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Road accidents: A pandemic that needs greater attention | #childsafety | #kids | #chldern | #parents | #schoolsafey


Road traffic injury fulfils the epidemiological triad of agent, host and environment and like any other disease, it has risk factors, variations and grades of severity. Like any other disease, it also has a predictable pattern and prognosis.

In India, 5.23 lakh people have died due to Covid-19 over the last three years. During the same period, 4.43 lakh fatalities occurred due to road accidents — the damage, therefore, is comparable. It should also be noted that for a large part of these years, a substantial section of the population was indoors due to frequent lockdowns and physical distancing. Roads had far less traffic on average as compared to the times when the virus wasn’t raging.

Deaths due to Covid-19 have now come down. But with more and more motorisation on Indian roads, it appears that the death toll due to accidents is only going to be higher if stricter practices are not brought in.

Let me share the trauma experience of my state — Uttarakhand. A Level 1 Trauma Centre was started in AIIMS Rishikesh in 2019. Over the next year, it was realised that the only Level 1 Trauma Centre in the state was not receiving patients. A quick analysis of the multiple casualty scenarios of Uttarakhand provided some clarity. In 2019 alone, more than 1,300 people in the age group of 30-45 years died due to accidents, indicating that their injuries were very severe. In contrast, when the severity of injuries of patients being brought to a Level 1 Trauma Centre (AIIMS Rishikesh) was considered, the mean injury severity score was found to be 14 (moderate severity). This indicates that most deaths took place before reaching the hospital.

Several people attained injuries when vehicles fell into gorges. This is somewhat unique to hill states like Uttarakhand. Such accidents result in more transfer of destructive energy from the vehicles compared to scenarios when vehicles collide amongst themselves. The best solution to this is making vehicles robust. There is a need for better vehicle body standards and regulations. The Bharat NCAP is a good step in this direction, though it focuses only on Light Motor Vehicles (LMVs). Irrespective of the type of vehicle in question, the need of the hour is a safety grading of vehicles. The NCAP safety grading should be extended to all vehicles, including trucks and buses.

In the UK, when a child is born, the nurse personally inspects the car of the parents to ensure that there is a proper car seat for the newborn. Without that, the baby is not allowed to be taken home. In India, such attention to child safety is restricted to a very small section of society. And even that section is largely unaware of safety norms peculiar to children travelling in four-wheelers. A 2019 study by SaveLIFE Foundation, for instance, found that nearly 76 per cent of the parents surveyed were unaware of the Child Restraint System (CRS). Of the respondents who were aware of CRS, only 3.5 per cent had used the same including booster seats at some point.

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By testing LMVs for child safety, with the help of Child Restraint Systems (CRS), the Bharat NCAP addresses this issue adequately for the first time.

India is home to both domestic and international brands of vehicles with nearly non-existent safety ratings as compared to developed countries. An injured person is 16 times more likely to die in India than in the USA with a similar mechanism of injury. Effective implementation of the Bharat NCAP could improve matters drastically. However, civil society, and people at large, must join the conversation and demand these regulations be made mandatory instead of them being voluntary. Blood should not be shed on Indian roads.

The writer is associated in various capacities with AIIMS Rishikesh, where he is Associate Professor at the Department of Trauma Surgery and Critical Care, In Charge, Heli Emergency Medical System (HEMS) and Course Director – Advanced Trauma Life Support (ATLS). He also advises the Government of India on developing Heli Emergency Medical Systems

First published on: 14-09-2023 at 18:12 IST

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