Foreigners travelling through a big city in a developing world often feel like the 'frogger' trying to cross a busy street. All kinds of traffic - bicycles, cars, trucks, animals, and so forth - stream back and forth in chaos. Sometimes locals offer unsolicited help. Othertimes, it just takes...well time. And while it's mostly charming, it's frequently frustrating.
For locals, however, it's more than a frustration or just another inefficiency of urban life. It's a public health nightmare. Street vending children lose their lives or get maimed daily. We've already discussed how road traffic accidents are the 9th leading cause of mortality world-wide.
In the developing world, however, we've made great progress. The CDC even claims the reduction in road traffic deaths to be one of the ten greatest public health advances over the last decade:
Increased Awareness and Response for Improving Global Road Safety
Since 2000, when the International Federation of the Red Cross International Disasters Report raised an alarm regarding the worldwide impact of road traffic injuries, significant progress has been made in establishing a global response strategy (25,26). In 2001, WHO launched a 5-year plan to improve global road safety; in 2004, along with the World Bank, WHO issued the World Report on Road Traffic Injury Prevention (26). From 2001 to 2009, the number of annual traffic-related fatalities in the European Union declined 36%, from 55,700 to 34,900 (27). The largest declines in the traffic-related mortality rates from 2000 to 2009 were observed in Spain and Portugal; rates decreased 59.2% in Spain, from 14.5 deaths per 100,000 population to 5.9, and 47% in Portugal, from 12.9 to 6.8 (28).
But they leave the developing world with an unchecked box in the 'to-do-for-the-next-25-years' list. And the urgency is here. As unappealing as 'mega-cities' and other large cities may be to us, they are a far better place for the advancement of the rural poor across the world. Large cities are opportunities for education, for entry-level jobs, for remittances, and for entertainment.
But they shouldn't be modern day killing fields. As we continue the progress of hiv/tb/malaria/vaccinations/neglected diseases, we need to understand the care needed for trauma victims. Whether it's increased access to free emergency rooms, to ortho surgeons or improved surgical techniques (i.e. safer internal fixation) and physiotherapy - we need to allocate resources to this scourge.
