Health and Safety seems to have a bad reputation in UK. You cannot pick up a copy of the Daily Mail without seeing an article critical of H&S: the firemen who can’t use a step ladder to change a light bulb in the station, or children who have been banned from playing conkers, all in the name of H&S.
Working here in Zambia has changed my view of Health and Safety a great deal. For example, in the past few weeks, I have seen:
A two year old child who had suffered third degree burns to her hand when she touched bare live electrical wires;
A child aged five with a skull fracture caused by a tree which fell on her head as she was eating breakfast;
An older child whose bare feet got caught in the back wheel of a bicycle while he was hitching a ride;
A nine year old girl who was sharpening a pencil for school with a razor blade and unintentionally made a 15cm deep cut into her forearm;
Two children who had disturbed a cobra and had had venom sprayed into their eyes;
A 12 year old girl who fell off her bicycle. She landed on a broken bottle and had a 5cm laceration on her neck, not far from her jugular vein;
A little lad playing soccer in street was concentrating on the ball, not the broken glass which sliced into his heel and ankle;
A young girl was chasing elephants from the family garden at night without a torch. She didn’t see the branch of a bush which caught her in the eye and scratched her cornea.
Most people get around here on bicycles. These are usually ancient wrecks, with no brakes and just an improvised metal rod for pedals. No one wears a helmet. The roads are pockmarked with potholes and the road edges are jagged and steep. I am surprised I don’t see more bike-related injuries in the clinic. Last month I was consulted by a young man who had headaches after he fell off his bicycle while riding over a bridge. He fell four metres down onto a sandy riverbed.
I asked one lad how he stopped his bicycle when it didn’t have any brakes and he said, “I take my feet off the pedals and put them either side of the front tyre.”
“But you ride barefoot. Doesn’t it hurt doing this?” I asked.
“Only if you miss the tyre and touch the metal rim with your heels,” he replied.
It is common to see two or even three people balanced on a bicycle, as it weaves between potholes. The little girl who was knocked out by a falling tree was brought to the health centre, strapped unconscious onto her father’s back, while he cycled.
From these anecdotes, it is obvious that children suffer most from accidents. Not all accidents are avoidable of course, but there doesn’t seem to be a culture of safety first. There is less awareness of danger than in UK. Perhaps the people are more fatalistic. They cannot afford safe means of transport. There are no council workers cleaning streets to remove broken glass.
But today I did see one workman setting fire to overgrown vegetation beside the road and mending potholes by filling them with crushed bricks. He was not looking his best when he approached me as I was driving slowly past. His two front teeth were missing and he was wearing a tee-shirt bearing the slogan, “It’s all about ME!” under an ancient jacket.
“When do you knock off, on Friday afternoon, doc?” he asked. “Can I come and see you about a private matter after work? I am lacking power.”
He was very disappointed when I told him that the Zambian Health Service does not provide free drugs for erectile dysfunction. “You have medicine for that, Doc? Are you keeping them all for yourself, then?” he asked me.
I told him if he managed to sort out the broken glass, fill up the potholes and make the street a bit cleaner, I would see what I could find. After all, the placebo effect is very real.