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Boda-boda motorcycles are the fastest mode of transportation in Uganda. They are not only swift, but also reliable in times of emergencies – when vehicles get stuck in a jam or can’t access certain areas, these motorcycles slither their way through with ease. However, they are also a leading cause of road accidents. So are boda-boda worth the risk?

Despite their ease at snaking through difficult areas in Uganda, boda-boda use has become the leading cause of death and injuries on most roads. It has led the national referral hospital to set up a special ward to handle victims of motorbike-related accidents.

Most boda-boda accidents stem from narrow roads getting congested with traffic. It is common in Uganda to see buses, taxis, trailers, lorries, motorcycles, bicycles and pedestrians competing for roads’ thin spaces.

Death traps

Doctor Robert Wongoda, a general surgeon and clinical head in the accident and emergency unit at the Mulago National Referral Hospital, says motorbikes are the leading cause of injuries on the roads and have now surpassed motor vehicle accidents.

Head and limb injuries are among the most common. “Head injuries are the commonest cause of death among motorbike riders and passengers,” he observes.

Riders also risk being assaulted by criminals, especially at night. Thugs usually pose as passengers, and when the motorcycle reaches a dark corner, riders are hit with hammers and iron bars, cracking their skulls. Thugs then take off with the motorbike and the day’s earnings. Dr. Wangoda says assault injuries have also contributed to the death of many riders.

“These injuries are preventable and would be less severe if riders wore crush helmets,” Dr. Wangoda says.

A study conducted by the Injury Control Center Uganda (ICCU) at the national referral hospital shows a decline in the use of crush helmets. In 2011, 30.5 per cent of riders used helmets, while 0.8 per cent of helmet use was recorded among passengers.

A previous study done by the ICCU and the World Health Organization in 2006 registered 42.6 per cent helmet use by riders and 0.26 per cent among passengers.

According to Dr. Wangoda, two patients die on average every week at Mulago hospital as a result of boda-boda accidents. Between 10 and 20 victims of boda-boda accidents are received at Mulago hospital on a daily basis and 20 per cent of the victims are left disabled.

The 2011 annual traffic report showed that a total of 1,762 serious accidents involving motorbikes occurred in the capital city during that year. Lawrence Niwabiine, the traffic commander of the Kampala Metropolitan Police, noted that 155 passengers perished in motorcycle-related accidents.

“It is very rare to hear that a taxi in Kampala city has overturned and killed passengers,” he told RFI. “The deaths we register in Kampala are related to boda-boda cycling and their behavior.”

Pedestrians are the most vulnerable road users in Kampala, followed by commercial motorbike riders.

“The boda-boda is the most unsafe means of transport in Kampala, and I would appeal to most road users to desist from using them in the city, especially at night,” Niwabiine warns.

“Criminals hide in the boda-boda industry and commit violent crimes in our society,” said Niwabiine. “And this is because the industry is not streamlined.”

He says around 90 per cent of riders are incompetent. “These riders did not get any formal training, and they do not comprehend road safety tips whatsoever,” he explains.

Niwabiine added that Uganda must develop a process to register all riders and their motorcycles, in order for law enforcement officials to follow them regularly.

Employment

With the high rate of unemployment, this fast-growing means of transport employs a bulk of youth in Uganda.

About 80 per cent of young people between 20 to 30 years old are earning a living by picking up and dropping off passengers.

However, it is still the most unsafe mode of transportation.

Traffic offenders

Urban areas have the highest concentration of commercial motorcycles, and the largest number of injuries reported. Riders often flout traffic laws, running traffic lights at city road junctions and driving on the wrong side.

Their driving is characteristically reckless, as they squeeze their way in between vehicles during traffic jams, putting the lives of their passengers at risk.

Vulnerability

Passengers are more often injured than riders, and women are more prone to motorbike accidents than men. More females are injured as boda-boda passengers than in road traffic accidents.

“Ladies sit on the boda-boda in the wrong way; these legs hanging on the side,” says Marble Tomusange, the executive director of the Injury Control Center Uganda. “The moment there is any impact on the boda-boda, you fall off. And if you are in between cars, they’ll crush your legs. That’s why many passengers get fractures.”

Some parents hire boda-boda riders to pick up and drop off their children at school in the morning, putting the lives of children at risk.

“It is dangerous to put a child on a boda-boda and it’s the worst abuse of his or her rights,” says Tomusange.

Health effects

Health experts warn that boda-boda riders may suffer eyesight problems because of the wind and dust that blows directly into the eyes. Many ride without helmets or glasses, and have seen a deterioration in their eyesight.

Experts also warn that long amounts of time spent on motorbikes exposes a rider’s reproductive organs to danger.

“When these guys sit on the boda-boda, they affect their reproductive organs,” Tomusange noted. “They sit on those things for a very long time in the same position, in the heat, in the cold, in all different conditions, and they are affecting their families.”

Riders also risk developing respiratory diseases because they do not wear jackets most the time.

While boda-boda motorcycles may be a fast and efficient mode of transportation for Uganda’s most hard to reach areas, health and safety experts continue to warn of the dangers for riders and passengers.

With more regulations in place, the boda-boda could thrive. But as things stand now, they are still risky business.

Tweeter

(CNN)merch 2015 Everywhere you look there are two-wheeled drivers waiting ominously for passengers to hop on board. They’re the backbone of public transport in Uganda and the fastest way to get around the capital city, Kampala. The boda boda motorbike taxi is a staple used by all sectors of society.

Traditionally, the usual way of catching a ride was to venture into any street corner packed with tens of boda bodas or simply waiting for one to pass by.

But now, a new local startup are bringing this classic mode of transport into the technological age by providing the ability to hail a boda boda at the click of a smartphone.

“Bodas are the main thing getting people from A to B,” says Alastair Sussock, co-founder of SafeBoda, “and we’re trying to professionalize this transportation in the city.”

The motorbike taxis have their greatest popularity globally in Uganda, with over 80,000 riding the streets of Kampala, according to Sussex who wants to seize upon the country’s burgeoning young population. Uganda has more than 24% of the population aged between 10 and 19 years old, according to UNICEF — and Sussock wants them to get on their bikes.

“Young people use smartphones in Kampala and it’s one of the youngest countries in the world,” he says.

For now, the Uber-like startup operates mainly in the northern districts of Kampala, where a click on the SafeBoda app — in addition to the traditional method of hailing them on the street — will bring you a Safeboda bike, complete with a uniformed driver in a bright orange jacket, helmet and fully trained in road safety. He’ll even have a helmet for you.

Staying Safe

Safety has long been a concern for those riding boda bodas as the bikes are a leading cause of death and head injury in Kampala. A study conducted at Mulago National Referral Hospital in Kampala, by researchers at Makerere University, identified approximately 40% of trauma cases at the hospital to be due to boda-boda accidents.

Catching my ride

I request a SafeBoda to take me to meet the team in the upmarket area of Kisementi, in Kampala’s central district. As i stand waiting, at least 10 regular boda bodas pass by beeping to get my attention and business. A driver called Richard Lalunga then arrives who I spot clearly in the distance thanks to his bright orange jacket and orange helmets — one on his head and one on his handlebars.

Lalunga has been a boda driver for four years and joined SafeBoda four months ago to learn more about road safety. He explains how he now earns more than ever before due to a loyal customer base stemming from his safe driving. The ride was in fact calmer than those taken with other bodas, and unlike some, as we ride along the congested streets no kerbs were scaled or mounted to avoid the traffic. The name stands – safeboda.

The dangers lie in the low use of helmets — by both drivers and users — alongside risky driving and poor road safety practices. This makes many fearful of catching a two-wheeled ride but the team at SafeBoda are trying to lure people back on board. They’re reinventing the boda boda reputation to prove they can be safe, as well as fast and economical.

“It’s a market-based approach to road safety,” says Sussock, an economist, who believes that as word spreads about the skills of his drivers, the income — and safety — of his drivers will rise and reflect this.

“People in Uganda don’t wear helmets,” says Sussock. “So how do we get them to wear helmets?” The answer, is by providing one.

Driver training is provided in partnership with the Ugandan Red Cross and takes place for up to three weeks to cover road safety and bike maintenance — and it seems to be working.

Thinking big

Since its inception in November 2014, the fleet of drivers at SafeBoda has reached 50, currently occupying four areas towards the north and center of the city. The main need for safe driving is in the congested streets of downtown Kampala where the company plans to expand into next.

“If we train people and make them good and responsible drivers, we’re going to save lives,” says Ricky Rapa Thomson, who manages the drivers. “But implementing has been a challenge,” he says about the difficulties in changing the mindsets of a population.

The team are dreaming big, with plans to expand to 100 by the end of March and 800 by the end of 2015. “With over 1,000 drivers we can begin to change the entire boda industry,” says Sussock.

They have been dubbed Uganda’s silent killers. Boda-bodas, the country’s ubiquitous motorbike taxis, snake through gridlocked traffic, navigate potholed roads and provide much-needed employment for young people. They are also maiming and killing thousands every year, monopolising hospital budgets and wiping out livelihoods.

Since they appeared on the streets of Uganda in the 1960s, the number of boda-bodas has swelled. One recent news report estimated there were more than 300,000 bikes operating in the capital, Kampala.

The number of motorbike accidents has increased exponentially. According to the Injury Control Centre, there are up to 20 boda-related cases at Mulago National Referral hospital in Kampala every day.

The strain on the country’s limited health budget is growing. According to a report by Makerere University College of Health Sciences and the department of orthopedics at Mulago, about 40% of trauma cases at the hospital are from boda-boda accidents (pdf). The treatment of injured passengers and pedestrians accounts for almost two-thirds of the hospital’s annual surgery budget.

Dr Michael Edgar Muhumuza, head of Mulago’s neurosurgery unit, believes the boda-bodas are deathtraps. “These are young people, the youth of tomorrow,” he says as he examines x-rays. “It’s a big problem [for] this nation. The last two, three years the number of these accidents has become much greater. It’s now very bad.”

As well as those who are injured or die in accidents, Muhumuza is seeing an increasing number of riders who have been beaten and left for dead after being robbed of their vehicles.

Politicians have expressed concern over the growing number of fatalities on Uganda’s roads. Photograph: Reuters

While boda-bodas are helping to reduce youth unemployment – one recent study estimated that 62% of young people in Uganda are jobless – the impact of a serious injury can prove catastrophic for riders and their families.

Ali Niwamanya, 25, a boda-boda driver, spent three months in Mulago hospital and another five at home recovering after a collision with a car in the capital in September. “I had a broken leg. It was too painful,” he recalls. “It was hard for me to get money because I could not work, and so my family had to suffer during that time.” Niwamanya is now in debt after taking out a 3m Ugandan shilling loan (£765) for a new bike.

While the human impact of the boda-boda craze is evident in the packed hospital wards, the strain that spiralling road fatalities could have on the economy is worrying politicians.

The death toll on Uganda’s roads is twice the average across Africa. The Ugandan annual crime and traffic/road safety report showed 3,343 road deaths were registered in 2011 (pdf) although the World Health Organisation has estimated the figure to be more than double that. Some are warning that, if action is not taken, the death toll from Uganda’s roads could top that from diseases such as malaria – and be second only to HIV and Aids as the leading cause of death in the country.

“This translates into a monetary loss to the country,” says Winstone Katushabe, secretary of the transport licensing board at the transport ministry. “It’s about 1 trillion shillings [£255m] in terms of loss to the economy, [with] investigations of accidents, post-trauma care, families you have to look after.”

Kampala’s metropolitan traffic police director, Lawrence Nuwabiine, agrees. He says Uganda must “fight this road carnage” with the same commitment it used to tackle HIV and Aids a decade ago.

“When we started [with] the issue of Aids, the president … said: ‘We are dying, every person must talk about Aids’,” Nuwabiine says. “And people started talking about Aids in churches, in schools. We managed to reach somewhere. But [with] this one, people are not talking about death as a result of these boda-bodas.”

Some measures are being taken to try to stem the problem. Last month, the government announced that the works and transport sector would be allocated one of the biggest chunks – about 15% – of the 2013-14 budget to improve and maintain roads.

Even though road safety measures were not specifically included within the budget, the government is establishing a national agency to run advocacy campaigns and manage roads.

In Kampala, the Capital City Authority is attempting to introduce regulations, including mandatory registration of drivers, first-aid training, reflector jackets and helmets, and a monthly fee of 20,000 Ugandan shillings paid by the city’s 250,000 motorbike taxis.

Other initiatives are also springing up. The Global Helmet Vaccine Initiative is holding a one-day workshop for 100 riders, part of a national scheme under which it has trained 1,800 boda-boda riders in basic road safety. On completion, each participant receives a yellow helmet bearing the slogan: “Your life is your wealth”.

It is a message that seems to be getting through. Ronald Katetemera, 27, says he will not be taking his new headgear off. “Every day it’s going to be the first thing I put on,” Katetemera says. “They say life has no money value. I have my children. I don’t want to die.”

Since 2010, the Global Helmet Vaccine Initiative has provided road safety training and helmets to 4,000 boda drivers in Kampala, the organisation says. Often called “half-helmets” by boda drivers, they are smaller, lighter, UN-certified and designed for tropical climates. Photo by Julia Burpee

By Julia Burpee

“What we see is so disturbing … open wounds, extensive laceration on the scalp with brain coming out, patient hardly breathing, fighting for his or her life,” says Dr Michael Muhumuza, head of neurosurgery at Mulago Hospital. “It’s quite a terrible picture for anybody to bear,” he says, describing the injuries he sees regularly as a result of boda boda accidents.

Muhumuza says he treats between seven to 12 patients daily who have been severely injured riding boda boda motorcycle taxis in Uganda. On average, 20 new critically wounded boda patients are received at Mulago every day, according to the hospital, let alone the hundreds who arrive with minor to moderate injuries.

In his emergency ward for head injuries, Dr Muhumuza points to dozens of boda victims. The patients come from around the country for treatment at the national referral hospital, the largest in Uganda, he says.

Walking from bed to bed, the doctor pulls individual patient x-rays. One belongs to a teenager who travelled from Kabale, about 400km away, for treatment. His skull was cracked open in a motorcycle accident, the neurosurgeon explains. “This is where his brain came out,” he says, pointing to a blotch of grey mush captured on the film.

With the exhausted tone of someone who has seen it all – he’s worked in Mulago’s neurosurgery department for 11 years – and who was treating fresh boda victims until 2am that morning, he laments: “these patients will be here for at least three months, maybe even six for some.”

It costs Shs8 million on average to treat just one severely injured motorcyclist at Mulago Hospital, according to a new study by the Uganda Christian University in partnership with Makerere School of Economics.

Some of this cost is borne by the accident victims and their families and friends and some is covered by “society as a whole,” the study continues; in 2012, “3,043 motorcyclists were reported to have been seriously injured as a result of motorcycle accidents in Uganda, this translates to Shs24.27 billion” in medical expenses.

To manage these cases, Mulago hospital directs 62.5 per cent of its surgery budget to treating victims of boda accidents says Barbara Mwanje, Africa manager of the Global Helmet Vaccine Initiative (GHVI), an organization advocating for helmet use and improved road safety.

“That’s the most telling indicator of just how big the issue is,” she says, adding that there are an estimated 80,000 registered bodas on Kampala’s roads, though likely thousands more. Since starting their operations in Uganda in 2010, GHVI has provided road safety training and helmets to 4,000 bodas.

She says the organization has been focusing on improving the safety of motorcycle drivers because of the “occupational hazards,” they face spending between 10 to 12 hours on bodas daily.

Riding bodas is common for Ugandans, but wearing helmets is not: only 30 per cent of drivers wear helmets and 0.02 per cent of passengers, according to the GHVI’s 2011 general population survey. Mwanje says that the percentage of drivers wearing helmets has increased to around 49 per cent, based on the organization’s 2013 study. However, the quality of helmets they wear is an issue as is the continuously low rate of boda passengers wearing helmets, she says.

SafeBoda is a new company in Kampala that aims to improve the safety of drivers and passengers. “There are lots of bodas on the streets,” acknowledges the company’s co-founder, Ricky Thomson. “What makes SafeBoda unique is [the drivers] get training from the Uganda police, the Red Cross … and they carry two helmets – one for you!”

Dr. Muhumuza says the company’s unique two-helmet approach is long overdue “The patients who are most severely injured are the passengers,” he says. The neurosurgeon attributes the predominance of injured passengers to their lack of helmet use.

Wearing helmets at the time of accidents has saved 87 per cent of boda drivers from physical injury, according to the Uganda Christian University’s 2014 study.

SafeBoda’s drivers hit Kampala’s streets at the end of November. There are currently 25 drivers working from their regular stages in Kisementi, Kololo and Bukoto, according to co-founder Thomson, who says providing helmets for customers is crucial.

“I lost my friend who fell [off a boda in an accident] and had a head injury. He spent three months in pain and then he died. He wasn’t wearing a helmet,” says Thomson, who worked as a boda driver for four years before starting SafeBoda. “I fell twice, but I never had a head injury, I always wore a helmet.”

“We believe prevention is the cure [so] we equip our bodas with helmets for themselves and their customer,” he says.

Another issue Thomson says SafeBoda is addressing is the lack of training boda drivers receive. The Uganda Police run workshops to train the company’s drivers about road rules.

Paul Kwamusii is a road safety specialist who has been delivering similar workshops on defensive driving, judgment and traffic laws for 22 years. In early December, the former police officer trained 600 boda drivers from different areas of Kampala as part of GHVI’s latest safety campaign.

“One issue coming out very clearly in these workshops is the need for more training,” he asserts. “Bodas ride before they’re trained. This is the first time they’re seeing training; one [man] told us that he’s been [a boda driver] for 21 years and has never been trained. There is a gap.”

Thomson agrees: “I learned [to boda] from the streets. No one taught me. All I knew is that if you see a space, you go. That’s why you see bodas going on sidewalks and everywhere. It causes accidents.”
While providing road safety training to boda drivers is an issue being addressed by different non-governmental organizations, like GHVI, training drivers in first aid is new and unique to SafeBoda.

“Many customers like it because I’m giving them a helmet … I’m explaining that we know how to treat someone who has been in an accident, to give the first aid,” says Ashraph Jamada Bamuwa, a SafeBoda driver located at Moyo Close stage in Bukoto, Kampala. “Some of them, they’re now my customers because of that.”