The white-tiled floor of Togo's largest trauma unit is awash with the blood of motorcycle riders. The patients' limbs are fractured, their scalps gashed and feet grotesquely twisted. Every day is the same, a relentless production line of injury which the hospital must triage.
Due to a shortage of beds, paramedics place the latest victims of motorcycle carnage on plastic sheets on the ground. Power cuts are frequent but there is no panic; the doctors stitching up a motorbike-taxi passenger continue resourcefully by torchlight, like battlefield medics.
In this chaotic emergency ward they know all too well that every motorcycle journey on the death-trap streets of the capital Lome is a roll of the dice.
'On the worst days we have 40 admissions from motorcycle accidents,' says Dr Ariste Dantio, a medic at Sylvanus Olympio Hospital.
With motorcycle ownership in sub-Saharan Africa increasing from less than five million in 2010 to an estimated 27 million in 2022, the rate of death and injury from road crashes has similarly surged.
The World Health Organization states that road traffic injuries are the leading cause of death among 15 to 29-year-olds in the region, far outweighing diseases, hunger, conflict and terrorism.
Although the continent has the lowest rate of motorisation, it has the most dangerous roads in the world.
In Togo, 72 per cent of all road deaths are due to motorcycles, accounting for 681 lost lives in 2021. Latest data suggests there were 189 motorcycle deaths in December alone, a horrifying statistical high in the small West African nation which tops the continent's motorcycle accident tables.
While the easy availability of low-cost motorcycles from China has provided cheap transport and greater freedom for millions seeking better lives, the risks involved have contributed to a road accident epidemic.
It's not just the young who have made it onto the hospital's trauma ward. One bed is occupied by a 70-year-old grandmother, who fractured her left leg after another rider slammed into the back of her motorbike-taxi.
'This was my first motorcycle accident in my whole life,' says Ayana Ayivi. 'The roads have become too busy, too dangerous, and most riders take no notice of those around them.'
A survey conducted by Amend, a charity that works to improve road safety in developing countries, last year suggests only 5 per cent of motorcycle-taxi riders in Togo, who represent more than half of all users, provide helmets for their passengers. Only 10 per cent of those riders had a licence, and 96 per cent were self-taught.
With no buses, and the train line passing through Lome used only for freight, a motorbike is the only available option for those who aspire to earn more by travelling for work, a potentially deadly gamble they accept.
Despite all the death and destruction, the expansion of motorcycle use in African countries like Togo has also brought clear benefits for local people.
Tom Bishop, a former UK Highways Agency consultant who now works as programme director for Amend, says more people, especially young men with low levels of education, are now employed and earning money thanks to the motorcycle.
'We have heard plenty of stories of riders who have been able to send their daughters to school, whereas before it might have only been their sons. Another side of this is pregnant women being able to go to hospital rather than giving birth in a rural area.'
Nonetheless, this freedom of opportunity can all change with a single crash, Bishop adds.
Mechanic Komi Sogbossi speaks from experience. His own future has been rewritten following a horrific crash which fractured his tibia - the bone cracked cleanly in two and perforated his skin - and left him facing exorbitant surgery costs, the equivalent of two years' salary. The 43-year-old father had no choice but to turn down the surgery and has since returned home from the hospital, just four days after his crash at a busy crossroads in Lome.
Komi knows he'll never be able to work properly again. Speaking in the dirt yard to the rear of his cinder block house, he struggles to hobble around on the single crutch his relatives purchased at the hospital. Komi knows he'll never be able to walk properly again.
Some have been forced to turn to money lenders to fund their surgery, like Koffi Agbadji, who borrowed two and a half million CFA Francs, equivalent to $4,200, after crashing on his motorbike.
The incessantly busy intersection at Marche de Be on the edge of Lome is a nerve-shredding experience, a terrifying cacophony of spluttering engines, angry beeping, pollution and law-breaking traffic. Riders whizz past carrying towers of plastic chairs, and even a wooden door, on their heads. One man clutches three goats with one hand and steers with the other.
Some bikes have two or three children on board, usually with one in front of the rider and two at the back. The children's faces look gleeful, as though on an amusement park thrill ride. Sometimes there are whole families of five, including both parents, on the same bike, or babies wedged precariously between two adults. Rarely do passengers have handles to grip, and almost all do not wear helmets; few of those that do have the chin straps attached.
Dr Anani Abalo, who leads the trauma unit, says that another alarming contributor to surging crashes is abuse of the prescription opioid tramadol by young riders. They pop 200mg pills smuggled in from nearby Nigeria throughout the day, putting them in a dazed stupor, and clumsily incapable of braking and steering.
In Italy, once considered a road traffic injury hotspot, the number of fatalities has almost halved since 2006, down from 5,669 to 2,395 in 2020. The UK, meanwhile, had 1,608 road deaths in 2021 - the sixth lowest death rate per million people across the continent.
In total, more than 1.3 million people die on the world's roads every year. But Sir David Spiegelhalter, a leading British statistician, says this scale of mortality is absorbed more easily than more startling mass casualty events.
'People do definitely treat, psychologically, deaths from road accidents differently to deaths from terrorism' he says. 'It's a well-known fact that people feel that road accidents are part of normal life to some extent, that they are not completely preventable even though you want to make the risk as low as possible.'
Nothing in Lome illustrates the horrors behind Togo's motorcycle boom better than the traffic hurtling down the highway outside La Promotion school, in the north of the city, where eight-year-old Romeo Kudadjey was hit walking home in March 2021. Although a mother and a child were killed at the same spot last year, nothing has been done, with calls for a pedestrian bridge left unanswered. When the school opened 30 years ago, the highway did not exist, but children have taken second place in the rush to expand transport infrastructure.
'It was the speed more than anything,' says Romeo's mother Poori, 42. 'The rider completely disrespected the rules. Nothing happened except the confiscation of his motorcycle.'
Valentin Soncy, whose 44-year-old brother Augustin died from a motorcycle collision this month, lists the changes required to avert future unnecessary deaths.
'The government needs to ensure that motorcycle drivers are more civilised,' says Valentin. 'If they drive too fast, without indicating, without stopping at red lights, then they must be stopped by the police.'
His impassioned words dissolve in the diesel smog of lorries leaving Lome's container port carrying spare parts for Togo's ever-growing motorcycle fleet.
Adapted from an article by © Tom Parry / Telegraph. For the full version, please get in touch.
Due to a shortage of beds, paramedics place the latest victims of motorcycle carnage on plastic sheets on the ground. Power cuts are frequent but there is no panic; the doctors stitching up a motorbike-taxi passenger continue resourcefully by torchlight, like battlefield medics.
In this chaotic emergency ward they know all too well that every motorcycle journey on the death-trap streets of the capital Lome is a roll of the dice.
'On the worst days we have 40 admissions from motorcycle accidents,' says Dr Ariste Dantio, a medic at Sylvanus Olympio Hospital.
With motorcycle ownership in sub-Saharan Africa increasing from less than five million in 2010 to an estimated 27 million in 2022, the rate of death and injury from road crashes has similarly surged.
The World Health Organization states that road traffic injuries are the leading cause of death among 15 to 29-year-olds in the region, far outweighing diseases, hunger, conflict and terrorism.
Although the continent has the lowest rate of motorisation, it has the most dangerous roads in the world.
In Togo, 72 per cent of all road deaths are due to motorcycles, accounting for 681 lost lives in 2021. Latest data suggests there were 189 motorcycle deaths in December alone, a horrifying statistical high in the small West African nation which tops the continent's motorcycle accident tables.
While the easy availability of low-cost motorcycles from China has provided cheap transport and greater freedom for millions seeking better lives, the risks involved have contributed to a road accident epidemic.
It's not just the young who have made it onto the hospital's trauma ward. One bed is occupied by a 70-year-old grandmother, who fractured her left leg after another rider slammed into the back of her motorbike-taxi.
'This was my first motorcycle accident in my whole life,' says Ayana Ayivi. 'The roads have become too busy, too dangerous, and most riders take no notice of those around them.'
A survey conducted by Amend, a charity that works to improve road safety in developing countries, last year suggests only 5 per cent of motorcycle-taxi riders in Togo, who represent more than half of all users, provide helmets for their passengers. Only 10 per cent of those riders had a licence, and 96 per cent were self-taught.
With no buses, and the train line passing through Lome used only for freight, a motorbike is the only available option for those who aspire to earn more by travelling for work, a potentially deadly gamble they accept.
Despite all the death and destruction, the expansion of motorcycle use in African countries like Togo has also brought clear benefits for local people.
Tom Bishop, a former UK Highways Agency consultant who now works as programme director for Amend, says more people, especially young men with low levels of education, are now employed and earning money thanks to the motorcycle.
'We have heard plenty of stories of riders who have been able to send their daughters to school, whereas before it might have only been their sons. Another side of this is pregnant women being able to go to hospital rather than giving birth in a rural area.'
Nonetheless, this freedom of opportunity can all change with a single crash, Bishop adds.
Mechanic Komi Sogbossi speaks from experience. His own future has been rewritten following a horrific crash which fractured his tibia - the bone cracked cleanly in two and perforated his skin - and left him facing exorbitant surgery costs, the equivalent of two years' salary. The 43-year-old father had no choice but to turn down the surgery and has since returned home from the hospital, just four days after his crash at a busy crossroads in Lome.
Komi knows he'll never be able to work properly again. Speaking in the dirt yard to the rear of his cinder block house, he struggles to hobble around on the single crutch his relatives purchased at the hospital. Komi knows he'll never be able to walk properly again.
Some have been forced to turn to money lenders to fund their surgery, like Koffi Agbadji, who borrowed two and a half million CFA Francs, equivalent to $4,200, after crashing on his motorbike.
The incessantly busy intersection at Marche de Be on the edge of Lome is a nerve-shredding experience, a terrifying cacophony of spluttering engines, angry beeping, pollution and law-breaking traffic. Riders whizz past carrying towers of plastic chairs, and even a wooden door, on their heads. One man clutches three goats with one hand and steers with the other.
Some bikes have two or three children on board, usually with one in front of the rider and two at the back. The children's faces look gleeful, as though on an amusement park thrill ride. Sometimes there are whole families of five, including both parents, on the same bike, or babies wedged precariously between two adults. Rarely do passengers have handles to grip, and almost all do not wear helmets; few of those that do have the chin straps attached.
Dr Anani Abalo, who leads the trauma unit, says that another alarming contributor to surging crashes is abuse of the prescription opioid tramadol by young riders. They pop 200mg pills smuggled in from nearby Nigeria throughout the day, putting them in a dazed stupor, and clumsily incapable of braking and steering.
In Italy, once considered a road traffic injury hotspot, the number of fatalities has almost halved since 2006, down from 5,669 to 2,395 in 2020. The UK, meanwhile, had 1,608 road deaths in 2021 - the sixth lowest death rate per million people across the continent.
In total, more than 1.3 million people die on the world's roads every year. But Sir David Spiegelhalter, a leading British statistician, says this scale of mortality is absorbed more easily than more startling mass casualty events.
'People do definitely treat, psychologically, deaths from road accidents differently to deaths from terrorism' he says. 'It's a well-known fact that people feel that road accidents are part of normal life to some extent, that they are not completely preventable even though you want to make the risk as low as possible.'
Nothing in Lome illustrates the horrors behind Togo's motorcycle boom better than the traffic hurtling down the highway outside La Promotion school, in the north of the city, where eight-year-old Romeo Kudadjey was hit walking home in March 2021. Although a mother and a child were killed at the same spot last year, nothing has been done, with calls for a pedestrian bridge left unanswered. When the school opened 30 years ago, the highway did not exist, but children have taken second place in the rush to expand transport infrastructure.
'It was the speed more than anything,' says Romeo's mother Poori, 42. 'The rider completely disrespected the rules. Nothing happened except the confiscation of his motorcycle.'
Valentin Soncy, whose 44-year-old brother Augustin died from a motorcycle collision this month, lists the changes required to avert future unnecessary deaths.
'The government needs to ensure that motorcycle drivers are more civilised,' says Valentin. 'If they drive too fast, without indicating, without stopping at red lights, then they must be stopped by the police.'
His impassioned words dissolve in the diesel smog of lorries leaving Lome's container port carrying spare parts for Togo's ever-growing motorcycle fleet.
Adapted from an article by © Tom Parry / Telegraph. For the full version, please get in touch.
