January 28, 2019 by Dr. Varner in Policy

I just witnessed a man get hit by a taxi. It wasn’t pretty.

The taxi stopped for a second. Then sped away.

I’m in Entebbe, Uganda, for an economics conference. Yesterday, I wanted to take in as much of the city as I could before we got down to business today. I hired a driver to take me around the city. I wasn’t in the car for more than three minutes when it happened.

The victim was unconscious, face down in the road. I asked my driver to stop and immediately went to attend the victim. He was bleeding rather profusely from the head. I could also see some ‘road rash’ on his left side.

At first, no one else stopped, the cars just swerved around the scene of an unconscious man on the road. Yep. Definitely not in America anymore.

Some other bystanders and my driver came and we moved the victim out of danger.

He had a massive scalp laceration, there was a large amount of blood, and it looked like he may have had a skull deformity.

I asked if anyone was able to call an ambulance. At this point, a rather substantial crowd that had gathered. After a lot of discussion in a language I did not understand, my driver basically told me an ambulance wasn’t going to come.

So, we got the victim into the car and sped to the main hospital along with two random bystanders who were in the back seat propping up the victim.

When we got there, a nurse came with a half-broken wheelchair. It was a group effort but eventually, we got our dazed victim into the triage area of the casualty department, and a young looking doctor promptly came.

I told him what had happened, offered further help if he needed it. The victim could talk a bit at this point and I was somewhat reassured by his neurological status.

With nothing else to do, I wished the victim and the doctor well, and my driver and I headed out. About four hours later we came back to the hospital to check on the guy, who was now fully awake. He thanked us for our help. He was still in the triage area. No CT had been done (I was given the impression the hospital didn’t have a machine), but he said that he had some broken ribs.

This experience drives home two very important points for me: The fact that in dire situations it’s unlikely an ambulance will come (I’m not sure if this is because the service doesn’t exist here, or that the people at the scene of the accident didn’t have any confidence in the service –either could be true); AND the fact that something commonplace in America, like a CT scan, was not available.

I’m left to deduce there are probably a lot of people who die here unnecessarily from trauma.

The victim clearly wasn’t out of the woods. At this point, he could still have brain bleeding, pneumothorax, retroperitoneal bleeding, or all kinds of other injuries that could kill him but no one will know until it is too late…

When someone dies unnecessarily from trauma because CT scanners, trauma blood, and on-call neurosurgeons aren’t available –that’s death by poverty.

This situation was very shocking to me, partially because I’ve never seen someone get hit by a car before, but also because I didn’t have the tools to help –and no one with any tools was going to show up.

My initial thought was that we would get the guy out of the street so he doesn’t get hit by another car, and then an ambulance would come, they’d secure his cervical spine and transport him to a trauma center. But that’s not possible in a world of severe poverty.

One of the many places I’ve seen here was a yard full of shipping containers, where more than half had ‘UN’ painted on them. And to me, that explained everything.

Donations from the UN may temporarily feed a few people, but a few handouts don’t make a real or lasting impact on people’s living standards.

Real prosperity cannot come from any government welfare or foreign-aid program, it can only come from genuine economic growth. This the only way to improve living standards across the board. Government handouts do nothing but obstruct entrepreneurship and development.

The record of the last 150 years is clear: Free markets, rule of law and respect for private property are the foundations of prosperity. Prosperity is the foundation for health.

Those involved in public health, specifically in genuinely poor places like Uganda, would do well to promote capitalism rather than grow the parasite of government if they genuinely want to improve people’s lives.

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