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SAMJ: South African Medical Journal

On-line version ISSN 2078-5135
Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.105 n.10 Pretoria Oct. 2015 



Data -> information -> knowledge -> wisdom: When is South Africa going to get her act together?



'For what can men do when so many have grown lawless? Who can enjoy the lovely land, who can enjoy seventy years, and the sun that pours down on the earth, when there is fear in the heart?[1]

As I completed this editorial, the government was considering amending the law to charge reckless drivers responsible for deaths on the road with murder, following recent news of the deaths of young girls travelling to a reed dance in open trucks! Of 36 killed in a bus crash. Of 16 killed when a minibus taxi failed to stop as a train approached, crashing through the barriers and onto the tracks. Of 12 killed as yet another minibus taxi rolled.

For decades the SAMJ has been publishing articles highlighting this country's unenviable record as one in which the chances of being killed or maimed in a motor vehicle crash (MVC), murdered or raped are extremely high - whether adult or child. Nearly 25 years ago, Muckart[2] referred to the 'malignant epidemic' ('malignant anarchy' might be more apt), calling for 'stricter application of the legislation governing alcohol, driving and firearm control' and stating that 'a regionalised trauma care programme is desperately needed to contain this epidemic'. He and a young colleague write along similar lines in this issue, reporting the appalling life-changing injuries and deaths of children in MVCs, as passengers and as pedestrians.[2] A number of similarly themed articles[4-6] further highlight our continued culture of horrific trauma and interpersonal violence. With regard to the latter, there is the recent hacking to death of the principal of a school in Pietermaritzburg, with rumours that she was murdered because of her appointment, in the setting of the killing of teachers by people who are selling teaching jobs.

Much is spoken these days of powerful computers and cloud computing, about 'big' data.[7] The articles in this SAMJ do not constitute 'big' data, but are no less compelling. Authors have trawled their respective data sets to garner information and to present the 'information' as 'knowledge' for us as individuals, as society and as provincial and national government(s). In the hands of the latter resides the 'wisdom' to act on the knowledge presented.

In 2013, non-natural deaths (transport accidents, crime, fire or drowning, suicide and others) accounted for some 45 000 deaths in South Africa (SA); 60% of deaths in young males (aged 20 - 24) were 'non-natural', and the highest number of female deaths were of girls aged 5 - 9.[8] Transport deaths were highest in Limpopo Province. Assault in the Western Cape Province was the second most common cause of death (after infectious disease) - at a rate more than three times that recorded in Gauteng. Both assault and transport deaths peak in March, June and December - December being 'particularly deadly for assaults', according to statistician-general Lohahla.[9]

In SA violence 'is related to problems such as poverty, unemployment, poor housing, rapid urbanisation, gender inequalities, erosion of family life and social decay in a society in transition'.[10] In any society, poor people bear most of the brunt of violence, which is associated with 'over-crowding, family disruption, weak social structures, high population concentrations, population transiency and social norms which encourage the use of violence to cope with difficulties'.[11] The poor bear most of the brunt of trauma in minibus taxi and bus accidents also ... 40% of motor crashes, at least in the Western Cape, involve minibus taxis.[6] Add to the mix taxi violence and conflict between taxi associations that place the lives of drivers and commuters at risk, and other ongoing crimes: 'theft of cables which reduces lighting on our streets, reducing visibility and endangering lives of drivers and pedestrians and causing traffic lights at intersections to malfunction or be out of order; theft of crash barriers and man-hole covers sold as scrap metal; fences stolen especially in rural areas & next to informal settlements, creating increased risks of animals entering and crossing roads; stones and other large obstructions placed on the roads with the intention of causing vehicles to crash and providing an opportunity to rob crash victims and stones thrown from cross-over bridges causing road crashes and leaving the victims defenceless to robbery. Then there are those who refuse to obey the rules of the roads: who are impaired and driving under the influence of drugs and alcohol; "Blue light gangs" who present themselves as police officials only to hijack and rob innocent road users; cash in transit robberies that not only endanger the lives of security guards but also all those who share the roads with these vehicles.[12]

According to the Road Accident Fund (RAF), which serves as the social security safety net for those who are maimed on SA's roads, motor vehicle crashes cost ZAR306 billion per annum (ZAR4.6 million of which is paid to lawyers).[13] In 2014 the RAF paid over 7 000 funeral claims, more than half resulting from the 14 000 road fatalities that occur every year.[12]

Thanks to Arrive Alive,[14] started in 2003 by Free State attorney Johan Jonck after losing his mother and a friend in separate car accidents, SA motorists can also contribute data on hazardous road conditions and on bad drivers, aimed at increasing awareness of road safety and reducing the number of deaths on the country's roads.



Janet Seggie




1. Paton A. Cry The Beloved Country. 1949. Chapter 12, p. 67.         [ Links ]

2. Muckart DJJ. Trauma - the malignant epidemic. S Afr Med J 1991;79(2):93-95.         [ Links ]

3. Naidoo R, Muckart D. The wrong and wounding road: Paediatric polytrauma admitted to a level I trauma intensive care unit over a 5-year period. S Afr Med J 2015;105(10):823-826. []        [ Links ]

4. Herbst CI, Tiemensma M, Wadee SA. A 10-year review of fatal community assault cases at a regional forensic pathology facility in Cape Town, South Africa. S Afr Med J 2015;105(10):848-852. []        [ Links ]

5. Sothmann J, Stander J, Kruger N, Dunn R. Epidemiology of acute spinal cord injuries in the Groote Schuur Hospital Acute Spinal Cord Injury (GSH ASCI) Unit, Cape Town, South Africa, over the past 11 years. S Afr Med J 2015;105(10):835-839. []        [ Links ]

6. Van Hoving DJ, Lategan HJ, Wallis LA, Smith WP. The epidemiology of major incidents in the Western Cape Province, South Africa. S Afr Med J 2015;105(10):831-834. []        [ Links ]

7. Wikipedia. Big data. (accessed 11 September 2015).         [ Links ]

8. Statistics South Africa. Mortality and causes of death in South Africa, 2013: Findings from death notification. (accessed 11 September 2015).         [ Links ]

9. South SA's mortality rate at its lowest in over a decade. (accessed 11 September 2015).         [ Links ]

10. Gilbert L. Urban violence and health - South Africa 1995. Soc Sci Med 1996;43(5):873-886. (accessed 11 September 2015).         [ Links ]

11. Mercy JA, Rosenberg ML, Powell KE, Broome CV, Roper WL. Public health policy for preventing violence. Health Affairs 1993;12(4):7-29. (accessed 27 August 2015).         [ Links ]

12. Arrive Alive. Crime as a threat to road safety in South Africa. (accessed 27 August 2015).         [ Links ]

13. South Road Accident Fund pays out a record R22bn. (accessed 27 August 2015).         [ Links ]

14. South Arrive Alive: SA's road safety website. (accessed 27 August 2015).         [ Links ]

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