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Johns Hopkins International Injury Research Unit

A World Health Organization Collaborating Center for Injuries, Violence and Accident Prevention

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Keyword: kenya

Recently, JH-IIRU director, Adnan Hyder and associate director, Kent Stevens, were invited to participate in surgical Grand Rounds at Virginia Commonwealth University (VCU) Medical Center.

While there, Dr. Stevens presented on care of the injured patient in the developing world, focusing on the Unit’s trauma care efforts in Kenya as part of the Bloomberg Philanthropies Global Road Safety Program.

There are four specific aims of the trauma care efforts in Kenya, 1) to understand and evaluate the transport systems in the country (both formal and informal); 2) to evaluate the existing emergency response system; 3) to explore the triage capabilities of participating hospitals/healthcare facilities;  and 4) to evaluate hospitals’ resources and infrastructure available for the injured patient.

In order to accomplish these goals, it is important to have multi-sector engagement including hospital administrators, practitioners and clinicians as well as the local and national governments and Ministries of Health. It’s equally important, Dr. Stevens said, to focus efforts on areas that will have the most impact.  

In order to be most effective, the Unit’s trauma care efforts are focusing training of both pre-hospital and in-hospital trauma care providers while also developing and implementing trauma registries,  and working to develop a dependable EMS communications system. The Unit is also advocating for increased stakeholder engagement in order to strengthen trauma care legislation in the country. Dr. Stevens is also developing a Trauma Care Quality Improvement Program and is o recommending continuing the trauma care evaluation using the Trauma Care System Profile (TSP) tool.

Improving the care of the injured patient in Kenya must be a multi-step approach that involves numerous organizations working in the country in an ongoing effort to ensure longevity of the program.

JH-IIRU Associate Directors, Kent Stevens and Abdul Bachani, along with post doctoral fellow, Fatima Paruk, are in Nairobi, Kenya this week as part of a series of high-level meetings as part of the Bloomberg Philanthropies Global Road Safety Program.

More than 3000 people die each year in Kenya as the result of road traffic crashes.  JH-IIRU, as part of the Global Road Safety Program, is working in two districts, Thika and Naivasha, to monitor and evaluate two major risk factors, helmet-wearing and speeding.

Research suggests that properly wearing a helmet can reduce the risk of head injury by nearly 70% and death by more than 40%. Research has also shown that an increase in average speed is directly related to both the likelihood of a crash and the severity of the consequences.

While in Nairobi, the JH-IIRU team will take part in the launch of a national speed prevention campaign, “Slow Down, Speed Kills.” The campaign, part of a joint collaboration with Global Road Safety Program consortium partner, the World Health Organization,  as well as The Ministry of Health and the Ministry of Transport, includes radio messaging and outdoor adverts on billboards. The aim is to raise awareness among motorists of the risks and consequences of speeding.

JH-IIRU’s work in Thika and Naivasha, as part of the Bloomberg Philanthropies Global Road Safety Program, shows that there has been a substantial increase in speed compliance. In Thika, speed compliance increased from 42% in June 2011 to 71% in June 2013, while the increase in Naivasha was from 50% to 77% for the same time frame. However, large vehicles, like matatus and buses and light trucks remain the least compliant in both districts.

The launch is part of the Bloomberg Philanthropies Global Road Safety Program. Click here for an infographic on the work the Bloomberg Philanthropies Global Road Safety Program constortium partners have been doing in Kenya.

According to the World Health Organization, 90% of all injury-related deaths occur in low- and middle-income countries, but often health care facilities in developing nations are unable to provide much-needed emergency services. And while injury -- in particular road traffic injury (RTI) -- has received increasing attention, strategies to strengthen trauma care have often been lacking.

 As part of the Road Safety in Ten Countries (RS-10) project, the Johns Hopkins International Injury Research Unit (JH-IIRU) has been tasked with implementing, monitoring, and evaluating trauma care in Kenya, because, while we recognize that injury prevention is the primary overall objective of the RS-10 project, even with the best interventions, injuries will continue to occur.

To that end, in an effort to build collaboration and consensus among the many organizations and individuals who provide initial care for the injured patient, Dr. Kent Stevens, JH-IIRU Associate Director for Trauma Systems and Clinical Services, co-led an Emergency Medical Systems (EMS) symposium in one of the two RS-10 intervention sites in Kenya.

“Connecting the Dots: A Unified EMS System in Kenya” was held from August 7-8, in Naivasha. Jointly sponsored by JH-IIRU and the CDC Kenya, the conference was attended by key stakeholders involved in pre-hospital and hospital care in Kenya. The attendees included emergency medical technicians as well as representatives from the Kenyan Ministry of Medical Services, the Ministry of Public Health and Sanitation as well as Kenyatta National Hospital and non-governmental organizations and academics.

The symposium aimed to cover all aspects of trauma care in Kenya, from preparedness to response, with an emphasis on how policy can be implemented and ways to engage decision makers in the country.

Dr, Stevens characterized the conference as a resounding success, “The discussions were lively and helpful, with wide participation and a solid plan of action put in place.”

Through improvement of pre-hospital and hospital care and understanding the experience of the injured patient in Kenya, JH-IIRU to will continue our commitment to saving lives, both in the short-term and for years to come.

EMS Kenya
Participants of "Connecting the Dots: A Unified EMS System in Kenya"

While it’s well-known that road traffic injuries (RTIs) are one of the leading causes of death and disability worldwide, estimates on the burden of injury in specific countries, especially those in the developing world, are often inaccurate or insufficient.  This is true in Kenya, where estimates quantifying the burden of road traffic injuries exist, but are more than 10 years old, making it difficult to demonstrate the magnitude of the problem to decision-makers in the country. What’s more, as countries like Kenya develop, the number of vehicles increase with the enhancement of road infrastructure. This increase often leads to higher rates of speed which then leads to more RTIs.

In the paper “Road Traffic Injuries in Kenya: The Health Burden and Risk Factors in Two Districts,” members of the JH-IIRU team, including associate directors Abdulgafoor M. Bachani and Kent Stevens, as well as Hadley Herbert, along with colleagues from the Department of Public Health at Kenyatta University in Nairobi and the Ministry of Public Health and Sanitation aim to address this issue.

The goal of the paper was to assess the current status of RTIs in Kenya using police and vital registration records. The team also conducted observational studies of three risk factors—speeding, helmet use and reflective clothing use—in two districts, Naivasha and Thika.

The assessment revealed that the burden of RTIs continues to increase, highlighting the necessity of a renewed effort to address this burden with a focus on incr
easing helmet and reflective clothing use, while enforcing speed limits.

As part of the Road Safety in 10 Countries project (RS-10), in 2012, the Johns Hopkins International Injury Research Unit (JH-IIRU) published “Public Health Burden of Road Traffic Injuries: An Assessment from Ten Low- and Middle-Income Countries,” a special issue of Traffic Injury Prevention. This landmark publication includes 11 scientific papers jointly authored with 50 colleagues from JH-IIRU and their in-country collaborators that contribute much-needed new knowledge to the burgeoning issue of road traffic injuries in low- and middle- income countries.

You can access the full article along with the entire special issue here.

To find out more about JH-IIRU and road safety, contact us at

More than 626,000 children under the age of 15 die each year due to injuries, with more than 95% of those fatalities occurring in low- and middle-income countries (LMICs).  In sub-Saharan Africa, injuries are especially high and result in approximately 43 deaths per 100,000 children each year. Yet despite this high burden of pediatric injury, there is little data to explain the epidemiology of injury in LMICs. And without proper understanding of the etiology of injuries, researchers cannot adequately address the risk factors for injury and implement injury prevention interventions.

Recently, members of the JH-IIRU team, including  trauma specialist Hadley K. Herbert, associate directors Kent A. Stevens and Abdulgafoor M. Bachani and director, Adnan A. Hyder, along with their colleagues at Childsafe South Africa and Red Cross War Memorial Hospital in Cape Town and the Virginia Commonwealth University Medical Center’s Department of Surgery, address this issue in “Patterns of Pediatric Injury in South Africa: An Analysis of Hospital Data Between 1997-2006,” published in the Journal of Trauma. The paper looks at the patterns of childhood injuries using hospital-based surveillance system in Cape Town, South Africa.

The results indicated that, between 1997-2006, more than 62,000 children presented to the Trauma Unit of the Red Cross War Memorial Children’s Hospital’s (RCH) Casualty Department with almost 69,000 injuries. The majority of injured were males and injuries included falls, road traffic injuries, burns and assaults.

To read more, you can access the paper

To find out more about the JH-IIRU’s work on childhood injuries, email us at

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