East Africa’s boda boda boom that turned into major public health concern

Despite the crucial role the boda bodas play in the mobility of persons and goods, they are a double-edged sword.

In this series of Healthy Nation special reportage, our journalists go behind the scenes to reveal the status of the boda boda transport sector in East Africa, reporting on the growing influence of the two-wheelers in the region, the gaps in regulation, the enduring menace of the motorcycle taxis and the toll of boda boda accidents on the region’s health sector.

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Editor's note - EA's Boda boda boom that became major public health concern

By Jane Njoroge

About two decades ago, East African countries woke up to a new mode of transport – the boda boda. 

The two-wheelers became popular as they filled a crucial gap at a time when there was limited infrastructure in many parts of the region, offering fast, flexible and reliable services to passengers in both urban and rural areas.

Doubtless, motorbikes are now a major part of East Africa’s micro-economy and source of livelihood for many, particularly thousands of unemployed youths.

Kenya has witnessed a steady growth in the number of motorcycles in the last 15 years after the government zero-rated import duty on motorcycles below 250cc in 2008, making them affordable to many people. The number of newly registered motorcycles thus went up by 55.1 per cent, from 16,293 units in 2007 to 51,412 units in 2008. By 2009, the country had 91,151 units, according to the Kenya National Bureau of Statistics. 

The National Transport and Safety Authority indicates that there were 1.39 million registered boda bodas in Kenya as at February, 2018. A similar spike of registration of bikes has been reported across East Africa.

But despite the crucial role they play in the mobility of persons and goods, motorbikes are a double-edged sword. With their rising popularity, the sector has been associated with road accidents and crimes such as theft and drug trafficking, thanks to riders operating in an environment of minimal regulations and control.

Many young people have ventured into the boda boda business without the requisite basic training, what has become one of the main causes of road accidents.

In the 15 years, thousands of riders, their passengers and pedestrians have been killed and injured in boda boda crashes, raising a great public health concern.

In this series of Healthy Nation special reportage, our journalists go behind the scenes to reveal the status of the boda boda transport sector in East Africa, reporting on the growing influence of the two-wheelers in the region, the gaps in regulation, the enduring menace of the motorcycle taxis and the toll of boda boda accidents on the region’s health sector.

Reporting from Kenya, Pauline Ongaji looks at the history of the boda bodas, what led to their influx and how they came in to fill the gap in reliable and efficient transport. She also delves into the dangers of how lack of a comprehensive framework to regulate the sector has made it a breeding ground for criminal gangs and at the same time endangered road users. Over the last 10 years, boda boda accidents have surged, with injuries and hospitalisations having a colossal impact on the country’s health system.

Mary Wangari visited Zanzibar Island, where she traced the history of boda boda sector, the tempestuous hurdles it has weathered so far and the ongoing efforts by the Zanzibari government to regulate it. Despite these efforts, boda boda-related accidents continue to leave families in anguish and financial misery at the same time weighing heavily on the Island’s health systems. 

In Burundi, James Kahongeh focused on last month’s ban of motorbikes from Bujumbura’s city centre after what the authorities described as a frightful rise in the number of crashes that maim or claim lives of thousands every year.

Now the bikes have been limited to few pockets of Bujumbura neighbourhoods, with a heavy police deployment on major streets of the capital to enforce the ban. In this city of 1.2 million inhabitants, like many others across the region, boda boda riders operated like a criminal enterprise with little regard for traffic rules. Across the city, the economic effects of the ban are palpable and disruption to public mobility is evident. But the government has stuck to its guns. 

Reporting from Tanzania, Elizabeth Merab looked at how the government through the city of Dar-es-Saalam is trying to cut down costs of treating boda boda accident victims. This has been done through partnership with community policing and driving schools that conduct civic education, sensitisation and implementation of safe boda boda use with the aim of reducing the burden of accident on the health sector.

In Uganda, Jurgen Nambeka digs deep inside the streets of Kampala, Gulu and Lira, where rowdy riders endanger the lives of pillion passengers and those of other motorists through reckless riding. Only a few wear helmets and reflector jackets while most of them ride unroadworthy bikes, often without a licence.

Interestingly, even a safety solution that sought to end the menace has failed, with many riders unsubscribing from the platform. They say SafeBoda eats into their profits and are now back to the legacy lawlessness where they appear to find pleasure in flouting traffic rules.

Rwanda, the country of a thousand hills, seems to be ticking all the right boxes in the regulation of motorbike taxis, as Hellen Shikanda found out. Rwanda is the only country in the region where riders religiously observe the requirement to wear a helmet and to carry one passenger at a time. To curb accident frequencies due to speeding, Rwanda has installed automated speed cameras and red light cameras that capture traffic offenders. The regulations are known by heart and you will rarely find anyone flouting them, whether in the city or deep in the villages.

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Riders choke Kenyan families with huge medical bills, deaths 

By Pauline Ongaji

May 22, 2021 will be stamped on Loreen Achieng’s memory forever. 

That Saturday afternoon, the 29-year-old Nairobi-based lawyer was heading to Lavington from Ngong Road to pick her car. The plan was to join her friends later, who were throwing her a birthday party.

The distance was short but while traffic had started piling from Lenana School towards The Junction, she decided that a boda boda would be the fastest way to go. 

She requested for one using an online application and in no time an old motorcycle vroomed in a throaty growl before her and then halted to pick her. 

A grim-looking man smelling of rum welcomed her into what he promised would be a ‘joyous ride’ as he twisted the right handle, letting out a wide open throttle roar after every twist. 

“When I saw him, his eyes told me that he was drunk. But I lacked proper proof. When I saw he maintained his balance I gave him the benefit of doubt and got on to the bike, after all I was just going nearby though running late,” she recounts. 

As they were approaching Dagoretti Corner, a courier rider overtook them at a high speed. “We were riding along the tarmac pavement as both lanes were heavy with traffic. The rider was manoeuvering the gridlock.” 

In a quick instance, the courier rider, which had overtaken them and now ahead of them, pressed the emergency brake. 

“My rider never saw this coming and rammed right into it as he tried to escape in between the courier and the vehicles on the main road,” Loreen tells Healthy Nation.

Loreen says she was sent flying into the air and landed on the rough main tarmac as all her belongings scattered all over. That was the end of the party. 

Luckily because of the traffic jam, vehicles did not run over her. The rider held on to the motorbike as it slid across the road breaking some of its parts.

“I survived with a cut on my leg and the exhaust pipe burnt my thigh. The tarmac road gave me a big bruise to my right arm.” 

Traffic police who witnessed the whole incident called the three parties aside but the courier rider fled the scene. 

They were not able to capture his number plate or company. “The police advised us to report the matter to Hardy Police Station and make a claim from the insurance of the rider but I opted to count my losses, thanking God I survived and went to seek treatment on my own account.” 

Apart from that, she says, she was also traveling out of the country the following week and thus knew she would need a sustainable solution for herself. 

She sustained a second degree burn and three scars, eventually. She would be dressed every three days.  She could not sit and sleep normally because the burn was huge and behind her right thigh.

“It affected my performance at work and at home and cost me close to Sh50,000 to completely heal,” she says. 

The incident left Loreen traumatised. “I escaped death by a whisker.” Since then, she has been very skeptical about boarding boda bodas. 

Along Nairobi’s Luthuli Avenue, Joseph Ndubi is standing on a pavement waiting for a friend to discuss a project on his laptop. He hangs the laptop bag on the right shoulder that faces the road. 

“It happens in a jiffy. Within no time the bag is gone with everything,” he recalls. 

A boda boda rider just sped towards his direction, then slowed down a bit to give the pillion passenger a chance to snatch the laptop bag. The bike then speeds out of sight.  He is disillusioned, with nowhere to report the theft and nobody to tell the end of his meeting with his friend, probably the end of the project. 

The influx of the boda bodas on Kenyan roads can be dated back to 2008 when the government zero-rated import duty on motorcycles of up to 250 cubic capacity.

This liberalisation of the motorcycle industry made them affordable to many Kenyans.

The boda boda business surged fast, with sales rising from Sh8 billion in 2014 to over Sh11 billion in 2018, according to a report by the National Crime Research Centre. 

And as they came in to fill in the gap in the transport sector, it gave an opportunity to many unemployed young men who started eking out a living by transporting goods and people.

The research indicates that some boda boda riders in Nairobi make up to Sh3,000 daily and that has been spiking demand in the purchase of bikes every month.

And while the Treasury is estimated to be collecting around Sh60 billion annually in fuel taxes from boda bodas, the sector remains with innumerable shortcomings, which are threatening to erase the gains made.

For years, the boda boda industry has gone unregulated and unchecked, making it a breeding ground for criminal gangs. Drug trafficking, organised robbery with violence and murder have all been orchestrated with the help of boda bodas, thanks to their ability to ride through dark alleys.

The rogue nature of the industry was on display last month when a video clip of a female motorist being attacked along Wangari Maathai Road in the capital spread online, prompting arrests amid public outrage.

Most of the motorcycle riders are not trained in road safety, and a significant number of riders do not have driving licences, meaning they are not conversant with traffic rules, and this has contributed to the fast-rising motorcycle-related deaths of riders and pillion passengers.

According to a National Transport Safety Authority (NTSA) report released last month, between January 1 and February 28, 2022, the number of pillion passengers killed in road accidents stood at 89, and 58 during the same period in 2021.

On the other hand, 240 motorcyclists were killed between January and February this year and 197 in 2021.

Between January 1 and February 28, 2022, the total number of motorcyclist and pillion passenger fatalities stood at 329.

NTSA reported that there were 1,393,390 motorcycles registered in Kenya as at February 2018 but the exact number of these motorcycles operating as boda bodas in the country is not known and documented.

The Motorcycle Assemblers Associations of Kenya estimates that 4.8 million people depend on commercial motorcycles directly or indirectly.

But families have lost loved ones as others struggle to pay huge medical bills for both riders and pillion passengers as a result of cycle-related accidents. This is bearing in mind that most boda boda operators lack third party insurance.

The health sector also hasn’t escaped the ripple effect. Major hospitals have since set up trauma centres purposely for the treatment of the rising number of seriously injured riders and pillion passengers, thus having an adverse ripple effect to the health budget.

Last year, the Homa Bay County Teaching and Referral Hospital indicated that the boda boda riders make up a significant percentage of most accident victims, with a majority suffering bone fractures.

According to the hospital, motorcycle injuries accounted for between 30 and 35 per cent of accident-related injuries treated at the hospital, most of them including bone fractures as well as internal injuries.

Due to this, the county government had Dr Juan Ramos, an orthopaedic surgeon from Cuba, move from hospital to hospital across the county to attend to such cases.

In 2019, statistics indicated that 1,421 riders and pillion passengers died compared to 1,049 drivers and passengers who lost their lives from motor vehicle-related deaths.

According to policy analyst Douglas Kivoi, the entire transport sector in Kenya requires serious policy and legal interventions to tame unruly boda boda operators.

“First of all, Kenya’s road network lacks lanes to protect bikers and motorcycles. Urban roads need to be redesigned to accommodate motorcyclists and cyclists.”

One of the short term remedies, he says, should be to get all boda boda drivers to attend driving schools.

“But the national government, the National Transport Safety Authority and county governments should organise continuous training for the riders, focusing particularly on road safety and decorum,” he told Healthy Nation.

Apart from that, he says, the government should also consider establishing a database of all boda boda operators in Kenya through mandatory registration followed up with an enforcement mechanism to ensure compliance.

Responding to this concern during the Jubilee government’s last budget speech last Thursday, Treasury Cabinet Secretary Ukur Yatani said the government will put in measures where boda bodas pay insurance premiums so they can be careful on the road.

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Tanzania tightens noose on motorcycle taxis to transform ailing sector 

By Elizabeth Merab and Herieth Makwetta 

It is seven minutes to 4pm and the Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania is buzzing with activity as relatives of patients stream in to see their kin.

In this 10-bed trauma ward, we meet three young men: 19-year-old Rashid Bakari Rashid, 25-year-old Ali Muhidini, and 32-year-old Uzima Ali Bakari all lying supine in beds draped with mosquito nets.

The three are here for the same reason — they were all injured in boda boda accidents.

Muhidini has spent the last three weeks on his hospital bed near the window.  “There is a bit of breeze here,” he tells the Healthy Nation team as he narrates how he ended up here. “I was involved in an accident when a car that was behind me rammed into me. In the confusion, another car hit me in the chaos. I ended up with two broken legs. On the right, I suffered a broken thigh bone and shinbone while my left knee was shattered.’’

To correct the fracture, Muhidini’s left leg is strapped and suspended on a five litre weight. The method of strapping the patient’s affected lower limb and attaching weights (known as skin traction) limits movement and reduces the fracture to help decrease pain, spasms and swelling. It also restores and maintains straight alignment and length of bone following fractures.

The young man needs Tsh1 million (Sh50,000) to undergo surgery, money that he says he still does not have. Bakari Rashid was returning home from an errand on a boda boda when a car veered towards them, forcing the rider to also steer the bike to avoid a head-on collision. They ended up in a ditch.

He recounts: “My left leg hit a barrier on impact. I could not stand up on my own.’’ Bakari was rushed to a nearby hospital in Mwananyamala, Kinondoni District.

The experiences of the three men are the experiences of thousands of people in this country where, like in the rest of the region, motorcycle business is a sought-after economic activity, both in urban and rural Tanzania.

At Muhimbili Orthopaedic Institute, boda boda-related accidents account for the majority of road traffic injuries treated or admitted, and, therefore, a significant amount of resources, including personnel. For many Tanzanians, minor injuries suffered from motorcycle accidents are often ignored, with most people opting for over-the-counter painkillers. This is what Uzima Ali Bakari, 32, had been doing every time he had an accident. Until last year, when he suffered a more serious injury.

"My injuries were not serious. I only had a bruised knee and a few scrapes on my legs. The rider sustained severe head injuries. I did not go to the hospital.’’

Later, Ali started experiencing pain in his lower back down to his legs. He took painkillers to remedy the pain. The condition persisted and worsened. By December, bending or sitting was a nightmare for him. He could also not sleep.

"An MRI showed I had a problem on my spinal cord. The doctor explained to me that the pain was as a result of a degenerated disc in my spine.” Ali was later diagnosed with a condition known as lumbar spinal stenosis, according to Dr Kennedy Nchimbi, an orthopaedic and trauma specialist at the Muhimbili Orthopaedic Institute.

Upon further probing, Dr Nchimbi discovered that the patient’s current condition was as a result of his past untreated injuries.

Findings of research show that motorcycle riders face a higher risk of severe injury, morbidity, and mortality than other road users. For every kilometre travelled, motorcycle riders are 20 times more likely to die from a crash than other motorists. A more recent study returned a grimmer picture: about 71 per cent of all road traffic injuries in rural Tanzania involved a motorcycle. This was before a series of interventions were made.

A 2016 analysis of factors associated with road traffic collisions in Tanzania reported motorcycles to be the leading cause of traffic crashes, accounting for 53.4 per cent of accidents in six public hospitals. In fact, road traffic injuries were involved in 43.9 per cent of trauma cases and 66 per cent of traumatic brain injury patients who presented were at a hospital in Northwestern Tanzania, making road traffic injuries the most common cause of injury.

Explaining how accidents cost the Tanzania’s health sector, chief medical officer, Dr Aifelo Sichwale,  says 10 out of 100 patients treated at hospitals’ emergency departments are usually accident victims, with up to 77 per cent of these being victims of boda boda and auto rickshaw (tuktuk) accidents.

“About 71.3 per cent of road accident victims who end up in hospital are men. Most of them are aged between 19 and 37,” Dr Sichwale explains. In a survey conducted in 2020 involving five regional hospitals, it was found that road traffic injuries account for 60.3 per cent of hospitalisation.

At Muhimbili Orthopaedic Institute, between 10 and 15 (or 70 per cent) of the accident victims treated here are boda boda-related. ‘‘We treat patients who are brought from either from the scene of accidents or referred from satellite hospitals. This depends on the extent of their injuries.’’ This hospital attends to an average of 5,300 boda boda accident victims annually, or about 450 patients per month.

Most of these patients require surgery and prolonged hospitalisation, he says.

“A large percentage of these patients suffer injuries to the thighbone and leg bone (33 per cent), skull (30 per cent), back (12 per cent), pelvis (10 per cent), and other parts (15 per cent).’’

Dr Sichwale adds: ‘‘About 80 per cent of them need surgery and long hospital admission, which could cost up to Tsh800,000. For those with head and back injuries requiring admission to the intensive care unit, this costs between Tsh4million and Tsh12million.’’ The doctor notes that this cost is usually demanded upfront, overwhelming patients who lack medical insurance.

He adds: “The institution finds itself running on losses while trying to assist patients who may never clear their hospital bills.’’

With 77 per cent of these falling in the 19 -49 age bracket, Dr Sichwale laments that Tanzania is losing a large percentage of its workforce to boda boda accidents.

Dr Nchimbi explains that the ballpark cost of treating boda boda accident victims outstrips the subsidised cost. From a survey done at the facility to determine the cost of treating a fractured thighbone, doctors discovered that it’s anywhere between $1500 (Tsh3.4 million) and $2000 (Tsh4.6 million).”

Abdi Issango, the Zonal Traffic Officer in Dar-es-Salaam, says that while boda bodas have created employment and eased transport, they are also contributing to massive loss of the country’s young workforce. “Our biggest challenge is untrained riders and those without licenses to ferry people. There are also young men using boda bodas as a means to commit crimes. It is this category that violates traffic rules the most,” Issango notes.

To sanitise the sector, the Dar-es-Salaam traffic department is now sensitising riders by partnering with driving schools. These encourage riders to wear safety gear, for instance, to reduce the severity of injuries during accidents. The department has also enlisted community policing to talk about road safety.

“Beyond education, we enforce the law on violators. We arrest riders who do not stop at Zebra Crossings or those who do not wear helmets. We also arrest riders who are carrying more than one passenger, or carrying them without protective gear.’’

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How rogue riders smeared Zanzibar’s splendour

By Mary Wangari

What makes you realise you have landed in Zanzibar Island is the sight of graceful tall palm trees swaying rhythmically to the soft ocean breeze.

It is 11am when we arrive at the Abeid Karume International Airport. Several white vans with red registration number plates are meticulously waiting to ferry visitors to their various destinations. 

Our host Kassim Omar waves at us towards a gaudy cab and after exchanging pleasantries, we soon proceed to our hotel in Stone Town. 

The town, also known as Mji Mkongwe, is located on the western coast of Zanzibar Island and is the central business centre of Zanzibar City.  The road from the airport is somewhat busy with mostly taxis and buses used to ferry the public. Here, they call them daladala and the nightmare of traffic gridlock is unheard of. 

We are fast approaching Stone Town when, out of the blues, a motorcyclist wearing only a black helmet cuts through us on a bend and speeds off swaying precariously.

The driver brakes muttering under his breath with the sudden impact jolting us back to reality. 

It is only when we reach Stone Town that the full craze of motorcycle public transporters, known as boda boda, becomes evident. 

For a moment, you get confused if you’re actually in the famous Zanzibar as furiously hooting car drivers face off with boda bodas, bajaj popularly known as tuktuk in Kenya and pedestrians. 

You have to be careful walking in these streets because boda boda operators are impetuously ferrying passengers and goods with reckless abandon. 

We trudge through unmarked cul-de-sacs, and for a city that drives on the left, you will have to step aside for loaded boda bodas moving in the opposite direction to pass. 

There’s zero regard to traffic rules and even their own safety. No rider is wearing a reflector jacket and       or two has made efforts to protect themselves by wearing a helmet.  Here, you don’t need to be a genius to decipher the impending if not already simmering cataclysm of an unregulated boda boda sector in Zanzibar. 

It is at Shamba Mawe in Nungwi village, a one hour drive from the city, where we come face to face with the stark reality of how boda boda accidents take a toll on citizens' health. 

We are cordially received by Asumini Simimi, who swiftly wakes her husband Juma Hamisi. 

All their 10 children, save for the eldest son, are present and they sit on a mat intrigued by our presence. 

Juma is obviously a proud father, which is evident from the way his face lights up as he introduces all his children by name. 

Their sixth born daughter Fatma Juma is using clutches. The 21-year-old has just arrived from an orthopaedic session at Mnazi Mmoja Hospital, the biggest referral hospital in Zanzibar. 

Fatma spent two weeks in a coma at the Intensive Care Unit following a serious boda boda accident. 

December 6, 2021 will forever be etched in this family’s memory as the day their lives took an unanticipated turn.  The conspicuous stitch scars across Fatma’s temples on the face, around her head and her left leg from the ankle up to the groin are a vivid reminder of how fortunate she is to be alive. 

Her husband and her unborn child were, however, not lucky as they died instantly in the grisly accident.  On the fateful day, Fatma, who was by then four months pregnant with their third child, together with her cousin Razia Kasimu, were headed to work in Nungwi town before the boda boda that was being ridden by her husband collided with a daladala in Baobao area. 

“It was 6am in the morning and as usual we were headed to the town where I used to work as ‘Mama N’tilie. When we reached Baobao, a bus came suddenly from nowhere and hit us. That is the last thing I remember,” she recounts. 

“I lost consciousness only to wake up two weeks later at Mnazi Mmoja Hospital after I was transferred from Kivunge Hospital. I was told my cousin was in the same hospital and that my husband had been taken to Pemba Island. My parents were hesitant to disclose to me that he had already passed on.” 

It took weeks of intensive counselling from Kadhis to help their daughter come to terms with the tragedy.  Her unborn baby had died in the womb as a result of the impact and she had to be induced with labour to eject the foetus. 

Other than the psychological and emotional turmoil, Asumini’s family has also been thrown into financial disarray as they have to deal with treatment and medicine expenses.  “We are grateful that our daughter is slowly recovering. But it has really been expensive. Her leg was also broken from the hip and she needed to have metal implants which cost us around Sh1 million,” explains her father.

Then there are daily doses that she cannot sleep without. She is constantly in pain especially when the weather turns cloudy. They have to pay doctors for her weekly checkups and there are also taxi expenses when we have to transport her for treatment. 

Our visit to the Accidents and Emergency Section in Kivungeni Hospital and Mnazi Mmoja Referral Hospital established that the majority of the patients being treated for minor and severe injuries are survivors of boda boda-related accidents. 

New national statistics released last month paint a grim picture of boda boda-related accidents, where a total of 3,268 cases were reported among them 1,245 fatalities in 2021.

Among those who succumbed were 56 school children, raising alarm over the blatant disregard of basic safety measures in the sector that is increasingly endearing itself among parents as an affordable means of transportation to school. 

Experts warn that the probability of getting involved in a boda boda accidents is 29 times higher than while on a vehicle in Zanzibar. 

Recklessness, alcohol and substance abuse among boda boda riders contributes largely to these accidents.  The boda boda industry in this island began in 2005 and most operators are young men aged below 30 years.  Majority, if not all of them, are novices to public road safety, with little to no basic education. Only a few have completed secondary education. 

According to Mak Masudi, a boda boda representative in Mahonda, most of these youths would be forced to work as beach boys or engage in criminal activities to fend for their families since they tend to marry early as per their customs and culture. 

Apart from low education levels, most of them do not have basic training on traffic safety rules and regulations and it is little wonder that only a few of them have licences. 

There are no specific passageways for pedestrians and motorcyclists and most roads are not marked. No bumps in the potholed roads in the outskirts of Zanzibar City.

Until last July, the sector had been largely unregulated, with youths as young as 16 year old venturing into the boda boda business without licences, as Mdungi Shariff, a Kaskazini A administrator, informs us. 

“Initially, there were no specific rules and procedures to regulate it and everyday people would just sprout from nowhere and start ferrying commuters,” he reveals. 

Last year’s laws are gradually being implemented. They include registration, licensing, training on safety and guidelines for apprehending defaulters. 

However, boda bodas still stick out like a sore thumb and are now the proverbial unwanted guests not only to taxi operators due to business competition, but also to locals in the largely Muslim nation.

From several riders and taxi drivers who spoke to Healthy Nation, it is crystal clear that there is no love lost between motorists , be it personal vehicles, cabs and boda boda riders even as both parties point an accusing finger to each other. 

“Vehicle drivers detest boda bodas. Some drivers even speak openly that if they encounter a boda boda rider on the road they will just knock them down. They are killing us yet most of the time they are the ones on the wrong,” says Naseeb Selemani, a boda boda representative. 

But the island’s middle and upper class have for years abhorred boda boda riders. So great was their distaste towards boda bodas that they barricaded roads in the villages to prevent them from conducting their business. 

“The locals are slowly warming up to us but at first most of them did not want us at all,” says 28-year- old Maksudi Ali.

But to some like Zulekha Asimini, boda bodas are a blessing in disguise. 

“I afford to pay for taxis all the time as they charge from Sh2,500 compared to bodabodas , who charge as low as Sh50,” says the mother of two as she hitches herself to ride pillion sitting with her legs facing the same side behind the rider. 

The new regulations under the Road Traffic Act also require riders to undergo mandatory training in certified driving schools. Wearing helmets for riders and pillion riders is also a requirement. 

Despite the new regulations, clearly there is still a long way to go as it has turned out to be a cat and mouse game between law enforcers and the riders. 

“We are not opposed to the training. We cannot afford it. The training centres should be spread across the country to cushion us from incurring unnecessary expenses,” argues Mbwana Juma, a boda boda operator based at Mahonda. 

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Rowdy and unruly: The muddle caused by Uganda’s goons on motorbikes

By Jurgen Nambeka 

You would think it’s a scene in the popular Netflix series ‘Squid Game’ as boda boda riders struggle through a chaotic swarm of other fellow riders, pedestrians, taxis, buses and heavy vehicles. 

One moment a boda boda flashes full lights right in front of you, another one brushes you as it speeds to drop a customer, five more are riding in the opposite direction and bewilderment hits you, unable to distinguish whether the country drives on the left or right.

At one designated area in Kampala where they park waiting for customers, you wonder if these riders care about their safety. Worn out wheels, torn seats, no helmets and just a few with reflector jackets.

Along Bombo Road, one rider has inverted his bike just at the road side. Why? He has run out of fuel, and with little cash to afford petrol, he inverts it then reverts, and now, using his mouth, pumps air through the petrol tank. After a minute, he kickstarts the bike and vanishes out of sight. 

Such is the scenario in several busy junctions of Kampala, Gulu and Lira, where every rider is in a hurry to help someone trying to beat the gridlock on their way to a destination.

But in this haste lies great lethality. Every individual using a boda boda in Uganda risks being among 10 people who lose their lives to boda boda accidents every day, according to a 2018 United Nations report.

Boda bodas, which are reported to have increased by 58.7 per cent since 2007, are believed to have emanated in the late 90s when business people used them to cross the Kenya - Uganda border to smuggle goods while evading tax levies.

The cross border movement led to the use of the word ‘boda’. Then ‘boda boda’ when many bikes increasingly crossed the border.

The form of transport was embraced because of the fast low-capacity transportation they provide for both the urban and rural people. 

The speed, which many embraced the bi-wheelers for, is now crucial for Ugandans entering and leaving the cities of Kampala and Entebbe, who hugely depend on boda bodas for transportation.

There are slightly over a million boda bodas in Uganda, according to the UN, and they continue to grow because of their low initial cost from China. But many boda boda riders here acquire them through creditors and have to toil extra hard to service the loans.

With the boda bodas causing congestion and most of the road accidents, the Ugandan government put in place a mandatory law in 2004 that warrants every rider to wear a helmet while riding.

However, the number of boda bodas who do not use the helmets meant to protect them is still high and the police do little to enforce the law. Despite having law enforcement officers on most of the roads in Uganda’s urban centres, boda boda riders still form a major part of road users disregarding road traffic rules.

The Global Road Safety Partnership report of 2021 shows that road safety in Uganda has rapidly deteriorated in recent years, with boda bodas leading in the number of road accidents caused in major urban areas.

Riders who want to satisfy their customers’ quest for punctuality ride their motorcycles haphazardly as long as they ‘secure the bag’ .

The bikes they ride are not insured despite the Insurance Regulatory Authority of Uganda, Uganda Revenue Authority and Ministry of Works and Transport working together to attempt to improve the management of third party insurance operations by introducing a mobile payment platform.

Supposing the riders are involved in a mild accident, fleeing the scene of incidence not to be caught is their main way out.

Many times the riders flee to avoid attacks by bystanders, who in some cases may even steal the motorcycles. Whenever the police are involved, it is chaotic since the riders may be charged with failing to register the motorcycle, wearing a torn helmet, reckless driving, lacking a third party insurance cover and riding unroadworthy bikes. 

According to the Ugandan law, anyone caught for reckless driving is fined between Sh39,000 and Sh60,000, which the boda boda riders who live from hand to mouth cannot afford. The alternative is a three-year imprisonment.

According to the 2021 World Bank’s Road Safety Country Profile report, Uganda has the highest number of mortalities on the roads in Africa. For every 100,000 people, 29 die in road accidents. There is a high probability of finding boda boda riders in Uganda without third party insurance cover.

A third party cover offers the boda boda operator whose motorcycle is insured protection against damage to the motorcycle, the rider and their personal belongings in case of an accident.

Without the insurance cover, any rider involved in a grisly road accident in Uganda has very low chances of recovering completely; with police reports saying that they record up to 300 serious accidents, 500 minor ones and 100 fatalities every month.

Figures indicate that of the 24,352 motorcyclists, passengers and pedestrians seriously injured in such accidents in three years, 16,000 were in Kampala.

The police argue that the accidents,  which in 2020 claimed the lives of 3,600 Ugandans, are as a result of reckless driving and congestion in the cities.

“I was riding my bicycle on the Northern Bypass in Kampala when a boda boda cyclist rammed into me from behind. I fell down and I don’t know how I was brought to the hospital. I don’t know what caused the accident because I was on the right side of the road,” one Helly Ebega, a security guard admitted at Rubaga Hospital, said.

A survey done by the New Vision newspaper indicates that Mulago Hospital’ s casualty ward, which has an official bed occupancy capacity of 52 beds, now admits about 150 patients every day.

“The hospital receives about 300 to 500 accident victims every day.  Half of these are victims of motorcycle accidents,” the report discloses. The hospital, the study says, is forced to leave many of the victims lying on verandahs and in the corridors unattended.

Nsambya and Rubaga hospitals also have a high number of motorcycle accident victims compared to other road accident victims.

At Rubaga Hospital, five of every six accident patients admitted are victims of motorcycle accidents, according to the research.

“At Nsambya hospital, most of the accident victims either fell off or were knocked by motorcycle.”

In many scenarios, a rider who makes between Sh900 and Sh1,300 a day cannot afford to be treated in a private hospital.

The few who can afford to get treatment at a public hospital suffer since some of the hospitals are not well equipped to handle fatal injuries. According to the UN, Uganda has inadequate rehabilitation services in health facilities. The few that have the service are under-resourced with a low number of workers, equipment, supplies and funding.

Many of the boda boda casualties end up staying at home for the fear of going to hospital and accumulating bills, which they cannot pay.

The pre-hospital care, which should guarantee them care as soon as they are involved in an accident, was not functional as per UN’s 2018 report. The service is, however, important since it determines whether the boda boda driver involved in the accident ends up disabled or dead in situations that could be managed.

It is astonishing that to save time, boda boda accident casualties are rushed to hospital by another boda boda, which may cause more injury. While the boda bodas have had traffic related disciplinary issues, the introduction of the SafeBoda solution has played a huge role in trying to clean up the industry.

The company, which was launched in 2015, uses a mobile application that allows a customer to book a boda boda and travel comfortably to their preferred destination.

Disparate from the normal boda bodas, once a motorist registers to be a rider with the company, they are trained on how to maintain their motorcycles, road safety and how to take care of a customer.

As soon as they are ready to start work, they are equipped with hairnets and spare helmets, which ensure that even their customers are protected and they feel safe during the ride. With increasing menace on the part of the normal boda boda rider, the SafeBoda cyclers are trackable and hence less likely to misbehave.

Before travelling, a customer enters the details of their destinations on the safe boda app. Within no time they are connected to a safe boda rider, who picks them at their pick up points and ensures they are comfortable and safe from when they board up to when their trip ends. They then pay the amount, which is generated by the app without interference from the rider.

SafeBoda offers a totally different experience compared to the normal motorcycle ride. “I have used both the normal boda boda and SafeBoda and can testify that the latter is better. They are less rowdy and more careful and will ensure you feel safe while traveling,” says Nobert Atukunda, an NTV Uganda journalist residing in Kampala.

Despite the dreamy subtle and less chaotic experience that the solution offers, several riders have complained of the service. Most of the riders who were once happy when the company topped up for customers paying less are now dispirited. An anonymous source from SafeBoda told Healthy Nation that half of the 25,000 registered users on the platform are not actively using it since the company has reduced the bonuses that attracted them at first.

Previously, the company was giving a 50- 100 per cent bonuses on every trip only for SafeBoda to drop its bonuses to 15 per cent and charge the riders a 5 per cent commission on every trip.

While all stakeholders in Uganda are considerate of how important the boda bodas are, an urgent need to completely regulate the sector remains.

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Burundi’s motorbike ban dilemma: To protect livelihoods or save lives?

BY JAMES KAHONGEH

There has been a certain sense of relief in the past few weeks for hundreds of Bujumbura residents who have either been injured or lost their kin through motorcycle accidents. When the Burundian government in March banned two and three-wheeler vehicles from accessing the city centre, operators were up in arms. One rider was shot dead in the vicious clash that ensured between the operators and the police.

Against the backdrop of the din of protests, however, thousands were celebrating.

Depending on who you talk to on the streets of Bujumbura, there are arguments for and against the embargo that has left public mobility extensively disrupted and livelihoods damaged or lost entirely.

Those like Nshimirimana Dyne are indifferent. The resident of Bujumbura’s Ngagara neighbourhood is a victim of an accident that left her with scarred knees and elbows for life.

Dyne, 29, remembers the day from hell with a mixture of cynicism and regret. ‘‘I was returning home from the market on a bicycle taxi. I had my sugarcane stock strapped at the back. A speeding motorcyclist hit us from behind. We lost balance and fell on the tarmac.’’

As many do after accidents, the rider fled the scene. With bloodied limbs but without money to go to hospital, the mother of four went home to nurse her injuries. ‘‘For days, I just lay at home, unable to provide for my children. Thankfully, I recovered in a week to return to work.’’

Few accident victims, though, return to their normal lives in the aftermath of motorcycle crashes. Some die. Many more are crippled for life. For those who end up in hospital, families sell assets to pay for their care.

The story of Dyne is that of thousands of Burundians who have either been maimed or killed in accidents by moto-taxi and boda bodas, called here ‘‘Bajaji’’ –borrowed from Indian multinational automaker Bajaj.

The World Bank lists Burundi as one of the 10 poorest countries in the world. Many youths have no jobs and resort to riding motorcycles to earn a living. But with minimal to no formal training for the majority of riders, and in a country with one of the world’s most dangerous roads, crippling injuries and death are always a mistake away. For passengers, taking a bike for a short trip is on many occasions to sign up for death.

Patrick Kalongo, a taxi driver, tells Healthy Nation that as many as 30 riders and pedestrians died in this city of 1.2 million people every week before the ban. ‘‘The riders are very careless. They are notorious for blocking other motorists and overloading.’’

Burundi’s Minister of Interior General Gervais Ndirakobuca in February said cyclists were responsible for the majority of road accidents that injured 2,000 people and claimed 1,300 lives in Bujumbura last year.

But what is the health burden of boda boda accidents in Burundi like? What is the toll to health facilities, communities, the government and the economy?

The World Health Organization (WHO) lists road traffic accidents as one of the major causes of ill-health and death in Burundi. In 2016, for instance, 54,700 people sustained serious injuries from road accidents. Whereas WHO’s estimated fatalities that year were 3,651, there was gross under-reporting by the government, with only 112 recorded deaths. 

Here, two and three-wheel vehicles account for 25 per cent of all registered vehicles. But these also account for 13 per cent of all road traffic accidents in the country. This is higher than the regional average of 11 per cent. 

In this country, 1,176 life years are affected due to disability from road crash injuries in every 100,000 people. Burundi has no known road safety targets. In fact, there is no age limit for imported four-wheel vehicles here, much less for motorcycles. Save for random inspections on roads, it is lawlessness for motorists and cyclists in this country.

But to understand the full extent of the impact of boda boda accidents, it is important first to know that the country’s healthcare is predominantly funded through donations. Expenditure on healthcare here accounts for a mere six per cent of the country’s Gross Domestic Product (GDP) of $3.26 billion.

Without donor support that Burundi so heavily relies on, most government operations, including healthcare, would run aground.

In the country of 11.6 million, about 70 per cent of the population lives in extreme poverty, according to the World Bank. In Burundi, 80 per cent of the people are employed in subsistence agriculture. With wide inequalities in access to healthcare, in spite of the needy population, majority of accident victims can scarcely afford to pay treatment fees. Many are therefore nursed at home.

The 2016 motorbike accident involving Burundi’s legendary drummer Antime Baranshakaje is a case in point. Barashankaje, 81, fractured his thigh in the accident that left him unable to walk and bedridden.

In the hospitals he visited, doctors advised him to undergo an operation. Such a procedure could only happen abroad and to do this, the traditional drummer had to pay BIF15 million ($5000 or Sh57,5000). This was a long shot for the elderly national hero. For many ordinary Burundians, raising this kind of money for treatment is unthinkable.

For more than two months, Baranhakaje lay at home in agony. He died the following year from illness and complications arising from the accident. The drummer’s experience illustrates the struggles most people here go through looking for treatment after motorbike tragedies.

Diane Cedric, a trader in the city, knows better than to take a boda boda ride. She had an accident in 2019 while going home from campus.

"I dislocated my left wrist and hurt my ribs. My parents could not take me to hospital. They took care of me at home for 10 days,’’ she recounts.

Now she wears long-sleeved dresses and tops to cover her scars. ‘‘They are very ugly. They make me uncomfortable,” she says.

Although the majority of accident victims such as Diane are successfully nursed at home, emergency and trauma facilities and bed occupancy in Bujumbura’s main health facilities of Buterere, Kamenge and Ngagara are dominated by cases of motorcycle accidents. Patients are admitted for anything; from fractured arms to broken ribs, concussions and other life-threatening injuries. 

Findings of a survey done elsewhere in the region show that blunt injuries are the most common complications from motorcycle accidents. Those involving the head account for 60 per cent of all injuries. According to the survey done in the northern Tanzanian city of Mwanza, most boda boda accident victims are treated through surgery, with 86 per cent of them requiring wound dressing.

On average, patients are admitted in hospital for anywhere between a day and 120 days. Those who die (16 per cent of victims) are usually in hospital for an average of five days.

Yet for more than 10 years now, motorcycle accidents have been a major but neglected public health concern in Burundi, with minimal government interventions to curtail the worsening situation.

Since 2019, international humanitarian organisation Doctors Without Borders (MSF) has supported healthcare in Bujumbura by reimbursing hospitals the cost of treating victims of accidents. This allows patients to get care without charges. The withdrawal last year of MSF from Burundi, however, left many locals badly exposed.

On impact to the economy, road accidents cost Burundi $343 million or 11 per cent of its GDP annually. Sixty-five per cent of fatalities in road crashes are people in the economically productive age bracket of 15-65 years. For every woman injured, maimed or killed in a road crash, two men are.

In the last two decades, poverty, a population explosion and poor access to basic services such as healthcare have made the boda boda sector in Burundi a socioeconomic relief. But also a ticking time bomb.

In the last one decade, thousands of people, most of them from rural Burundi and with few economic prospects, have built their livelihoods around the boda boda economy. In the capital Bujumbura, half of the 1.2 million residents use these taxis to move to work, to school and to run errands.

Away from urban centres, motorcycles are the main mode of transport for green produce in the provinces. In the banana-growing areas, for instance, owning a bike is a big deal. Owners help to move Burundi’s staple food from farms to the market.

The boda bodas may be banned from accessing the capital for now, but in villages and towns such as Cibitoke, Muyinga and Gitega, they remain an important part of life, and with that a threat to health and life.

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Rwanda enjoys smooth ride on two-wheelers

By Hellen Shikanda 

The steep and hilly Rwandan terrain would make anyone with the fear of being on a motorcycle opt to walk or use an alternative means of transport. 

The winding, though neatly tarmacked, roads of Kigali, Rwanda’s capital, make it even more dreadful for people suffering motorcyclophobia. A voice in their head possibly gives them an illusion of an impending accident or an injury anytime they think of hiking on a motorcycle.

With hindsight, therefore, one is tempted to believe that Rwandese authorities had such people’s interests at heart when they came up with regulations for the sector, commonly known as taxi-moto or simply moto in Rwanda, and boda boda in Kenya. Undoubtedly, in Rwanda, one thing stands out—the safety of all passengers must be guaranteed.

And so as a visitor, it is not surprising to note one constant, almost like a pattern, that all Rwandese motorcycle operators wear helmets and have another for their passengers. While you may be quick to adapt to helmet-wearing as a visitor, you are likely to miss a piece of cloth that is a must have just before donning the helmet. 

“We can’t allow a passenger to use our helmet without a piece of cloth beneath the helmet. This is a rule that came about when the pandemic struck. It helps in reducing the spread of Covid-19,” a motorcycle operator tells Healthy Nation.

Riders’ accounts

Healthy Nation finds Eric Hitimana and his colleague Jean-Pierre just after they have dropped off passengers at the University Teaching Hospital of Kigali (Centre Hospitalier Universitaire De Kigali), abbreviated as CHUK. It is the largest and oldest referral hospital in the city. A fleet of motorcyclists is outside the gate, where people are either dropped off by personal vehicles, taxis or motorcycles; rarely the public service vehicles. Motorbikes are the most preferred means of transport here.

Jean-Pierre has been a rider for 10 years. In a decade, he has had an accident just once, which made him lose eight months of his life.

“I remember I had a male passenger whom I had picked from the supermarket and we were headed for his home. I was still in the town’s vicinity and I remember following all the traffic rules to the letter. A car that was in front of me stopped so suddenly I had no time to swerve and move to a safer place,” he narrates.

“I don’t remember what happened next, but I was taken to hospital... I had an injury in my leg; a bone fracture that made me stay in hospital for almost a year, eight months, to be precise.”

Hitimana, on the other hand, has been an operator for five years only. He has been fortunate enough never to have had a serious injury in relation to his job. 

“I am lucky. I have only had a minor accident, which disfigured my tooth. It was just a slight miscalculation that cost me my tooth. That aside, my rides have all been safe,” he tells Healthy Nation.

Innocent Marie, named changed because of patient confidentiality, got into an accident three weeks ago. She was admitted to a city hospital and doctors said she had internal bleeding. Save for the wounds that showed signs of drying up when Healthy Nation visited, her recovery is nigh. Marie does not remember how the accident occurred but she acknowledges that her rider was speeding.

“I remember warning him a couple of times. We escaped accidents a number of times until it finally happened. It was like déjà vu, which happened, anyway. We are lucky to have helmets; otherwise, I would have been badly injured or even dead,” she says.

“My legs hurt, my hands, too, but I know I will be back on my feet soon.”

Surveillance 

In 2020, Rwandese authorities installed over 500 speed cameras across the country. They are wide pole-like erections painted black and grey. The locals have since christened the cameras Sophia. As a visitor, you may dismiss it as a sophisticated traffic light. 

“We call it Sophia because the cameras were introduced in the same year that a humanoid robot called Sophia was brought to the country. It behaves like a human being. A typical snitch,” explains Venant, a taxi driver in Kigali.

“You see, when Sophia notices that you are speeding, it instantly takes note of your details by taking a photo, sends you a fine receipt and notifies you of an ultimatum of when to pay. You cannot run away from Sophia. It works just like the police, a stricter one, I must say.”

As you drive south to the villages in Rwanda, way past Nyanza District towards Huye District, there are trapezoidal mobile speed cameras placed by the police at accident black spots. 

Deterrent charges 

Speeding is punitive and the charges are harsh. If an offender pays instantly, it costs them about 25,000 Rwandan Francs (about Sh2,800). If one delays payment, say beyond two days, the amount shoots up to 35,000 Rwandan Franc (about Sh3,900).

Aime*, a University of Rwanda student who owns a moto, was on Sophia’s radar and had to pay.

“I was rushing to submit an assignment that was due... I passed by three Sophias and all of them captured my details and sent a receipt to my phone. I had three days to pay 75,000 Rwandan Francs (about Sh8,500). That was money I had not budgeted for, but breaking the law has its repercussions, you know.” 

Besides, the Rwandan government introduced red light cameras (RLCs) last December. An RLC is an automated system that spots and takes images of vehicles and motorcycles that violate traffic signals even when the police are not around. 

Motorcyclists are still learning to work with it and all those in Kigali have a metered system installed on their phones to allow streamlined cashless payment for violations, using an online tariff called MoMo. Further, they don’t speak on the phone while riding. They have to park off the road first.

In June last year, there was an uproar by Rwandese on Twitter after someone shared a photo of a woman carrying her baby on the back while on a taxi-moto, risking the baby’s health.

“One passenger per rider has no exemption, not even children can ride on the same taxi-moto with their mother. It has to be a really special case like a sick child. Still, you have to notify the police because you will be arrested if you don’t,” Hitimana, a rider, tells Healthy Nation.

Cooperatives 

Most motorcycle operators are members of cooperatives.

Dr Jean Bosco Harelimana, the head of Rwanda Cooperative Agency, tells Healthy Nation that joining a cooperative for taxi-motos is voluntary and is not coerced.

“There are professional required permits for driving and then having a moto (the motorcycle). One also has to write a motivation letter and if successful, you are invited in person to see if you have the same vision as theirs,” says Dr Harelimana.

More than 46,000 taxi-moto riders are attached to the 181 cooperatives in the country. In Kigali, about 25,000 taxi-moto riders are part of a cooperative.

However, some riders who spoke to Healthy Nation were indifferent to how the cooperatives surcharge them for insurance.

“It is managed internally within their cooperatives. The reason they have cooperatives is to work together and negotiate their premiums. When you negotiate alone, you are likely to have a higher price,” explains Dr Harelimana. 

The insurance uproar is due to the claims made in the event of an accident. Insurance companies reported that the claims had increased. The matter escalated to parliament. 

Media reports show that 70 per cent of accident claims in Rwanda are caused by motorcycle accidents. This made insurers increase their premiums, which most riders could not afford.

“I think the insurers and the cooperatives are greedy by overcharging us. The insurance pays for accidents only when it is not the rider’s fault,” one rider tells Healthy Nation.

The latest statistics available on motorcycle accident casualties were released in 2017 before the regulations came into effect. At the time, the Rwanda National Police reported over 200 accidents, of which Kigali accounted for 176.

CHUK could not immediately share data on moto accidents, but a doctor, who did not wish to be quoted, said there were not many casualties in the emergency ward when we visited.

Reporting by Jane Njoroge, Ange Iliza, Hellen Shikanda, Elizabeth Merab, Jurgen Nambeka, Herieth Makwetta, Pauline Ongaji, Mary Wangari and James Kahongeh