Is Kenya safe? A doctor who is thinking of working here asked me this tonight during a phone call. That is an interesting question to answer. Sagam village, where we work and live feels very safe. Tonight. like most nights in Sagam, is pretty quiet. The night air is filled with the hum of insects, occasional bird calls, the high-pitched sonar squeaks of bats on the hunt, and a particular rhythmic chirp from a frog that creates the image of a flashing red beacon in the night. And while the occasional inebriated man wielding a farming machete will get into a squabble and need suturing and casting at the hospital, I feel safer walking around here than I do in many big cities in the US.
One of the biggest safety concerns in Kenya, and in many African countries, is road safety. A friend of mine recently wrote an informative blog entry on infant car seats, which can be found here. She's lived and worked in the developing world and can attest to the great disparities in car safety between countries. Common-place sightings here include small children riding behind handle-bars on motorcycles and being held on their mom's laps in overcrowded mini-buses.
Road traffic accidents, or RTAs as they are referred to in Kenyan hospitals, are very, very common here. The reasons are many, including poor road conditions, minimally enforced traffic laws, driving under the influence of alcohol, poorly maintained vehicles, lack of sidewalks for pedestrians, and near absence of emergency medical services and personnel, to name just a few. The other night we were brought face-to-face with the brutality of RTAs in a resource-poor setting. We were getting ready to sit down to dinner when we received a frantic call from the hospital. There had been an accident involved a car vs. multiple pedestrians, and the victims had been taken to our small hospital. We collected our gear and rushed over to do our part to help the many staff that were attending to the several victims. Though we tried our best with the skills and tools at hand, some were lost despite our efforts. The images from the resuscitation will stick with us for a very long time. These losses will only begin to decline with stronger government road safety regulation, as well as improved emergency medicine services. While I can't do anything about Kenyan road traffic legislature, hopefully the local clinicians and nurses we are training at the hospital, as well as the training program in family and emergency medicine that we are helping to initiate, will be a small step towards tackling this big challenge.