FOCUS ON – World Day of Remembrance for Road Traffic Victims: highlight on Burkina Faso. | November 19, 2017
This Sunday, November 19 will be the World Day of Remembrance of the Road Victims. On this occasion, we would focus on the barrier to access to functional rehabilitation for the victims. In Africa, road traffic injuries are the leading cause of death among young people aged 15 to 29 and the fifth leading cause […]
This Sunday, November 19 will be the World Day of Remembrance of the Road Victims. On this occasion, we would focus on the barrier to access to functional rehabilitation for the victims.
In Africa, road traffic injuries are the leading cause of death among young people aged 15 to 29 and the fifth leading cause for the entire population. It is also an important cause of temporary or permanent disability for a large number of road accident victims. Actions to reduce or prevent these accidents are scarce and studies on the evaluation of the accidents and their consequences on health have been rare.
The Research Institute for Development, Handicap International and the Chaire REALISME have conducted a study in Ouagadougou, to measure the number of road accidents, the number of victims and injured, as well as their health status from their admission to the hospital up to one year after the accident.
The consequences of road accidents are long-lasting and costly. Among the sample interviewed, the cost of care in the year following the accident was an average of 400,000 XOF, a catastrophic health expenditure for the vast majority of households in Burkina Faso.
One year after their accident, 8% of patients still use crutches to get around and 13% of those interviewed express a need for re-education since the accident, but they also say they have financial difficulties to access it.
Patients are forced to give up treatment or to stop rehabilitation, either because they do not want treatment in the public health system, which they consider to be of poor quality, or because of the cost of care.
“I was doing my rehabilitation at the center next to the cathedral, but I left because it is an expense. Really you cannot afford to follow because the session costs 5,000 XOF. I did 3 sessions a week, I saw that I lacked the resources ; that’s why I stopped that for the moment. So I try to do it myself at home with those who are with me. “
(Honorine, hotel worker, 30 years old, single)
The needs for functional rehabilitation are important, but the supply is low and expensive for the poor. Rehabilitation care is not taken into account in the health system and is not integrated into the minimum package of training for health services. Beyond the high cost of physiotherapy sessions, the availability of qualified personnel and the geographical accessibility constitute additional access difficulties.
Access to prostheses or rehabilitative care is also very uneven. Burkina Faso has few rehabilitation centers at the national level, and caregivers give little incentive for patients to seek rehabilitation. In 2014, an analysis of the Ministry of Health (Ministry of Health of Burkina Faso, 2016) shows that only 2% of assistive device needs and 4% of physiotherapy needs are satisfied due to lack of personnel and structures.
“The boss said he will take care of the prosthesis. He had me send pro-forma bills, but until then he still did not say anything. The 300 000 FCFA are for the prosthesis and the 10 000 FCFA are for the shoe: I need help for the prosthesis; I really need help. I cannot say to give me money so that I can eat; I prefer to ask for a job, to try to get out of it. “
(Saydou, 32, business employee, leg amputee and father of two)
The circuit of legal compensation is complicated and inequitable
Of those surveyed, 21% did not complete the legal process of their accident one year after the accident. However, legal compensation is crucial because it contributes to household expenses for care, especially for patients who need rehabilitation or prosthesis. But the stages of legal compensation are numerous and long. It begins with confrontation at the police station and sometimes continues in court. The whole population does not have the knowledge and the help they need to assert their rights.
“We filled out all the police forms and went to testify but until then we were not called back. I have someone who takes care of it. He said that as those from the justice department did not do the work first, until then there is no continuation. He said the judge in charge of the case said to calm down and wait for the activities to resume properly. “
(Issiaka, 32 years old)
The recommendations of the study
The IRD, Handicap International and the Chaire REALISM have identified key recommendations to facilitate access to functional rehabilitation for victims of road accidents in Burkina Faso:
- Increase the number of rehabilitation services,
- Provide training for rehabilitation professionals,
- Integrate rehabilitative care into the minimum packages of health training activities,
- Reduce the costs of care for all and ensure the exemption for the poor,
- Develop legal assistance to enable victims to assert their rights.
About the study:
A research conducted in 2015 evaluated the number of accidents and injured and their health status immediately after the accident and seven days and thirty days after being treated at the University Hospital Yalgado Ouedraogo. 1843 accident victims were followed, 38 of whom died (Bonnet et al., 2015).
In 2016, this research was complemented by a survey of 443 road accident victims who were unable to perform a daily task, 30 days after their accident. We also met 14 people to better understand their path of care, costs and judicial consequences of the accident.
Authors: Emmanuel Bonnet, Clement Bagnoa, Philippe Allard, Eric Remacle, Georges Rouamba, Valery Ridde.