Bystanders dear the wreckage of an a minivan involved in a road crash recently
Road traffic injuries remain the leading cause of trauma in Uganda, contributing up to 13 per cent of all deaths, a new emergency care survey has revealed, with health experts warning that many of these fatalities are worsened by improper first response handling at accident scenes.
Medical professionals say that while some accident victims may survive the initial impact, many die or suffer irreversible damage because of how they are lifted, moved, or transported before receiving emergency medical care. The president of Uganda Medical Association (UMA), Dr Herbert Luswata, explains that in most road traffic accidents, well-meaning bystanders often rush to assist victims by lifting or moving them without proper medical training, an act he says can cause further internal injuries, especially to the head, spine, or chest.
“One of the silent contributors to trauma-related deaths is the way casualties are handled right after accidents. You find someone with a spinal injury being lifted onto a motorcycle or into a pickup without any neck or spine support that worsens their situation,” Dr Luswata says.
UMA president says the major effect lies within the uneven distribution, where type C ambulances are mainly covering Kampala, metropolitan areas, and some cities that have come up.
“In the far areas, the type of ambulances we have are type A, which are more of carriers with usual non-medical personnel. We lack basic emergency services in regional hospitals like emergency chest x-rays, emergency ultrasound scans, and emergency CT scans for brain injuries or brain trauma,” Dr Luswata said.
He added: “This is a big problem because sometimes even in our national referral hospital like Mulago, when they bring accident victims with a head injury, sometimes you cannot be able to carry out a brain CT scan as immediately as required and we end up referring patients outside Mulago to go and do brain CT scans and then come back and we work on them.”
In response, the Ministry of Health stated its plans to train boda boda riders, police, and community first responders, recognising that these groups are often the first to arrive at crash scenes or to call for help. According to the State Minister for Health in charge of general duties, Ms Anifah Kawooya, the goal is to create a basic but effective front-line emergency response network that can stabilise victims before proper evacuation, as the country still faces a major shortage of ambulances, especially along key highways, with a reported decline in deaths.
“We still face a significant shortage of ambulances, particularly for road traffic emergencies. For example, along the Kampala–Masaka Highway, a hotspot for road crashes, there is no dedicated highway ambulance. The nearest one is stationed at Masaka Regional Referral Hospital, which is far from many of the accident scenes, and that delay puts lives at risk,” she said.
At the national level, according to Ms Kawooya, Uganda currently has about 253 ambulances, and an additional 10 are deployed for emergencies along water bodies, which are insufficient for the population and geography. She noted that every major route and constituency should have a well-equipped, functional ambulance. But the largest proportion of these are type A ambulances that lack equipment and trained medical personnel, on which many communities still rely. Road accidents account for nearly 70 percent of cases at facilities such as Mulago National Referral Hospital.
Emergency care
According to the Emergency Care Systems Survey Report 2024, released on the International Emergency Medicine day in Kampala on Tuesday last week, further states that Uganda registered 133,935 emergency cases throughout 2023 across various regions, with the Albertine region having the most cases. 35.8 per cent of these emergency cases led to admissions for further treatment and observation, 2.1 per cent resulted in death, and 17 per cent of the cases documented were trauma and injuries.
Despite the survey reporting a 50 per cent reduction in emergency-related deaths in recent years, the commissioner for emergency medical services, Dr John Baptist Waniaye, noted the gravity of the situation.
“We continue to record high numbers of deaths from trauma, road accidents, infectious diseases, and mental health crises. It is essential that emergency medicine be prioritised to ensure a rapid, skilled response to life-threatening conditions.
‘‘Many regional referral hospitals cannot conduct emergency brain CT scans, which are critical for trauma cases. Even the few emergency physicians being trained are not fully absorbed by the government, and we are strongly calling for a specific budget to support their recruitment,” he said.