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than the changed perspectives that emerged from the

Enlightenment era itself. Here, I believe, anthropological

thinking, rather than anthropology, can and will have a

crucial role to play.

Anthropological studies that explore negative impacts

and unintended consequences of development projects

provide important pathways into the negotiation of new

ways of moving forward. They are good to think with

rather than useful for building an action agenda using the

existing development premises. They provide different

perspectives and thus enrich understanding of copingmechanisms informal ways in which people negotiate

with outsiders and/or sustain their livelihoods despite

rather than because of development interventions in the

name of the state. Examples of this approach can be found

in the work of Norman Long, James Scott, James Ferguson

and Keith Hart.

Similarly, there is the approach informed by the new

cosmopolitan anthropology that involves the ethnographic

analysis of banking institutions themselves as well as of

development agencies an investigation of the tribal cul-

tures within financial institutions (see Gillian Tetts recent

book), or the history of the development and deployment

of social development specialists in the World Bank by

scholars such as David Mosse. Annelise Riles work on

the ethnography of international human rights is also note-

worthy in this regard.

The role of such institutions as the World Bank, and

of the bases on which the dismal science of economics

has been promoted, have acquired greater prominence

through the global banking crash, the failure of the devel-

opment project and the need to renegotiate what is seen

as being of value. More fundamentally, this reconsid-

eration reflects an evolving cross-disciplinary concern

to transcend the nature/culture divide, to recognize and

incorporate complexity thinking, and to rethink dominant

modes of interpretation. This involves crafting our ways

through complex engagements and networks, weaving

a tapestry that acknowledges and incorporates multiple

threads that link the hand to the head, the mind to the body.

Anthropology could be much more central to this new

engagement because it has been able to negotiate between

the lines drawn by other disciplines.

This requires the transcendence of the disciplinaryboundaries that currently constrain us (and all the social

sciences), and which have only emerged in the last hundred

years. It also means a greater focus on particular histories

and contexts that can then be jointly crafted into emergent

paths. For me, that is what anthropology has always been

about. I think we need to legitimize anecdotes and value

judgements by foregrounding storytelling and identi-

fying the (often implicit) values in all e-value-ations.

* * *

These threads can be successfully woven together by

telling ones own story the inevitable compromises

that have had to be made, the misrepresentation of mes-

sages, the negotiations with stakeholders, the developing

encounters with different peoples and ideas, the personal

contexts and compromises that rarely get included in the

explicit record, but which inform ones own ramblings

through an evolving set of landscapes. We need to develop

the ability to read between the lines and create opportu-

nities, to combine the personal with the political in the

pursuit of more sustainable outcomes, and to recreate the

bases for building trust and more empathic connections.l

Mosse, David (forthcoming).

Social analysis as corporate

product: Non-economists/

anthropologists at work

in the World Bank in

Washington DC. In Mosse,

D. (ed),Adventures in

Aidland: The anthropology

of professionals in

international development.

New York/Oxford:

Berghahn.

Rifkin, J. 2009. The empathic

civilization: The race to

global consciousness in a

world in crisis. Cambridge:

Polity Press.

Riles, A. 2000. The network

inside out. Chicago:

University of Michigan

Press.

Sennett, R. 2008. The

craftsman. London:

Penguin.

Scott, J.C. 2009. The art

of not being governed.

London: Yale University

Press.

Strathern, M. (ed.) 2000.Auditcultures: Anthropological

studies in accountability,

ethics and the academy.

London: Routledge.

Taleb, N. 2010. Theblack

swan: The impact of

the highly improbable.

London: Random House.

Tett, G. 2009.Fools gold.

London: Little, Brown.

MARKLAMONT

2011 marks the beginning of a UN Decade of Action for

Road Safety. Its scope is ambitious: to save five million

lives and prevent 50 million injuries by the end of the

decade in 2020. According to statistics published and

defended by the World Health Organization (WHO), a

major participant in the global road safety lobby, some 1.3

million people die every year in road crashes, with up to

20 million more disabled for life. WHOs slogan, Road

safety is no accident, represents a shift in thinking about

road crashes, with an organizational turn towards publichealth interventions and, more specifically, a construction

of the perceived problem as one of violence and injury

prevention.

Framing road safety in terms of public health has led

to the medicalization of the problem, with the WHO

endorsing catchphrases describing road deaths and inju-

ries as an epidemic on wheels or a disease of develop-

ment. In some instances, the preventative focus of the

WHOs interventions has called for novel ways of looking

at wearing seat-belts or helmets as prophylactic, speaking

of these as vaccines and raising confidence that a public

health approach to this global problem will be effective.

The global road safety campaign is, however, multi-

faceted in its concerns and works with bodies outside ofpublic health, including lobbies representing the interests

of the automotive industries, some elements of which pro-

vide funding for the safety campaign.

A major source of funds is the Fdration Internationale

de lAutomobile (FIA), which partially finances the

Commission for Global Road Safety. Initially set up in

2006, this organization has extensive ties with the auto-

motive industries and motor sport, such as Formula One.

The WHOs relationship with the FIA was, at one time, a

focus of media attention when the FIA supported tobacco

companies application to represent and sponsor motor

sporting events, even permitting British American Tobacco

to become involved with Formula One and exercise adver-

tising rights. The FIAs sponsorship of road safety has also

generated criticism from some public health professionalsand epidemiologists (see Roberts 2007), principally

because many members of the FIAs Global Road Safety

Commission are executives of major corporations in the

automotive and petroleum industries. Through its recent

collaboration with the international financial institutes

(IFIs), high finance and insurers, the commission stands

Mark LamontMark Lamont is a lecturer in

anthropology, at Goldsmiths,

University of London. His

current research is on the

cultural history of health and

safety in eastern Africa. His

email is: m.lamont@gold.

ac.uk.

Fig. 1. Sticker encouraging

matatu commuters to

challenge dangerous drivers,

Eastern Province, Kenya

(2008).

An epidemic on wheels?Road safety, public health and injury politics in Africa

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2/54 ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010

to exercise considerable behind-the-scenes influence over

global transport policy (Roberts 2007).

Justifications for the World Banks involvement in this

lobby stress the economic costs of road death and injury

measured against gross national product, estimating that

states indebted to the International Monetary Fund (IMF)

and World Bank lose more income to road crashes than

they generate from development aid, tallied at a total of

some $US 65 billion annually. This work of translating the

horror of individual cases of death and injury into abstract

financial aggregates, or mind-boggling statistics, domi-

nates most of the knowledge production directed at this

yet-to-happen UN decade of action.

As some observers have noted, road safety is a tech-

nocratic knowledge, involving the idea of knowledge

transfer in the fields of the three Es: engineering,

enforcement and education (King 1999). In contrast to the

cultural history of health and safety initiatives in countries

with an advanced industrial automotive complex, where

road safety emerged as a concern of public health pro-

fessionals, medics, engineers, consumer rights lobbyists

and insurers, the global road safety lobby is characterized

more by the international politics of lending and indebted-

ness, a politics medical and social researchers have been atpains to make public (Roberts and Mohan 2001).

Running concurrently with several other UN decades,

whatever action is to take place should be of interest to

anthropologists, principally because the World Banks rec-

ommendations argue for the state to be the central organ-

izer of road safety measures through the establishment

of national governing bodies funded by IFI loans. In the

context of IFI-indebted states, action is an apt metaphor

for the expansion of transnational governance, with public

health and safety as the professional vehicle for its influ-

ence on national transport policy.

As Carol MacLennan (1988) observed with regard to

the history of automobile-related injuries in the USA, the

politics of public health is directly related to the problemof state power. As an exercise in transnational govern-

ance, the UN Decade of Action for Road Safety is further

defined by its tacit exclusion of the West from the global

road safety lobbys targets, an ideological stance that

reproduces a strong developmentalist logic in its proposed

interventions. In this article, I focus on the lobbys appeal

to the language of public health, especially the descrip-

tion of road death and injury as an epidemic on wheels,

and argue that, in Africa, such an approach depoliticizes

the contexts of road safety interventions, and objectifies

injury politics in ways that disempower those seeking

compensation.

Public health and the doctrine of responsibilityI am broadly interested in the cultural history of health

and safety as a mutable form of governance, and recently

began an ethnographic study of the global road safety

lobby through an engagement with road death and injury

politics in Kenya. Kenya suffers in excess of 3000 road

deaths every year, a number said to be on the rise owing to

the larger volume of imported second-hand vehicles and

the growing availability of consumer credit.

I first became involved in this project through wit-

nessing road crashes, being involved in them, and through

bereavement. But road safety is an urgent issue for all

African countries: as I write, during South Africas hosting

of the FIFA World Cup, a major news story breaks about

the road deaths, in separate crashes, of three young British

tourists and the great-granddaughter of Nelson Mandela.

It need not be overstated, but these cases become news-worthy because of the highly inflated coverage of the road

deaths of foreigners and celebrities in the African media.

South Africa sees some ten thousand road deaths annu-

ally, casting a gargantuan shadow over these few reported

cases. Africas road carnage, as it is often called, is in

danger of being essentialized, and the ongoing tragedies

almost certainly trivialized (see Roberts 2007).

Radical epidemiologists involved in road safety, from

William Haddon Jr in the 1960s to Ian Roberts today,

make very clear how they liken road crashes to infectious

disease, seeing both as stemming from environmental

causes. This is a methodological issue that public health

educators fail to clarify. This move has precedent in the

USA, where the shift to an epidemiological stance towards

road crashes emerged out of a tolerance of road death

and injury, an ideological position, MacLennan suggests,

radically different from our concern with diseases such

as cancer and AIDS, which are characterized by a strong

public demand for a cure (MacLennan 1988: 233).

This comment by an anthropologist raises several issues

in relation to the distinction between road safety in Africa

or other developing nations worldwide and the more

recent concern with automotive safety in the USA and

other vehicle manufacturing nations. The key lies in the

notion of a cure, and where this may be brought about.

The global road safety lobby is not principally concerned

with questioning the deep assumptions of automobility, but rather with extending it as an ideology and making

automotive transport a necessity of everyday practice well

into the future.

In the USA, automotive safety has emerged out of a

long and protracted struggle between consumer activists,

scientists, government agencies and the automotive indus-

tries over questions of design and tort law (Jain 2004). It

focuses on the harm that car, lorry and motorcycle design

can do to the soft machine of the human body.

Road safety, in Africa, begins from the assumption that

automobility is not a problem in fact, it can be a solution

to many problems of development but that road users

are. The larger context of road safety in Africa incorpo-

rates concerns that 20 years ago were subsumed under thecategory good governance, exemplified by campaigns to

eradicate corruption. Road safety in Africa is not about

automobiles to the same extent as automobile safety is in

the USA, but rather about fixing decrepit road infrastruc-

tures, reforming insurance loopholes, delivering efficient

licensing and proficient drivers, and reducing illicit prac-

tices between drivers and traffic police. That the public

health idiom has come to pervade the rising focus on road

safety in Africa surely raises questions about the direction

this lobby is taking in different parts of the world.

A brief period of fieldwork with taxi drivers in Dar es

Salaam, Tanzania, brought to the fore how road safety

campaigns in eastern Africa appropriated the language of

public health, arguing that road crashes were a disease,epidemiologically on par with malaria or tuberculosis.

This medicalization of the public health and education

component of the global road safety lobby was further

illuminated through discussions with colleagues in South

Africa, who had for some time noted the way recent road

Ferguson, James 1990.

The anti-politics

machine: Development,

depoliticization, and

bureaucratic power in

Lesotho. Cambridge:

Cambridge University

Press.Jain, Sarah 1999. The

prosthetic imagination:

Enabling and disabling the

prosthesis trope. Science,

Technology and Human

Values 24(1): 31-54.

2004. Dangerous

instrumentality: The

bystander as subject in

automobility. Cultural

Anthropology 19(1):

61-94.

King, Mark 1999.

Transferring road safety

knowledge and techniques

to South East Asia:

Contexts and challenges.

InProceedings of the21st Conference of the

Australian Institutes

of Transport Research.

Available at: http://eprints.

qut.edu.au/11308/1/11308.

pdf.

MacLennan, Carol 1988.

From accident to crash:

The auto industry and the

politics of injury. Medical

Anthropology Quarterly

2(3): 233-250.

Miyazaki, Hirokazi 2004.

The method of hope:

Anthropology, philosophy

and Fijian knowledge.

Stanford: Stanford

University Press.Mohan, Dinesh and Roberts,

Ian 2001. Global road

safety and the contribution

of big business: Road

safety policies must

be based on evidence.

British Medical Journal

323(7314): 648.

Moodie, Ellen 2006.

Microbus crashes and

Coca-Cola cash: The value

of death in free market

El Salvador.American

Ethnologist32(1): 63-80.

Roberts, Ian 2007. Formula

One and global road

safety.Journal of the

Royal Society of Medicine

100: 360-362.

Vaughan, Megan 1991.

Curing their ills: Colonial

power and African

illness. Stanford: Stanford

University Press.

Fig. 2. Look out for

bicyclists: road safety

signage on the Arusha-Dar

es Salaam road, sponsored by

Vodacom. Tanzania, 2008.

MARKLAMONT

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3/5ANTHROPOLOGY TODAY VOL 26 NO 5, OCTOBER 2010 5

safety campaigns borrowed from HIV/AIDS activism. One

cited a public-service radio advertisement for buckling up

that centred on a conversation where a woman urged her

partner to wear a seat belt (Rebekah Lee, personal com-

munication). This particular advertisement ended with the

challenge: If you love your partner, youll wear a seat

belt. In the South African context there is a not-so-very

subtle reference in place, where the substitution of seat

belt for condom tells a similar story about a new sub-

jectivity of (inter)personal responsibility in looking after

ones own health and safety amid quite threatening struc-tural insecurity.

Personal responsibility is a hallmark of the global road

safety lobbys educational and enforcement campaigns.

Targeting individual behaviour is widely viewed as the

only way to reduce road fatalities and injuries. At the

exclusion of structural considerations, like the poverty that

forces water-cart operators and street hawkers to jostle for

space with cross-continent fuel tankers and presidential

convoys, personal responsibility and the notion of a ration-

ally calculating and obedient subject run fluidly through

the discourse of road safety campaigns.

In 2009 Costa Ricas transport minister, Karla Gonzales,

was presented with a prize by the Make Roads Safe cam-

paign the road safety NGO that meets with the auto-motive industrys approval for her introduction of new

seat-belt legislation and an extensively mediated public

awareness campaign for buckling up, with the slogan

Por amor (For love). The campaign logo, a cartoon

heart being buckled up, signals the idea of (inter)personal

responsibility for ones own safety.

A bold theory of human agency is inflected through

much of the global road safety lobbys assumptions. The

Make Roads Safe campaign ideologically supports other

campaigns that stress human error as the reason behind

road crashes. Hardly ever are cheap transport costs,

unsafe lorry fleets, or even the ideology of automobility

itself brought into conversations about the rising rates of

death and injury. Arriving at this ideological conclusionthat accidents are caused by individual behaviour, and

therefore subjecting this behaviour to legal and political

liability, many states described by anthropologists as neo-

liberal have embraced road safety campaigns that empha-

size the role of personal responsibility in crash causation.

I was intrigued, then, by the series of stickers I photo-

graphed in Kenya while riding in a matatu (e.g. fig. 1),

the ubiquitous Toyota buses that ply the countrys roads,

encouraging passengers to challenge drivers who drove

dangerously. Sponsored by Safaricom, Kenyas part state-

owned mobile telecommunications supplier, these stickers

were graphic, even gory, showing a severed foot still clad in

a bloody shoe, asking in bold red font, Will YOU survive

the matatu ride? Speak up, stand up. Such an invocation

to act against the wishes of a matatu driver would scarcely

have been thinkable only a decade ago. The change wasdue, many Kenyans told me, to the tough new regulations

of 2003, commonly known as the Michuki Rules, after

the then Transport Minister, John Michuki.

This enforcement legislation aggressively regulated

the public service vehicle sector, introducing a number of

reforms including mandatory MOTs and the installation

of speed limiters restricting public vehicles to a maximum

speed of 80 kph. But this legislation also attempted to

shape the subjectivity of drivers and passengers, urging

them to take responsibility for their actions, including

asking drivers to refuse to pay traffic police their illicit

dues, as a kind of exercise in active citizenship.

Similarly, in Tanzania, along the road from Dar es

Salaam to Arusha, one of Tanzanias most competitivehighways, Vodacom has sponsored road signage urging

individual drivers to acknowledge that bicyclists share the

road with motor vehicles and to be conscious of pedes-

trians and animals crossing the road. The sponsorship of

road safety by large corporations in these eastern African

countries is not fortuitous. The appeal to personal respon-

sibility with respect to automobility is, however, part of

a larger project of shaping conduct with respect to (inter)

personal responsibility in which public health policy

merges into enforcement and education as witness, for

example, the total ban on public smoking in all of Kenyas

municipalities in 2007.

In what follows, however, I introduce a case that inter-

rogates the concern of public health with (inter)personalresponsibility for road safety and raises the question least

likely to be raised by road safety activists in Kenya: that

of social and economic inequalities. Even with this ideo-

logical focus on personal responsibility, it remains the

case that the majority of those killed or injured on eastern

Fig. 3.Road safety activists

and professionals point to

the derelict state of Africas

infrastructure, but what

design issues will engineers

face in the latest wave of

new road construction

in urban contexts? With

many pedestrians making a

livelihood as street hawkers,

designing safe roads is a

question of how social space

is actually used alongside the

automobile.

PAHO

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African roads are frequently blamed for their own deaths

on the grounds of their lack of knowledge about the

danger of being on the road, as one insurer put it to me.

One consequence of this ideological stance is that their

deaths are trivialized and the circumstances surrounding

injuries depoliticized.

One in a million

October 2007, rural Kenya. The construction of an asphalt

road commissioned by the Ministry of Roads and Public

Works, under contract to the large engineering construc-tion company H. Young, was a long anticipated develop-

ment championed by the people of Mikinduri. For years,

the only repairs made to their road networks had been

conducted by British American Tobacco, road works that

inevitably drew on cheap, unskilled local labour and whose

faade of durability barely lasted one seasonal cycle from

drought to deluge. Cut off from the regions markets twice

a year by heavy rains that washed out bridges and turned

tracks into impassable bogs, the dream of a 52-kilometre

sealed road linking them to Maua and Mutindwa, the

regions largest towns, was fast becoming a reality the last

time I visited this favourite of my former field sites.

The project cost $US 27.3 million and took 18 months

to complete, transforming the hilly landscape and the

time it took to traverse it. When I was last there, huge

loaders and excavators trundled about, shaking the sun-

baked earth and kicking up plumes of dust seen from

miles around. The still unfinished road became a staple

topic of conversation.Khatand maize farmers alike spoke

with relief about market accessibility. Teachers expressed

enthusiasm that they could travel to administrative centres

quickly and easily. And Mikinduris three bus operators

noted with confidence how much cash they would save on

maintenance, with parts lasting longer.

People were excited when they spoke of a planned

roundabout at the main junction: something urban in a

trading town that only received electricity a decade ago.But others were also worried about the children who, they

argued, were conditioned to the slow pace of vehicles on

the dirt road and would not appreciate the dangers of cars

and vans moving at high speeds along the tarmac. And so,

predictably, it came to pass that a child died.

She was about seven or eight years old. Sent by her

mother to buy cigarettes for a house guest, this little girl

was run over by one of the H. Young dump trucks and

crushed. Contrary to what might be expected of an eth-

nographer, I couldnt bear to go and witness the scenes

aftermath. A senior policeman spoke about the killing in

the evening, describing it for a small group of sombre

men over bottles of beer. There was an underlying shock

and anger running through all those I spoke to about theincident, much of it reserved for the girls mother, a local

liquor seller who, it was alleged, was drunk at the time she

was told the horrifying news.

The girls father was one of my close friends clansmen,

and various plans to force H. Young to accept liability

and claim some kind of blood compensation were mooted

throughout the month I stayed in the town. Legal action,

it was asserted, would be taken once the various police,

hospital and insurance forms had been filled in and sub-

mitted. I tried my best to follow the case over the fol-

lowing year through a mixture of mobile phone calls and

emails. Perhaps triggered by her death, I have since then

looked intently at road death and injury politics in Kenya,

tracing in this little girls unnecessary and avoidable deatha path through which to interrogate the topic of road safety

in eastern Africa.

Then, last month, after another attempt to follow the

saga of Mikinduris asphalt road, my friend sent me the

briefest of messages:

I have just interviewed the cousin of mine who followed up the

case. Simply put, The H-Young defense accused the victims

of a total of thirteen counts bordering on negligence and irre-

sponsibility. Subdued, the father, through his lawyer, accepted

an out-of-court installment of Ksh 210,000. End.

In this case, the pay-out was a few thousand US dollars.

Ellen Moodies (2006) ethnographic study of a micro-bus

crash and Coca-Cola cash in El Salvador followed one

compensation claim in which death was commodified and

trivialized through big business compensation, reflecting

on the ways in which corporations have gained groundin the courts and policing process under neo-liberal gov-

ernmentality. Accident compensation inevitably trans-

forms the meanings of death. In what Sarah Jain (1999)

has termed the material semiotics of injury politics, the

significance of my friends punctuation, End, I think

was to signal to me to leave off, let live, and not pry.

Compensation paid to the father and blame reversed onto

the drunken mother, this girls death is no longer meant

to be a case study of any kind: it is just one in a million.

But it is not an isolated case. This is not one in a million

deaths to have occurred in 2007, just a statistic, but part

of an unsettling pattern that can be recognized through its

injurious politics in the abandonment of actuarial and judi-

cial process.

In Kenyas daily national newspapers, the uncompen-

sated victim of a matatu crash is a regular focus of col-

umnists writing human interest stories. A photograph of a

blind and paraplegic 44-year-old woman called Wanjiku (a

common enough name used to signify any adult working-

class or peasant woman in Kenya) evokes not so much

pity as it does a kind of frank caricature of Kenyan ine-

quality. Such stories, like ones about people with AIDS,

fill a niche in the Kenyan imagination. Bereft of livelihood

and limb, Wanjiku cannot feed or wash herself. Previously

a robust, healthy and hard-working mother of four, she is

now abandoned and forgotten. A neighbours small child

comes to bring her bits of food and water. If and when thecourts decide upon her claim for compensation, she cries,

her children will come back for the money, but not for her.

Lying in the dark of her timber and corrugated tin-roofed

house, the question of compensation is ontologically fused

with her lingering, painful disability. It is no longer a ques-

tion for doctors and nurses, but for insurers and lawyers.

We need to pause and ask whether road deaths and

injuries can be reduced to disease and illness, as some

epidemiologists have asserted. If the little girl died from

malaria, would the circumstances and implications of her

death be the same? If the wounded woman permanently

isolated in her house were dying of advanced AIDS,

would her death not be subjected to different moral

dispositions and legal consequences? I ask these ques-tions because I think that the conflation of road death

and injuries with disease theoretically undermines what

Paul Farmer, in his engaged work, has been emphasizing

about the structural conditions determining who gets sick

and dies and why.

As injury epidemiologists, public health educators and

insurers increasingly eschew the Aristotlean notion of

accidents as unforeseen misfortune and come to see them

as crashes, with human agency to blame, the tendency to

view road death and injury as an epidemic on wheels, as

prominent WHO professionals have recently advocated,

has unintended but highly constraining implications for

what interventions can be made with the aim of reducing

the number of people killed and maimed by automobiles.To borrow from James Fergusons (1994) ethnography

of development in Lesotho, the place of public health in

the global road safety lobby risks being an anti-politics

machine if forms of social differentiation, objectification

and exclusion are not pragmatically accounted for.

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Fig. 4.An H. Young

bulldozer excavates the route

of the planned road from

Mutindwa (Meru Town) to

Mikinduri and Maua.

Kenya, 2008.

Diseases of development

But what do such examples taken from Kenya tell us

about road safety as a method of hope (Miyazaki 2004)

enmeshed with public health and its professions? The

range of professionals working on road safety does raise

the classic problem of people talking past one another, and

if we take Miyazakis understanding of hope as a method

that unites different forms of knowing leading to a radical

temporal reorientation of knowledge (ibid.: 4-5), perhaps

downplaying the political and legal ramifications of road

collisions and highlighting them as an iatrogenic conse-quence of automotive capitalism that is, a disease of

development this strategy provides a focus through

which the global road safety lobby can galvanize resources

and act in an apparent, if not real, unison.

The diffuse metaphors of medicine, say, drug addic-

tion as a cancer, or child neglect as a plague, can reach

across different forms of knowing and suppress points

of potential or real disagreement. Similarly, speaking of

road death as an epidemic on wheels simplifies what is

at stake and, in a continent such as Africa, can build upon

development discourse in which disease and cure legiti-

mize (colonial) interventions (see Vaughan 1988). Indeed,

the recent focus on road safety in terms of curing their

ills, as Vaughan puts it, works ideologically in Africa

because it has a long historical precedent of medical, and

hence developmentalist, intervention.

Lest I be misunderstood, and be accused of an unwar-

ranted attack on a worthy cause, my intention here is to

demonstrate how relying on a language of public health

concerning road safety in Africa plays into a historical

context in which disease, illness and affliction become

essentialized as something inherently African. I would

argue that the same thing sadly goes for road crashes in

Africa, perhaps exemplified by the Swahili proverb Ajali

haina kinga (accidents have no remedy), but urge that

we see these conflations as ideological reflections of a

larger process of long-term transnational governance, aproject that has the perhaps unanticipated effect of dimin-

ishing road crash victims lives and technocratic denial of

the politics involved in road safety engineering, enforce-

ment and education.

As the Make Roads Safe campaign confidently refers

to helmets and seat belts as vaccines, it operates in an

ideologically interventionist context, in which the legiti-

mization of medical interventions, past and present, goes

unquestioned as an unmitigated good. What needs to be

known, however, is to what degree this appeal to public

health, as a form of good practice, creates situations in

which injury issues, especially those of the poor, con-

tinue to be settled out of court, or not at all. l

tRenDs In RoAD tRAFFIC DeAtHs

0

1 000

500Numberoroadtrafcdeaths

1970 1978 1982

3 500

1990 2006

1 500

2 000

1974 1986 1998 2002

2 500

3 000

1994

Fig. 8. Most casualties on

African roads are sustained

by people standing at the

roadside or pedestrians, many

of whom are killed on the soft

shoulders of busy roads going

to and from work or home.

Here, in South Africa, there is

new impetus to purchase life

insurance as cover against

accidental death.

Fig. 6 and 7.A comparison

of road traffic death trends

in Kenya (above) and the

United Kingdom (below). In

2007 deaths in Kenya and

the UK respectively were

predominantly of pedestrians

(47% compared to 21%),

followed by passengers in

4-wheel vehicles (33% and

19%), cyclists (9% and 4%)

and riders of motorized

2- or 3-wheelers (1% and

19%). http://www.who.int/

violence_injury_prevention/

road_safety_status/country_

profiles

tRenDs In RoAD tRAFFIC DeAtHs

0

3 000

Numberoroadtrafcdeaths

1971

9 000

200620011991 2005

4 000

6 000

7 000

19961986

1976 1981

5 000

2 000

8 000

1 000

MARKLAMONT

MARKLAMONT

GRSP,P.VENTE

WHO/KENYATRAFFICPOLICEDEPARTMENT

WHO/ROADCASUALTIESGREATBRITAIN2006

Fig. 5. Accidents have no

remedy: image painted for

a church youth group road

safety campaign. Mburahati,

Dar es Salaam, Tanzania,

2008.