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| Sunday, 6 June 2004 |
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Features |  |
| News Business Features Editorial
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Road deaths: a national tragedy Road trauma and road traffic accidents (RTA) are a global problem. In Sri Lanka it is a menace, and has become a national tragedy. A total of 1.26 million die annually on the roads in the world, and of these 87% of the fatal accidents occur in the developing countries. Road traffic injuries and deaths are a major public health crisis that is being neglected by governments, and the media. Although the tragedy of road deaths is so enormous, it attracts less media attention than other less frequent but more unusual causes. Road deaths account for more than 23% of all deaths from injury compared to 3.4% from war globally. Road traffic injuries now constitute more than 2.5% of the global burden of disease, and in Sri Lanka this would be several folds higher, this is why prevention of road traffic accidents, is very much the responsibility of the medical community too. In a sense the medical community, and the Ministry of Health in Sri Lanka should be ashamed of themselves for being relatively quiet for this long. There is a major anti-dengue propaganda to contain a mortality of 15-20 per year and anti-Malaria campaign to contain 210 deaths a year and so on, then why not we also launch an anti-Road traffic accident campaign to prevent 2000 deaths a year? The dire need for action is reflected by the major global initiative taken by the World Health Organisation this year to prevent road traffic injuries worldwide. Forty four percent of the world's road deaths occur in the Asia & Pacific region but yet only 14% of the world's motor vehicles are found in this region. In highly motorized countries such as US, Japan and Australia the annual morality on the roads per 10,000 registered vehicles were less than ten in 1965 and less than 5 in 1992. This measure, i.e. annual fatality per 10,000 registered motor vehicles, which is also considered an index of road safety exceeded 40 in 1996 in Sri Lanka. In contrast, the numbers of road deaths are decreasing in the highly motorised countries despite their multiplication of roads and vehicles. Over fifty thousand road traffic accidents occurred in Sri Lanka in year 2002 and over two thousand of these were fatal accidents. This number is growing by 3-5% annually. Today on average six people die everyday due to road traffic accidents in Sri Lanka. This daily death toll and the number injured are now exceeding the death toll and injuries that occurred during the North-East war. This is why the road trauma in this country has now reached proportions of a national tragedy. It is clear that the counter-measures adopted by the responsible authorities and governments to reduce the number of road trauma in this country have failed to date. The incidence of road trauma is still on the rise. Why is this? What action can we take? The national burden The costs of road trauma are massive. For every one who dies on the road, another eleven are injured, and some of them suffer life long disability. The losses broadly include (a) the medical costs involved in treating victims (b) loss to society through contribution by the victim (c) policing and legal costs (d) costs in terms of pain and grief borne by families and loved ones and (e) damage to vehicles and property, estimated costs of road trauma in Sri Lanka was a staggering Rs. 8.13 billion in 1999, Rs. 8.79 billion in year 2000, and Rs. 10.25 billion in 2001. This is close to 1-2% of our GNP. In Sri Lanka 41% of fatal road injuries and 61% of all traffic accidents are reported from Western Province. The most risky roads to travel in Sri Lanka are (a) A3 Peliyagoda to Kochchikade, (b) A2 Colombo to Aluthgama and (c) A1 Colombo to Nittambuwa. The three-wheelers are involved in 18% of all accidents, buses in 17% and vans in 16% and motorcycles in 12%. Only 6% of the accidents involve cars. In the Western Province people injured in an accident are as follows: 38% pedestrians, 26% passengers, 14% pedal cyclists, 12% motorcyclists and 10% drivers. Three-wheelers, buses and vans constitute the most common vehicles involved in a road traffic accident. Together these are involved in more than 50% of all accidents, and constitute mainly commercial vehicles. Buses and three-wheelers are extreme contrast in size but are equally involve din accidents. Thus the size of the vehicle cannot be a factor contributing to this preponderance. The environment is the same and the roads are the same and hence it is the driver behaviour that may be contributing to a high incidence of their involvement in road accidents. The message is clear. The quality of commercial driving is in question. We see daily that most commercial drivers have little courtesy for other road users. Some of them openly and consistently flout road rules without hesitation. Thus, if we are serious in preventing road traffic accidents, then, there is a special need to focus on the rules and regulations governing and training needs of the commercial drivers. Why are so many pedestrians involved in road accidents ? Are they careless ? This is likely, but the most important reason should be inadequate facility for pedestrians on the roads. In cities we see that unauthorised makeshift shops or parked vehicles occupy all space and pavements meant for pedestrian use, forcing pedestrians to be on the middle of the road. The authorities take little action to keep these pedestrian paths and pavements clear even in major cities. Regrettably our road designers also have given little concern for pedestrians. In a developed country the road design would automatically include sidewalks, pedestrian crossings, footbridges, subways, and walkways (foot paths) to keep pedestrians safe and away from traffic. What are our designers doing? Even our newly built roads have no pedestrian paths. Some roads have no space at all for pedestrians. Why is it that we are continually funding such substandard road development? There are many resource personnel in this country who can advice, for example, even scholars who had completed their PhD's on road design. Unfortunately our governments make little use of their services. Why not we capitalize on our own resources to obtain professional advice on these matters? Why not the judiciary consider and hold the road development, and maintenance authorities responsible for accidents when poor road design is constantly contributing to accidents? The insurance companies should consider bringing to book the road developers who appear to be responsible for recurrent accidents, for example, the Telecom would dig 3-4 feet deep manholes on the road, keep them open for days without adequate protection or sign posting and people and vehicles fall into these death traps day and night. Who should be responsible for these crimes ? Why are law enforcing authorities so quiet ? Predisposing factors The epidemic of road trauma that we witness today can be reduced only by attending to the four basic aspects that contribute to road traffic accidents i.e. (a) road user discipline (b) vehicle roadworthiness (c) road condition (d) road environment. It is regretful that even our senior police officers blame the use of mobile phones or speed as the major or sole cause of road traffic accidents in this county. This is far from the truth. The responsible authorities and police should be more scientific in their approach to the containment of this problem, especially because we are severely limited in resources. The reason for rising road trauma is partly due to uncoordinated, non-scientific and ad hoc approach to its curtailment. Poor brakes, no lights, malfunctioning wipers, poor tyres, lack of road capacity, black spots, narrow roads, bottle necks, bad surface, poor lighting, undisciplined drivers and pedestrians, all contribute to road traffic accidents. Hot weather, mist, walls built close to roads and even trees grown on pavements are considered factors contributing to road traffic accidents. Thus, prevention of road traffic accidents needs attention to all factors mentioned and not just driver behaviour. Minimising disproportionate speeds is also important. For example in a dual carriageway, bullock-carts are obvious vehicles that would be the cause for accidents and not vice versa. Pedestrian discipline The police, media and even public focus very little on pedestrian discipline. In an accident that involved a pedestrian, the driver of the vehicle would always be considered at fault. This may even end up with violence against the driver, who may really be innocent. Sometimes the vehicle involved also gets severely looted and damaged. Does anybody question how the pedestrian was involved in the accident ? How often do you see a pedestrian using right side of the road as they are expected to do ? How often do you see the parent escorting a child walk along the left side of the road and holding the left hand of the child making him walk on the middle of the road ? Unfortunately very little or no effort has gone to improve pedestrian discipline in this country. Authors: CDA Goonasekera, HJ Suraweera, M. Salgado To be continued |
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