Foreign roads can be deadly for U.S. travelers
Gary Stoller, USA TODAY, 8/14/2007 (excerpted)
Motor vehicle crashes — not crime or terrorism — are the No. 1 killer of healthy Americans in foreign countries. And the threat to travelers is poised to increase dramatically as worldwide economic growth gives more people access to motor vehicles.
Corporate employers, including energy giant Chevron, are teaming with safety advocates to combat what they view as a rapidly worsening epidemic of highway deaths and injuries, particularly in developing countries.
"The road-safety problem worldwide for travelers and locals constitutes a growing public health crisis," says Tony Bliss, lead road safety specialist for the World Bank. He says it's "a far greater problem than many more widely acknowledged diseases."
Much of the growth in motor vehicle usage is in developing countries, where roads are sub-standard, signage deficient, traffic regulations lax and enforcement spotty. While local residents bear most of the risk of death and injury, travelers can be particularly vulnerable because of their lack of familiarity with surroundings and with local customs.
Frequent business travelers Mian Chin and Richard Hadden are two of many Americans involved in separate accidents abroad who say they're lucky to be alive.
Chin, 52, an atmospheric scientist from Maryland, was in a bus accident last August during a business trip from western China to Tibet. The bus driver said, "'We're finished,'" she says. "We thought we were going to die."
The brakes failed on a steep mountain road, but, luckily for Chin and 24 others inside, the bus plowed into a herd of yaks, slammed into a retaining wall and stopped. One woman hurt her back, and Chin needed stitches on her arm and wrist, but it was "a miracle that no one was seriously injured," she says.
Travelers' risks are not limited to developing nations. Hadden, an author and a professional speaker in Jacksonville, was in a head-on collision in England in 2002 on a single-lane road bounded on both sides by 12-foot hedges. "Suddenly, a local man driving carelessly at about 50 mph came around a blind curve," he recalls. Both cars were totaled, but no one was hurt.
The World Health Organization and the World Bank estimated in a 2004 joint report that 1.2 million people are killed each year in traffic crashes, and 20 million to 50 million are injured or disabled. About 85% of the deaths are in low- and middle-income countries. The organizations predict that traffic fatalities worldwide will increase to 2.3 million in 2020, nearly double today's fatalities.
Over the 30-year period ending in 2020, the report predicts an 80% increase in fatalities in low- and middle-income countries vs. a 30% decline in high-income countries, including the USA.
The fatality rate is soaring in low- and middle-income countries for many reasons, including a growing number of motor vehicles, unsafe roads that are also used by pedestrians and cyclists, weak enforcement of motor vehicle laws, little government investment in road safety and poor emergency medical response to accident scenes.
Drivers' unfamiliarity a factor
There are no data showing how many, or how often, travelers to foreign countries are involved in motor vehicle crashes. But safety experts suspect it is riskier for travelers to drive outside their own countries.
A 1999 study by Australia's Federal Office of Road Safety, for example, concluded foreigners are at higher risk than Australians of being killed in motor vehicle crashes in that country. Contributing factors: a greater tendency not to wear seat belts and "their unfamiliarity with Australian conditions."
The U.S. State Department began keeping statistics three years ago and says it has received reports that 719 Americans were killed during the past three years in motor vehicle accidents. Its statistics include only deaths reported by family members and some media accounts. More deaths might go unreported.
Make Roads Safe, a non-profit global safety campaign, studied State Department data and found that crashes killed 31% of healthy Americans who died abroad during the past three years. The data exclude medical problems such as heart attacks, focusing instead on deaths that have no link to pre-existing health conditions.
Mexico's a particular concern
State Department data show that travelers should be particularly concerned in Mexico, a USA TODAY analysis shows. In the three years ended in 2006, at least 280 Americans lost their lives in motor vehicle crashes in Mexico, the nation Americans visit most.
Contrast that with Americans' experience in Canada, their second-most-visited country. Though Canada gets about 70% of the number of U.S. visitors to Mexico, the State Department has recorded just 11 U.S. traffic deaths in Canada for the 2004-2006 period.
Causes of motor vehicle deaths in Mexico vary. The State Department's consular information sheet for Mexico warns travelers that taxis and buses "often do not comply with traffic regulations," including speed limits and stopping at red lights.
It also warns travelers to avoid driving on highways at night and to be aware that the training and availability of emergency responders might "be below U.S. standards." Multi-lane expressways have narrow lanes and steep shoulders, and "single-vehicle rollover accidents involving U.S. citizens are very common."
Travelers to foreign countries who rent motor vehicles face many distractions, says Stephen Hargarten, chairman of emergency medicine at the Medical College of Wisconsin and co-author of the Make Roads Safe report.
Hargarten says American business travelers are more likely to get involved in auto wrecks abroad than during trips within the USA. They're often fatigued from jet lag when they get behind the wheel and then face the distractions of driving in a foreign country.
Injury-prevention specialist Bella Dinh-Zarr, the report's other co-author, says local customs can be disorienting and dangerous for visitors. In countries such as England and Scotland, driving on the left side of the road, as well as narrow roads and numerous roundabouts, can confuse Americans. Some locals in Latin American countries drive at night without their lights on. Animals are free to stray on many foreign roads, which are frequently unlit at night.
TRAVEL TIPS FOR THE ROAD
Travelers can take precautions to prevent being killed or injured in auto accidents abroad.
• Before heading abroad, educate yourself about a foreign country's roads, driving laws and road culture. The Association for Safe International Road Travel has reports on about 150 countries' roads on its website, www.asirt.org . Check the State Department's consular information sheets for information on traffic safety and road conditions.
• It may often be safer to use mass transit or to hire a car with a driver than to drive yourself.
• Avoid driving at night on mountain roads or in countries with poor safety records.
• Carry a cellphone and contact information for emergencies.
• Check whether your auto insurance provides coverage in an accident. Check whether your health insurance provides coverage if medical care or an emergency evacuation is needed.
Twenty-three of the most dangerous roads in the world, according to the Association for Safe International Road Travel: Country
Dangerous road
Comment
Bolivia
The Old Yungus Road
50-mile mountain road that connects Coroico to La Paz
Brazil
Interstate 116
Potholes, poor signals and heavy traffic in southern Brazil
China
Sichuan-Tibet Highway
A rough, high-elevation road between Chengdu and Tibet where landslides and rock avalanches are common.
Costa Rica
Pan American Highway
Called the Hill of Death, the stretch from San Isidro de El General to Cartago is full of potholes and steep curves.
Croatia
Coastal roads
Adriatic Coast roads are narrow, curvy, and congested, and many lack shoulders and guardrails.
Ecuador
Cotopaxi Volcan road
25-mile dirt road that crosses a swift-moving stream at the Cotopaxi National Park entrance.
Egypt
Luxor-al-Ghurdaqah road
Many crashes on this road to the Red Sea occur at night because Egyptians drive with headlights off.
England
A44
More than 25% of crashes on the stretch linking Leominster and Worcester are head-on.
Greece
Patiopoulo-Perdikaki road
A steep, gravel road with an unmarked edge in the Agrafa region.
India
Grand Trunk Road
Heavily used by trucks, the country's busiest road is overloaded with ox carts, animals, bicycles and pedestrians.
Kenya
Nairobi-Nakuru-Eldoret Highway
More than 300 die annually in crashes commonly caused by speeding, improper passing and drunken driving.
Mexico
Highway 1
A winding, narrow potholed road from Tijuana to Cabo San Lucas that lacks guard rails, shoulders and road signs.
Morocco
Marrakesh-Agadir Road
Heavy truck traffic and buses and taxis that pass on steep, blind curves
Namibia
Swakopmund-Walvis Bay road
Heavy truck traffic and frequent head-on collisions when drivers misjudge distance between vehicles while passing.
Nepal
Prithvi Highway
Landslides and road cave-ins during the rainy season are common on this narrow road with heavy traffic linking Kathmandu to Pokhara.
Nigeria
Lagos-Ibadan-Ogbomosho-Ilorin-Jebba-Minna-Abiyo Expressway
A congested road with deep potholes and a median in disrepair that links northern and eastern Nigeria. Drivers may drive on the wrong side to avoid traffic.
Pakistan
N-35 (Karakoram Highway)
Landslides, floods and mud can block this northern Pakistan mountain road that passes through deep gorges and is a route to China.
Peru
Kuelap-Celendin-Cajamarca road
Narrow, gravel mountain road with sheer drops and hair-pin turns on descent from Barro Negro Pass to Las Balsas.
Portugal
IP3
Steep, deteriorating road with no barrier between lanes linking Coimbra and Viseu.
Scotland
A77
A winding single- and two-lane road in southwestern Scotland with varying speed limits and many fatal crashes.
Spain
Carretera Nacional N340
A narrow Costa del Sol coastal road where drunken drivers and tourists unaccustomed to driving on the right have caused many crashes.
South Africa
N3
Between Warden in Free State Province and the bottom of Van Reenen's Pass in KwaZulu-Natal Province, there's a high crash rate because of fog, rain, wind and winding stretches.
Turkey
Bodrum-Milas-Soke road
Winding coastal road without barriers on many stretches that's especially dangerous when wet.
Source: Association for Safe International Road Travel