Medico-legal aspects regarding drunk driving: experience and competency in practice of community service doctors

Background: Drunk driving has been reported to increase the risk of road traffic accidents associated with death and severe injury.In South Africa, an increase in blood alcohol concentration of as little as 0.01 g per 100 ml above the legal limit may warrant criminal prosecution or the denial of an insurance claim for damages. However, multiple court cases have been withdrawn because of the incompetence of officials at various stages of the investigation. The scope of the mistakes range from poor scene handling to the incorrect handling of blood samples at the laboratory to eventual laboratory testing of blood samples. Using a group of community service doctors (CSDs) as a cohort study group, this study investigated the competency of medical graduates in relation to the medico-legal aspects of drunk driving.Methods: A self-administered questionnaire-based study was done with 150 CSDs. The questionnaire was administered in Afrikaans and English and was dispatched electronically via e-mail. All potential participants were contacted telephonically to obtain verbal consent. Results are displayed as percentages.Results: A response rate of 59.3% was achieved. The results obtained in this study confirm that some CSDs lack competency in handling medico-legal aspects relating to drunk driving, and are thus unable to serve the communities they have been assigned to adequately. Their lack of skills and knowledge suggests that the present undergraduate Clinical Forensic Medicine curriculum is inadequate.Conclusion: It would be beneficial to revise the curriculum for Clinical Forensic Medicine in undergraduate medical training to address the gap in knowledge and practice of various demands of forensic medicine required from new medical graduates and CSDs

A Survey of Commercial Drivers' Perception on the Causes of Road Traffic Accidents in Nigeria

Background: Road traffic accident is a multifactorial phenomenon that affects victims to different degrees depending on the type of accident. The aim of this study was to study commercial driver's attitude and their perceived causes of accidents on Nigerian roads.Methodology: A cross-sectional study of commercial drivers from various motor parks in a Nigerian urban city was carried out using questionnaires. Every volunteer was asked to complete a questionnaire that revealed patient demographics; age; education level; time of accident and perceived cause(s) of the accident. All participants were males and licensed drivers.Results : Drivers in the age range of 38 - 47 years (n = 174; 46.77) were mostly involved in road traffic accidents. Road accidents were much more prevalent on rural roads than on urban roads. Majority of the drivers (n = 198; 53) had secondary level of education; while 112 drivers (30) had primary level of education. One hundred and eight drivers (29.03) believed the accidents were as a result of the road. 21.24 (79) stated that the time of the day; which could be in the daylight; dusk or at night; could influence road traffic accidents.Conclusions : The drivers perceived that the nature of the road; time and weather are some of the major contributory factors to road accidents. However; it was deduced from the study? that behavioral patterns on the road; violation of traffic rules and driving under the influence of alcohol were the major contributory factors in commercial drivers' involvement in vehicular accidents

Ambulance or taxi? High acuity prehospital transports in the Ashanti Region of Ghana

Introduction: African emergency medical services (EMS) systems are inadequate, thereby necessitating its selective use. This study aims to investigate differences in mode of arrival to the Emergency Centre (EC) at Komfo Anokye Teaching Hospital in Kumasi, Ghana by acuity, injury and referral status. Methods: A cross-sectional survey was conducted in the EC at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, in 2011. A survey was administered to all patients triaged to the EC. Patients were excluded if they were under 18 years of age, unable to communicate in English, Twi, or Fante, had altered mental status, or were deceased. Data were inputted into an excel spread sheet and uploaded to SPSS. Descriptive statistics were computed. Inferential statistics were performed testing for differences and associations between modes of arrival and acuity level, referral and injury status.Results: Of the 1004 patients enrolled, 411 (41%) had an injury-related complaint, and 458 (45.6%) were inter-facility transfers (''referrals''). 148 (14.8%) arrived by ambulance, and 778 (77.6%) non-ambulance (38% private cars, 38% taxis). 67 (6.7%) were triaged as Red, 276 (27.5%) as Orange, and 637 (63.4%) as Yellow (highest to lowest acuity). Ambulance arrival was positively associated with a higher triage score (OR: 1.53). Patients referred from other facilities were almost twice as likely (OR 1.92) to arrive at the KATH EC via ambulance than those not referred. Patients with injuries and higher acuities patients were more likely to be transported to KATH by ambulance (OR 1.86 and 1.87 respectively). All results are highly statistically significant. Conclusion: Although a minority of patients were transported by ambulance, they represented the most acute patients arriving at the KATH EC. Given the limited availability of EMS resources and ambulances in Ashanti, selective ambulance use appears warranted and should inform prehospital care planning

Taxi 'Sugar Daddies' and Taxi queens: Male Taxi Driver Attitudes Regarding Transactional Relationships in the Western Cape; South Africa

Media reports are emerging on the phenomenon of young girls who travel with older mini-bus taxi drivers; and who are thought to have sex with the drivers in exchange for gifts and money. The extent to which such relationships might facilitate unsafe sexual practices and increased risks for both the men and the young women; often referred to as taxi queens; remains an important question in the light of the current challenges of HIV/AIDS in sub-Saharan Africa. However; very little research has been undertaken on this issue; especially regarding the perceptions and experiences of taxi drivers. Thus this paper aims to provide some preliminary findings on taxi drivers' attitudes and beliefs about taxi queens and their relationships with taxi drivers. A 22-item questionnaire was administered to 223 male taxi drivers in two regions in the Western Cape Province; South Africa. Taxi drivers in this study largely saw the relationship between taxi drivers and the young girls who ride with them as providing status for both the girls and drivers; and there seemed to be recognition of the transactional nature of the relationship between taxi drivers and taxi queens. The stigmatisation of young girls who ride with taxi drivers was evident. Drivers had knowledge and awareness of the risks of unsafe sex and supported condom use; although there appeared to be some uncertainty and confusion about the likelihood of HIV infection between drivers and girls. While taxi drivers recognised the role of alcohol in relationships with young girls; they seemed to deny that the abuse of drugs was common. The study highlights a number of key areas that need to be explored with men in the taxi industry; in order to address risk behaviours for both taxi drivers and the girls who ride with them

Kwazulu-Natal Minibus Taxi Drivers' Perceptions on HIV and AIDS: Transmission; Prevention; Support and Effects on the Industry

In South Africa; the minibus taxi drivers are largely becoming another high-risk category in the HIV and AIDS epidemic. Although previous studies have shown that knowledge of HIV and AIDS is relatively high among the taxi drivers it is still not clear how this sub-population perceive the support rendered to them with regard to HIV and AIDS prevention strategies. This study aimed to focus on this atypical workplace and explore the KwaZulu-Natal; minibus taxi drivers' perceptions on HIV and AIDS. In this study; qualitative methods were utilized to determine the minibus taxi drivers' understanding of HIV and AIDS infection; HIV prevention strategies; existing support strategies and effects of HIV and AIDS on the taxi industry. Focus-group discussions were conducted; to collect data. The results showed that even though the taxi drivers had some understanding on HIV and AIDS there was still a dire need for interventions that were geared towards addressing HIV-related needs of the drivers in this industry

Knowledge, attitude and use of seat belt among commercial drivers in Sokoto Metropolis

Background: Every year about 1.2 million people are killed on the world's roads and up to 50 million are injured or disabled as a result of road traffic accidents. The effectiveness of seat belt usage in reducing the severity of the sequelae of road traffic accidents is widely known. The aim of this study was to determine the knowledge, attitude and use of seat belt among commercial drivers in Sokoto Metropolis.Methods: The study design was cross-sectional and descriptive. Pre-tested, structured, interviewer administered questionnaires were used for data collection. Each correct response to the knowledge questions was scored one mark and wrong response or non-response was scored zero.Results: A total of 430 questionnaires were analyzed. The mean knowledge score (%) of the study subjects was high (64.8±17.7). Majority (57.9%) of the respondents had positive attitude towards compulsory use of seat belt. 363 (84.4%) of the respondents reported that they use seat belt when they drive. There were statistically significant associations between age (p<0.0001), ethnicity (p=0.02), education (p=0.001) as well as attendance of driving school (p=0.000002) and the reported use of seat belt.Conclusion: This study has identified high level of knowledge, positive attitude and reported use of seat belt. It is recommended that public awareness of the safety benefits of seat belts and strong enforcement are necessary to achieve optimal use of seat belt

Accidents and Injuries: Message from The Uganda National Road Safety Council

"The national Road Safety Council (NRSC) has been at the forefront in raising road uders' concern and commitment towards road safety as an effort to address the accident challenge. During 1996; the council was involved in various safety campaigns aimed at reducing and controlling accidents on Uganda's roads. The road safety week is the climax of the activities carried out by the council each year. The theme for 1996 road safety campaign week was: ""Avoid death and destruction on the road"". The 1996 road safety week started on 9th December with a ministerial statement by the Minister of Works; Transport and Communications. The week was observed nationwide. Emphasis was placed on districts found along the Northern corridor i.e. Malaba-Kampala-Kabale highway. this route registers heavy traffic and a high accident rate. The council members joined the district leaders in road safety activities. The climax of the week's events were during the closure on 17th December 1996 at the constitutional square. it included marching along the streets of Kampala by the transport associations; children and police officers. An appeal was made to the Public Service Vehicle drivers to adopt safer practices by valuing the lives of the travelling public. Speed precipates accidents. The situation becomes worse during Christmas and other festive seasons when there is general excitement in society . The NRSC distributed posters during the 1996 Christmas season with a message ""don't drink and drive"". The travelling public should be safety conscious and actively monitor the drivers' behaviour. Finally; an appeal was made to all road users to adopt safety practices in Uganda's traffic system."