Road traffic deaths and injuries

Seeking an effective road injury prevention policy:

Prof. P. Hewage Department of Geography, University of Kelaniya

Deaths related to road traffic are seen as a “disease of development”. Road traffic injuries are a global public health problem, killing almost 1.2 million people a year and injuring between 20 -50 million. Unless effective measures are taken, the problem will get worse. Since a sizeable portion of death and injury is comprised by vulnerable road users - pedestrians, cyclists and motorcyclists, the loss of life and health involved in this situation should be avoided.

Current situation

Table 1: Number of road accidents and deaths reported to police, Sri Lanka
 (2000 - 2006)

Item			2000	2001	2002	2003	2004	2005	2006 
Total no. of road 
accidents		54,089	52,057	55,031	59,444	53,458	43,171	33,339 
Fatal accidents		1963	1993	2029	1933	2126	2141	2065 
Grievous accidents	3449	3770	3719	3919	4560	4968	4710 
Non grievous 
accidents		11574	11504	12935	13744	13918	14376	11866 
Damage only 
accidents		37103	34790	36348	39848	32864	21686	14698
Deaths			2,140	2,159	2,160	2,096	2,214	2,306	2,179 

Source - Police Department, Sri Lanka

Road traffic deaths and injuries are a major public health problem in Sri Lanka as well. The data released by the Police Department demonstrate that 2,179 people in Sri Lanka died as a result of road traffic accidents in 2006. This represents an average of 6 persons dying each day from road traffic accidents. In addition to these deaths, 18,641 accidents have occurred in the same year causing various levels of injuries to people involved (The level of injuries include: fatal, grievous and non grievous). The deaths and fatal accidents between 2000 and 2006, as shown in Table 1 indicate no sign of a decline despite a reduction in total number of road accidents is seen during that period.

(see Table 1 elsewhere)

The global statistics confirm that road traffic accidents have become one of the most prominent causes of death all over the world. According to the data released by World Health Organization (WHO) for 2002, road traffic deaths accounted for about 2 percent of all global deaths and ranked as the first leading “external cause” of all deaths. The classification of external causes of death include suicide, violence, war, road traffic injuries, poisoning, falls, fires, drowning and other intentional injuries. Furthermore, these road traffic deaths

accounted for 23 percent of all deaths worldwide happened due to external causes.

The road traffic deaths as reported by the Department of Census and Statistics, Sri Lanka can be analyzed to identify comparable figures applicable to Sri Lanka. The road traffic deaths accounted for 1.6- 1.8 percent of all deaths in the island and transport accidents are the second leading external cause of death in Sri Lanka. Transport accidents are responsible for between 11-14 percent of all deaths caused by external reasons.

In general, the comparative figures for Sri Lanka are lower than corresponding figures for the world. However, when Sri Lanka’s transport accidents data are compared with the data for high-income countries, a different picture emerges. These observations illustrate the fact that Sri Lanka should be looking forward of

Table 2: Road traffic deaths per 10,000 motor vehicles for selected countries

            Lowest countries 	                                         Highest countries

Norway		1.2 	USA		2.1	Mauritius 	36.3	Zambia		84.8
Sweden		1.3 	Denmark 	2.4 	Kazakhstan	36.5 	Bangladesh	85.6
Switzerland	1.5 	Luxembourg	2.4	Botswana	41.0	Cameroon	93.5
UK		1.6 	Spain		2.8	Cape Verde	42.0	Sierra Leone 	107.2 
Japan		1.7 	Austria 	2.9	Senegal 	45.6 	Benin		111.7 
Netherlands 	1.8 	France 		3.0 	Myanmar 	47.7 	Ghana 		111.9 
Australia 	1.8 	Madagascar 	3.1 	Liberia 	53.7 	Uganda 		132.0 
Italy 		1.9 	Belgium 	3.2 	Kenya 		55.1 	Tanzania 	136.7 
Canada 		2.0 	Brunei 		3.3 	Mali 		61.3 	Lesotho 	150.9 
Taiwan 		2.1	New Zealand 	3.3 	Nepal 		62.7 	Nigeria 	161.0 
Finland 	2.1 	Ireland 	3.4 	Mongolia	68.1	Rwanda		193.2
Germany	2.1	Sri Lanka		8.2	Swaziland	80.4	Ethiopia	197.0
Source: http://www.phrasebase.com

the ways of minimizing the burden of road traffic injuries.

(see Table 2 elsewhere)

As evident in Table 2, the lower levels of road traffic deaths in high-income countries are attributed, by the researchers, largely to the implementation of a wide range of road safety measures designed under an effective road injury prevention policy. These measures include seat-belt use, vehicle crash protection and traffic law enforcement.

Any reduction in the road traffic injuries may not necessarily mean an improvement in road safety for all people mainly because vulnerable road users - pedestrians, cyclists and motorcyclists have a higher risk of being involved in an accident. According to the Police Department data, as shown in Table 4, pedestrian fatalities comprise the largest proportion of all deaths due to transport accidents in Sri Lanka.

The proportion of drivers killed is much lower than the fatalities among pedestrians and passengers. The inappropriate diversity in vehicles and the heavy amount of mix between the slow-moving and non-motorized road users, as well as fast-moving, motorized vehicles may have caused pedestrians and cyclists are at higher risk of being killed by the accidents. In developed countries where a larger number of motor vehicles are used, there are fewer motorcyclists, cyclists and

Table 3: No. of persons killed in road accidents in Sri Lanka by type of person, 
2000 - 2003

Persons killed 	2000 	% 	2001 	% 	2002 	% 	2003 	% 
Pedestrians 	857	39.8	803	37.2	816 	37.4 	747 	35.6
Passengers	493	22.9	444	20.6	469	21.5	515	24.6
Pedal cyclists 	317	14.7	341	15.8	340	15.5	311	14.8
Motor cyclists 	247 	11.6 	300 	13.9 	338 	15.5 	281 	13.4
Drivers		232 	10.8 	270 	12.4 	216 	9.8 	171 	8.2
Others 		5	0.2	3	0.1	6	0.3 	71 	3.4
Total 		2,151 	100	2,161	100	2,185	100	2,096	100

Source: Police Department, Sri Lanka

pedestrians killed in road accidents.

(see Table 3 elsewhere)

Road accidents place a heavy burden on the national economy as well as on the household economy. For example, the road traffic deaths are much higher among males than females, and if those males are employed, the loss of life or physical damage may have grave consequences on the family economy.

The data given in Table 5 confirms that nearly 85 percent of people died in road accidents are males in Sri Lanka. The gender difference in deaths may possibly be the result of both heavy exposures to road transport and risk-taking behavior of males. The data also indicate that though road travel brings the society many benefits, the price society is paying for it is very high.

Main reason

One of the main factors contributing to the increase in road crash injuries is the growing number of motor vehicles in use. Researchers have pointed out that there is a correlation between motor vehicle growth and the number of road crashes. When compared with the data in developed countries as well as in newly industrialized countries such as South Korea, Sri Lanka’s per capita motor vehicle population is much below than the expected level fitting for a middle income country

Table 4: Motor Vehicles per 1,000 people by country, 1999 

Country		Motor Vehicles	Country		Motor 	
		per 1,000			Vehicles per 
		people				1,000 
	 					people

USA		779		South Africa	144
Japan		677		Turkey		100
Australia	616		Indonesia	81
New Zealand	565		Sri Lanka 	74
Norway		559		Philippines 	42
Malaysia	451		India		34
United Kingdom	434		Pakistan	23
South Korea	296		Kenya		14
Thailand	280		Bangladesh	3
Singapore	164		Ethiopia 	2  

Source:  World Bank data, 2003

(see Table 4 elsewhere)

However, in Sri Lanka, the growth of vehicle population in recent years is on the increase with the expansion of economy and societal needs. As seen in Table 7, the number of vehicles increased by 75 percent during the seven year period between 2001- 2007.

The sudden increase in the vehicle population may have placed an extra burden on the entire system of road transport in Sri Lanka causing more road accidents. During this period, higher increase was reported in three

wheelers (322%) and in motor cycles (185%).

This emphasizes the importance of planning for the needs of these vehicles and people who use them. For instance, the use of helmet or seat belt is not applicable at all for three wheelers and therefore, the options are to be identified for prevention of road traffic injuries.

(see Table 5 elsewhere)

While the defeat of terrorism in the North and East as well as in other parts of the country has turned a new page in the socio economic spheres, we should not neglect the possibility of increased road traffic injuries in those areas as people are moving increasingly.

The case of reunification in Germany provides a good illustration of how changes in political and economic factors can influence crash injuries. In Germany, many people experienced a surge in access to previously inaccessible areas. In the two years following reunification, between 1989 and 1991, there was a four-fold increase in death rates for passengers. The overall death rate in road crashes in this period nearly doubled.

In Sri Lanka, records show that road traffic accidents have been the highest type of accidents during the New Year celebrations. From December 30, 2008 to January 1, 2009, 779 persons have been involved in accidents and, of this total, 249 (32%) were road traffic accidents. Furthermore, the number of road traffic accidents during the New-Year celebrations has increased from 212 in 2008 to 249 in 2009.

Effective policy needed

The development of a road injury prevention policy should involve a wide range of institutions and people representing a diverse range of interests. They include government institutions, police, media, citizens, universities, schools, NGOs and many others. The government intervention is crucial for securing road safety.

The evidences have shown that strategies for reducing traffic injury are more effective under a specific government institution with the power and the funding.

For example, with the establishment of Swedish Road Safety Office (SRSO) in Sweden, the number of road deaths was reduced each year between 1970 and the mid-1980s.

Table 5: Growth of vehicle population in Sri Lanka (2001 - 2007) 

Total	2001		2002		2003		2004		2005		2006		2007 
Number	1,779,016	1,892,367 	2,073,869	2,297,711 	2,527,380 	2,827,902	3,125,794

Source: Department of Motor Traffic, Sri Lanka

Similarly, between 1995 and 2002, the city of Bogot , in Colombia experienced a falling of number of traffic-related deaths by almost a half with the implementation of a range of policies. The first was to set up a data reporting system on deaths from violence, and in particular from traffic crashes. Using the statistics, an interagency Committee produced a set of public policies aimed at reducing the number of accidents. The key is that the governmental organization responsible for road safety should be defined, with its specific roles.

Essential

In addition to the establishment of a body with the responsibility for road safety, a strong political support is also essential to bring about a productive impact of the policy on prevention of road injuries.

An effective road safety policy can also be supported by the members of parliament. For example, a Parliamentary Committee was responsible for the introduction of breath testing, leading to a considerable reduction in deaths in state of New South Wales in Australia.

In the state of Victoria, also in Australia, an action by a Parliamentary Committee had led to the world’s first legislation on compulsory use of seat-belts. As a result, car occupant deaths had fallen considerably. It is important that the parliament should provide both power and funding to the relevant institutions to implement road safety measures.

A strong policy on road traffic prevention should be supported by the research as well. As such, research capacity is another key issue of the road safety. National level research can identify people at increased risk of road injury, major factors contributing to the road traffic injuries and their implications for policy formulation.

There are many examples of the role of research effort carried out by universities and other research institutions in developing a policy on road traffic prevention. Accident Research Units are found at universities mainly in the developed world such as Australia, England, USA and Germany. Non-governmental research institutions have also made significant contributions to the road traffic prevention in developed countries.

Valuable contribution

Vehicle producing industry, insurance industry and other related industries in the transport can make a valuable contribution to road safety by helping better designs and providing important information on safety.

Non-governmental organizations can contribute to road safety by influencing the effective implementation of strategies and by providing a forum for information on solutions to the road crashes. Mothers Against Drunk Driving (MADD) in USA has a story of success with mandatory prison sentences, and a minimum drinking age set at 21 years. In developing countries, the role of NGOs is not successful mainly due to lack of funding.

While the formulation of a policy on road injury prevention is primarily the responsibility of government, the implementation can be done with productive participation between the private and public sector.

Effective participation is possible in many areas of road injury prevention. The state of Victoria in Australia has developed a partnership between traffic law enforcement and traffic injury compensation schemes. In this scheme, victims of road crashes are compensated through a system in which the insurer pays for any damages incurred in a crash, regardless of which party was considered at fault. The funds are diverted for this purpose from annual vehicle registration charges. This strategy has successfully been implemented in South Africa.

Rates

A partnership between government and motor vehicle importers can deliver important information to the customers about the performance of cars in realistic crash tests. In a program adopted in Australia, USA and EU, new cars are subjected to a range of crash tests and their performances are rated with a “star” system. Such programs help consumers realize the value of safety and take the information into account when they purchase new vehicles. The vehicle importers should respond by importing vehicles with improved designs.

In conclusion, the road traffic injuries are a growing problem in our country and it is a public health issue which needs proper planning to minimize its devastating impact on the society.

The neglect of traffic accidents is the traditional view that happens to others. The term “accident” can give the impression that “it is inevitable, unpredictable and unmanageable”. The World Health Organization and the World Bank argue that the road deaths and injuries are unacceptable, and largely avoidable. Therefore, the road traffic accidents require meticulous efforts for prevention.

There is also a need to recognize the current situation in road accidents and to take appropriate action. As such road traffic injury prevention should be given proper attention and resources for human loss and injury are to be averted. A good example can be found from Japan as the following graph (Graph 1) illustrates the downward trend of deaths.

Graph 1: Number of deaths due to road traffic accidents in Japan, (1947 -2006)

Source: “Remembrance”, Video Clip Produced in Japan

The writer acknowledges the use of following document published by the World Health Organization. “ M. Peden, R. Scurfield, D. Sleet, D. Mohan, A. A. Hyder, E. Jarawan and C. Mathers (ed), World report on road traffic injury prevention, 2004”