Causes of Road Traffic Accidents induced Physical Disabilities and its Socio-economic Consequences to Victims and their families in Dar es Salaam Region of Tanzania



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Graduate School of Development Studies


Causes of Road Traffic Accidents induced Physical Disabilities and its Socio-economic Consequences to Victims and their families in Dar es Salaam Region of Tanzania.

A Research Paper presented by:



Mariana J. Makuu

(Tanzania)

in partial fulfillment of the requirements for obtaining the degree of

MASTERS OF ARTS IN DEVELOPMENT STUDIES

Specialization:

Development Research


(DRES)

Members of the examining committee:

Dr John Cameron

Prof. Michael Grimm

The Hague, The Netherlands
December, 2010

Disclaimer:

This document represents part of the author’s study programme while at the Institute of Social Studies. The views stated therein are those of the author and not necessarily those of the Institute.



Inquiries:

Postal address: Institute of Social Studies


P.O. Box 29776
2502 LT The Hague
The Netherlands

Location: Kortenaerkade 12


2518 AX The Hague
The Netherlands

Telephone: +31 70 426 0460

Fax: +31 70 426 0799

Acknowledgements

This piece of work would not have been possible without contribution and support from different people. My sincere appreciation and thanks to Dr. John Cameron for his support and encouragement. I am deeply indebted to him for showing confidence on me and his constructive guidance and advice not only through this paper but also for being my convenor. Professor Michael Grimm thanks so much for your insights and valuable comments. I will never forget your readiness, quick response and attention on my doubts.

I extend my special thanks to MOI management and staffs, Traffic Police Dar, CHAWATA, Students’ office and all participants for their valuable contribution to my paper. My thanks to the ISS community and DRES family (lecturers, course administrators and fellow students) for their support, cooperation and encouragement.

My special thanks to the Netherlands Government for sponsoring my studies. I will not forget my husband for his support and encouragement throughout my study as well as taking good care and support for our children during my tour to the Netherlands; thank you so much. Lastly I am indebted to my friends Rolf, Tove and their son Tor for their social support and encouragement throughout my study.

Contents


Acknowledgements iii

List of Figures v

List of Maps vi

List of Photos vi

List of Acronyms vii

Abstract viii

Chapter 1 Introduction 1

Chapter 2 Epistemology, Methodology and Methods 6

2.1. Study area 6

2.2 Epistemology 6

2.3 Methodology 7

2.4 Methods/Tools for primary data 7

2.5 Collection of secondary data 9



Chapter 3 Conceptual, theoretical framework and literature review. 13

3.1 Road traffic accidents (RTAs) 13

3.2 Disability 13

3.3 Risk perception theory 15

3.4 Systems theory approach 16

3.5 Literature review 17

3.5.1 Risk factors contributing to RTAs inducing PDs 17

3.5.2 Studies on road traffic injuries and fatalities 18

3.5.3 Studies on prevention of road traffic crashes 18

3.5.4 Data availability 19



Chapter 4 In what ways do victims and their families develop coping mechanisms and new capabilities after PDs induced by RTAs? 21

4.1 Coping mechanisms 21

4.1.1 Negative response 22

4.1.2 Religious response 22

4.1.3 Job response 23

4.1.4 Realistic response 23

4.1.5 Dependency response 24

4.2 New capabilities 24

4.3 Conclusion. 25

Chapter 5 What are the causes of RTAs inducing PDs in Dar? 27

5.1 Data from police Dar 27

5.1.1 RTAs trends in Tanzania from 2000-2007. 27

5.1.2 Causes of RTAs in Tanzania. 29

5.2.1 Behavioural factors of road users (perception of risks) 30

5.2.2 Vehicle factors (systems model) 33

5.2.3 Road factors 35

5.2.4 Traffic management factors 35

5.2.5 Conclusion 36

Chapter 6 Why do some PDs induced by RTAs end up to permanent disabilities? 37

6.1 Data from police 37

6.1.1 Who are mostly affected by RTAs inducing PDs 37

6.2 Data from hospital (MOI) 37

6.2.1 The situation of outpatients and inpatients attendance and admission due to RTAs at MOI from July 1998- June 2006 39

6.2.2 The situation of operations performed July 1998 -June 2006 41

6.2.3 The situation of physiotherapy attended July 1998 to June 2006 due to RTAs 42

6.3 Qualitative data 42

6.3.1 What are causes of PDs induced by RTAs? 42

6.3.2 Who are mostly affected by RTAs inducing physical disabilities? 44

6.3.3 Accessibility of first- aid and treatment for RTAs victims 45

6.3.4 Medical treatment and rehabilitation services 46

6.3.5 Conclusion 48

Chapter 7 Conclusions 50

7.1 Overview 50

7.2 Conceptualizing RTAs as a systemic outcome 50

7.3 Risk perceptions of road users and RTAs inducing PDs 53

7.4 Medical response and PDs induced by RTAs 54

7.5 Need for improvements to RTAs data base and road safety measures 55

7.6 Sustainable livelihoods of victims and their families 56

7.7 An integrated approach to researching RTAs causing PDs 56



References 60

Appendices 67

78

List of Tables

Table 1: Fatalities and injuries in Dar due to RTAs based on gender 2000-2007 29

Table 2: Causes of RTAs in Tanzania 2000-2005 30

Table 3: Gender distribution, OPD attendance and admission due to RTAs June 2006 37

Table 4: Physiotherapy sessions attended from July 1998 to June 2006 42



List of Figures

Figure 1: The Systems theory approach 16

Figure 2: RTAs trends in Tanzania 2000- 2007 29

Figure 3: Outpatient admission from July 1998 to June 2006 due to RTAs 39

Figure 4: Inpatients admission from July 1998 to June 2006 due to RTAs 41

Figure 5: Operations performed from July 1998 to June 2006 due to RTAs 41

Figure 6: The systems, road user and the medical response to RTA induced PDs. 57



List of Maps

Map 1: Regional Map of Dar es Salaam 6

List of Photos

Map 1: Regional Map of Dar es Salaam 6

List of Acronyms

AIDS: Acquired Immunodeficiency Syndrome

BICO: Bureau for Industrial Cooperation

CHAWATA: Chama cha Walemavu Tanzania (Disabled People Organization)

DALADALA: Commuter buses in Dar.

Dar: Dar es Salaam

DFID: Department for International Development

DRES: Development Research

FGDs: Focus Group Discussions

GDP: Gross Domestic Product

GIS: Geographical Information System

HIV: Human Immunodeficiency Virus

ICF: International Classification of Functions

MOI : Muhimbili Orthopaedic Institute

PDs: Physical disabilities

RTAs: Road traffic accidents

SUMATRA : Surface and Marine Transport Regulatory Authority

WHO: World Health Organization

Abstract

The research paper explores causes and socio-economic consequences of RTAs induced PDs on livelihoods and wellbeing of victims and their families due to livelihood change patterns in Dar. After identification of how the victims and their families develop coping mechanisms and new capabilities the paper analyses the causes of RTAs inducing PDs; why some PDs induced by RTAs end up becoming permanently disabilities, who are mostly affected by RTAs induced PDs and how victims access first-aid and medical treatment after RTAs.

The findings show that all road users contribute in one way or another on RTAs inducing PDs because of taking many risks. Through the findings the mostly affected group of people by RTAs inducing PDs is the pedestrians, passengers and motor cyclists especially young males because of nature of their daily activities that expose them to more risks. Victims and their families through the findings suffer from psychological, social and economic aspects. Lack of a special rescue team and inadequate health services are among several factors that have been claimed as contributing to PDs induced by RTAs as well as fatalities that could be avoided. RTAs induced PDs is a burden to the public hospitals and government as a whole due to its economic impact and yet the need to allocate more resources to the prevention and control of RTAs inducing PDs. The study concludes that RTAs induced PDs have adversely affected lives of many people and this area requires more research to better understand the causes and socio-economic consequences.

Relevance to Development Studies

RTAs induced PDs is a global development epidemic that deprive people’s lives psychologically, socially and economically due to livelihood change patterns. This study on causes and socio-economic consequences of RTAs induced PDs on livelihoods and wellbeing of victims and their families seeks to inform researchers the current situation of RTAs induced PDs in Tanzania. Furthermore the study seeks to inform researchers and policy makers how an integrated approach to researching RTAs inducing PDs can be useful in developing road safety measures for prevention and control of RTAs induced PDs.



Keywords

Road traffic accidents, physical disabilities, livelihoods, capabilities, coping mechanisms, treatment, rehabilitation, poverty




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