Trauma in Ethiopia

Ethiopians recently heard from their health ministry that a Health Sector Transformation Plan should lead to provision of further health extension workers in smaller communities. Health workers are believed to have contributed to falling maternal and neonatal mortality and a reduction in TB mortality by 63% since 1990. ¹

However, in our teams’ experience the United Nation’s Sustainable Development Goals and the international community hoping to address them seem to be neglecting the burden from trauma and road traffic injuries.

In 2010 there were 5.1 million deaths from injuries – almost one out of every 10 deaths in the world.

The total number of deaths from injuries was greater than the number of deaths from infection with HIV, tuberculosis and malaria combined (3.8 million). ²

Approximately 1.24 million of these deaths stem from road traffic injuries with 92% of deaths occurring in low- and middle-income countries.

Sixty percent of these deaths are among young adults (age range, 15–44 years) and 75% of those who die are men. This disproportionately impacts the most economically productive with consequences for both individual families and nations. ³

On a single day last year, 59% of patients in the Emergency Department at Harar General Hospital presented with trauma. In an equivalent 24-h period in a tertiary trauma centre in England, only 2% of patients presented with trauma.

The lack of a coordinated multi-sector approach towards trauma has had a severe burden on overall aid effectiveness. In 2009 World Bank data demonstrated that overall aid funding was grossly undermined by budget losses from road traffic injury costs. In some countries this led to an overall funding deficit of as much as half billion US dollars. ⁴

The World Health Organization made 2011–2020 the Decade of Action on road safety. But there is little in the international press to suggest this has made an impact.