by Tiffany Aquino
Imagine living in a community where your whole life, your village is situated around a rough, barely passable dirt road. One day, the president of your country decides to visit your region, so trucks full of dirt come rolling in and lay a beautiful, fairly even road outside your home in a matter of weeks. All of the sudden, your road goes from barely passable, to cars passing regularly...and not just any cars, for the only ones who generally venture out this far are the heavy duty trucks and SUVs, ones that are tough enough for the dirt road and potentially rough ride. You go from barely ever seeing a car in your community, to them flying by at 20, 30, even 40 mph. Or even more dramatically, you get a paved road and now these vehicles can pass by your house at full speed, with drivers barely seeing you as they go about their journeys.
Now imagine what your first instinct would be. Would you, even as an adult, stop and say to yourself "I should look both ways before crossing the road now". Probably not. Maybe you keep walking on the road as you always have, maybe you move further to the side, but still are grateful for an easier walking path.
It's quite the paradox - infrastructure development actually ushering in significant health and safety risks to a community. Communities are being infused with economic opportunity and access to goods and services from new roads, while these leapfrogging technologies lead to a significant increase in safety risk. I could go into citations of studies and history of such types of technological leapfrogging, but instead I'm just going to give my own personal theory (disclaimer: I'm sure it’s possible others have theorized about this too) of why this paradox exists, based on my experiences and observation from living in a variety of contexts, the most recent of which was a rural village in Eastern Africa.
Growing up in an environment like the US has plenty of perks, one of which was being born in a time and place where road safety was already being emphasized. From the time I was old enough to run, I was taught to look both ways before crossing the street. I was required to sit in a car seat, and never left to play by the roadside. Though some towns may not have had paved roads by then, they were the minority, and road systems and safety policies were developing at a pace fairly even with automotive technology. Essentially, places like the US had time to build cultural norms, values and policies around the concepts of road and car safety as the cars got quicker, bigger, and more widespread. Infrastructure improved over long periods of time (think: it’s taken us over a century to reach the road quality we have now), paved roads were not instantly built in communities as soon as the Model T rolled off the assembly line.
Now, in many developing contexts, communities will go from no roads (or very poor ones) and no cars, to a modern paved highway and full speed modern vehicles, even semi-trucks, in a few years’ time. To me it seems that even when policies are in place for safety, nothing can replace the longer term cultural shift that must take place in order for safety behaviors to become instinct. Perhaps it’s time to focus on new ways of leapfrogging progress in societal safety norms to catch up with the leapfrogging development. Day after day I watched hundreds of community members walk along the roadside (or in the road) headed to the market, to their jobs, or wherever that day's activities took them, and day after day I saw close calls, too close for comfort, of people not watching for cars, of scary night time driving, of children unattended running out in the road, of drivers with no regard for pedestrians or road hazards - all kinds of continuous threats to a community's safety.
The best I could do was to travel with this knowledge, to remember that not everyone would have the same safety instincts I do, and to walk, drive and ride with caution, and encourage others to do the same. Hopefully in the process I was an example to others, and helped a little in moving the cultural norms in the direction of safety.
Tiffany completed her undergraduate studies in Psychology at Drexel University. After college, she volunteered with a medical team in Bolivia and worked as a foster care social worker in Philadelphia. Eventually, she returned to work in mental health as a clinical research coordinator, where she managed studies examining drug efficacy, relapse prevention and pharmacogenomics for anxiety and depression. She co-authored several peer-reviewed publications on this research. Tiffany earned her Master's in Public Heath from the University of Pennsylvania. This lead her back to Latin America, where she completed a master's internship in Nicaragua with Acción Médica Cristiana, a community health NGO. There, she learned from and worked alongside community health workers, focusing on health education and outreach for maternal and child health, food security and access to medication. Tiffany was a 2012-2013 Global Health Corps Fellow, working in Rwanda as a Monitoring and Evaluation Officer for Partners in Health. She has traveled to many additional countries in Latin America and Europe, as well as Tanzania, Burundi, Kenya, and Uganda. She currently resides in Brooklyn, NY. In her spare time, she enjoys hiking, yoga, sewing and traveling.