BackgroundRoad Safety is a major cause of death around the world and South Africa has one of the highest road fatality rates. Many measures, engineering and medical, are investigated. However, analysis of the accessibility of emergency care facilities is often overlooked. This paper aims to fill the gap between pre-crash engineering solutions and literature on trauma injuries and emergency care procedures. The focus is on the role that accessibility to emergency care facilities in rural areas plays, given that 50% of the world’s population lives in rural areas, which are often omitted from international research. The Western Cape (a rural province with low population volumes and high volume roads in South Africa) is analysed as an example of access to trauma care in rural areas.MethodIt is internationally accepted that the time to emergency care facilities influences the survival chances. However, the international literature still debates the exact time period. In this paper, the ‘Golden Hour’ is used to analyse the accessibility of emergency care facilities in rural areas and establish a geographical analysis method which identifies risk areas. The analysis can be repeated if the international literature debates regarding the exact time period changes.ResultsA Geographical Information System (GIS) tool revealed that 53% of the fatalities in the rural parts of the Western Cape occur outside the Golden Hour. In high risk crash areas, the fatality risk is up to nine times higher than the province’s rural average.ConclusionsPeople in need of trauma care after a road crash are most likely to survive if they receive definitive care timeously. At the time of the study, the rural areas in the Western Cape had 44 Emergency Medical Services stations and 29 medical facilities that can assist to provide definitive (trauma) care. Further optimisation of the facility locations is recommended and research has begun.More advanced geographical modelling is possible when improved data becomes available on the ‘Golden Hour’ theory, differential times for varying injury types or travel speeds of ambulances. This, more advanced, modelling can reduce the road crash burden in rural areas around the world further.

Background The Sustainable Development Goals (SDGs) and universal design (UD) principles call for inclusive planning. Within the transportation field, this includes the development or improvement of facilities that accommodate people with disabilities. Between 10% and 20% of the African population is affected by disabilities. A lack of understanding of the needs of people with disabilities leads to isolation. Within the transportation field, isolation manifests itself as a reduction in trip-making. Methods This paper investigates the availability of transport policies and guidelines in 29 different African countries, focusing on the inclusion of persons with disabilities. A desktop study was conducted creating heat maps for 29 African countries, followed by the analysis of secondary data in the case study area, South Africa, demonstrating that the lack of adequate policies, guidelines, and appropriate implementation leads to a lack of accessibility, opportunities, and social isolation, measured through trip frequencies. Results The data analysed revealed that many African countries omit, or only superficially include, people with disabilities in their transport policy framework. Ghana has the most inclusive People with Disabilities Act, while South Africa is most inclusive regarding their planning and design of transport facilities and services. In South Africa, 4.5% of the population did not travel at all in the 7 days before the interview, as disability or age prevented them from doing so, or due to a lack of appropriate travel services. When comparing the trip rates per week, people with disabilities travel significantly less, between 27.2% and 65.8%, than their abled counterparts. Conclusions The study reveals that people with disability live less integrated, more isolated lives due to the lack of acknowledgement in the transport policy framework and accommodation in infrastructure and services. The results underpin the need for disability-inclusive planning in the African context and provide recommendations for actions that mitigate the isolation challenges faced by people with disabilities. Municipalities play a crucial role in improving the quality of life for people with disabilities.

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Transport users make mode choices based on a variety of factors. These factors are economic or service driven, based on individual roles, habits, and interests, as well as age, life cycle stage, and gender. Analysis reflects different mobility patterns for males and females relating to care activities. Literature suggests that experiences of harassment have a significant effect on user choices. This study examines how South African data compares with international studies. Mode use and trip purposes, distances, and times differ depending on gender and are affected by the experience of harassment, which affects females more than males. Analyzing trip making in South Africa revealed that travel modes, distances, and times are not significantly different across gender. South African females make fewer trips than males, but significantly more care trips. Different modes of public transport score differently regarding potential experience of harassment, with trains performing the worst. The reason mode choice is not significantly different between females and males is assumed to be because of financial reasons. Investigating harassment perception in Cape Town reveals that females experience harassment more often and this influences their choices regarding care trips. These findings have significant implications for transport policy in South Africa and suggest that more nuanced policies are required.