How 16-Year-Old Girl Lost Both Arms in Boda-boda Crash

When schools opened in January this year after nearly two years of closure in a bid to control the spread of Covid19, Ruth Nalubega, was not be among the children who reported back. Not because she is no longer interested in learning, but because she is unable to write anymore.

The 16-year-old girl lost all her arms in a boda-boda crash on July 24 last year. This means she needs to learn other skills like writing with toes if she is to go back to school or secure herself artificial limbs. Nalubega’s woes started when she stopped a moving Boda-boda in Mukono town at around 6pm to take her to Lugazi town, a distance of 18km.

At the time when Nalubega was involved in a Boda-boda crash, Uganda was in her second total lockdown where public and private vehicles including motorcycles were not allowed to move. Moving on the road with a vehicle or a motorcycle was a privilege for only essential workers but still with stiff restrictions.

President Yoweri Museveni banned inter-district movement. However, Nalubega had just paid visit to her uncle in Mukono Municipality. But as weeks passed by, she developed the urge of going back to be with her siblings and parents in Kigenda, Lugazi town, Buikwe district. Since she had limited movement options. She boarded an ‘errant’ Boda-boda rider. Motorcycles like other public and private means of transport had been banned to ferrying passengers save for cargo.

With her bag at the back, Nalubega stopped a moving motorcycle at a quarter past 6pm which was just a kilometer to Mukono town. But her journey was abruptly cut when a speeding truck hit them from behind and she landed beneath.

“I found myself under the tyres. I briefly cried for help but I eventually lost conscious. I don’t remember how people removed from the tyres and took me to hospital. I regained my conscious when I was at Mulago hospital and I didn’t have any of my arms,” Nalubega recalls.

The crash which turned Nalubega into a now a person with disability happened near Mukono police station on the Kampala -Jinja highway. This road falls in the Kampala Metropolitan East policing region. The region, according to police road cash statistics, registers an average of 1,400 crashes every year of which more than 200 involve death. For instance, the road safety and traffic report of 2020 shows 1,501 crashes occurred in Kampala Metropolitan East but 234 involved loss of life.

Most of the victims of road crashes on Jinja-Kampala highway are rushed to Kawolo hospital for treatment. Nevertheless, those in critical state like what Nalubega was in, are referred to better health facilities. Dr Haruna Wamala, the Kawolo hospital administrator, says they register over 30 patients of motorcycle crashes every quarter.

“For motorcycles we normally get between 30, for bicycles we have 28 since we are in a peri-urban area. It is normally during night time. This is because the police are not on the road, no police near the black spots like Mabira and Bulyantete. Sometimes when I leave work by 5pm, we may not have gotten any crash victim. But when you come to work in the morning, the ward is full with different crash types,” Dr Wamala explains.

Faridah Nampiima, the traffic police spokesperson, while releasing statistics for the week  of February 28 and March 6 this year, she attributed the 89 deaths of which Kampala East had five fatalities due to speeding, not wearing seatbelts and reckless usage of the road. These are the same factors that have been cited year in year out as leading in causing road crashes.

“We appeal to all road users to use the roads with due care. We remind all road users that road safety begins with you. Avoid behaviours that would lead you to miss use the road. We expect every road user to be considerate to each other,” Nampiima emphasizes.

Ndugu Omongo, the executive director of Uganda Professional Drivers Network –UPDN, argues that lack of training for Boda-boda riders is one of the major reasons behind these crashes. Omongo believes if there were training centres for riders like it is for drivers, it could help to instill skills and discipline into motorcyclists.

“The Boda-boda job is seen as a survival venture for many youths. They buy motorcycles or ride for their bosses without any skills. Many don’t know what road signs mean. Trainings schools teach someone how to be patient and how to respect other road users. Many Boda-boda riders are impatient and they get knocked for that,” Omongo says.

Francis Abigaba, whose treatment for motorcycle head injury, according to hospital documents seen by this reporter, cost more than 9 million shillings describes his Boda-boda job as a deadly one.  Abigaba was treated at Mulago hospital and still receives post trauma treatment. He believes he was knocked by an amateur rider.

Abigaba was hit at around midday on Ngangi-Kitutu road in Kibaale district by another motorcyclist in December 2019. Kibaale district falls under Albertine region. Police reports show road crashes claim more than 200 people in Albertine region every year.

“I had never held in my hand the 9 million shillings I spent in the hospital. Even at the time of the crash, I was had only saved Shs500,000. I was helped by my brother who is a priest and friends. I spent seven days in ICU and I believe I could have died if my brother had not rushed me to Mulago hospital,” Abigaba explains.

Dr Olive Kobusingye, a renowned injury epidemiologist and former head of trauma unit at Mulago National referral hospital, agitates for complete ban of boda-boda transport in crowed areas like Kampala. The two wheels mode of transport according to Dr Kobusingye should be replaced with mass carrier buses.

Without prioritizing mass carrier buses for people who regularly go to work in the central business district, Dr Kobusingye says Ugandans will continue paying high for a risky boda-boda transport since it is perceived to be faster and friendly for the ever-congested roads.

“If someone has a significant head injury, it means he will be taken to a center which has a neural surgeon. Sometimes they need multiple specialists like specialist in bones and joints. For patients that do not even need a lot of sophisticated care, they too need to be in ICU and that is a minimum of Shs2 million every day. If this patient was the bread winner, it means that their family is in destitute. If the patient has been in hospital for a month and all their savings have been spent,” Dr Kobusingye said.

Dr Kobusingye, says more than 40 percent of financial budget allocated to Mulago trauma centre is spent to treating victims of boda-boda crashes. Dr Wamala adds that at Kawolo hospital, treatment for accident injuries is always ten times compared to inpatients.

“It is ten times more than an inpatient in the ward. So if a patient is supposed to get a box of normal saline then multiply it by 10. So if a box of normal saline is 3000, then you multiply that by 4 to make 12000 and now, an accident victim you multiply that by 10. This is because the victim is dehydrated, and needs more bottles of normal saline than a normal patient. So, all other drugs we administer you multiply by 10,” Dr Wamala explains.

Agnes Nakanani the mother to Ruth Nalubega says she borrowed almost from every person she knows to treat her daughter. Abigaba is thankful to Mulago hospital doctors who treated his skull that had been damaged in the crash, Abigaba spent 37 days bedridden in casualty ward. Mulago hospital, according to ministry of health, attends to more than 60000 emergencies every year. But the biggest number of emergencies registered at Mulago hospital are victims of road crashes particularly boda-boda riders and their passengers.

Dr Kobusingye explains that post-crash treatment is a no joke. This is because some victims may never walk again and need fulltime care while others need artificial limbs which are extremely expensive. According to BBC of story of June 28, 2019, the new high-tech prosthetic limb developed in UK cost over £100 (about Shs470000).

Charlotte Kangume, a victim of road crash while speaking to journalists on road safety reporting training at the head office of African Centre for Media Excellence (ACME) about a fortnight ago, narrated that she had spent more than Shs16m on artificial limbs for her amputated leg. Not only the cost for artificial limb becomes a challenge for amputees, but societal stigmatization force many to believe they are unworthy anymore and as a result they resort to alcohol and drug abuse.

Police report for 2020 released by Commissioner Lawrence Niwabiine in April last year shows more than 1500 people die in boda-boda accidents every year while over 4000 survive with serious injuries. This means that Boda-boda crashes killed at least four people every day while more than 10 motorcycles riders and passengers sustain excruciating injuries every day. Written by JK