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Interview: VTCA’s Muwaga Hannington on pre-hospital care, worrying crash data; plans and more 

(Last Updated On: 2 February 2023)

Located in the heart of Mukono Municipality, Vision for Trauma Care in Africa (VTCA) has since its inception trained and equipped hundreds of boda boda riders on emergency care, road safety and other topics.

Recently I spoke to the organisation’s Team Leader, Muwaga Hannington who shared with me what they do and have done for nearly a decade. 

This is how he responded to my questions.

First, tell us who you are.

I’m Muwaga Hannington, Team Leader at Vision for Trauma Care in Africa (VTCA). I’m a qualified orthopaedic and emergency care practitioner who has been in practice since 2014 and I do practice from Mukono.

You founded VTCA. What do you do in the community?

We founded VTCA after an experience with cases. These were cases of road crashes. I took the passion to advocate for road safety and how best we can help the victims once they get in a crash. So, my team and I serve Mukono at the moment and also trying to pass out information on road safety to other people and the country.

How many cases (victims of a road crash) have you handled since you started?

We have handled quite many cases. Being my area of practice, in the emergency department of a hospital, five are reported to the facility every day.

What are their conditions when they arrive at the facility?

What is heartbreaking is the state in which the patient comes. Sometimes the way bystanders carry these patients are alarming. Some bring in a patient not knowing how to stop the blood from gushing out. Others just carry the fractures which were a bit stable and made worse by how he or she has been evacuated. So, the state in which a patient comes to the emergency department is not appealing. The people who handle them are not professionals and if they are, then it is not what they can do.

We see that there is a gap and how best we can evacuate a victim from the scene of a crash.

Is there a way you are trying to address these gaps so that patients to be referred here and elsewhere are handled very well?

Yes. We have taken action to address this. One,  we have taken health education to the bystanders or persons to rescue the victims. We are training and. I’m telling them how best to handle this problem next time.

Two, being that boda bodas are the most vulnerable people and immediate mode of transport, we have trained them in basic trauma management, best transportation; managing airways; fracture mobilisation and how they can control bleeding. How best they can make decisions when a crash happens?

How many boda bodas have been trained?

We started with a cohort within Mukono municipality. We have trained 225 boda-boda riders, and we have equipped them with first aid kits to help them execute their duties. These boda bodas are at different stages and they are serving the community and helping themselves as well.

What are some of the challenges they have shared with you in handling this situation?

I have tried to interact with most of them under their body, “Mukono boda boda first aiders”. They have faced a challenge of lack of supplies like gloves, bandages and they say they end up using their hands 

Two, where they refer patients, especially to private clinics, officers there say they are the same people who caused the crash. We find there is no security for them. Another thing is that they tell me that when a patient is in a bad state, they are asked to deposit a patient to be worked on, and if they refer to a government facility, they are told to buy gloves, etc., and that they (the first responders) find it a bit bias after all they are doing a voluntary work.

Are these challenges similar to what you face within the organization here?

They are not different. Being that we are the sole provider of the supplies, we also run out of supplies but we have always called on other people, and partners for them to help us with supplies like gloves and bandages. So, the challenges are not different. We have called upon Mukono district to help us and they promised to do so when the budget is passed.

You have talked about the lack of Good Samaritan Law. What do you think should be done?

First of all, we need to tell the community what the law is because I’m sure most of us do not know it and let them know what it means to rescue somebody. Two, we need to engage our policymakers, we tell them: people have to be protected. Also, we need to ensure that facilities or hospitals where victims are taken know they are serving others, to save somebody’s life.

You seem to be doing many works that need to get the attention of the government. Could there be a plan to share with them a concept of what you do, have done as far as road safety and emergency care are concerned?

Yes. There is a plan to share because we need to mitigate road crashes. We should stop this talk of ‘it’s bad driving’ and ‘stop the blame game’ and involve the youth. The government should involve us and we design the formula for the road infrastructure. We also need to handle behavioural change, repeatedly communicating with different people, the schools and road safety should be part of the curriculum.

We know that a crash happens and when it does what is next? I want to thank the government for trying to put ambulances along the roads with the help of the Red Cross but they are not enough. I can get a crash along the Kampala-Jinja highway and how fast, how best an evacuation happens. Somebody gets a crash in Amuru, up country; an ambulance from Kampala takes good hours to arrive.

We need to develop aeromedical ambulances and aeroplanes. Recently, our minister had a problem but even the aeroplane that evacuated him was not aero-medical. The government is training emergency medical practitioners, and that is okay. So, we need to equip these health centres and make them very functional not buildings – they should be functional.

Every highway should have a functional trauma centre. We have one in Kawolo, and one in Mulago; Masaka, Nkozi, Mityana and Mubende.

You have engaged with boda bodas for quite some time and I don’t know if you have had a chance to teach team road safety. When you look at those who die you find that those who had not put on helmets are gone or get injured – the same applies to drivers and passengers who abuse seatbelts. What do you tell them?

When we are selecting boda bodas for training there are criteria we follow. One, someone should have a valid riding permit, reflector jacket and helmet. We also tell them ‘please your life first’. The reflector jacket shows a driver that the (boda bodas) exist on the road and that they should at all times have their helmets on.

Of the boda bodas you have trained or been evacuated to your facility or elsewhere, if you know, how many have died due to a road crash?

Among those we have trained, three have lost their limbs and seven have passed on (these are not part of us). I got a report that they died on the spot and I try to find out the causes of death or crash. I was told three of them did not have helmets and others died due to a head-on collision along the Northern bypass. 

Among 225 cohorts, two got minor injuries and three lost their limbs.

Some of the body riders during training on emergency care.

What are your strategic plans going forward?

One, we want to disseminate the training not only in Mukono. We want to move to different areas because boda bodas do not only live in Mukono. We want to increase the number of those in pre-hospital emergency care. We will not only consider boda bodas but we need to train lay people (bystanders) who regularly take pictures after a crash.

We are planning on a campaign to have road safety in schools since most crashes are about behavioural change. We plan to develop an emergency call centre which is functional.

About the call centre, is there a time frame?

Yes. We want to have it in two years.

Statistics now show that 12 people die daily due to road crashes. Does this worry you?

It (really) worries me. That means, in my simple mathematics, “Every minute there is somebody who is dying.” We all know that malaria has a treatment plan. I’m sure we also can have a plan on how to stop traffic crashes.

What is your call to the general road users?

My call to them is that we are all victims of road crashes. Let us be one who is unborn. I call upon everyone to be vigilant, and curious about how we use the roads. Let us not be part of the statistics of road crashes; let us be advisors to others. When we join hands we can change these numbers.

Let us stop needless deaths and disabilities due to road crashes.

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