May 22, 2011

REGULAR readers of these columns may wonder why this week we are featuring an article discussing deaths in India due to road accidents. Conventional wisdom would have placed this problem alongside other “rich peoples maladies” such as obesity, coronary heart ailments or diabetes. But just as it is now widely recognised that these ailments are today afflicting growing numbers even among lower-income groups, so too is it with fatalities in road accidents, even though reasons are quite different and the analogy cannot be stretched too far. India has the highest number of road traffic fatalities in the world, with one road accident every minute and one fatality every four minutes. Not only are the numbers dying in road accidents in India alarmingly large, but increasing numbers of fatalities are from lower-income groups.

Not that road fatalities are peculiar to India. They are in fact a world wide phenomenon, causing widespread concern, due to which the United Nations has declared the coming decade to be the "Decade of Action for Road Safety 2011–2020." The World Health Organisation (WHO) estimates that road traffic fatalities will go up from being the 9^th leading cause of death globally (and 10^th in the South East Asian region including India) in 2004 to 5^th position by 2030. Almost 1.3 million people die around the world from road traffic crashes each year and between 20 million and 50 million more are injured. And more than 90 per cent of fatalities occur in low- and middle-income countries, which have less than half of the world’s vehicles.

If one takes into account not just deaths but injuries, related economic losses and losses due to damage to vehicles, these are large enough to seriously threaten development in many countries of the South. Global losses due to road traffic accidents are estimated at around $518 billion and cost governments between one and three per cent of their gross national product. An estimate by the Planning Commission puts the figure for India at 3 per cent, more than she spends on education or health. Affected families often have to bear huge burdens due to loss of life or serious injury to wage-earners, medical and rehabilitation costs.

But the extent of the problem in India, the categories of people affected, and many of the reasons behind this modern epidemic, certainly marks India out as an especially bad case. But while the problem in India is more acute than in most countries, and getting worse by the day, it is mostly ignored by the government and sadly by the public too. Everyone seems to view road fatalities as a simple “fact of life,” a perception aided by the very word “accident,” something that happens by chance. In fact, most “accidents” are nothing of the kind, they are caused by someone or something, and in India they are further reflective of deeper maladies of governance and its role in regulating social behaviour.

A status document currently under preparation by the ministry of health and the ministry of road transport and highways (MoRTH), as part of its work relating to the UN Decade, states that 1.6 lakh people were killed in road accidents in India last year, up sharply from 2009 when 1.25 lakh fatalities occurred. That is a shocking increase of 28 per cent in one year!

Road injuries are now among the top three causes of death for those in the 5-44 age group, compared to 5^th place worldwide, and among the top ten causes of death among children in the 0-4 age bracket comparable to countries with much higher vehicular densities. If we compare statistics from some countries, we can see how bad India’s record is. In doing so, we should note that road traffic data from different countries often represent different things. For instance, in Western countries, comparisons are usually made in deaths per vehicle-kilometre. However such figures are not available for most developing countries and in fact can also be misleading because, for example, the US has the highest vehicle-kilometres traveled but these tend to be largely on the safest dual-carriage highways or freeways. So in order to avoid comparing apples with oranges, let us consider the number of road deaths per capita or rather per lakh population and, simultaneously so as to get an idea of proportion, let us also compare number of vehicles per capita. (see Table below)

The table shows that whereas, apparently India does not appear in an unfavourable light compared with other major economies in terms of deaths per lakh population, India has proportionately about 1/50^th of the number of vehicles per capita as Germany or 1/10^th that of China. In other words, if the number of vehicles per capita were to increase in India to, say, the level of China, the fatalities in India would be 10 times higher. And the rapid increase in the number of road fatalities seems to match the sharp growth in vehicle ownership in shining India.

Country	No. of Vehicles per capita	No. of Road Deaths per 100,000 persons
USA	779	12.3
Germany	558	4.5
China	128	16.5
Brazil	156	18.3
India	12	16.8

Let us look at some other related and revealing trends in India as revealed in the MoRTH report on road accidents in India 2009.

Around 13 per cent of the road traffic deaths in India are pedestrians, 4.5 per cent are bicycle riders, 20 per cent are two-wheeler riders, 7 per cent three-wheeler riders, 15 per cent are people riding in passenger cars or taxis, whereas 22 per cent deaths are in trucks and about 8 per cent in buses. About 70 per cent of the almost 100 million vehicles in India are two-wheelers, so a high involvement of two-wheelers in crashes may be no surprise. But what other figures in the MoRTH report show is that percentages of fatalities involving two-wheelers, three-wheelers and cars are lower than the percentage of road accidents involving these types of vehicles, the reverse is true for trucks, buses, and bicycles. In other words, bicycle riders are more likely to be killed in road accidents than those in motorised personal vehicles. But if deaths in trucks come as somewhat of a surprise, consider this.

53 per cent of the total registered accidents in 2009 occurred in rural areas which also had more fatalities (62 per cent) than urban areas (38 per cent). Casualties in rural areas were also greater at 60 per cent than in urban areas. Reasons can be deduced: roads in rural areas are most often single carriageway with no separation of on-coming vehicles and vehicles are unable to travel very fast in crowded cities and towns.

All these above data should be taken to indicate broad-brush trends. But a note of extreme caution needs to be exercised with regard to MoRTH data. Not only do they reflect only accidents that are registered with the police, which usually happens only with respect to fatalities, much of the information on causes is highly dubious and are products of clearly subjective inferences at local levels since it is well known that no serious accident cause analysis is carried out by the police except in rare cases attracting public notoriety. And that brings us to the slippery slope of what concerned authorities perceive to be the major causes of road traffic accidents and fatalities, and what measures they propose to take.

Take for instance the assertion in the MoRTH report that “drivers fault” accounted for almost 80 per cent of road accidents, of which around 58 per cent were caused by “drivers exceeding speed limits,” about 10 per cent of these resulting in deaths. There is absolutely no evidence presented as to how these figures were arrived at. However, to some extent, these data are merely truisms. As stated at the outset, there are very few genuine “accidents,” such as for instance a vehicle swerving to avoid an animal on the road and hitting another. Most “accidents” are in fact caused by one or other party doing what he should not be doing, such as driving on the wrong side of the road which must clearly be the case in head-on collisions. “Speed kills” too is a truism. A crash taking place at 70 kmph could be fatal whereas the same crash at 10 kmph would most often result in simple injuries.

A WHO study brings out that an increase of one kmph in speed results in a 3 per cent increase in the incidence of injury crashes and a 4 to 5 per cent increase in fatal crashes. A 5 per cent increase in speed leads to approximately 10 per cent increase in injuries and a 20 per cent rise in fatalities. Pedestrians have a 90 per cent chance of survival when struck by a car travelling at 3 kmph or less, but under 50 per cent chance of survival if the impact is at 45 kmph, with almost no chance of survival at 80 kmph. But none of this tells us anything about why the “accident” took place in the first instance: was the car driving on the correct side of the road, did the vehicle run through a red light?

Similarly, it is true that safety devices such as the safety belts in cars and crash helmets for two-wheeler drivers and passengers can prevent fatalities or serious injuries, but they have no role to play in preventing accidents happening in the first place. Studies show that wearing a crash helmet correctly reduces the risk of death by almost 40 per cent and the risk of severe head injury by over 70 per cent, and mandatory helmet laws reduce head injuries among cyclists by about 25 per cent. Reducing fatalities and serious injuries are doubtless of the utmost importance, but perhaps prevention of accidents is at least if not even more important. And this is where the MoRTH report breaks down into gibberish and shibboleths raising serious doubts about reversing the present horror story on Indian roads.

Having attributed over 80 per cent of road accidents to driver error, the MoRTH report suddenly changes tack and attributes accidents to everything else! It lists type of road users and colliding vehicles; environmental and road related factors (such as road design and geometry, intersections and other areas of traffic conflict; vehicle- related factors including non-use of protective devices; nature of traffic management; and emergency care for accident victims. Under road safety measures the authorities propose to take up, the report presents a long wish list, but buried somewhere is one innocuous and easy to miss line about “strengthening the licensing system.” It is either sheer blindness or helplessness on the part of government to ignore the most important causes of road accidents in India: that road users in India have no clue to correct road behaviour because there is no system in place to properly train and test drivers, and because there is virtually zero enforcement on the part of traffic authorities to inculcate correct behaviour. In fact, everybody in India knows that the easiest identity document to procure is Drivers License which can be obtained easily at the cost of a photograph and a small bribe without so much as a proper test or even an appearance at one. And if there is no enforcement once a driver is on the road, improper road behaviour and rash driving get reinforced.

Indeed, in typical ostrich manner, the report almost completely ignores these and, in fact goes out of its way to negate their importance! In its concluding sections, the report highlights the “4 Es” of accident prevention and control the world over, namely education, enforcement, engineering and environment, and emergency care, and then quickly dismisses the first two! It argues that disseminating road safety awareness through public campaigns are not effective as isolated measures, and does not even speak of licensing as part of this process. In the international literature, education or public safety awareness is spoken of taking a rigorous licensing system for granted, for Indian authorities it is best to not even acknowledge the issue lest one is called upon to do something about it. And on enforcement, the report only mentions clauses in relevant Acts that deal with crash helmets and seat belts. Problems will not go away simply because you ignore them! But that is exactly what the report does, and goes on to emphasise engineering solutions in road design and construction, and ambulance systems to get accident victims to hospital quickly. Important no doubt, but ignoring the root of the problem, namely the license to kill! Is it surprising then that in India even an aircraft pilot’s license can be procured through fraud?

More than a hundred countries came together last week to pledge to reduce road accidents and fatalities as part of the UN Decade call. India is among the very few nations yet to even finalise a draft of its road safety plan as part of this endeavour. Are there any takers for India to achieve the ambitious target of reducing road fatalities by 50 per cent by 2020?

People's Democracy