In observance of the ongoing Road Safety Week, Dr Edmond Fernandes, MD Candidate, Dept of Community Medicine, Yenepoya University and CEO, Center for Health and Development(R), Mangalore highlights the urgent need for enhancing road safety and recommends measures that would help in doing so
Roads form the lifeline for a great number of people in India. Millions of people earn their living everyday. But a case in point is if these millions who travel through the arterial system of India’s roads, make it safely and make it without any damage to either being or machine. It does not matter whether one is biking, walking or cycling or on a holiday, what remains of significant importance is the safety that goes along with it.
The condition of roads in India needs to be given a serious thought. The 26th National Road Safety week is in observance. But have we considered going beyond this week of observance?
Every year we have lakhs of Indians who die on the roads and millions who injure themselves. The 26th edition for road safety brings a very relevant theme to the table, it says, “Road safety is not a slogan, it is a way of life.”
The need is to raise awareness about post crash intervention and pre-hospital care. Road safety gives a clarion call for doctors and allied health service professionals to train citizens, communities and institutions in basic life support. Death from airway obstruction or external haemorrhage could be avoided by training and empowering communities in first aid. Often, situations arise where ambulance is out of bounds and in that case, auto-rickshaw becomes the next best alternative. Squeezing the victim into the three wheeler may lead to a cervical spine injury, a common occurrence due to ignorance. On the area of the wound, people apply sand, oil, turmeric and whatever is available in a bid to contain excess bleed. Training for drivers in basic life support will go a long way and all community medicine departments of medical colleges can begin this initiative. The list for different blood transfusion units in the city can be disseminated so that relatives of victims begin to get a fairly good idea of the same. Legal entanglement of road traffic crashes and the insurance creates a heightened anxiety state to the families which ought to be taken care of prudently by the doctors managing the patient.
The draft on the road safety bill points out that around four per cent increase in GDP will be seen if there are safer roads, wherein the efficiency will also increase. But this is mere wishful idealism. Today, India’s road connectivity is terribly poor. Even in tier-1 cities we do not have proper lighting, the roads are made of poor quality material and hence are in bad condition.
Speed breakers have no paint mark to signal the bump and speeding vehicles get tossed up on such occasions. Sign boards are grossly inadequate. During rains, in the coastal areas, the roads are filled with potholes. The roads in the coastal belt in Karnataka are some of the poorest in the world.
The world injury report says that around 1.2 million people are killed on the roads every year and more than 50 million are injured and become disabled. The rehabilitation process to minimise disability and restore life actively can be taken up extensively through social responsibility. However, this remains a grey area and is yet to be defined.
How long can we continue to ignore road traffic accidents? The implementation and enforcement of the Motor Vehicles Act has not been done. The traffic cops are understaffed. CCTV cameras need to be installed at different locations in all the cities and districts to keep a check on speeding vehicles.
Post crash intervention knowledge among citizens is also poor. The ministry of road transport should release grants to create more awareness. It is my recommendation that before issuing a driving license; the person should also be trained for basic first aid and basic car engineering, which has not yet seen the light of day.
I welcome the proposal in the draft bill for a motor accident fund to offer immediate relief of accident victims. But approaching for funding in a shock situation would be an added ordeal. There is a need for a national road safety policy which will add to the existing efforts which are not enough by any means. Thousands of people spend weeks in hospitals and for most of them, life will never be the same again. The present checks and balances are way too little to address this burgeoning problem.
Death due to road accidents is preventable. 46 per cent of road accident deaths take place among pedestrians, cyclists and motorcyclists. In 2004, road traffic accidents were placed 9th on the list of injuries and deaths. It is predicted that by 2030, road accidents will rise to the 6th spot, ahead of deaths due to diabetes and lung cancer. There is a need to equip hospitals to strengthen their trauma centres and response systems. The golden hour after the accident matters the most.
Some research studies point out that the highest number of accidents take place between 6 pm to 10 pm for a variety of reasons. Accident rates are also very high among males as compared to females. The road rage aspect of driver behaviour will need to understood in depth. Every district will need to set up a lead agency for tackling its emergency on the roads, because the road engineering in every area varies depending on the geographical location. Rapid action team for roads needs to be initiated and ethics for driving needs to be re-learnt. Today, when an ambulance rushes by with a siren, seldom do drivers give way. Everyone seems to exude an urgency that borders on desperation. We ought to change this. Driver behaviour plays a vital role in road safety. It is estimated by a US traffic department survey that driver distraction is the most responsible factor for crashes and near fatal crashes. Through this we learn that moulding minds is a bigger priority than just giving licenses.
Often we are faced with hit and run cases, because if the driver stops to help the victim, he may become a victim of public outrage. And in the bargain, the victim also suffers. This worsened problem calls for a greater introspection.
Community medicine doctors, public health professionals, emergency medicine practitioners and orthopaedic surgeons will need to come together to ensure speedy medical services to road accident victims. This would help to minimise deaths on the road greatly.
Let us also pledge to drive safely and follow the traffic rules. Making this a discipline will create a commonwealth for safer roads.
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