Passengers play a key part in road safety in Kenya.

2188 www.thelancet.com Vol 373 June 27, 2009 Aboard a Kenyan long-haul minibus (matatus), some hold their breath, others try to sleep, and many pray for the merciful intercession of the Almighty but, like characters resigned to a tragic script, they rarely speak up. In this universe of steel and glass, 15 feet by fi ve, the driver is king. “He tore his way down the road, hooting at those unlucky enough to be in his way, swerving just at the last second to overtake other motorists, all the while carrying out endless phone conversations”, one passenger wrote in a local newspaper. “I mouthed a silent prayer for journey mercies.” But a new study in Kenya, where more than 3000 people die each year in road accidents, suggests that, when passengers are encouraged to speak up, they avert disaster. Heckle and chide: results of a randomized road safety intervention in Kenya found that placing stickers in minibuses urging passengers to confront reckless drivers reduced accidents by 50–65%. Some of the stickers depict severed, bloody legs and feet, with the slogan “A careless matatu driver is your wake up call! Stand up. Speak up. Or will the rest of you survive today?” “We wanted to bump people into a diff erent way of behaving”, said William Jack, one of the report’s authors and an economist at Georgetown University. “These stickers are supposed to make you feel that when you are scared you can say something.”