Type of Injury No.
(% )Concussion 139 (14.1 )
Sprain 171 ( 17.4 )
Laceration 450 (45.7)
Dislocation
11 (1.1 )
Fracture 160 (16.3)
Amputation 3
(0.31
Contusion 130 (13.2)
Others 5
(0.5 )
~. DISCUSSION
This investigation was successful in documenting the occurrence and impact of hospital treated rvlVrs in Addis Ababa, Ethiopia. The MVI rate found in this investigation was very high, at two to three times greater than the rates rejXlrted in other developing countries/l,3/ and up to five times higher than rates reported in several developed countries. /6. 7, 8) In Addis Ababa the numter of vehicles per capitais far fewerthanmost developed countries, at onecarper 34 people.This would tend to lessen the opjXlnunity for host-agent contactand thus reduce MVI's rates, A similar influence is exerted by the Sunday driving restrictions and the midnight to 5 AM curfew,
A large proportion of injuries occurred while in a street This pattern is different from developed countries where a large prDjXlrtion of injuriesare vehicle occupan!.l9, 10/ An imjXlrtant factor forcing people into the streets is the absence of sufficient and segregated sidewalks. Another factor which would tend to increase MVI's rates is pedestrian behaviour. In Addis Ababa many people do not know or follow basic road safety thus crossing in the middle of streets and often within traffic.
Several studies have made it apparent that MVI's are most prevalent among adolescent and young adult males)ll, 121 Similarly in this study, young males weretwoto threetimes more likely to sustain a MVI's or death. This may be explained by the fact that malesare in the streets far more than females. As well, risk tehaviour or unsafe road practices are more common in malesJ1/
The body parts affected by MVI'saresimilar to those reported in other sWdies, with multipleparISaffected, the extremities and head injuries teing the commones!.l9, 13/ Frequency of MVI's varies by the day of the week and hour of the day.
Saturdays, Mondays, and Tuesdays were high incidence days. There are two possible expl2nations for the finding, one focussed on the tehaviour of the drivers and the other focussed on the tehaviour of pedestrians. Because of gasoline rationing, most drivers obtain enough fuel to drive vehicles on Saturday, Monday and Tuesday. Thus MVI's may occur on these days simply tecause more vehiclesareteing driven. The tehaviour of pedestrians may better explain why tetween 6.00 amand 12.00 noon there are more MVI's. Theseare the hours when students and workers travel to their work site.
Infact, around noon, two sessions of swdentsareof the streets,one on their way home, and the other on their way to school.
While the influence of these f""tors has beenreportedelsewhere, the patterns vary considerably from one country or urban centre to the next/14, 15, ltV
5. CONCLUSION AND RECOMMENDATIONS
On the basis of a 12-week sWdy of MVIs in Addis Ababa, the incidence density was calculated to be 279 per 100,000 person years. This was considered to te very high particularly given the relatively small numter of vehicles in the city. An analysis of the significant determining factors indicates that many of these injuries could te prevented.
In order to present the siwation accurately, the city of Addis Ababa requires a more systematic reporting system. At the present time, not all accidents involving injuries arerejXlrted by the jXllice. For example, police records were lacking for 40% of the hospital cases in the present sample. In addition the seriousness of the situation must be recognized and then jXllicies developed,
Recommendations are organized according to the three constiwents of motor vehicle injury: the host, the agent and the environmenL
1. The Host
Education and training programs should te expanded for the public using the mass media.
2. The Agent
The only feasJble recommendation here is to standardize the examination drivers take in order to oblain a licence. Drivers who are responsible for accidents should receive demerit jXlints and have their licenses suspended for a period of time when they reach a set numter of points.
3. The Environment
Starting time at work could te staggered for some of the larger industries and companies to reduce traffic at certain times such as when children are going to school.
Other aspects of the environmen~ such as the presence of sidewalks, crossing zones, stop signs, speed limit signs, and pedestrian lraffic lights were not examined in the present snxly. Further research into these variables is necessary in order to make confident recommendations about improving the environmenL
6. ACKNOWLEDGMENTS
My gratitude goes to the International Developmentand Research Council ofCanada(lDRC) for generously funding this study and to the McGill·Ethiopia Cotnmunity Health Projectteam for their supportand cooperation throughout the study.
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