Chapter 9 The International Context

Every morning, Cecilia, ten years old, wakes up in a slum in Dar es Salaam, Tanzania. She makes herself a chai tea and heads out alone on the city’s chaotic roads on her way to school.

Three-quarters of Dar es Salaam’s children walk to school in this fast-growing city of 4.4 million located on the Swahili coast in eastern Africa. The dangers they face on those journeys are extreme.

About 70 percent of the city’s population lives in informal settlements, in families earning the equivalent of just a few dollars a day. Cecilia’s family will likely never be able to afford a car. Only a small portion of Tanzania’s richest people drive. Cecilia’s father earns around one hundred dollars a month as a security guard.

In Dar es Salaam, slum dwellers rely almost exclusively on walking. Although car ownership is growing, Tanzania remains primarily a walking country. For every one thousand people in Tanzania, there are only 39 vehicles; in the United States, by comparison, there are 873.1

But even with so few cars, lower-income nations like Tanzania have staggering traffic death rates. According to the World Health Organization, people in “developing nations” account for just 1 percent of the world’s cars, but 13 percent of the world’s 1.3 million annual fatalities.2

People in sub-Saharan Africa are particularly vulnerable. In Tanzania, for example, two-and-a-half times more people are killed on a population-adjusted basis than in the United States and about eleven times more than the world’s safest country, Norway.3

These traffic deaths are, in significant share, pedestrians. In the United States, 16 percent of traffic deaths are pedestrians, but walkers make up 40 percent of the dead in sub-Saharan Africa.

Official transport data from many lower-income countries are unreliable, but Julie Babinard, a senior transport specialist with the World Bank, said that 40 to 60 percent of trips in Africa are made on foot.4 By contrast, according to the US Census Bureau, only 2.7 percent of US workers commuted by walking in 2017.5

Workers crowd into the streets in fast-growing African cities like Dar es Salaam, Lagos in Nigeria, and Abidjan in Côte d’Ivoire every morning when it is still dark, often hauling wares to sell at markets. Many cannot afford the price of urban housing and commute long distances from rural areas. “Often there are no transport services available,” said Babinard. “The poor are still needing to walk to work.”6

In many so-called developing countries, transportation mode is stratified to an extreme degree by class. The World Resources Institute analyzed transportation modes by income in Nairobi, Kenya, for example. Among low-income people, walking was their primary mode for some 62 percent, and only a vanishingly small share—3 percent—traveled by car. For those belonging to the upper class, however, it was different; almost one-third—29 percent—used cars for transportation, a slightly higher proportion than those who walked.7

“Sub-Saharan Africa, in particular, has a vast income and mobility divide—a wealthy elite and small middle class while more than 90 percent of people earn less than ten dollars per day,” said Kate Turner, a spokesperson for the FIA Foundation, which supports road safety initiatives around the world.8

Until very recently, infrastructure development in much of Africa has catered almost exclusively to drivers. According to a survey by the International Road Assessment Programme, only a small percentage—less than 10 percent—of roads in sub-Saharan Africa with speed limits greater than 40 kilometers per hour (about 25 miles per hour) have footpaths at all.9 Even when they do have sidewalks, they are often impassible, crowded with vendors or consumed by motorcycle parking.

At times, international development groups have contributed to the problem. One of the worst examples is in Accra, Ghana, a city with a fast-growing population of 2.5 million.10

In 2012, the Millennium Challenge Corporation, an international nongovernmental organization, funded the upgrade of National Highway 1, or N1, between the Accra airport and port. One stretch, 14 kilometers (8.7 miles) long, was widened to a six-lane divided highway. The project was designed to “reduce bottlenecks” on the highway, which carried about twenty-five thousand vehicles a day, and aid Ghana’s economy.

Completed in 2012 and renamed the George W. Bush Highway, the N1 has been a disaster for pedestrians. Turner calls it “one of the worst international development mistakes . . . with vast numbers of fatalities.”11 Six of the ten most dangerous areas of Accra are on that highway.12

A FIA Foundation report explained that the highway runs through residential neighborhoods in Kwashieman, Lapaz, and Abeka, where many residents earn as little as two dollars per day. “The N1 highway has been built through the centre of the Kwashieman community dividing it in two,” the FIA Foundation reported. “Throughout the day, hundreds of people line up to cross the six-lane highway with traffic travelling at speeds of up to 130km/h [approximately 80 miles an hour]. Whole families stand by the road attempting to get across to their places of work, to services and schools.”13

Experts say that there is an urgent need for better pedestrian infrastructure—namely, sidewalks—in these countries. “In somewhere like Nairobi, the majority of people walk and bicycle,” said Turner. “But the only thing that’s happening in Nairobi is building more bypasses. . . . All it does is encourage more people to aspire to have vehicles. They end up back in the same situation where they have gridlock.”14

In addition to inadequate infrastructure, poor nations have other challenges that make streets much more dangerous than wealthy nations. In many less developed countries, for example, there is little to no police enforcement of traffic rules.

“Basic safety rules just are not respected,” said Soames Job, Global Road Safety Lead for the World Bank. “In many countries, seat belts are not even a required element to be used. Some states don’t even have a license requirement.”15

In addition, in many lower-income countries, police departments are often rife with corruption. For example officers, who earn low wages, may insist on a bribe to escort a group of people across a dangerous street.

Inadequate vehicles are also a problem. The cars that often arrive in poor nations are almost exclusively those discarded by wealthy nations. Many vehicles are overloaded, old, and unsafe.

These countries are nevertheless seeing huge increases in vehicle ownership. The United Nations reported in 2018 that Kenya and Ethiopia were seeing growth in their vehicle fleet at the rate of 12 and 10 percent a year, respectively. The United Nations reports that 96 percent of vehicles imported into Kenya are used.16

Under these conditions, schoolchildren under age fourteen, like Cecilia, are at the greatest risk. Compared to that of the United States, Tanzania’s population is very young, with about 45 percent of the population being less than fifteen years old.17 But a staggering number of youth in Dar es Salaam have their lives shattered just trying to make their way to school.

A survey by the African road safety group Amend of fifteen thousand children in twenty-two schools in Dar es Salaam was used to estimate death rates for children ages five through fourteen. The group estimated that there were about forty-five traffic deaths per ten thousand children. This result indicates that far more children are killed by cars, trucks, and motorcycles in urban Tanzania than are killed by AIDS, malaria, or diarrheal diseases.18

When looking at six schools, with 2,675 students, the survey found that 59 children were injured in traffic crashes in 2014 alone. That was more than 2 percent of the total school population injured in traffic collisions in a single year.19

But people in Tanzania have fought for safer streets heroically. Children in Dar es Salaam sometimes stage impromptu protests, including a boy who sat in the middle of Nyerere Road in Dar es Salaam to protest a crash that injured one of his schoolmates at his school in April 2016.

“Unfortunately, this being a regional road, responsible authorities have always discouraged the use of speed humps—speed reduction—due to the ‘political and economic sensitivity’ of these roads,” said Turner. “In the end, speed humps were not put in place, but a police officer was later brought in to assist pupils to cross.”20

Cecilia’s case was held up as a case study in a report by the FIA Foundation.21 In early 2016, she was one of the unlucky ones—she was struck by a motorcycle while walking to school on a footpath by the side of a busy road.

She struck her head and was rushed to the hospital by one of her teachers for treatment. (A lack of prompt medical care is another contributing factor to the high traffic fatality rates in poorer countries.) But even though she was released from the hospital later that day, the effects have been long-lasting for both Cecilia and her family. She had to be seen at several follow-up appointments and missed a month of school. When the FIA Foundation last reported on her case in September 2016, she had still not caught up with her classmates and had ongoing issues with concentration.

Her family suffered long-term financial repercussions as well. Medical treatment for her injuries cost one hundred dollars—a monthly salary for her family. They were forced to borrow the money from family and friends, and more than a year later, they had not been able to repay.

Incidents like these compound the already enormous inequality in countries like Tanzania, say experts. “The poorest are most likely to be injured and to then become even poorer as a result of losing a breadwinner, the cost of treatment, or a family member giving up work to become a carer,” said Turner.22

In the aggregate, high traffic fatality and injury rates also prevent poorer nations from becoming wealthier and more stable. Traffic crashes exert huge economic costs on the overall economy and hinder economic growth. A 2017 report from the World Bank estimated that Tanzania could increase its gross domestic product 32 percent if it could reduce traffic injuries 50 percent over a twenty-four-year period.23

Although many of the trends are concerning—especially increased motorization and the growth of SUVs globally—there are reasons for hope around the world as well.

Mexico City

In Mexico City as recently as 2015, one thousand people were being killed every year in traffic. About half of those killed were pedestrians and cyclists.24

The streets in this North American megacity (population 8.8 million) are Darwinian. The Mexican driver’s licensing process essentially consists of having a picture taken. Not until 2005 did the government start using Breathalyzer tests to crack down on drunk driving (a move that caused an almost immediate 43 percent decline in fatalities).25

Most importantly, pedestrians simply are not respected on Mexico City’s congested streets. Only about 15 percent of trips in Mexico City are made in cars.26 Still, the whole of the city’s transport apparatus seems to be geared toward accommodating that privileged minority.

In 2011, Jorge Cáñez, a lifelong Mexico City resident, decided to do something about it. “Nothing really special happened,” he said. “It was just, I was tired of this chaotic city I live in. I was tired of walking like an extreme sport. I was just tired of all this infrastructure for cars.”27

Together with some friends, Cáñez painted a bright-green sidewalk along the Avenida de los Poetas Bridge, a terrifying stretch of highway that has heavy foot traffic. “We bought paint with our own money,” he said. “Then we just started to paint sidewalks and crosswalks and bike lanes all over the city.”28

Initially, there was pushback from some neighbors, but Cáñez and his group were able to win the ear of the government. Since then, the group—Camina, Haz Ciudad—has completed demonstration projects like the one on the Avenida de los Poetas Bridge all across the city.

With official government support, they have used flexible bollards and paint to narrow the crossing distance at 150 intersections. At those intersections, crashes have dropped 50 percent, said Cáñez.29

Despite the population being heavily dependent on walking, in 2011, when Cáñez got started, there were no advocacy groups devoted to pedestrian safety in Mexico City—or anywhere in Mexico, for that matter.

One of Cáñez’s great innovations, however, was helping lighten the mood around the discussion. He began dressing in a Lucha Libre–style costume, used by Mexican professional wrestlers, and doing demonstrations in crosswalks.

Wearing a mask and cape, he would direct traffic or hold out his arms while schoolchildren would pass by. He would even, theatrically, push on the front end of cars that were infringing on the crosswalk. The good-natured energy of the demonstrations disarmed drivers, who were often happy to slowly reverse or yield. It also helped generate some visibility for the issue.

Cáñez calls the character Peatónito, from peatón, meaning pedestrian, and ito, a term of endearment.

“It’s been a good way to communicate the message of pedestrian rights,” he said. Even though car crashes are the leading cause of death for everyone between the ages of five and twenty-three in Mexico (similar to the United States), “it’s been a very invisible topic,” he said.30

The pedestrian advocacy scene in Mexico City and Mexico overall has since flourished. Today, there are more than a dozen groups advocating for pedestrians in the city, and almost two dozen aligned advocacy groups have formed across the country, including one in almost every Mexican state.

The concept has spread throughout Latin America as well. For example, there are now five active groups in Brazil, including Corrida Amiga and SampaPé in São Paulo.

These efforts are starting to have a real impact, perhaps most apparent in Mexico City. Since the city announced its Vision Zero campaign in 2015, traffic deaths have fallen a remarkable 21 percent.31

Advocates like Cáñez hope that they are on the verge of a bigger win as well. They hope that Mexico’s new president, Andrés Manuel López Obrador, will pass the National Road Safety Law. This law, a package of sixty-nine different reforms, would strengthen vehicle regulations, toughen penalties for drunk driving, and task different levels of government with setting goals for crash reductions and monitoring progress toward them, among other things. It would also create a nationwide fund for addressing traffic safety and establish a transportation hierarchy with vulnerable users—pedestrians and cyclists—at the top.32

Areli Carreón, known as the bicycle mayor of Mexico City, said that after four years of struggle, the thirty-five citizens organizations fighting for the changes are “really enthusiastic of finally achieving it.”33

But the battle for more walkable streets in Mexico City is also fighting against some strong cultural headwinds. Vehicle ownership is growing fast in Mexico City. The World Resources Institute estimated that Mexico overall sees a 4.2 percent increase in vehicle ownership per year.34

“As the economy develops, and people get more money, the first thing they want to buy is a car,” said Cáñez. “To have a car is a social status symbol. If you have a car, you are more important in the mindset of the society, especially in a developing country.”

But that mindset has begun to shift perceptibly recently, even in Mexico City, Cáñez said. “In a couple of neighborhoods, it’s no longer cool to have a car,” he said. “It’s only like 2 percent of the city,” he said, primarily the Condesa and Roma neighborhoods, which lean toward the young and fashionable, but it is still promising. “At least there’s somewhere in Mexico City where car culture isn’t the norm.”35

A Growing Divide

A child in a lower- or middle-income country, like Cecilia in Tanzania, might face extreme risks to walk to school, but things are very different in parts of Western Europe.

In 2019, for example, not a single child was killed in traffic in the city of Oslo, the capital of Norway, a city with a population 673,000. That year, only one person was killed in traffic within city limits in total (and he was a driver, not a pedestrian).

The achievement comes as Oslo city leaders have taken bold measures to limit the dominion of cars and trucks in the city. In 2019, it pedestrianized its entire center city. Cars are forbidden or severely restricted within an area of approximately one square mile of the city’s core.

City leaders had been taking aggressive measures to prepare for the transition since 2015. In 2017, the city eliminated almost all its on-street parking and converted the space to additional facilities for walkers and cyclists.36 The few spots that remain are reserved for people with disabilities or for electric vehicle charging. Other drivers can take advantage of a few garages at the outskirts or are routed around the area on a ring road.

As the city successively removed parking and increased pedestrian space, there was some grumbling and political backlash, but pedestrian activity rose. Overall, the increase in public space makes the city more pleasant, leaders say. Oslo is one of the fastest growing cities in Europe, adding about ten thousand residents a year. Limiting the number of cars not only reduces injuries but also improves air quality and makes more room for more people.

“Cities have been built for cars for many decades, and the car has been seen as a status symbol, and I guess it still is for some people,” Hanna Marcussen, Oslo’s vice mayor of urban development, told Fast Company in 2019. “We need to plan our cities better for the future so that the private car is not setting the premise for how we build our cities anymore.”37

Banning or greatly restricting cars within the central area of historic European cities is becoming more and more common. Madrid, a leader on this front, banned most cars from its center city in 2018. Despite signs of backlash, the decision has proved popular and enduring. When a far-right government won power in the city the following year and called for reversing the ban, tens of thousands of protesters flooded the streets38 and were successful in winning political support to continue the car-free zone.

In addition, both Paris and London have long-term plans to phase out cars from central areas and streets. Already London has imposed congestion pricing to limit traffic in its central area. In addition, the city imposes steep fees on high-polluting vehicles within its designated Ultra Low Emissions Zone.

None of these policies would be possible without generous support for transit and years of work building bike facilities and other supportive infrastructure. These European cities also benefit from a housing stock that predates the auto era and a built environment that is dense and pedestrian friendly.

Car-free zones, and other measures, have helped produce dramatic reductions in air pollution, which is a leading killer in many of these cities. In addition, they have helped Western Europe, along with Japan, become the world leader on traffic safety. Norway now has just 2.7 traffic fatalities per 100,000 residents—or less than one-fourth of the United States’ per capita fatality rate.

As Europe has improved, however, this has caused a growing global divide on this key public health issue. It is especially apparent as poorer nations with inadequate infrastructure and protections for pedestrians, like Tanzania, become increasingly motorized.

Internationally, the United States lies in a strange middle position. It is clearly a wealthy country. But in the United States, people die on the roads at rates not seen in the rest of the wealthy world, and in recent decades, it has fallen further behind.

In 2016, the US Centers for Disease Control and Prevention released a study showing that wealthy nations in Western Europe and Asia (notably Japan) have seen traffic deaths decline on average about twice as fast as in the United States since around 2000. If the United States were to match the traffic death rate of Sweden, approximately twenty-six thousand American lives a year would be saved.39 As a result, in part, of the lack of progress on traffic safety, researchers who study life expectancy predict that US life expectancy will decline in the next few decades compared to peer nations. (Besides traffic deaths, guns and opioids are the other big factors.)40

Canada

Even compared to countries that are culturally and geographically very similar, the United States is a deadly place to travel. On a population-adjusted basis, Canada, for example, loses less than half as many people on the roads every year as the United States.41

What explains Canada’s superior performance? Its land use is not much different from the United States’. In fact, Canada’s densest city, Toronto, has fewer people per square mile than New York City or Chicago. And San Francisco has greater population density than Vancouver.42

There are, however, differences in the ways communities are designed in Canada and in the United States. Many experts point out that the United States’ suburbs are more sprawling. And Canada, crucially, provides better alternatives to driving than the United States. Canada’s transit commuting rate, at 11 percent, is more than double that of the United States (about 5 percent),43 and transit ridership is closely associated with lower traffic deaths. Not only does transit ridership reduce driving, but it also supports the kind of walkable neighborhood patterns that reduce driving trips altogether—what planners call a virtuous cycle.

Canadian traffic safety expert Neil Arason, author of the book No Accident, said that offering alternatives to driving is an important explanation. Thanks to the presence of functional alternatives, Canada can, for example, set stricter rules about drunk driving. People caught drunk driving in Canada have their licenses revoked automatically, unlike in the United States, where drunk drivers may face jail time but not have their driving privileges interrupted. Canada also has better seat belt compliance than the United States, with only about half as many unbelted passengers.44

In this way and many others, traffic laws in the United States are outliers among the wealthy world and are much more lenient than all its peer countries—and many poorer nations as well. US seat belt laws are more permissive than those in all of Europe, Canada, Russia, China, Australia, and India and do not conform to the best practices recommended by the World Health Organization. US impaired driving laws are more permissive than those in Canada, Australia, most of Western Europe, China, and Brazil.45 Speeding laws are another area where the United States is out of alignment with the United Nations’ recommendations, which call for speeds to be limited to less than 51 kilometers per hour on urban roads (about 31 miles per hour) and allow localities to adjust them. In the United States, speed limit laws are generally governed by each state and are difficult for cities to change. In many urban areas, pedestrians contend with speed limits of 35 miles per hour or more.

“The U.S. is a bit obsessed with freedom,” Arason said. “There’s two kinds of freedom: ‘freedom to’ and ‘freedom from.’ There’s freedom to drive fast. And there’s freedom from death and injury on the roads. I remember when Texas raised its speed limit, people said it’s a matter of personal responsibility. (It now allows a maximum speed of 85 miles per hour.) But if someone is speeding and they’re coming at you head on, there’s not much you can do.”46