Foreign Roads Can Be Deadly for U.S. Travelers

Can crashes are the No. 1 killer of healthy American's in foreign countries.


— -- Motor vehicle crashes -- not crime or terrorism -- are the No. 1 killer of healthy Americans in foreign countries. And the threat to travelers is poised to increase dramatically as worldwide economic growth gives more people access to motor vehicles.

Corporate employers, including energy giant Chevron, (CVX) are teaming with safety advocates to combat what they view as a rapidly worsening epidemic of highway deaths and injuries, particularly in developing countries.

"The road-safety problem worldwide for travelers and locals constitutes a growing public health crisis," says Tony Bliss, lead road safety specialist for the World Bank. He says it's "a far greater problem than many more widely acknowledged diseases."

Much of the growth in motor vehicle usage is in developing countries, where roads are sub-standard, signage deficient, traffic regulations lax and enforcement spotty. While local residents bear most of the risk of death and injury, travelers can be particularly vulnerable because of their lack of familiarity with surroundings and with local customs.

Frequent business travelers Mian Chin and Richard Hadden are two of many Americans involved in separate accidents abroad who say they're lucky to be alive.

Chin, 52, an atmospheric scientist from Maryland, was in a bus accident last August during a business trip from western China to Tibet. The bus driver said, " 'We're finished,' " she says. "We thought we were going to die."

The brakes failed on a steep mountain road, but, luckily for Chin and 24 others inside, the bus plowed into a herd of yaks, slammed into a retaining wall and stopped. One woman hurt her back, and Chin needed stitches on her arm and wrist, but it was "a miracle that no one was seriously injured," she says.

Travelers' risks are not limited to developing nations. Hadden, an author and a professional speaker in Jacksonville, was in a head-on collision in England in 2002 on a single-lane road bounded on both sides by 12-foot hedges. "Suddenly, a local man driving carelessly at about 50 mph came around a blind curve," he recalls. Both cars were totaled, but no one was hurt.

The World Health Organization and the World Bank estimated in a 2004 joint report that 1.2 million people are killed each year in traffic crashes, and 20 million to 50 million are injured or disabled. About 85% of the deaths are in low- and middle-income countries. The organizations predict that traffic fatalities worldwide will increase to 2.3 million in 2020, nearly double today's fatalities.

Over the 30-year period ending in 2020, the report predicts an 80% increase in fatalities in low- and middle-income countries vs. a 30% decline in high-income countries, including the USA.

The fatality rate is soaring in low- and middle-income countries for many reasons, including a growing number of motor vehicles, unsafe roads that are also used by pedestrians and cyclists, weak enforcement of motor vehicle laws, little government investment in road safety and poor emergency medical response to accident scenes.

There are no data showing how many, or how often, travelers to foreign countries are involved in motor vehicle crashes. But safety experts suspect it is riskier for travelers to drive outside their own countries.

A 1999 study by Australia's Federal Office of Road Safety, for example, concluded foreigners are at higher risk than Australians of being killed in motor vehicle crashes in that country. Contributing factors: a greater tendency not to wear seat belts and "their unfamiliarity with Australian conditions."

The U.S. State Department began keeping statistics three years ago and says it has received reports that 719 Americans were killed during the past three years in motor vehicle accidents. Its statistics include only deaths reported by family members and some media accounts. More deaths might go unreported.

Make Roads Safe, a non-profit global safety campaign, studied State Department data and found that crashes killed 31% of healthy Americans who died abroad during the past three years. The data exclude medical problems such as heart attacks, focusing instead on deaths that have no link to pre-existing health conditions.

State Department data show that travelers should be particularly concerned in Mexico, a USA TODAY analysis shows. In the three years ended in 2006, at least 280 Americans lost their lives in motor vehicle crashes in Mexico, the nation Americans visit most.

Contrast that with Americans' experience in Canada, their second-most-visited country. Though Canada gets about 70% of the number of U.S. visitors to Mexico, the State Department has recorded just 11 U.S. traffic deaths in Canada for the 2004-2006 period.

Causes of motor vehicle deaths in Mexico vary. The State Department's consular information sheet for Mexico warns travelers that taxis and buses "often do not comply with traffic regulations," including speed limits and stopping at red lights.

It also warns travelers to avoid driving on highways at night and to be aware that the training and availability of emergency responders might "be below U.S. standards." Multi-lane expressways have narrow lanes and steep shoulders, and "single-vehicle rollover accidents involving U.S. citizens are very common."

David Bloom of Peoria, Ill., and Todd Smedley of Carlsbad, Calif., were killed in 2005 on a two-lane desert highway linking San Felipe and Mexicali when a water truck slammed into their dune buggy. In March 2005, Amy Kent, of Santa Barbara, Calif., was killed and a friend seriously injured when they were run over by a car illegally racing on a beach in Rosarito.

Some deaths that occurred in Mexico could have happened anywhere. Donna Warfield, 61, of San Diego, was killed in April 2004 when the car her husband, Roy, was driving struck a metal railing on the toll road between Ensenada and Rosarito Beach. He was charged with drunken driving.

Rochelle Sobel of the Association for Safe International Road Travel says travelers to a country are "vulnerable road users." They tend to be "unaware of the specific risks to which they will be exposed as pedestrians, passengers and drivers," says Sobel, an American who founded the global safety group after her 25-year-old son, Aron, and 22 others were killed in a bus crash in Turkey in 1995.

Travelers to foreign countries who rent motor vehicles face many distractions, says Stephen Hargarten, chairman of emergency medicine at the Medical College of Wisconsin and co-author of the Make Roads Safe report.

They're often driving unfamiliar cars on unfamiliar roads with unfamiliar signs. They may not know local motor vehicle laws, traffic patterns, driver behavior and road hazards. The traffic mix on many roads may be unfamiliar, including horse-drawn vehicles, motor scooters and pedestrians.

Hargarten says American business travelers are more likely to get involved in auto wrecks abroad than during trips within the USA. They're often fatigued from jet lag when they get behind the wheel and then face the distractions of driving in a foreign country.

Injury-prevention specialist Bella Dinh-Zarr, the report's other co-author, says local customs can be disorienting and dangerous for visitors. In countries such as England and Scotland, driving on the left side of the road, as well as narrow roads and numerous roundabouts, can confuse Americans. Some locals in Latin American countries drive at night without their lights on. Animals are free to stray on many foreign roads, which are frequently unlit at night.

To counter the threat to its employees and contractors, Chevron is campaigning to bolster highway safety laws in many nations. Chevron, which operates in 180 countries with 56,000 employees, created an Arrive Alive program that aims to upgrade safety by bringing together governments, businesses, local communities and international donors.

Chevron says Nigeria last September implemented stricter motorcycle-safety laws following advocacy work there by Arrive Alive. Among other things, the laws restrict motorcycles to one passenger and require helmets in Lagos, the nation's commercial capital.

In Uganda, Arrive Alive is working with the World Bank to develop a national road-safety policy, including better signage, improved speed limit enforcement and establishment of pedestrian crossings. Similar projects are underway in Guatemala and South Africa, Chevron spokesman Alex Yelland says.

The company's focus on road safety has cut employee and contractor fatalities from eight in 2002 to one last year, Yelland says. Yet highway crashes "remain the No. 1 cause of serious injuries," he says.

Separately, seven automotive and oil companies have committed $10 million for a Global Road Safety Initiative, a five-year program to improve road safety in China, Brazil and 10 Southeast Asia countries.

The program aims to provide training to safety officials and money for safety projects in countries with high fatality rates and "substantial road-safety problems." The companies involved are Ford, General Motors, Honda, Michelin, Renault, Shell and Toyota.

Despite the awareness of a road-safety crisis by some corporations and international organizations, much more needs to be done by local governments and safety advocates, the World Bank's Bliss says. By 2030, road deaths will rank as the No. 2 killer, behind HIV/AIDS, of all men, he says.

"Justifiably, billions of dollars are being mobilized to address the HIV/AIDS crisis," Bliss says, "whereas the road-crash crisis is only in the early stages of being recognized as a global priority."

ABC News Live

ABC News Live

24/7 coverage of breaking news and live events