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The strategies considered as the best for Population Health report

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A general overview of health problems and road traffic accidents

One of the leading causes of life-long disability and death throughout the world has been considered to the occurrence of road traffic injuries. Approximately about 1.24 million people around the world die on the roads of the world annually along with another 20-50 million people being subjected to non-fatal road accident injuries. The research concerning road safety in developing countries like South Africa has been rather scarce. There has been an acute increase in the number of road accidents in South Africa observed over the span of last three decades as stated by (Verster, and Fourie, 2018). Since transport through means of air, rail or water has been relatively high, the usage of road vehicles has seen an upsurge. However, in order to comply with this usage of road transport, there has been almost no effort made in order to improve the road infrastructure in order to ensure the safety of the commuters who are exposed to the road and the unsafe environment around it on a daily basis. According to (Bikam, 2019), between the years 1990 and 2010, an increase in the number of road accidents has been observed to go up by 46%. It is frequently observed that it is much likely for the severity of road accidents to be a lot more in South Africa than any other country taken into consideration. The main reason that seems to be behind this is the involvement of several vulnerable road users as well as a derogatory condition of public transport. These conditions often tend to include overcrowding, the lack of seatbelts and vehicle environments that are deemed to be rather hazardous.

In South Africa, a multi-disciplinary approach has been taken into consideration in order to tackle the increase in road traffic accidents (RTAs) which started to pose as a major public health issue. In sub-Saharan countries, the rate of fatal injuries being caused by the increasing road car accidents has become rather alarming as stated by (Gutierrez-Osorio and Pedraza, 2020). This trend of an alarming increase has started to become a real and major issue of public health challenge in the face of all the organisations and agencies that are concerned for the prevention of the same. Ample number of approaches which have been taken in order to reduce the number of injuries caused by road car accidents have mostly turned out to be half-hearted or ineffective. Every day, over 1.35 million people are killed on the road as a result of accidents throughout the world. Road accidents are a primary cause of mortality for people all over the world for a number of causes, including drunk driving, unskilled driving, malfunctioning cars, poor visibility, distracted driving, failure to utilise helmets, seat belts, and kid restraints, and a lack of road infrastructure (Power, et al.,2020). In order to help in the prevention of this public health catastrophe, strict implementation of traffic rules, creation of a sense of awareness and methods of scientific engineering need to be properly devised and put to use.

South Africa is plagued by a slew of health issues. Following the disastrous pandemic crisis in 2020, there are a lot of health-related hazards that humanity must take extremely carefully. This virus had had a significant impact on public health, and even now, as it nears its conclusion, we are still not completely free of the risk factors it left behind. There have been instances when several policies have been taken into consideration for the prevention of road car accidents and for the initiation road safety initiative. There have been situations where like higher traffic fines have been imposed so that people take driving at reasonable speed. There have been imprisonments and fuel levy insurance to cover accident claims as well as other forms of punishments that have been taken into consideration for the prevention of road rash to prevent road car accidents. Under new policies, several non-government organisations have planned for literary campaigns that include spreading awareness for the control of road car accidents in the country as stated by (Murphy, et al.,2019).

About road accidents, almost 1.35 million people around the globe are killed on the road due to accidents every day. Road accidents are a leading cause of death of people around the world and there can be several reasons for the same like- drinking and driving, incapable drivers, faulty vehicles, lack of visibility, distracted driving, non-use of helmets, seat belts and child restraints, lack of road infrastructure etc.

As per (Moorthy, and Sankar, 2020), it is generally noticed that the severity of traffic accidents is substantially higher in South Africa than in any other country taken into account. The major explanation appears to be the engagement of various vulnerable road users, as well as a deplorable state of public transportation.One of the most significant points about road traffic accidents is that 93% of these occur in the low- and middle-income countries which are also the owner of 60% vehicles around the world. Due to such road fatalities the countries lose 3% of their GDP individually and most of these accidents occur to people aged between 5 to 29 years as per (Qureshi,et al.,2020).

Health problems prevalent in South Africa
It has been observed that people mostly focus their attention on coping with financial setbacks and the apparent physical injuries that have occurred as a result of any road car accidents. In South Africa, though several cases of road crash incidents result in fatal injury, a greater number of people are subjected to deal with long term physical injuries and health disorders such as strokes and other heart diseases. However, one of the most common form of health issues that prevail in a person after they have been through a car crash, is the psychological effect of the apparent emotional distress which seems to fade away but prevails as mental health problems as per (Lin, Gong,and Dai, 2018). These mental health problems include:

• Acute and Post-Traumatic Stress Disorder
The most common health issue which the survivors of road car accidents tend to face is PTSD or Post-Traumatic stress disorder. The primary causes of post-traumatic stress disorder in these individuals with non-fatal injuries is accidents caused by that of motor vehicles. These accidents might also lead to Acute Stress Disorder or ASD which is very similar to PTSD and shows multiple same symptoms but lasts only for a few weeks.

• Persistent Anxiety
There have been instances when the survivors of road car accidents suffer from mild anxiety or minimal anxiety for months. However, studies say that there could be change of severe levels or moderate anxiety which can be present for several weeks in the survivors. It has been observed that persistent anxiety has been more susceptible to women who have been a part of the road car accident even 6-8 months after the crash as per (Lin, Gong,and Dai, 2018).

• Major Depressive Disorder
It has been noticed that depression mostly comes hand-in-hand with the physical injuries of the person surviving in the crash as a result of the sustaining pain. The physical injuries and pain which tend to restrict the survivor from taking part in his daily chores or regular activities plays a pivotal role in giving rise to depression which is clinically known as major depressive disorder or MDD.
Road traffic problems in context to South Africa
It has been observed that the heavy burden of road traffic problems that exist in South Africa have become one of the leading factors that cause death and morbidity in the country as per (Mokoatle, Vukosi Marivate, and Michael Esiefarienrhe Bukohwo, 2019). In this case of South Africa, there have been observed a bunch of risk factors and traffic problems which tend to play a pivotal role in causing these road accidents and fatalities. These factors are comprised of the following:

• Speeding
The World Health Organization has put to light that there has been observed an increase of 3% injuries and fatalities occurring on road as a result of an the average speed of vehicles being raised by1 km/hr. This increase in the average vehicle speed has also observed an increased risk of fatality in these road accidents by 4-5%. The main explanation lying behind this data is the fact that a higher stopping time is required by the vehicles running at higher speeds which require a greater distance to stop when required.

All road users are put under the risk of injury and are prone to accidents as a result of vehicles with increased speed. Studies have shown that the risk of car passengers from vehicles running at 80km/hr is 20 times more than that of a vehicle that runs at 30km/hr. the pedestrians are also put at a higher risk because of speeding vehicles. It has been observed that when hit by a car running at 30km/hr, they have a 90% rate of survival. However, if hit by a car running at 45 km/hr, their chances of survival drop below 50%. the majority of South Africans have been seen to exceed the mentioned speed limits while travelling in South Africa as per (Feng, et al.,2020).

• Alcohol
It is a fact known to all that a drunk pedestrian or a drunk driver has their senses impaired the action of alcohol on their body and thus leads the restriction and slowing down of their actions and numbing of instincts on the road. The World Health Organization has thrown light on the fact that any crash is 17 times more likely to happen in case of an alcohol impaired driver as opposing to a sober driver.

It has been noticed that there is long standing battle that exists between the South Africans and alcohol consumption. This has been considered to be one of the pivotal reasons in problems arising against public health care and safety. This has been apparently understood by the help of statistics where during the times of any festivity, there have been instances of multiple drivers being caught because they have been driving under the influence of alcohol. A survey conducted by the World Health Organisation stated that South Africans have the highest number of accidents which tend to occur as a result of driving under influence the main reason appears to be the lack of stigmatization among the people for the ones who are often known to indulge in this sort of practices.

• Unsafe vehicles
The neglect of vehicle disputes which often include the negligence of basic maintenance tends to be a pivotal reason in causing defects and problems in brakes, lights as well as the tyres. Approximately 9% of the road accidents have been observed to be a result of these defects which are often left unheeded by the drivers (Feng, et al.,2020). It has been observed that these vehicle defects mostly consist of problems with the tyre and closer inspection the vehicular parts are supposedly considered highly beneficial for determining whether the crucial automobile parts are fit for usage on road and without posing any added threat by causing road accidents. The minibus taxis in South Africa have primarily been the culprit in matters such as this and as a result have to undergo mandatory tests to pass roadworthiness.

• Usage of seatbelt and child restrainers
Studies have reported that the usage of seatbelts have varied in South African drivers from 45-60 % and was notices to be much lower in the Central Business Districts. It has been found that the main reason behind this is the fact that the drivers tend to consider the seatbelt to be rather unimportant while travelling in environments that promote low speed. Shifting the focus to the usage of child restraints, hospitals are known to have treated 20 child passengers on an average who have been brought in as a result to being subjected to road accidents.

• Infrastructure
Segregated and fragmented planning and development have been continuously observed in South Africa as a result of Apartheid planning. The household present in recklessly developed areas which houses people with low-income have been considered to be the real victims of these accidents. The areas that they reside in tend to have proper roads and sidewalks and at times not even proper lightings. The problems tend to continue even through the amount of pedestrian movement in these places is quite high thus making them prone to road accidents.

• Distractions
It has been acutely notices that the presence of distractions while driving leads to an increased risk of road car accidents. The focus of drivers shifting from the road while they drive has been one of the pivotal reasons. Common distraction often includes behaviors like applying make-up or talking on cellphones as well as eating food. They is an increase of 23% chance of accidents when the driver has been texting as they drive (Feng, et al.,2020).
Internationally recognized strategies to reduce road traffic accidents

Since road accidents have become very common, as discussed above, the United Nations have set some standards in order to reduce it by one half of its number currently (Feng, et al.,2020). Following are the road safety measures as set by United Nations:

For the drivers:
1. No matter how short a trip is, always use a seatbelt when in car, a helmet when on bike and a child restraint.
2. Do not drive when intoxicated with alcohol or drugs. Drive while you are completely sane and capable of making road judgements.
3. Do not overspeed. Always drive in the prescribed speed limit.
4. Do not get distracted while driving. Keep your focus on the control of the car, and on the road.
5. Do not use headphones while driving.
6. Obey the traffic signals and have a proper knowledge of the roads.
7. Do not drive at a stretch for long hours, it stresses the mind and hence causes accidents due to lack of visibility. Take proper safety break after every 2 hours while driving.

For the Pedestrians:
1. Be alert when crossing streets. Obey the traffic signals. Look both ways and then cross. While having a child along with you, take extra care while crossing. Use the zebra crossing.
2. Try to ride in taxis that have seatbelts in them.
3. Try to avoid riding in overcrowded or overweight public vehicles.
4. Do not cross roads while intoxicated.
5. Avoid rushing on the road. Consider going out with enough time in your hands.

The strategies considered as the best for this report
As the strategies were discussed above, the following two for each of the cases have been considered as the most effective for this report.

• Health strategies:
As per the discussion above, I think the most effective strategy to counter health issues is to regularly consume a balanced diet and workout on a regular basis. This is because, before any external measures to be considered, it is important that we keep out internal system fresh and effective. When one has his internal organs working well and has the system on track with regular exercise, he/she can easily overcome different diseases without much effort. Moreover, the intake of optimal macro nutrients can keep the human body even more healthy (Moorthy and Sankar, 2020)
It is to be understood that a very effective strategy against health issues is getting vaccinated. Vaccination is an important step to enhance the immunity of a person against several diseases. It is important for a person to take all the prescribed vaccine at all stages of life to stay protected against fatal and deadly diseases like small pox, covid 19, tuberculosis etc. Moreover, it is also important because sometimes a person might be carrying germs in his body that could affect another person and, in that case, if both of them are vaccinated, none of them stays at risk (Dwyer, et al.,2020)

• Road safety strategies:
From the discussion in the previous segment, I think the major reason of so many road accidents in South Africa the other parts of the world is because of over speed driving. As per (Qureshi,et al.,2020), 202 people were killed in the year 2020 for over speeding in South Africa. Therefore, I think people should care more about the speed limit they are reaching while driving a car or a motor cycle. This way both the driver as well as the pedestals can be saved from fatal accidents and injuries. Moreover, the drivers should consider the roads, turns and speed breakers. The traffic rules should be made stricter to avoid such accidents.
Drinking and driving according to me, is the second most important aspect to be considered about road accidents. People should start being more careful about their intoxication limits and drive only when they are completely in their senses. Even if a person is intoxicated, he should let another person drive or drop him/her home instead of taking careless risks that could prove fatal for him/her as well as the pedestals on the streets. Moreover, the traffic police should also be stricter about this and increase the number of check points for preventing such cases (Qureshi,et al.,2020).

Conclusion
From the above discussion, it is clear that above everything the life of a person is the most important. However, for the same, the citizens of South Africaneed to be more responsible about their health and the health of the ones around them. Since it has been observed that over the last three decades, there has been a significant increase in the number of traffic accidents in South Africa and since the use of air, rail, and water transportation has been quite high, the use of road vehicles has increased. They need to take better care of their health by starting to be more active physically, quit smoking, consuming a balanced diet, getting properly vaccinated etc. However, virtually little effort has been made to upgrade road infrastructure in order to protect the safety of commuters who are exposed to the road and the harmful environment surrounding it on a daily basis in order to comply with this utilization of road transport.They should start taking hygiene even more seriously since it is the starting point of staying healthy. People should be washing hands more often, keep themselves clean, eat clean, keep the air around them clean, sanitize surfaces frequently etc. By following these health standards, a better and healthier atmosphere can be achieved which can result in a better environment for all of us.
For the ones driving and travelling on street, they need to be more responsible and careful about themselves. People should start wearing helmets and seatbelts more often, obey traffic signals, use zebra crossing, drive under prescribed speed limits, stop drinking and driving etc. to avoid meeting with fatal accidents. Moreover, it is important that the traffic rules are made stricter in order to prevent such accidents from occurring.

Recommendations
As the discussion above follow, here are some recommendations that could help this report be better at understanding:
• People should start taking better and proper care of their living standards in order to avoid health issues.
• People should stop smoking cigarettes in order to live a longer and healthier life.
• People should start taking proper diagnostic care and treatments in order to avoid health issues.
• People need to start working out regularly along with the consumption of proper nutrition.
• People need to undertake proper sanitization and hygienic standards.
• People should start wearing masks when they are sick to keep the air around them clean.
• People should start obeying the traffic rules and drive under a limited speed.
• People should start wearing seatbelts and helmets more often, even if it is a small trip.
• People should consider driving only when they are completely in their senses.
• The traffic rules should be made stricter and penalties should be increased for any kind of discrepancy in the rules.

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