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Continued from last week

"About 32.8 per cent were walking outside the pedestrian crossings. 10 per cent was getting on or off a bus indicating the scant respect the bus driver has for his passengers. Those trying to board a bus fell when the bus suddenly pulled away and the fallen persons were either run over by the rear wheel of the bus or by the vehicle behind the bus.

Darting across the road after emerging from behind a parked vehicle contributed to 3.8 per cent injuries, Pedestrian crossings placed in front of a bus are a hazard especially to school children 5.3 per cent of injured pedestrians were under the influence of alcohol 62.8 per cent of the injured pedestrians wore dark clothes after dusk.

Discussion

Traffic is a major risk factor to human health. Javed and Navin illustrated this with a 3 circle concept of Motor vehicles, Road users and Environment. When the 3 meet the stage is set. Motor traffic injuries are therefore predictable and can thus be prevented.

The WHO recommends a four systems approach to be considered under speed control, good road design, traffic management and interventions in driver behaviour. Note the shift in emphasis of the onus of an accident from the driver to the authorities. Controlling driver behaviour comes last on this list of priorities.

In our series just about every risk factor known to be responsible for motor traffic injuries was encountered. Excessive speed, alcohol, not wearing seat belts and helmets, using mobile phones while driving, fatigue, driver illness, young male drivers, poorly trained self taught drivers, driving without valid licenses, poorly maintained vehicles, unprotected vehicles, pedestrians not using pedestrian crossings, driving without lights after dusk and pedestrians wearing dark clothes after dusk.

Speed Control

Most drivers, whatever the vehicle, enjoy driving at excessive speed in the 20-40 year old male who in this series formed the largest group injured amongst the driver category. Private bus driver who has a mandate to earn the maximum in the shortest possible time is the other group.

Three solutions are suggested.

1. Buses and similar heavy vehicles should be compulsorily fitted with speed limiting governors which would necessarily limit their maximum speeds.

2. Limiting speeds to 40 kph in urban areas and to 80 kph on highways. Road signs at frequently placed intervals must be displayed on all roads. A remarkable phenomenon of Sri Lankan roads is the paucity of roadside signs indicating the speed limit.

Listeners would be surprised if they were to be told what the speed limit is on Magazine road and Elvitigala Mawatha, by far the only highway that deserves to be called one in Sri Lanka. The local law enforcement officer must be given a mandate that it is entirely his responsibility to enforce this rule.

Police patrol vehicles like distinctively coloured motor bicycles are important disincentives for fast driving.

3. Engineers should be given the task of constructing "speed unfriendly" roads. eg. Bumps rumble strips, road narrowing when approaching major intersections. Barriers rather than double white lines should be used in the middle of the road to prevent overtaking at blind corners.

12 per cent are admitted to driving without a valid license and 78 per cent of the drivers had been self taught. Driving must be considered a science. It cannot be learned by trial and error. It is an established fact that 90 per cent of accidents occur due to human error. It must be made compulsory that all future applicants for driving licenses should have followed a course in an authorized Driving school.

Apart from teaching the Highway Code these schools should be provided with a Manual containing the curriculum which would have a core of essentials for safe driving. There will also be a section on the courtesies of safe and civilised driving.

These would, as a few examples illustrate, help to develop a different culture of driving eg. 1. Slowing down at every pedestrian crossing whether there is a pedestrian on it or not and not tooting the horn and accelerating even when there is a pedestrian on the crossing. 2. Allowing a vehicle which is reversing into your path to reverse and not tooting your horn and driving faster to beat him to it. 3. Slowing down and allowing a driver to cross your path rather than tooting the horn, speeding and staring menacingly at the driver. There are many more.

The evidence that higher fines and stronger punishments act as deterrents is not strong. Fines have been increased recently and we can await the outcome. The newspapers carried a story that all efforts are being made to make it easier for fines to be paid. We wonder whether the opposite should be tried i.e. to make the hassle of paying the fine itself a punishment.

Moreover, it was found in this study that only about half of the drivers or riders were familiar with the Highway Code. Offenders should be made to sit for the examination on the Highway Code that new applicants are required to sit.

Legislation must be urgently enacted to have a new Driving License with central computer records. As in Australia, U.K, U.S.A., a point's scheme for different offences must be drawn up. Points will be accumulated for such offences and when it reaches a certain value eg. 12 points when the License will be suspended for a year. These offences would include such dangerous driving practices like driving after alcohol, at excessive speed, through red lights etc. The focus is on 'prevent accidents by punishing, not punish after the accident'.

Only two of the injured drivers had been tested for alcohol. Here again prevention strategies are better than punishment after the event. It is a heartening sign to see Police officers patrolling the roads late at night when drunken driving is commoner.

Seatbelts is the greatest success story of injury prevention. Wearing seatbelts minimizes injury by 40 to 45 per cent. In spite of this statistic only 4.7 per cent were wearing seatbelts. It is time to bring the wearing of seatbelts from an optional status to a compulsory one, both for driver and the front seat passenger.

Helmets worn by motor bicycle riders and pillion riders reduce the risk of head injury by 20 to 45 per cent. In our study 20 per cent and 38 per cent of these groups did not wear helmets. This obviously needs to be rectified.

The question of implementation of the law without fear or favour is a question that would spring to most people's minds. Politicisation of the bureaucracy including the Police force would raise serious doubts in one's mind whether these plans could be implemented.

This becomes a predicament when politicians with their back up vehicles speed through roads without any consideration for the road user. A recent news item highlighted how France's Minister of Justice was ticketed for speeding. If politicians need to get about in a hurry special patrol cars should be sent in advance to create a lane without the present system of rude shouting and gesturing by officers in these back-up vehicles, at motorists using the road.

Driver fatigue and long hours of driving are further examples of the human factor in causing accidents and injuries and death. The frailty of human behaviour and perhaps vanity makes most drivers deny that they are sleepy when driving although they probably are. Public awareness is essential.

Drivers should be educated to take adequate rest before driving long distances. If one needs to drive in spite of this our advice to drivers is to chew something; keeping chewing gum in the glove compartment should be encouraged.

Education

The importance of education of the public and potential drivers cannot be emphasised enough. However education has to take place at various levels. The Highway Code must be taught at preschool level, in Universities, and to all categories in the Government and Private sector. We should be dubbed the 'Highway code nation'.

In Australia there are mini parks simulating roads and busy intersections where the culture of proper road behaviour is inculcated into young minds.

Pedestrians

The analysis of mortality rates for different categories of road users reveals that in years 2002 and 2003, the largest of number of deaths was in the pedestrian group. Our study too shows that the largest category injured too was pedestrians.

Adequate publicity should be given in all forms of media on the real danger to the pedestrian. 50 per cent of those injured were after alcohol. One third were walking on the wrong side of the road ie. with the flow of traffic. The majority wore dark clothes after dusk.

The wearing of luminous arm bands must be encouraged, more so for push cyclists and they must be made freely available at a reasonable price. Jay walking or walking outside the pedestrian crossing must be penalised. Pedestrians should be cautioned against standing on the middle of the road at night since visibility against the lights of oncoming cars is virtually nil.

A paradigm shift: Vision Zero

Education has shown to be effective with sustained advocacy. The Swedish model of Vision Zero (1997) recognises the primacy of human well being and human life, overriding ones desire to get there quickly (mobility).

Safety: Minimise opportunities for error.

Change: Research and change provided by enforcers, co-operation by road users.

Ethics: Priority of human life and health over mobility.

Responsibility: Shared by providers and users.

This is a social responsibility that has to be ingrained into every driver's mindset before he gets behind the wheels of any type of vehicle. Respect for road rules, speed limits, pedestrian crossings etc. will make roads safer for the human.

The responsibility for safety and for accidents has to be shared by providers and enforces, not only users. An accident is a failure of the system. Humans are equated with errors - from errors of judgment to errors of function.

Every possible precaution should be taken to reduce or better eliminate the opportunity for errors. There should be a paradigm shift. The Police Officer in Charge of a particular area must be entrusted with the responsibility of achieving the goal of a percentage reduction of accidents every month when compared to the figure recorded for that month the previous year. Incentives for achievers and reprimands for non-achievers and could be worked out.

Scant regard is given in Sri Lanka to the role of the vehicle in the evolution of events that lead to an accident. 16.5 per cent of the vehicles in which the injured were travelling in had serious defects and 14.8 per cent of three wheeler drivers had tampered with a safety mechanism in the handle lock which facilitated a smaller turning circle but increased the chances of the vehicle toppling over. Legislation has to be brought in for spot inspection of vehicles and for certification of road worthiness for older vehicles.

There is in Sri Lanka, a Ceylon Association for the Prevention of Accidents and a National Road Safety Strategic Plan. They have outlined some of the issues I have also raised today.

These include: more traffic courts, independence of the police force, incentives to the traffic police, harsher punishments including suspension of driving licenses including punishments to jay walkers, more devices to detect traffic offenders including Alcometers, elimination of alleged corruption in police force.

Will it work? If implemented, yes.

Yet accidents happen and more accidents continue to happen. Newspaper headlines continue to scream out to the country the continuing carnage on our roads. The Police are skeptical that this has any effect apart from just arousing curiosity and cursory interest.

Our study confirms where we already now. There are no startling revelations. Some would even say, "Here is a clear example of reinventing the wheel". However, the study reveals one stark fact. That fact is that in spite of knowing the problem, in spite of doing what has been already done, the situation has not changed, the problem continues with all its terrible consequences.

These consequences include the loss of 40,000 lives in the next 20 years and the lives of one million people affected, not to mention the enormous economic burden to the country. As I mentioned earlier the effect of a Tsunami on humans once every 20 years ! We need to act now since the cost of this problem will add over 11.6 Billion rupees to our already strained economy.

. Hence our recommendations include:

Strong central control i.e. traffic police to be under the President or Prime Minister.

. High status for traffic police.

. Empowerment of private sector & whole population. Participation in the exercise of safe driving and in helping authorities to enforce traffic rules.

. Institutionalised driver training and standard curriculum.

. Harsh punishment, legislation for driving license disqualification on accumulated points.

. Highway Code retesting for offenders.

. Develop a manual of core knowledge and courtesies of driving

. Discourage Motorcycles/Three wheelers.

. Checks for vehicle safety and road worthiness.

. Legislation to revise speed limits.

. More speed limit signs displayed at frequent intervals.

. Re site pedestrian crossings away from bus halts.

. Luminous arm bands encouraged for pedestrians and push cyclists.

. Traffic Police given mandate to reduce accidents in his area by a percentage each month compared to the number of accidents for that month in the previous year.If these recommendations are implemented, not only will there be a reduction in the number of accidents every year but the stage will be set for a different culture, of an orderly society. And no fear of the effect of a Tsunami in 20 years from now.

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