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Accidents are preventable

2. Road Accidents - Part I



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by Vidyajyothi Dr Wijaya Godakumbura


The writer is a Consultant Surgeon who has received four international and three Sri Lankan awards for two decades of work on burn prevention. This is the second installment of a series of articles  based on his Sinhala book ‘Protect Your Child from Injury’. It contains sections taken from several WHO, WB  and UNICEF publications and his own observations. It has been approved as a library book for schools. 


Even to travel a short distance we now like to use buses, taxies or our own vehicle. As a result, there are many vehicles on the road, which means more accidents and more injuries. Experts say that the "most dangerous and most complex thing that man has to face today is the road environment". In low and middle income countries pedestrians constitute the majority,  i.e. 30%-40% of those who sustain traffic injuries, where as in high income countries passengers  sustain more injuries and out of them, 50% are children.


 


Some disturbing facts:


The first vehicular accident occurred in 1896, and during the next 116 years 35 million people have died on the roads!  In 2004, 262,000 children died from road accidents worldwide, and for  every death, 250 children warranted hospitalization. The highest number of deaths was in the 15-19 age group, while the second spot was taken by the 5-9 age group. Children, those with disabilities and the elderly are the most vulnerable, and over 90% of road accidents occur in low and middle income countries.


 The annual total global loss of lives from road accidents is 1.2 million, which is 33% of all deaths caused by accidents. Road deaths, which now occupy    the 11th position in the overall list of causes of death,  are expected to climb up to the 6th position in a few years! The annual global monetary loss is Rs. 55,000 billion.  We all know what a major road accident could do to a family, but few would know that several types of mental diseases  also could occur,  such as insomnia, fear and a feeling that another accident could occur.   They are more severe when the accident had caused the death of a parent,  and could remain for one month in 80% and for 12 months in 44% of children. In Sri Lanka, there are about 2,400 road deaths every year which is one death every four hours. Among them, 82% - 85% are males.


 In  the ‘World Report on Road Traffic Injury  Prevention’ published by the World Bank and the WHO, the heads of these two world bodies have stated, inter alia,  as follows.


"Road traffic injuries are a growing public health issue. Everyday thousands of people are killed and injured on our road, and every year, millions of people spend weeks in hospital after severe crashes. More than half the people killed are  young adults aged between 15 and 44 years - often the bread winners in a family. Road traffic crashes and injuries  are preventable; yet current efforts to address road safety are minimal in comparison to this growing human suffering. In high income countries established interventions such as legislation to control speed and alcohol consumption, mandating the use of seat belts and helmets and safer design and use of roads and vehicles  have contributed to significant reductions in their incidence and impact. In low and middle  income countries these injuries are high, costing  more than the total development aid they receive.


 The time to act is now. We urge governments and other sectors of society, to embrace and implement the key recommendation of this report".


 As Table  1 shows,  road deaths are going to be a huge problem in Sri Lanka and other S/E Asian countries, unless effective actions are taken without delay.


The age factor:


Parents travel with children until they are about 8-9 years old. After that the children travel alone, and because "their small stature makes them harder to be seen by car drivers and they  lack knowledge, skill and concentration level to manage the road envirenment" (quoted from a  WHO/UNICEF  book). E.g., Children find it difficult to notice safe places to cross the roads. Actually, in our country, it is not easy even for adults as the markings of some zebra crossings are faded, and in other palaces there are no signs to indicate them.


Among the youth, males are more prone to road accidents. This difference is most marked in the 15-19 year group, which is 3:1. There are several reasons why young people are more likely to meet with road accidents.


*        Young people tend to drive faster than adults .


*        Effects of  alcohol  are more pronounced in the young.


*        Many young people are using mobile phones while driving.


*        They generally do not like wearing seat belts.


*        The chances of an accident occurring  are higher among young people when people of similar ages are inside the vehicle.


*        More accidents occur in the evenings and in the early hours. These are the times when young people are at the wheel.


 


Table 2 shows that motor cycle riders are topping the list, and  1,167 motor cycle riders and 387 pedestrians die for each death from accidents involving trains and airplanes. (There are no three wheelers in the country where this study was done).


Three wheeler accidents:


A study done by a medical team on admissions to Colombo Children’s hospital after road accidents showed that one third were from three wheelers. The team  has noted  that drivers break the steering column lock to increase the turning angle. This  causes the vehicles to topple,  and  then children are thrown out as there are no door panels at least  on the right side. The parents have to bear this in mind, and   urgent action is needed by the traffic Police in this regard. I feel holding  on to the front cross bar would  give the passengers some  protection.


Motor cycle crashes:


Malaysia has been able to reduce them  significantly by raising the minimum age required to get a rider’s license from 16 to 18 years. By reducing the permitted alcohol level in the blood Australia has achieved a reduction by 33%. A foot or a part of a loose dress like a saree can get entangled in a wheel. It is sad that some manufacturers fail  to cover the wheels. While motor cycle accidents are falling in high income countries, they are rising in South East Asia.  In 2007, there had been 7,085 motor cycle accidents in Sri  Lanka, and 75% of the deaths were from head injury. When helmets are not worn, the risk of head injury goes up by 300%. Because wearing of helmets is compulsory around 99% in urban areas wear them but  sadly, most  parents do not put them on their children.


                             


Causes of road accidents:


                                                                                                                                                            These fall in to four categories, and if officials, motorists and pedestrians pay attention to them, many accidents could be prevented.


Drivers: Haste, speeding, driving under the influence of liquor, fatigue, sleepiness, mental diseases like depression, physical disabilities like defective vision and hearing, inadequate training and deliberate breaking of traffic rules.


Pedestrians: Jay walking, use of mobile phones on the road even while crossing,  not crossing at marked places, trying to get into moving vehicles, footboard travel, wearing black or dark coloured clothing in the night etc.


Environment: Rain, mist, poor road conditions, poor lighting, no zebra crossings in appropriate places and faded yellow lines in them, traffic lights erected too low, absence of luminous paint in the places where it is needed, tar barrels on the highway etc.


Vehicles: Vehicles that are not road worthy, defective breaks, worn out tyres, poor lights, dirty windscreens and defective wipers, etc. There are some general factors too.


There are over 3 million vehicles on the road now.  "Sri Lanka’s vehicle imports were increasing at an alarming rate  burdening  the entire road transport system and leading to more accidents" says Mr Udaya Mallawaarachchi,   the Chairman   of the National Council for Road Safety. According to him 525,421 vehicles were registered in 2011, which is a 45% increase over the previous year’s figure of 359,243. Our vehicle population " would go up to 4.8 million by 2021 and to 7.8 million by 2031" says Prof. Amal Kumarage of the Moratuwa University. "By 2031, the average speed in Colombo district would drop from  22 km per hour to 15 km per hour" (Quoted from The Island).  There should be a control of vehicle imports while improving public transport in order to reduce the congestion on roads, fuel import bill and road accidents. The increase of import duty done a few months back is prudent and it has caused a fall of vehicle imports. Age of the vehicles is important too;  Higher the age, greater is the possibility of accidents. Half the number of vehicles in our country are over 10 years old!


When vehicles transporting  fuels are involved in accidents, there could be injury to hundreds.  Three  years ago, such an  accident occurred in Congo. Instead of running away from the area, what some people did was to collect the petrol that was flowing on the ground.  A huge fire ensued,  killing 230 and injuring 196. Authorities  should warn these drivers in our country to be extra careful.


 To be continued tomorrow


 
 
 
 
 
 
 
 
 
 
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