I don't know about you but when I travel home from a mission, I find the sound of the aircraft door thudding shut behind me and the change in pressure as the air blows through the cabin, strangely comforting. It is not that I am happy to leave the country or the friends that I have worked with, it is the fact that I am now on the safest part of my journey.
In July last year it was even more important. I had taken my 15 year old grandson on his first visit to Africa. I left with the family warnings, "you remember to bring him back in one piece". It was a bit like the Spartan mothers who said "come back with this shield or upon it". "With it" sounded better!
I owe a debt to my driver Emmanuel who cared for our day to day travel. Out and about in Accra one morning and in the middle of a conversation, the car suddenly veered to the right at a junction. We went silent. Where we had been a few moments before was a truck full of pineapples, sailing past us out of control, hitting a bus, before it careered through the red light and eventually ran out of momentum and stopped in the middle of the road. Fortunately there were no injuries.
Emmanuel had been paying attention to what was happening on the road, both in front of him and what was happening behind him, because he used his mirrors. He had noticed the driver of the lorry jumping up and down as he pumped the brakes and knew that the best plan was to get out of the way.
This is my first piece of advice when travelling abroad. Get a competent driver and avoid driving yourself, if you can. Emmanuel moved to different companies over the years but I always hired Emmanuel. The hire company was secondary. Emmanuel would always turn up with a roadworthy vehicle and he was one of the best drivers I have known.
Road safety isn't rocket science although some of the technology may be. Road safety is about risk management and reducing risk, by taking time to work through the things that could go wrong (system failures) and what you can do to prevent it.
Failure to use a seat-belt is a major risk factor for road traffic deaths and injuries among vehicle occupants. Passengers who were not wearing their seat-belts at the time of a collision account for the majority of occupant road traffic fatalities. In addition, passengers who do not wear seat-belts and have a frontal crash are most likely to suffer a head injury. A study in Norway calculated that head injuries make up some 60% of all injuries to vehicle occupants. The study concluded that drivers and front seat passengers who do not use seat-belts suffer almost the same percentage of head injuries as non-users in rear seat's (If you want to be a seat belt expert, download this manual: http://www.who.int/roadsafety/projects/manuals/seatbelt/en).
We often cut corners when it comes to safety abroad. I remember doing a survey at a junction in Africa and an American Embassy vehicle pulled up. The passenger wasn't wearing a seat belt, so I knocked on the window and gestured that he should put it on. He refused and the driver went on. I puzzled why he would not use a seat belt, when back in the States it would have been second nature to wear one? I could only conclude that he didn't wear a seat belt for the right reason in the first place. He wore it in America because he would be penalised if he didn't. It was not because seat belts save lives, it was because seat belts save fines!
Traffic injuries are now seen as a health risk and the second leading cause of death and injury in developing countries
There is often a tendency, especially in Africa, to lapse when it comes to seat belt wearing, after all, who is going to catch you? I remember going to church one Sunday in my nice clean white shirt. When I got to the Service and released the seat belt, there was a diagonal band of ochre coloured dust from my shoulder to my thigh. People don't use seat belts, they say, because they are dirty (they often prefer to drive with windows down than with the air-conditioning on). Dust blows on to the belts and then they are un-wearable.
My advice is never get in a vehicle where the seat belts do not work. A simple check is to give the belt a sharp tug across the chest. If it doesn't lock solid, it is broken. If the seat belts don't work, what else doesn't work? Is your life worth so little? Never get in the front seat without making sure the rear seat passenger has a seat belt on. If they don't they can kill you (see 'Belt Up in the Back. For Everyone's Sake.' http://www.youtube.com/watch?v=TWLmoeoHrP4). Seat belts have saved thousands of lives and serious injuries.
Changing behaviour and creating a safety culture in an organisation is not easy. Back in 2004, I worked with some Ghanaian colleagues developing a "Voluntary Code of Conduct" in 2004. 
They idea was to roll out a simple safety code for organisations, that would in time become part of their terms and conditions of employment. It is an investment in people. The Kjaer Group, the leading provider of vehicles and automotive services to the international aid and development sector, companies and expatriates worldwide adopted the Code. The Red Cross has subsequently adopted the Code of Conduct (see 10 commitments).
According to the Association for Safe International Road Travel (ASIRT), Americans are travelling increasingly to countries where the chances of being killed or seriously injured may be from 20 to 40 times greater than in the U.S. The chance of being killed in a crash abroad is also higher than getting a strange disease. That is why traffic injuries are now seen as a health risk and the second leading cause of death and injury in developing countries.
