The road to death and injury
Dinesh Mohan
Road
traffic injuries (RTI) are the only public health problem where society and
decision makers still accept death and disability on a large scale. This human
sacrifice is deemed necessary to maintain high levels of mobility and is seen
as a necessary “externality” of doing business. Deaths among workers in
factories, mines, railroads and dockyards were commonplace and accepted in
early twentieth century. This is not acceptable any more. Many societies do not
award the death penalty no matter how serious the crime. This attitude is
absent when it comes to road traffic injuries and fatalities.
Recent
estimates suggest that RTIs result in more than one hundred and fifty thousand fatalities
in India annually another three million persons suffer injuries that need
hospitalisation or expert medical treatment. For a young Indian the chance of being
killed or disabled from a RTI is higher than a heart attack, HIV or cancer.
This trend is showing no signs of decline. Hardly a day goes by when an angry
crowd does not try to lynch a driver or burn a vehicle involved in a pedestrian
crash. Villagers on their own have also constructed “illegal” speed humps
(speed-breakers) in thousands of villages to slow down vehicles speeding
through their neighborhoods. But, policy makers, courts, police departments,
engineers and NGOs keep pushing for policies that have been shown not to work.
According
to the Road Traffic Safety Bill passed by the Swedish Parliament in 1997 “The responsibility for every death or loss
of health in the road transport system rests with the person responsible for
the design of that system”. This puts the responsibility on the engineers
who build and maintain the road and the police department that manages traffic
on that road. Not primarily on the people who use the road because it has been
demonstrated that road user behavior is conditioned by the system design and
how it is managed. This view has been endorsed and supported by the World Health
Organisation’s World Report on
Road Traffic Injury Prevention released three years ago. Many in India have
this report on their desks but seem to ignore its contents and its
recommendations.
Take the case of our intercity
highways that are being converted to four or six lanes. Now cars owners are
thrilled to speed through at velocities in excess of 100 km/h sharing the road
space with pedestrians, cyclists, and tractors. This violates all principles of
safe transport. When a high-speed road is constructed in say Netherlands, they
have to ensure that it is a separate facility and another low speed road is
provided for slower traffic. Even the design of our highway ignores basic
principles of safety accepted the world over. For example, all our highways
have a median 30 cm or greater in height separating the two directions of
traffic and a sharp slope on the sides. Both these features are prohibited on
high-speed roads. If your tire touches the median it will be destroyed, your
car will be launched in space and land on the road spinning. For this reason,
no raised obstructions are allowed on roads where vehicles travel at speeds
greater than 50 km/h. You have to provide a 5 m wide run off area, or, if you
don’t have the space, a guard rail or a concrete barrier (called a New Jersey
barrier) is provided to slow down the vehicle and keep it on the road. This
neglect of basic design principles has resulted in hundreds of needless deaths
on our national highways. Thousands more will die uselessly on our new highways
in the years to come.
The situation in our cities is no
better. There is no European or Japanese city where the speed limit is more
than 50 km/h on major roads and more than 30 km/h on local residential streets.
Road design that makes it difficult to speed, enforcement and modern
technological tools achieve this. We know that at 30 km/h impact the
probability of death for a pedestrian is about 10% and at 50 km/h about 90%.
This is the scientific basis for setting city speed limits. This is also why no
cities with low crash rates have built high-speed roads crisscrossing them. We
on the other hand are building highways and flyovers that encourage people to
speed and discourage use of public transport. Not one flyover design in the
country has provided for safe entrances and exits.
We also know from experience that
road users are not deterred by extreme forms of punishment or very heavy fines.
However, they do respond quickly to their perception of the probability of
being caught. This is why helmet laws are so effective when there is police
presence on the road. On the other hand, sending fine notices by post to
offenders in Delhi does not seem to have had much effect as crash rates
continue to increase. This is probably because no other road user knows that someone
has been caught violating a rule. It is important that every day a road user
witnesses someone being hauled up for jumping a red light, speeding or driving
dangerously through traffic. This is possible only when we have continuous
patrolling of the streets and well-designed random policing systems. Instead of
instituting well-proven procedures, we continue to push exorbitant fines and
jail terms. If severe punishment was the solution then the daily lynching of
errant drivers and road rage should have brought down our crash rates to zero.
Our management of traffic at
crossings best exemplifies our lack of scientific approach. We allow free left
turns at traffic lights and the police officials zealously defend this
practise. This allows vehicles to move continuously and there is no safe time
for pedestrians to cross the road. The pedestrians then move further upstream
and run across the road at their peril. We then blame them for jay walking,
being stupid or both. We continue the bad practice when most cities with good
safety records do not allow free turns at crossings and provide safe pedestrian
crossings every 700m-800m on the surface and not subways or foot over bridges.
These are just a few examples of
wrong policies being pursued in the face of available evidence to the contrary.
The consequence of all this is that essential policies and countermeasures
needed to control the epidemic of RTI remain neglected. The first step in RTI
control would be to implement those policies that have international validity
and those that have a fair chance of success irrespective of the income levels.
The second would be to set up a National Road Safety Agency along with State
Road Safety Agencies that are independent of road building departments. These
agencies would oversee data collection, standard setting, policy evaluation and
research activities. The third step would be to establish and strengthen
research and teaching centres in all areas associated with road safety. This
would slowly help us feel our way in the right direction.
