by individual behaviour, and therefore subjecting this behaviour to legal and political liability, many states described by anthropologists as ‘neo-liberal’ have embraced road safety campaigns that empha-size the role of personal responsibility in crash causation.

I was intrigued, then, by the series of stickers I photo-graphed in Kenya while riding in a matatu (e.g. fig. 1), the ubiquitous Toyota buses that ply the country’s roads, encouraging passengers to challenge drivers who drove dangerously. Sponsored by Safaricom, Kenya’s part state-owned mobile telecommunications supplier, these stickers were graphic, even gory, showing a severed foot still clad in a bloody shoe, asking in bold red font, ‘Will YOU survive the matatu ride? Speak up, stand up’. Such an invocation to act against the wishes of a matatu driver would scarcely have been thinkable only a decade ago. The change was due, many Kenyans told me, to the ‘tough’ new regulations of 2003, commonly known as the ‘Michuki Rules’, after the then Transport Minister, John Michuki.

This enforcement legislation aggressively regulated the public service vehicle sector, introducing a number of reforms including mandatory MOTs and the installation of speed limiters restricting public vehicles to a maximum speed of 80 kph. But this legislation also attempted to shape the subjectivity of drivers and passengers, urging them to take responsibility for their actions, including asking drivers to refuse to pay traffic police their illicit ‘dues’, as a kind of exercise in active citizenship.

Similarly, in Tanzania, along the road from Dar es Salaam to Arusha, one of Tanzania’s most competitive highways, Vodacom has sponsored road signage urging individual drivers to acknowledge that bicyclists share the road with motor vehicles and to be conscious of pedes-trians and animals crossing the road. The sponsorship of road safety by large corporations in these eastern African countries is not fortuitous. The appeal to personal respon-sibility with respect to automobility is, however, part of a larger project of shaping conduct with respect to (inter)personal responsibility in which public health policy merges into enforcement and education – as witness, for example, the total ban on public smoking in all of Kenya’s municipalities in 2007.

In what follows, however, I introduce a case that inter-rogates the concern of public health with (inter)personal responsibility for road safety and raises the question least likely to be raised by road safety activists in Kenya: that of social and economic inequalities. Even with this ideo-logical focus on personal responsibility, it remains the case that the majority of those killed or injured on eastern

Fig. 3. Road safety activists and professionals point to the derelict state of Africa’s infrastructure, but what design issues will engineers face in the latest wave of new road construction in urban contexts? With many pedestrians making a livelihood as street hawkers, designing safe roads is a question of how social space is actually used alongside the automobile.

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6 ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010

African roads are frequently blamed for their own deaths on the grounds of their ‘lack of knowledge’ about the danger of being on the road, as one insurer put it to me. One consequence of this ideological stance is that their deaths are trivialized and the circumstances surrounding injuries depoliticized.

One in a millionOctober 2007, rural Kenya. The construction of an asphalt road commissioned by the Ministry of Roads and Public Works, under contract to the large engineering construc-tion company H. Young, was a long anticipated develop-ment championed by the people of Mikinduri. For years, the only repairs made to their road networks had been conducted by British American Tobacco, road works that inevitably drew on cheap, unskilled local labour and whose façade of durability barely lasted one seasonal cycle from drought to deluge. Cut off from the region’s markets twice a year by heavy rains that washed out bridges and turned tracks into impassable bogs, the dream of a 52-kilometre sealed road linking them to Maua and Mutindwa, the region’s largest towns, was fast becoming a reality the last time I visited this favourite of my former field sites.

The project cost $US 27.3 million and took 18 months to complete, transforming the hilly landscape and the time it took to traverse it. When I was last there, huge loaders and excavators trundled about, shaking the sun-baked earth and kicking up plumes of dust seen from miles around. The still unfinished road became a staple topic of conversation. Khat and maize farmers alike spoke with relief about market accessibility. Teachers expressed enthusiasm that they could travel to administrative centres quickly and easily. And Mikinduri’s three bus operators noted with confidence how much cash they would save on maintenance, with parts lasting longer.

People were excited when they spoke of a planned roundabout at the main junction: something urban in a trading town that only received electricity a decade ago. But others were also worried about the children who, they argued, were conditioned to the slow pace of vehicles on the dirt road and would not appreciate the dangers of cars and vans moving at high speeds along the tarmac. And so, predictably, it came to pass that a child died.

She was about seven or eight years old. Sent by her mother to buy cigarettes for a house guest, this little girl was run over by one of the H. Young dump trucks and crushed. Contrary to what might be expected of an eth-nographer, I couldn’t bear to go and witness the scene’s aftermath. A senior policeman spoke about the killing in the evening, describing it for a small group of sombre men over bottles of beer. There was an underlying shock and anger running through all those I spoke to about the incident, much of it reserved for the girl’s mother, a local liquor seller who, it was alleged, was drunk at the time she was told the horrifying news.

The girl’s father was one of my close friend’s clansmen, and various plans to force H. Young to accept liability and claim some kind of blood compensation were mooted throughout the month I stayed in the town. Legal action, it was asserted, would be taken once the various police, hospital and insurance forms had been filled in and sub-mitted. I tried my best to follow the case over the fol-lowing year through a mixture of mobile phone calls and emails. Perhaps triggered by her death, I have since then looked intently at road death and injury politics in Kenya, tracing in this little girl’s unnecessary and avoidable death a path through which to interrogate the topic of road safety in eastern Africa.

Then, last month, after another attempt to follow the saga of Mikinduri’s asphalt road, my friend sent me the briefest of messages:

I have just interviewed the cousin of mine who followed up the case. Simply put, The H-Young defense accused the victims – of a total of thirteen counts bordering on negligence and irre-sponsibility. Subdued, the father, through his lawyer, accepted an out-of-court installment of Ksh 210,000. End.

In this case, the pay-out was a few thousand US dollars. Ellen Moodie’s (2006) ethnographic study of a ‘micro-bus crash and Coca-Cola cash’ in El Salvador followed one compensation claim in which death was commodified and trivialized through big business compensation, reflecting on the ways in which corporations have gained ground in the courts and policing process under neo-liberal gov-ernmentality. ‘Accident’ compensation inevitably trans-forms the meanings of death. In what Sarah Jain (1999) has termed the ‘material semiotics’ of injury politics, the significance of my friend’s punctuation, ‘End’, I think was to signal to me to leave off, let live, and not pry. Compensation paid to the father and blame reversed onto the drunken mother, this girl’s death is no longer meant to be a case study of any kind: it is just one in a million. But it is not an isolated case. This is not one in a million deaths to have occurred in 2007, just a statistic, but part of an unsettling pattern that can be recognized through its injurious politics in the abandonment of actuarial and judi-cial process.

In Kenya’s daily national newspapers, the uncompen-sated victim of a matatu crash is a regular focus of col-umnists writing human interest stories. A photograph of a blind and paraplegic 44-year-old woman called Wanjiku (a common enough name used to signify any adult working-class or peasant woman in Kenya) evokes not so much pity as it does a kind of frank caricature of Kenyan ine-quality. Such stories, like ones about people with AIDS, fill a niche in the Kenyan imagination. Bereft of livelihood and limb, Wanjiku cannot feed or wash herself. Previously a robust, healthy and hard-working mother of four, she is now abandoned and forgotten. A neighbour’s small child comes to bring her bits of food and water. If and when the courts decide upon her claim for compensation, she cries, her children will come back for the money, but not for her. Lying in the dark of her timber and corrugated tin-roofed house, the question of compensation is ontologically fused with her lingering, painful disability. It is no longer a ques-tion for doctors and nurses, but for insurers and lawyers.

We need to pause and ask whether road deaths and injuries can be reduced to disease and illness, as some epidemiologists have asserted. If the little girl died from malaria, would the circumstances and implications of her death be the same? If the wounded woman permanently isolated in her house were dying of advanced AIDS, would her death not be subjected to different moral dispositions and legal consequences? I ask these ques-tions because I think that the conflation of road death and injuries with disease theoretically undermines what Paul Farmer, in his engaged work, has been emphasizing about the structural conditions determining who gets sick and dies and why.

As injury epidemiologists, public health educators and insurers increasingly eschew the Aristotlean notion of ‘accidents’ as unforeseen misfortune and come to see them as ‘crashes’, with human agency to blame, the tendency to view road death and injury as an ‘epidemic on wheels’, as prominent WHO professionals have recently advocated, has unintended but highly constraining implications for what interventions can be made with the aim of reducing the number of people killed and maimed by automobiles. To borrow from James Ferguson’s (1994) ethnography of development in Lesotho, the place of public health in the global road safety lobby risks being an ‘anti-politics’ machine if forms of social differentiation, objectification and exclusion are not pragmatically accounted for.

ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010 7

Fig. 4. An H. Young bulldozer excavates the route of the planned road from Mutindwa (Meru Town) to Mikinduri and Maua. Kenya, 2008.

Diseases of developmentBut what do such examples taken from Kenya tell us about road safety as a ‘method of hope’ (Miyazaki 2004) enmeshed with public health and its professions? The range of professionals working on road safety does raise the classic problem of people talking past one another, and if we take Miyazaki’s understanding of hope as a ‘method that unites different forms of knowing’ leading to a ‘radical temporal reorientation of knowledge’ (ibid.: 4-5), perhaps downplaying the political and legal ramifications of road collisions and highlighting them as an iatrogenic conse-quence of automotive capitalism – that is, a ‘disease of development’ – this strategy provides a focus through which the global road safety lobby can galvanize resources and act in an apparent, if not real, unison.

The diffuse metaphors of medicine, say, drug addic-tion as a ‘cancer’, or child neglect as a ‘plague’, can reach across different forms of knowing and suppress points of potential or real disagreement. Similarly, speaking of road death as an ‘epidemic on wheels’ simplifies what is at stake and, in a continent such as Africa, can build upon development discourse in which disease and cure legiti-mize (colonial) interventions (see Vaughan 1988). Indeed, the recent focus on road safety in terms of ‘curing their ills’, as Vaughan puts it, works ideologically in Africa because it has a long historical precedent of medical, and hence developmentalist, intervention.

Lest I be misunderstood, and be accused of an unwar-ranted attack on a worthy cause, my intention here is to demonstrate how relying on a language of public health concerning road safety in Africa plays into a historical context in which disease, illness and affliction become essentialized as something inherently African. I would argue that the same thing sadly goes for road crashes in Africa, perhaps exemplified by the Swahili proverb ‘Ajali haina kinga’ (‘accidents have no remedy’), but urge that we see these conflations as ideological reflections of a larger process of long-term transnational governance, a project that has the perhaps unanticipated effect of dimin-ishing road crash victims’ lives and technocratic denial of the politics involved in road safety engineering, enforce-ment and education.

As the ‘Make Roads Safe’ campaign confidently refers to helmets and seat belts as ‘vaccines’, it operates in an ideologically interventionist context, in which the legiti-mization of medical interventions, past and present, goes unquestioned as an unmitigated good. What needs to be known, however, is to what degree this appeal to public health, as a form of good practice, creates situations in which injury issues, especially those of the ‘poor’, con-tinue to be settled out of court, or not at all. l Data cleared by the Ministry of Public Health and Sanitation.

Post-CRAsH CARe

Formal, publicly available pre-hospital care systemNational universal access number

Non/a

DAtA

Reported road traffic fatalities (2007)2 893c (72% males, 28% females)

Reported non-fatal road traffic injuries (2007)12 470d

Costing study availableNo

c Police data, defined as died at the crash scene.d Police data.

kenyAPopulation: 37 537 716

Income group: low

gross national income per capita: $680

RegIsteReD VeHICles

1 004 243 total (2007)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesOther

56%18%11%10%

2%3%

InstItutIonAl FRAmewoRk

lead agencyFunded in national budget Yes

national road safety strategyMeasurable targetsFunded

YesYesYes

Ministry of Transport

nAtIonAl legIslAtIon

speed limits set nationallyLocal authorities can set lower limitsMaximum limit urban roadsEnforcementa

YesYes

50 km/h

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or policeRoad traffic deaths involving alcoholEnforcementa

YesNoneb

Noneb

No—

motorcycle helmet lawApplies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementa

Non/an/a—n/a

seat-belt lawApplies to all occupantsSeat-belt wearing rateEnforcementa

YesYes—

Child restraints lawEnforcementa

Non/a

a Enforcement score represents consensus based on professional opinion of respondents, on a scale of 0 to 10 where 0 is not effective and 10 is highly effective.

b Drink–driving not defined by BAC limit.

Random breath testing and/or police checkpoints

VeHICle stAnDARDs

Car manufacturers required to adhere to standards onFuel consumptionSeat-belt installation for all seats

NoNo

RoAD sAFety AuDIts

Formal audits required for major new road construction projects Regular audits of existing road infrastructure

YesNo

PRomotIng AlteRnAtIVe tRAnsPoRt

National policies to promote walking or cycling National policies to promote public transportation

NoYes

4

2

3

— Data not available.n/a Data not required/not applicable.

DeAtHs by RoAD useR CAtegoRy

Passengers 4-wheelers

(33%)Pedestrians (47%)

Riders motorized 2- or 3-wheelers (1%)Cyclists (9%)

Source: 2007, Traffic Police

Drivers 4-wheelers (9%)

tRenDs In RoAD tRAFFIC DeAtHs

0

1 000

500Num

ber o

f roa

d tra

ffic

deat

hs

1970 1978 1982

3 500

Year

1990 2006

1 500

Source: Kenya Traffic Police Department

2 000

1974 1986 1998 2002

2 500

3 000

1994

Fig. 8. Most casualties on African roads are sustained by people standing at the roadside or pedestrians, many of whom are killed on the soft shoulders of busy roads going to and from work or home. Here, in South Africa, there is new impetus to purchase life insurance as cover against accidental death.

Fig. 6 and 7. A comparison of road traffic death trends in Kenya (above) and the United Kingdom (below). In 2007 deaths in Kenya and the UK respectively were predominantly of pedestrians (47% compared to 21%), followed by passengers in 4-wheel vehicles (33% and 19%), cyclists (9% and 4%) and riders of motorized 2- or 3-wheelers (1% and 19%). http://www.who.int/violence_injury_prevention/road_safety_status/country_profiles

Data cleared by the Department for Transport.

Post-CRAsH CARe

Formal, publicly available pre-hospital care systemNational universal access number

YesYes

unIteD kIngDomPopulation: 60 768 946

Income group: High

gross national income per capita: $42 740

nAtIonAl legIslAtIon

speed limits set nationallyLocal authorities can set lower limitsMaximum limit urban roadsEnforcementa

YesYes

48 km/hNo consensus

Drink–driving lawBAC limit – general populationBAC limit – young or novice driversRandom breath testing and/or policeRoad traffic deaths involving alcoholEnforcementa

Yes0.08 g/dl0.08 g/dl

No17%b

No consensus

motorcycle helmet lawApplies to all ridersHelmet standards mandatedHelmet wearing rateEnforcementa

YesYesc

Yes98%d

No consensus

seat-belt lawApplies to all occupantsSeat-belt wearing rateEnforcementa

YesYes

91% Front, 84–90% Reare

No consensus

Child restraints lawEnforcementa

YesNo consensus

a Enforcement score represents consensus based on professional opinion of respondents, on a scale of 0 to 10 where 0 is not effective and 10 is highly effective.

b “Road Casualties Great Britain: 2006 Annual Report.”c Some exceptions.d 2006 Estimation by Department for Transport.e 2006–2007, Department for Transport, observational studies.

Random breath testing and/or police checkpoints

VeHICle stAnDARDs

Car manufacturers required to adhere to standards onFuel consumptionSeat-belt installation for all seats

YesYes

RoAD sAFety AuDIts

Formal audits required for major new road construction projects Regular audits of existing road infrastructure

YesYes

PRomotIng AlteRnAtIVe tRAnsPoRt

National policies to promote walking or cycling National policies to promote public transportation

YesYes

DAtA

Reported road traffic fatalities (2006)3 298f (76% males, 24% females)

Reported non-fatal road traffic injuries (2006)264 288g

Costing study availableYes (deaths and injuries)

f Police data, defined as died within 30 days of the crash.g Police data.

RegIsteReD VeHICles

34 327 520 total (2006)MotorcarsMotorized 2- and 3-wheelersMinibuses, vans, etc. (seating <20)TrucksBusesOther

84%4%9%1%1%2%

InstItutIonAl FRAmewoRk

lead agencyFunded in national budget

Non/a

national road safety strategyMeasurable targetsFunded

YesYesYes

n/a Data not required/not applicable.

tRenDs In RoAD tRAFFIC DeAtHs

0

3 000

Num

ber o

f roa

d tra

ffic

deat

hs

1971

9 000

Year

200620011991 2005

4 000

6 000

7 000

19961986

Source: “Road Casualties Great Britain: 2006 Annual Report” “Road Traffic Collision Statistics (Northern Ireland) Annual Report 2006”

1976 1981

5 000

2 000

8 000

1 000

Drivers 4-wheelers (36%)

Passengers 4-wheelers (19%)

Source: “Road Casualties Great Britain: 2006 Annual Report” “Road Traffic Collision Statistics (Northern Ireland) Annual Report 2006”

Pedestrians (21%)

Other (1%)

Cyclists (4%)

Riders motorized 2- or 3-wheelers (19%)

DeAtHs by RoAD useR CAtegoRy

MA

RK

LA

MO

NT

MA

RK

LA

MO

NT

GR

SP,

P. V

EN

TEW

HO

/ K

EN

YA T

RA

FFIC

PO

LIC

E D

EPA

RTM

EN

TW

HO

/ R

OA

D C

AS

UA

LTIE

S G

RE

AT B

RIT

AIN

200

6

Fig. 5. ‘Accidents have no remedy’: image painted for a church youth group road safety campaign. Mburahati, Dar es Salaam, Tanzania, 2008.