Market centre at dusk: hazard priorities, then a spill and two casualties
18:50 on a market day, in a trading centre on the Kisumu–Kakamega road. The sun has gone and the street lights on your side are out. You are doing about 45 km/h in a 50 km/h zone with dipped headlights on. On the left, stalls spill onto the shoulder and people cross between them. A matatu has stopped in the lay-by on your left and passengers are climbing out. Ahead, a boda boda carrying two passengers and a jerrican strapped to its side pulls out and rides towards you on your side of the road, overtaking the stopped matatu. A handcart loaded with sacks is being pushed along the left edge. The surface is loose gravel where a culvert was repaired last week. A lorry offloading maize sits on the left shoulder ahead with people around it. Then a pedestrian steps out from in front of the matatu, about 25 m ahead of you.
1. Rank the hazards you are dealing with in the ten seconds before the pedestrian appears, and state what speed and road position the situation actually permits.
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Ranking, worst outcome first:
- The boda boda riding at you on your own side. Head-on closing speed, dark, overloaded, likely badly lit, rider unprotected. This is the one that kills people.
- The pedestrian hidden by the stopped matatu. A large stationary vehicle beside a market is a screen; assume someone is about to walk out from in front of it.
- The loose gravel patch. It lengthens your stopping distance and will trigger a skid if you brake hard mid-corner on it.
- The handcart on the left edge. It narrows your escape route to the left exactly when you may need it.
- The offloading lorry and the people around it. Unpredictable movement, poor lighting.
Speed and position: 45 km/h is too fast for a market centre at dusk with a matatu stopped and pedestrians between stalls. You need roughly 25–30 km/h, foot covering the brake, ready to stop rather than to swerve. Keep slightly left of the lane centre - not close to the stalls, not on the crown. That gives you room to move left for the boda boda, keeps you clear of the handcart, and keeps you visible.
Give a short horn warning to the boda boda, and identify now where you would go if you had to: the gap between the handcart and the matatu is your escape lane.
2. The boda boda clips your front left wing. The rider is down and the pillion passenger's leg is trapped under the bike; the jerrican is leaking and you can smell petrol. Set out your actions in the first minute, in order.
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- Stop, handbrake, hazard lights. Switch the engine off and keep the key on you. A hot exhaust next to spilled petrol is the single biggest escalation risk on the scene.
- Stop the second collision before treating anyone. Send two bystanders up the road in both directions with torches or phone lights to slow traffic. Place your warning triangle if it can be done safely.
- Control the fire risk. No smoking, no naked flames, no jump-starting, no restarting your car, nobody standing over the spill. Move bystanders back. Do not right the bike in a way that dumps more fuel or drags the trapped leg.
- Assess the casualties. Responsiveness and breathing for both. Assume the rider has a head or spinal injury - do not pull his helmet off.
- Call 999 or 112. Give the exact location, the number of casualties, and say there is a fuel spill.
- Treat what is bleeding and keep the passenger still and warm. Talk to her continuously.
Injury means the police attend the scene; cooperate fully and give a factual account. Because the car is involved, you must also report the accident at the nearest police station if for any reason officers do not attend.
3. Give the specific first aid for the two casualties, and explain the things you would deliberately not do.
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Rider - conscious, forearm bleeding:
- Direct pressure with the cleanest cloth available, pressed hard for about ten minutes without lifting it to look. If blood soaks through, add another layer on top rather than removing the first.
- Raise the arm if there is no obvious fracture.
- Keep him still, seated against something solid. Do not walk him around to 'check he is fine' - he may be confused from a head injury.
Passenger - leg trapped:
- Do not pull her out and do not attempt to lift the bike alone. Get three or four people to lift it as a unit while someone slides her clear, and only if the leg is not impaled and the fuel is not igniting.
- Splint the leg against a board or rolled newspaper, padded and secured above and below the injury, if you can do it without moving her more than necessary.
- Watch for shock: pale, cold, clammy skin, a fast weak pulse, thirst. Keep her warm, reassure her, and give nothing to eat or drink.
Deliberately not doing:
- Not removing the rider's helmet unless he stops breathing - then airway takes priority and you would need two people, one holding the neck.
- Not moving anyone with a suspected spinal injury, unless there is fire.
- Not applying a tourniquet unless bleeding cannot be controlled by pressure and you know how to use one.
- Not giving food, drink or painkillers to either casualty.