Road accidents or preventable and predictable massive public health concerns?

I was watching a movie in the first floor of our house that fateful afternoon of '94 when that call came and changed our lives forever. It was my mother who had called from the ground floor of our house to inform me through her uncontrollable tears that she had just then received a call that my younger brother had died in a road accident. I rushed down hoping against hope that it was someone else. My dad was sure it wouldn't be someone else – as I drove our car frantically towards Gurgaon where the accident had happened – and advised me to drive slowly. He had done his maximum possible to see to it that we never developed a fascination for motorbikes. An avid reader of about a dozen papers everyday, my father was definite that a motorbike was a sure-shot route to disaster on Indian roads. So the soonest he could, he bought a car for us. I still remember that day in 1993, after he had bought a fifth-hand 1977 model Toyota, he entered the house, lay down on the bed in a relaxed manner and told my grandmother, “I have put a "kavach" (a shield) around my children today.” Unfortunately, that was not to be.

So, that afternoon, did my brother really let my father down by taking a ride on a two-wheeler from our institute’s campus to the highway to have lunch? No. I believe every 20-year-old at times takes his own decision and thinks that this much seems quite fine a risk. We all have the right to go out on the road and come back alive. It’s India’s pathetic road safety that let him down. We are a country of road killers. The highest number of road deaths in the world happens in India. If it were America, chances are fifty times more that my brother would have been alive.

While with only a mere 12 million vehicles, we have about 114,000 deaths on Indian roads, with about 250 million plus cars in the USA, they have only 41,000 road accident fatalities per year. That is, in India for every 100 cars we have one road death; in USA, there’s one road death for every 5,000 cars! And how does this difference take place? Is it because there people don't drink? Well, the daily normal alcohol consumption per capita is far higher in the West, especially among the youth – which is involved in the maximum number of road accidents. Is it because people in the West don't drive fast? Well, the average speed limits in developed nations are far higher than those in India. And it is in developed nations that more youths have access to vehicles on the road and ergo tend to be more reckless; then how is it that the West manages to systematically bring their accident numbers down to such abysmal lows, while we aren't even bothered? Or is it that only the 26/11 deaths should be considered as deaths but thousands of more preventable deaths happening in every other family around us are not deaths but God’s sweet will? Can you fathom this, that as a nation, we lose $20 billion annually to road accidents, enough money to do away with 50% of our country's malnutrition problem?

Here is a look at what some countries plan for their citizens! A country like USA decided to take a target of reducing road deaths by 20% in ten years; for UK, the target taken was 40%; Austria took 50%; and even a country like Malaysia took a target of bringing road deaths down to less than 3 per 10,000 vehicles! What about India’s targets? Well, what’s that? The government cares a damn if we are dying on the roads or of equally preventable diseases like diarrhoea. The United Nations actually puts road deaths in their public health agenda for it’s very clear that these deaths are massively preventable. UN’s global forecast, thanks to more and more cures for common diseases and more and more cars in irresponsible and unconcerned countries like India, shows road deaths becoming the third highest cause of premature deaths after ischemic heart disease and unipolar depression by the year 2020, replacing lower respiratory infections, diarrhoeal diseases and prenatal conditions, which occupied the top three slots in 1990 (a year when road deaths were ranked the 9th highest cause of premature deaths). About four decades back, in the US, William Haddon gave a simple 3x3 matrix called the Haddon matrix to show how to prevent road deaths. I am sure that in India, from the Roads and Transport Minister to the Commissioner of Traffic, none would have the slightest of ideas about that simple matrix (refer to figure). That, of course, was years back. Today, we have countries investing billions on research to reduce road deaths and coming out with technologies like alcohol sensors, seat belt alarms, automatic speed limiters etc.

In India, however, we don't even need to do all that. Our future development initiatives, like in many nations including China, need to have a focus on better road planning – from keeping roadsides clear of crashable objects (like trees, concrete pillars etc) to having separate lanes for pedestrians and cyclists to planning cities in such a manner where even the usage of vehicles can be restricted by making places of residence, schools, shopping and work closer to each other, wherein people start preferring even walking down; Denmark actually plans to make large portions of its capital Copenhagen car-free! We need new and extremely strict rules for obtaining licenses! My friends, who had been driving cars in India for donkeys-years, had a major worry when they went to settle down in UK, and that was whether they would qualify for a simple driving license out there; they were worried because of very strict rules and guidelines in UK with respect to issuing licenses. Recognising the fact that the maximum number of road deaths are caused by young individuals in their first year of driving, many countries have rules preventing youths from driving alone during the first year of driving/driving from 10 pm to 5 am/driving with any alcohol trace – things we must adopt in India as well. Also, recognizing that those are mainly youths on two-wheelers/motorbikes who cause the maximum deaths in faster developing countries (Malaysia, Indonesia, Thailand...), rules disallowing people with fresh driving licenses in the first year to drive 125 cc or higher powered bikes are a must. Road accidents have clear-cut statistics and a study of that is the easiest way to finding out a solution. Of course, there is the eternal debate in countries like India – with such publicized amounts of BMW/Porsche/Lamborghini deaths – about transfer of international technology mindlessly to countries like India which have such a high number of pedestrians and cyclists on the main roads; not to talk of street dwellers, who sleep on the roadside! And more so if these technologies should be available in the hands of youth (who are involved in significantly all of these crashes and deaths) before, say, five years of driving experience. There clearly are a number of things to be done – from far stricter alcohol consumption limits for driving to traffic rules to courts which function so that the fear of punishment is a real threat, like it is in the West.

It’s a shame that we haven't been able to even make it compulsory for women to wear helmets. And our traffic police? The least said the better. Making people stick to rules is their last concern. The roads where people are breaking all rules, you will rarely find them. But go to the Emporio Mall in Delhi’s Vasant Kunj area at any peak hour and you will find not one or two but at least four traffic policemen standing at the turning just before the mall. There are no traffic lights there. Then why do the policemen stand there? Well... Lots of rich, fashionable women and couples visit that part of Delhi, and it’s quick money harassing them for nothing!

All in all, the reason I write this piece is because road accidents are not only preventable but can be wiped out – a country like Sweden implemented something called Vision Zero in 1997, with an ultimate aim to bring down road accident deaths/severe injuries to zero! That’s called vision. And near-about that’s what is ultimately possible.

Yes, parents do have a role to play. When my dad bought me my first car, he explained to me endlessly that a car was like having a killing machine in your hands. It will in all probabilities, in Indian conditions, protect your life in the case of an accident; but remember, it will probably kill the other person – especially someone from a much poorer economic background whose life is far more important for his family – road accident deaths are also a big equity concern in that sense. I love cars, have driven the best of cars, but perhaps never in the last ten years would anyone have heard me using the car horn – because I never let such a situation arise when I have to use the horn! I used to be rash once upon a time, and my brother the safe driver who my father would always praise. One day, perhaps out of slight jealousy at that comparison, I had asked my father, what if I were driving safely but someone jumped in front of my car? Then there would be an accident, wouldn't there be? He had calmly replied, “A car is a killing machine. If your speed limit is right, you will even save that person from committing suicide.” I haven't forgotten that one lesson till this day.

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