More advocacy needed on traffic accidents - officials urge by Michelle Nurse Guyana Chronicle January 26, 2000 THE health sector needs to be more advocative on the issue of the new "morbidities", including traffic accidents, if it is to move towards the goal of a more healthy Guyanese society, Chief Medical Officer, Dr Rudolph Cummings says. In an interview with the Chronicle recently at his Ministry of Health office, Cummings acknowledged that these issues have either not been addressed, or have not been sufficiently dealt with for their level of expression in Guyana. He was at the time responding to a query on the degree of attention the local health machinery places on traffic accidents, in particular, and the ill health and deaths they cause. According to a Panos briefing document issued last September, road traffic collisions are, for men aged 15-44, the largest cause of ill health and premature death worldwide, and the second largest in developing countries. "The high toll of road traffic collisions in developing countries has received little attention from public health specialists," the document says. And with respect to violence and accidents, the document says that in 1993, at least four million deaths - three million in the developing world - resulted from accidental or intentional injury, including 300,000 murders. In Latin America and the Caribbean there are more than 1,000 violent deaths every day, it adds. "Violence, currently 19th in the leading causes of disability, could rise as high as 12th place, and suicide could climb to 14th place", it states. Last year's road fatality figure in Guyana reached an alarming 191. Twenty-two of these were children, the Police Traffic Department reported. "The new morbidities - accidents, substance abuse, mental disorders, and violence in general have either not been addressed or have not been addressed sufficiently for their level of expression in Guyana", Cummings said. "Within the last few days within the print and television media there have been some reference to suicide in Guyana...Obviously issues of safety do not easily come to mind as health issues...They have not yet been recognised here for what they are, as health issues. "But they are health issues in the sense that the health sector needs to take an advocative stance in particular to deal with them," Cummings said, pointing out that Guyana is not "rich enough" to provide "clinical intervention" once the problems occur. There is the infrastructure to do the job, the Chief Medical Officer (CMO) said, but the surgical capacity might not be there, or there might not be enough nurses, anaesthetists or other personnel, "or the same things don't gel on one day" to produce the desired results. "This is all a result of poverty...these are real issues. "In the primary health care framework, we need to be extremely proactive to ensure that we have laws which protect people in a situation: laws against speeding, (for) crash helmets, seatbelts, driving under the influence of alcohol...," the CMO said, alluding to inter-agency cooperation to achieve health goals. "Obviously in dealing with prevention of disease, the inter-sectoral relationships are severely challenged, since oftentimes prevention is not necessarily the forte of the agency charged with managing illnesses," he said. "We had begun, since (1978), to talk of health promotion, a major principle of which is healthy public policy. That translates into a situation where all types of development need to be a priori investigated for potential hazardous health impacts," Cummings said. The authorities here are placing increased attention on the reduction of traffic accidents with top officials, including a minister and a private doctor joining others to recommend stiffer penalties and legislation to curb the lawlessness and carnage on the roads. Home Affairs Minister, Mr Ronald Gajraj, on a recent GTV 11 programme, said that while Guyana has legislation to deal with certain situations which occurred on the roads, the laws do not seem sufficient for the types of incidents over the last two to three years and more particularly within the past nine to ten months. The minister pointed out that last year some 134,782 traffic violation charges were made compared to 119,000 in 1998 and 95,000 in 1997. "Very often we hear complaints that we need to change the law and impose stiffer penalties in our legislation, but more often than not, we do not hear criticisms levelled against the courts for not dealing with the matters in a manner according to law. "A man is charged with dangerous driving, he pleads guilty, goes to court and he is fined $2,000 and goes his way smiling when the law stipulates a fine of not less than $25,000...so he goes out on the road, feels like a road hog and tries to make back his $25,000," the minister said. In this vein, Dr Max Hanoman is advocating that in addition to raising the penalties for traffic offences, the insurance agencies must also raise premiums for vehicle insurance. "Government direction is needed on this issue. There is need for proper direction in the laws that govern people. "Proper laws provide for proper health; poor laws lead to poor health," Hanoman said. A © page from: Guyana: Land of Six Peoples