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September 20, 2018

Vital signs on the road to dementia

Road to dementia has many signs
Road to dementia has many signs

A road is meant to take you some place. When the Thika superhighway was officially launched in November 2012, we all felt a sense of pride that finally we had our very own stretch of highway, complete with various interchanges.

Two years later, as in common with everything we have moved on, and now there are only a few people who marvel at how life used to be before the highway was built. Most of us have incorporated the road into our lives; radio airwaves in the morning still talk of slow traffic jams tailing back into the horizon as soon as the sun rises, which in this January to early March period it really has.

A road is most useful not only when it is well built, but if its’ use is well regulated. One of the things that the Thika superhighway has reintroduced into the lives of motorists is clear road signs.

Before the highway was done only a few of our major roads had tiny, really old signs that gave distance reading to some destination, not always yours. At junctions, signs would appear for a few days before disappearing, reflecting the unreasonable thinking of some Kenyans that a road is not just for travelling along.

Why not use the material for building stalls along the road? Then you can sell various stuff to motorists slowed down by enormous bumps put there because you sell various stuff on the road and are therefore a menace to motorists.

Then there are the curious road signs, an example of which is along Muthaiga road, entering from the Thika superhighway side, where a road sign dictates that no public service vehicle should enter the road.

A casual interpretation of the sign is that along this road you must have a private vehicle, implying that you have no business here unless you own a vehicle. What would happen if everyone in the city decided to own and drive their own vehicle? We have a rough idea to the answer following the recent drop in fuel prices.

We live in one of the most unequal societies on earth and despite public official rhetoric that we would want otherwise implementation of policy seems to favour promotion of inequality.

When challenged, usually not because they have listened to anyone but because some kind of ugly gridlock has occurred, rather than follow the sensible path, policymakers, including those at the lowest levels, would rather take the easy option such as allowing hawkers not just along but on a major road, than create an environment that is safe for all.

It is the equivalent of refusing to chew your food properly then when you start choking, washing it down with a lot of water and hoping that all will be well. Once perhaps but it cannot be the normal way of eating. In medicine, the inability to swallow food properly is termed ‘dysphagia’.

Depending on where the dysphagia occurs it can be either high, in the mouth or throat or; low in the oesophagus the tube that connects your mouth to the stomach. Apart from the feeling of choking, other symptoms include coughing when eating or drinking, bringing food back sometimes through the nose and persistent drooling of saliva. Persistent dysphagia can lead to weight loss and recurrent chest infection.

Of interest is that dysphagia usually has an underlying cause, perhaps cancer of the throat or oesophagus; acid reflux from the stomach; stroke or dementia. Treatment consists of managing the underlying cause and specific interventions such as speech and language therapy so that the person learns new swallowing techniques; changing the types of food so that they are easier to swallow; and surgery, widening the oesophagus if it has narrowed. There are of course people who choke on food not because there is an underlying pathology but because they are in a hurry to eat, a social and psychological issue of our society. And this is where the Thika superhighway offers a good lesson.

A road should not just be the tarmac put on top of the foundation. It should incorporate all the legitimate road users, providing signs that they can use to guide them to their destination, the appropriate speed, the right lane and so on. At the same time those who really should not be on the tarmac at any time are prevented from wandering on to the road to set up stall.

This should include very brave policemen and women who now like to stand in the middle of roads flagging down vehicles, a disaster waiting to happen. If we build public policy in this deliberate way putting up signs that help guide people on what next there will be less signs of dysphagia and less association of public office with dementia.

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