Feature Stories

Since the start of 2023, Tanzania has experienced a troubling rise in road traffic accidents, with over 1,550 people killed in crashes by mid-December. These accidents have not only taken a heavy human toll but also exerted a significant economic and social burden on the country. Addressing the issue of road safety requires a comprehensive understanding of the causes of accidents, their impacts on public health and the economy, as well as potential solutions.

Causes of road traffic accidents in Tanzania

The causes of road traffic accidents in Tanzania are multi-faceted, stemming from a combination of human error, vehicle conditions, and poor infrastructure.

• Human Factors: Driver behavior plays a crucial role in road safety. Speeding, reckless driving, failure to follow traffic laws, and distracted driving are some of the most common causes of accidents. Alcohol consumption and fatigue also contribute to a significant number of crashes, particularly during long-distance travel.
• Poor Road Conditions: A significant portion of Tanzania's road network, especially in rural areas, is in poor condition. Potholes, lack of road markings, and insufficient lighting make driving hazardous. Many roads are narrow and unable to accommodate the growing number of vehicles, leading to frequent accidents.
• Vehicle Conditions: Many vehicles on Tanzanian roads are poorly maintained, which increases the likelihood of mechanical failures. Faulty brakes, worn tires, and outdated safety features have all been linked to serious accidents.
• Overloading: Overloading is another critical factor that contributes to road accidents. Buses and trucks often carry more passengers and goods than their capacity allows, leading to instability, reduced maneuverability, and an increased risk of collisions.

Health and economic impacts

Road accidents in Tanzania have far-reaching consequences on both the health sector and the economy.

• Health Impact: Road traffic injuries are a leading cause of hospital admissions and a major contributor to the burden on Tanzania's healthcare system. Victims of road accidents often require long-term medical care and rehabilitation, which strains already limited healthcare resources. Moreover, the psychological trauma faced by survivors and their families cannot be overstated.
• Economic Impact: The economic cost of road traffic accidents is substantial. According to studies, road accidents in Tanzania result in a loss of approximately 3% of the country's Gross Domestic Product (GDP). These losses arise from healthcare expenses, lost productivity due to injuries and deaths, and damage to vehicles and infrastructure. Additionally, many accident victims are of working age, which further exacerbates the economic consequences by removing key contributors from the workforce.

Efforts to improve Road Safety

Several initiatives have been launched to curb the growing number of road accidents in Tanzania, but much more needs to be done.

• Government policies: The Tanzanian government has made efforts to improve road safety through policies and regulations. These include stricter enforcement of traffic laws, the introduction of speed limits, and mandatory vehicle inspections. The use of seat belts, helmet laws for motorcyclists, and campaigns to reduce drunk driving have also been promoted.
• Road infrastructure development: Ongoing road infrastructure projects are expected to improve safety conditions. The expansion and modernization of major highways, improved road signage, and better traffic management systems can reduce the frequency and severity of accidents.
• Driver education and awareness campaigns: Efforts to educate drivers on safe driving practices are crucial. Road safety campaigns targeting both professional drivers (e.g., bus and truck operators) and private vehicle owners can help change driving behaviors. Public awareness programs focusing on the dangers of speeding, drunk driving, and the importance of regular vehicle maintenance are key to preventing accidents.
• Global support and partnerships: Organizations like the Global Road Safety Facility (GRSF) have been working with the Tanzanian government to improve road safety. Their involvement includes providing funding for infrastructure improvements, capacity-building efforts, and data collection systems that can help policymakers make informed decisions.

The way forward

To successfully reduce road traffic accidents in Tanzania, a multi-pronged approach is needed. While government initiatives are essential, they must be supported by public cooperation and international partnerships. Prioritizing road safety not only saves lives but also helps to alleviate the economic burden that road accidents place on the country.

Future interventions should focus on improving road conditions, strengthening enforcement of traffic laws, enhancing vehicle safety standards, and promoting a culture of responsible driving. By addressing the root causes of road accidents and implementing sustainable solutions, Tanzania can pave the way for safer roads and a more secure future for all its citizens.

References

• Xinhua. (2023). 1,550 people killed in road accidents in Tanzania since start of 2023: minister. Link
• Global Road Safety Facility. (n.d.). Tanzania Road Safety Profile. Link
• ResearchGate. (2009). Road Traffic Accidents in Tanzania: A Ten-Year Epidemiological Appraisal. Link
• Global Scientific Journal. (2021). Road Accidents in Tanzania: Causes, Impact, and Solution. Link
• ScienceDirect. (2022). Road Traffic Accidents in Tanzania: Exploring the Economic and Health Impacts. Link

The number of recoveries from the Marburg virus in Rwanda has reached 30, while the total number of vaccinated individuals stands at 771 as of Tuesday, October 15, according to the Ministry of Health.

An update from the ministry also confirmed 62 cases of the virus, including 15 deaths and 17 patients currently in isolation receiving treatment.

By Tuesday, October 15, 2024, 30 people had recovered, and one additional death was reported, bringing the death toll to 15.

A total of 4,010 tests have been conducted so far, with 140 new tests carried out on Tuesday alone.

Since the outbreak was first declared on September 27, all new confirmed cases have been linked to the hospital cluster in Kigali, and affected individuals remain in isolation and treatment.

Read Ministry of Health's update here.

Kenya has ramped up its efforts to combat the spread of Mpox and neglected tropical diseases (NTDs) with the receipt of vital testing kits and medicines from global health partners, including the World Health Organization (WHO) and USAID. This support arrives as the country records its first Mpox death, with confirmed cases rising to 13. Health officials emphasized the significance of these resources in strengthening the nation’s capacity for disease surveillance and response, particularly in regions with high disease burdens. The Ministry of Health also announced upcoming mass drug administration campaigns aimed at controlling NTDs like lymphatic filariasis and schistosomiasis. Read more here and and here . 

 

Countries that have faced Marburg virus outbreaks, such as Tanzania, Ghana, Equatorial Guinea, and Guinea, have employed several key strategies to contain the virus. These include the deployment of specialized surge teams trained to manage health emergencies and the activation of Emergency Operations Centres to coordinate efforts efficiently. Rapid response teams were mobilized to enhance surveillance, case management, and real-time assessments. Robust contact tracing and surveillance systems were implemented to break the chain of transmission, while specialized treatment centres provided intensive care and isolated infected patients, helping to prevent further spread. Collaboration with the WHO ensured timely access to necessary resources, including medical supplies and expert support. Read more in the New Times.

Across Rwanda, stringent health protocols are being implemented to curb the spread of the Marburg virus. Public spaces like churches, hospitals, and busy locations such as Nyabugogo taxi park now require individuals to sanitize their hands and undergo temperature checks before entry. If a person’s temperature exceeds 36°C, further evaluations are conducted. The Ministry of Health, supported by the Rwanda Governance Board, has mandated religious institutions to enforce strict hygiene measures, discouraging risky behaviors such as certain Holy Communion practices and funeral rituals for those who died from the virus. Public compliance with these guidelines, including voluntary handwashing and mask-wearing, is on the rise. Additionally, a trial vaccination drive was launched on October 6, prioritizing high-risk individuals like healthcare workers. Read more in the New Times.

With the ongoing outbreak of the Marburg virus in some regions, travelers need to be cautious and well-informed about the risks and the necessary precautions to ensure their safety. The World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), the European Centre for Disease Prevention and Control (ECDC), and the UK Foreign Office have all issued relevant advice to guide travelers in making safe decisions. Below is a summary of their recommendations and travel advice.

What is Marburg Virus?

Marburg virus is a highly contagious and deadly virus that causes Marburg Virus Disease (MVD), a hemorrhagic fever similar to Ebola. It is transmitted through direct contact with the bodily fluids of infected individuals, contaminated surfaces, or infected animals such as bats. The virus has a high fatality rate, and there is currently no specific treatment or vaccine.

Travel Recommendations

World Health Organization (WHO)

The WHO has not recommended any travel or trade restrictions with Rwanda or any other countries affected by the Marburg virus. However, the organization advises travelers to stay informed about the outbreak and take basic precautions to minimize the risk of exposure. WHO encourages all travelers to monitor official channels for updates on the outbreak and to follow local health authority guidance when in affected areas.

U.S. Centers for Disease Control and Prevention (CDC)

The CDC has issued a Level 2 travel notice for Rwanda, which means that travelers should practice enhanced precautions. Key recommendations include:

Avoiding contact with sick individuals who show symptoms consistent with Marburg Virus Disease (MVD), such as fever, vomiting, diarrhea, or unexplained bleeding.

Avoiding healthcare facilities in outbreak zones unless seeking urgent care.

Obtaining travel insurance that covers medical evacuation and treatment for infectious diseases before traveling.

Monitoring for symptoms of MVD for 21 days after leaving an outbreak area, such as fever, headache, muscle pain, rash, vomiting, or unexplained bleeding. In case of symptoms, travelers should immediately isolate and seek medical care.

CDC also advises travelers to stay updated on the outbreak and prepare for potential changes in travel conditions or advisories.

European Centre for Disease Prevention and Control (ECDC)

The ECDC emphasizes the importance of travelers being aware of the ongoing Marburg outbreak and following the guidance of local health authorities. Their key recommendations include:

Avoiding contact with individuals showing MVD symptoms and steering clear of healthcare facilities in affected areas for non-urgent medical reasons.

Avoiding wildlife habitats such as caves or mines that may be inhabited by bats, and refraining from handling or consuming bushmeat.

Reporting symptoms upon return from affected areas. Travelers returning to the EU/EEA should promptly seek medical attention if they develop symptoms consistent with MVD and disclose their travel history to healthcare providers.

UK Foreign Office

The UK Foreign Office has not yet advised against travel to Rwanda, but it acknowledges the outbreak on its website and urges travelers to consult local authorities before traveling. Organizations that send workers to affected areas are encouraged to register with the UK Health Security Agency (UKHSA) Returning Workers Scheme. This allows returning workers to be monitored for potential symptoms of MVD.

General Precautions for Travelers

Travelers heading to regions affected by the Marburg virus should consider the following precautions:

Avoid close contact with sick individuals, especially those showing symptoms such as fever, vomiting, diarrhea, or unexplained bleeding.

Steer clear of healthcare facilities in affected areas unless necessary.

Avoid high-risk activities such as visiting bat-inhabited caves or handling wildlife, particularly primates, bats, and bushmeat.

Monitor for symptoms for 21 days after leaving the outbreak area and seek immediate medical attention if symptoms develop.

Stay informed through reliable sources like the WHO, US CDC, Africa CDC, ECDC, and local health authorities about any changes in the outbreak and travel advisories.

Conclusion

While the Marburg virus outbreak poses serious health risks, taking proper precautions can significantly reduce the chances of exposure and infection. Travelers to affected areas should stay informed, avoid risky behaviors, and be prepared for potential changes in travel restrictions. By following the guidance of health organizations like WHO, CDC, ECDC, and the UK Foreign Office, travelers can protect themselves and prevent further spread of the virus.

References:

World Health Organization (WHO). Marburg Virus (https://www.who.int/news-room/fact-sheets/detail/marburg-virus-disease )

U.S. Centers for Disease Control and Prevention (CDC). Marburg Virus Travel Notice (https://wwwnc.cdc.gov/travel/notices/level2/marburg-rwanda )

European Centre for Disease Prevention and Control (ECDC). Marburg Virus Disease (https://www.ecdc.europa.eu/en/marburg-virus-disease )

UK Foreign Office. Foreign Travel Advice (https://www.gov.uk/foreign-travel-advice/rwanda/health )

Marburg virus disease was first recognized in 1967 during simultaneous outbreaks in Germany and Yugoslavia, linked to African green monkeys from Uganda. Since then, outbreaks have occurred mainly in Africa, with cases in Ghana, Guinea, and Uganda, among others. The disease is highly fatal, with recent outbreaks (before the current in Rwanda) in Tanzania and Equatorial Guinea in 2023. Key historical outbreaks include Angola (2004-2005) and the Democratic Republic of Congo (1998-2000), which had some of the highest fatality rates. Read more on this link

In the face of recurring health crises and outbreaks of infectious diseases such as Ebola, malaria, yellow fever, and COVID-19, GIZ programmes across Regional Economic Communities (RECs) in Africa, together with their partners, are constantly engaging and co-creating collaborative and coordinated Pandemic Preparedness and One Health approaches to disease management.

Aligning with these efforts, in June 2024, the GIZ Regional Programme, Support for Pandemic Prevention in the Economic Community of West African States (ECOWAS), invited the joint East African Community (EAC) and GIZ Pandemic Preparedness programme to a stakeholder workshop hosted by the West African Health Organization in Banjul, Gambia. The meeting aimed to develop collaborative mechanisms for the effective engagement of Civil Society Organizations (CSOs) and community leaders in epidemic preparedness, with a particular focus on Risk Communication and Community Engagement (RCCE).
Read more

Between March and May 2024, Eastern Africa experienced devastating heavy rains and widespread flooding, driven by El Niño. Known as the Long Rains, this period caused landslides, mudslides, and severe damage across the region. The effects were particularly harsh on women and children, who lost lives, homes, and farmland. Agriculture, an industry where women play a crucial role, was severely impacted.

Women, often the primary caregivers, were especially affected. Their responsibilities for securing water, food, and healthcare for families became more difficult with the destruction of homes and displacement. Many women were forced into temporary shelters, where they faced increased risks of gender-based violence, including harassment and abuse.

The floods also triggered major public health crises, with clean water and sanitation systems compromised. Diseases such as malaria, cholera, and measles surged, posing serious health risks to pregnant women and children. Access to healthcare services became increasingly limited, further worsening maternal health issues.

To address health concerns during floods, the World Health Organization (WHO) recommends several protective measures. Communities need to be aware of evacuation routes and warning signals, with women, children, and people with disabilities given priority. Ensuring the availability of clean drinking water is critical, particularly for women responsible for water collection and food preparation. Good hygienic practices and safe food preparation techniques are essential to reduce the risk of disease outbreaks, while avoiding flooded areas and using mosquito repellents help minimize exposure to hazards like drowning or mosquito-borne diseases, including malaria.

Looking ahead, proactive measures are vital to reduce the impact of future disasters, which are becoming more frequent due to climate change. Monitoring weather forecasts can help communities prepare, particularly women, who often lack access to timely information. Safe shelters and preparedness kits with essential supplies, such as flashlights, cash, and first aid, can empower women to protect their families. Investments in infrastructure, agriculture, clean water, healthcare, and emergency systems are necessary to build resilience. Designing buildings to withstand extreme weather and relocating from flood-prone areas can offer additional protection, especially for women who manage household resources.

By prioritizing gender-sensitive responses and addressing the specific needs of women and vulnerable groups, Eastern Africa can better prepare for future natural disasters, fostering more resilient and inclusive communities. More details on this Link 

It is vital that public health professionals engage with issues concerning trade organisations and treaties.
The world is getting smaller. Increased globalisation, resulting from advances in travel and telecommunications, has facilitated an ever greater mixing of people, customs and cultures, and more rapid cross border flows of goods and services, people and capital, and ideas and information. For some this heralds increasing standards of living—including health—for all. For others it brings greater exploitation of poor countries, adverse impacts on health, and the destruction of indigenous cultures. But why should this concern those working in public health? Read more in an article in the Journal of Epidemiology and Public Health on this Link