The George Institute For Global Health
Global
United Kingdom
India
China
Australia

The Tragedy of a Preventable Death

The death of Union Minister Gopinath Munde in a road crash in New Delhi earlier this week is undoubtedly a tragedy; for the family and for the community. The 100,000 plus estimated road deaths that occur each year in India go way beyond a tragedy.

Road deaths go way beyond the personal impact felt; the sorrow of losing a family member is one aspect, the economic aspect is another. Road deaths disproportionately affect the poor. They plunge families into poverty: up to 40% of families experience catastrophic health costs as a result. They impact on national productivity: most road deaths occur in men in the prime of their lives, at the time they are most economically productive. Road deaths restrict economic growth, drive up health care costs and condemn millions to life long disability.

The great tragedy is that this death, and most road deaths are predictable, and preventable. This death appears to be one that could have been prevented by use of a seatbelt. Seatbelts are highly effective in reducing death and serious injury in the event of a crash – studies have shown they reduce death by up to 60% in the event of a crash.

There are multiple other measures that reduce road deaths: laws on speed, seatbelt wearing, motorcycle helmet use and drink driving, when appropriately enforced, and backed by community education and mass media campaigns, work very well to reduce road deaths. There is countless evidence to show these interventions work. Studies from Vietnam and China show that such measures can be implemented with effect in Asian settings.

Such measures must be accompanied by other change: well-constructed roads that take safety into account, efficient licensing, registration and maintenance systems for motorised vehicles, separation of vulnerable road users from larger vehicles (footpaths for pedestrians for example), and alternate transport systems that take people out of private vehicles and onto mass transit systems.

Investment in pre-hospital care, trauma care and rehabilitation services are also critical. Having timely access to effective trauma care in appropriately prepared hospitals significantly improves outcomes; affordable access to rehabilitation services enhances patient outcomes further.

What is required however is political will. Strong leadership is required to pass the appropriate legislation and enforce it, and to support the critical mass communication campaigns needed to sustain the effectiveness of such measures. Leadership is critical to investment in appropriate trauma care. We know what measures work – what we need is powerful policy action to drive implementation.

With strong leadership, the burden of death and injury on India’s roads can be dramatically reduced. Strong leadership from India will also drive action in other countries in the region who suffer from a similarly high burden. India can be a leader. Is the leadership there?

Authored by Vivekanand Jha, Executive Director, George Institute for Global Health, India and Rebecca Ivers, Director, Injury Division, Professor of Public Health, The University of Sydney.

References

  1. Jagnoor J, Suraweera W, Keay L, Ivers RQ, Thakur JS, Jha P. Unintentional injury mortality in India, 2005: Nationally representative mortality survey of 1.1 million homes. BMC Public Health 2012, 12:487 (doi:10.1186/1471-2458-12-487).
  2. Cummings P, Wells J, Rivara, FP. Estimating seat belt effectiveness using matched-pair cohort methods. Accident Analysis and Prevention 2004: 35, 143–149.
  3. Liu BC, Ivers R, Norton R, Boufous S, Blows S, Lo SK. Helmets for preventing injury in motorcycle riders [Review update]. Cochrane Database of Systematic Reviews 2008, Issue 1.
  4. Stevenson M, Yu J, Hendrie D, Li L, Ivers R, Zhou Y, Su S, Norton R. Reducing the Burden of Road Traffic Injury: Translating high-income country interventions to middle- and low-income countries. Injury Prevention 2008;14:284-289.
  5. Passmore, J.W., Nguyen, T.H.T., Luong, M.A., Nguyen, D.C. and Nam, N.P. (2010b).Impact of mandatory motorcycle helmet wearing legislation on head injuries in Viet Nam: results of a preliminary analysis. Traffic Injury Prevention, 11(2):202-206.
  6. World Health Organisation. Global status report on road safety 2013: supporting a decade of action. Geneva ,WHO, 2013 (available at: http://www.who.int/violence_injury_prevention/road_safety_status/2013/re...).
  7. Sasser S,Varghese M, Kellermann A, Lormand JD. Prehospital trauma care systems. Geneva, World Health Organization, 2005 (available at: http://www.who.int/violence_injury_prevention/publications/services/04_0...).