Road Safety Trends and Road Safety Trends and Vulnerable Groups in Vulnerable Groups in

South AsiaSouth Asia

Raj V Ponnaluri, P.E.Raj V Ponnaluri, P.E.Transforming Transforming

TransportationTransportationJanuary 15, 2009January 15, 2009

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Opening CommentsOpening Comments

Road traffic concerns continue to plague developing countries.

Exponential population growth is straining economies and governance.

Migration, for better living standards, is causing urban densification leading to: Urban traffic congestion Unsafe roadways Deteriorating air quality

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RTIs WorldwideRTIs Worldwide WHO: Worldwide RTIs claim 180,000 lives in children

under 15 yrs of age; males 50% more affected than girls.

Low-to-middle income countries account for 85% of deaths due to RTI; SE Asia and West Pacific contribute > 50% global RTI deaths.

Global road death toll to rise by 66% bet. 2000-2020; 28% decline in HI nations [Kopits, Cropper].

Fatalities to rise by 2 per 10 K persons in developing nations; drop by 1 per 10K in HI nations.

WHO Global Burden of Disease, 2002: RTIs primary cause of death among 15-19 worldwide.

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World Fatality Trends (1980-1995)World Fatality Trends (1980-1995)

Source: Transport Research Laboratory; Extracted from “The neglected epidemic: road traffic injuries in developing countries” by Nantulya and Reich.

Of all regions,Asia is impacted

the most

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South AsiaSouth Asia SA’s population of 1.45B; 400M or 29% of world’s poor;

5%-6% growth rate last decade. Institutional issues; poor road infrastructure hamper

MDG. India ranks 2nd in world’s fatalities. Bangladesh: low motorization yet alarming 85.6

fatalities per 10 K V; Nepal (24.3), India (20.3), Pakistan (18.7) and Sri Lanka (15.5).

Projected fatalities increase: 144% between 2000 and 2020 [Kopits and Cropper]

Road Crashes in South Asia:Road Crashes in South Asia:A PerspectiveA Perspective

The most recent aggregate crash data is over a decade old: 1992-1994.

Out of 8 SA nations, details are not available for Afghanistan and Maldives.

Literature consistently supports the paucity of data.

When available, under-reporting and aggregation makes analysis difficult.

SA: Fatalities and InjuriesSA: Fatalities and Injuries

Source: Asian Development Bank

SA (25 F/10K V),Nepal (61), Bangladesh (49),

India (25)

SA (104 I/10K V),Sri Lanka (190)

India (112), Nepal (93)

SA (5.7 F/100K P),Sri Lanka (8.9), India (6.8),

Pakistan (4.9)

SA (24 I/100K P),Sri Lanka (104), India (30),

Pakistan (12)

Severity Index:SA (19 F/100 Crashes),

Bangladesh (41), Nepal (40), Bhutan/Pak (30)

In Essence….In Essence….

Rank (1992 -1994)

Fatalities per 10,000

Vehicles

Injuries per 10,000

Vehicles

Fatalities per 100,000 People

Injuries per 100,000 People

Severity Index (Fatal Crashes / Total Crashes)

1 Nepal Sri Lanka Sri Lanka Sri Lanka Bangladesh

2 Bangladesh India India India Nepal

3 India Nepal Pakistan Pakistan Bhutan/Pakistan

India experienced the most fatality and injury ratesfollowed by Sri Lanka. Pakistan had experienced

high rates of fatalities and injuries per 100K people.Nepal and Bangladesh also saw RTI concerns.

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South Asia: Road Traffic Injuries in South Asia: Road Traffic Injuries in Children under 19 yearsChildren under 19 years

Mortality rates: World (<15Y) = 10.1 per 100,000 children South Asia (<19Y) = 17 per 100,000 children

Mean RTI incidence: 880 per 100,000 children.

RTIs account for 24% of all C < 19 injuries.RTIs: 30% peds, 26% bus riders, 3%

cyclists.67-80% RTIs occurred in males.

Source: Road traffic injuries in urban Africa and Asia: A policy gap in child and adolescent health, Hyder et. al.

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South Asia: RTI Burden on Children South Asia: RTI Burden on Children and Adolescentsand Adolescents

40% of all male cases in 0-9 age group. Children and adolescents represent

22% of RTIs who seek care; 13% of RTI deaths. Traffic mortality equated to 16 HeaLY (healthy life

years lost) per 1000 people. HeaLY: measures the gap between current health

status and ideal/standard health. Including disability HeaLY is 27.7 per 1000 population;

est. loss of 30,592 children and adolescent per annum in SA alone.

Source: Estimating the burden of road traffic injuries among children and adolescents in urban South Asia, Hyder et. al.

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South Asia: Road User Types in South Asia: Road User Types in Children and AdolescentsChildren and Adolescents

Source: Estimating the burden of road traffic injuries among children and adolescents in urban South Asia, Hyder et. al.

Hyder et. al. showed that only a small number of studies (26 of 1505) to evaluate RTIs of children under 19 yrs are available.

Studies showed varying (30% to 50%) female RTIs.

DATA is SCARCE and not readily available.

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Sri Lanka, India: RTIs and AlcoholSri Lanka, India: RTIs and Alcohol Permissible BAC vary from nation to nation. Enforcement has been the key to curbing alcohol-

related RTIs. Sri Lanka:

Of the 54 hospital cases (De Silva et. al., 2001), 67.4% of fatal crashes attributable to alcohol consumption

10% drivers were found to be under the influence (Ratnayake, 1998)

Several studies in India (post-2000): From Gururaj, Bangalore: 11% to 40% alcohol-related RTIs From Narayanan, TN: 12% alcohol-related RTCs Though high, in some instances, 42%-89% tested were alc. +ve

Source: Alcohol and road traffic injuries in South Asia: challenges for prevention. Gururaj.

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Indian Domination in South AsiaIndian Domination in South AsiaAs of 1992, India accounted for:

71% of SA’s population 82% of SA’s motor vehicles 86% of SA’s two- and three-wheel vehicles 83% of all road-related fatalities 88% of road-related injuries And 87% of total road-related crashes

Hence studying India can help point key areas for crash mitigation and life-savings.

Crash Risk in India – 1970~2005Crash Risk in India – 1970~2005 Fatality and Injury risk

per 10,000 vehicles is dropping mainly

due to large vehicle volumes increases.

Fatality and Injury risk per 100,000 people

is increasing despite accelerating population

growth: cause for concern.

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India: 2001 vs. 2005; Nationwide vs. UAsIndia: 2001 vs. 2005; Nationwide vs. UAs

Nationwide Main Risk Types:

Heavy Vehicles, MTWVs, and Buses

35 UAs Main Risk Types:

MTWVs, Peds, Heavy Vehicles, Buses

UAs where most women travel to work, children

go to school and urban poor depend on public transport are

at high risk

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Major Risk Categories - NATIONWIDEMajor Risk Categories - NATIONWIDE Heavy Vehicles – Trucks/Lorries

Truck volumes on the rise due to national highways, industrialization and fast-moving-cons.-goods

26% and 23% of nationwide fatalities in 2001 and 2005 7.7% increase in fatalities during the 4 years

MTWVs Provision of national highways is helping increase intra-state and

inter-city travel among rural regions 12% and 16% of nationwide fatalities in 2001 and 2005 67% increase in fatalities during the 4 years

Buses Outside the railways, STUs and private operators move people 15% and 12% of nationwide fatalities in 2001 and 2005 Marginal (2.7%) increase in fatalities during the 4 years

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Major Risk Categories – CitiesMajor Risk Categories – Cities MTWVs

Primary mode of work-based and leisure travel; men of all ages, young (< 25) and middle-aged women (25-40) as well

22% and 27% of fatalities in 35 UAs during 2001 and 2005 39.6% increase in fatalities during the 4 years

Pedestrians Lack of road space, encroachments; all people at high risk,

especially the handicapped, children and elderly 17% and 20% of fatalities in 35 UAs during 2001 and 2005 31.5% increase in fatalities during the 4 years

Heavy Vehicles – Trucks/Lorries 18% and 14% of fatalities in 35 UAs during 2001 and 2005 11.6 drop increase in fatalities during the 4 years Drop attributable to movement restrictions during daytime

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India: 2001 Male, Female by Vehicle TypeIndia: 2001 Male, Female by Vehicle Type

Men:Women =83%:17%;Women Share: Ped: 21%; Bus, Car, 3-W: 20% each;MTWVs: 12%; Bikes: 10%.

59% or more incidentswere treated outside a

medical facility.

2001 - Medical Attention in Rural, Urban and all India

Despite less women at risk overall, given that several have limited

access to healthcare, it is likely that a large number of women

may remain untreated.

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Andhra Pradesh, IndiaAndhra Pradesh, India

Fatalities at schools/colleges increased but persons injured dropped. Large increase in fatalities

and persons injured at several locations: Poor ACCESS MANAGEMENT.

AP: 2001 and 2006 Fatal Crashes (%) at key locations

2001 to 2006: Fatal Crashes (as a % of all

crashes)at these vulnerable locations increased,

albeit slightly.

Fatal crashes increased substantially while non-injury crashes dropped signifying a concerning trend of crash intensity.

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AP: Fatalities and Persons InjuredAP: Fatalities and Persons Injuredby Age and Genderby Age and Gender

Among various age groups, Female fatalities ranged 14%-32%

with the max in age range 6 to 14 yrs. Among both males and females, 21-44

year olds had 58% fatalities.

Year 2006 vs. 2001 Comparison (% change)  Fatalities Persons Injured

AGE Male Female Total Male Female Total< 5 yrs 164 53 122 183 175 180 6-9 yrs 121 119 120 250 266 255 10-14 yrs 97 84 93 21 245 49 15-17 yrs (15) 47 (7) (11) 88 1 18-20 yrs 121 1 87 63 232 78 21-24 yrs 126 (40) 70 49 (35) 21 25-34 yrs 68 (34) 43 96 (24) 63 35-44 yrs 65 (16) 45 143 (5) 105 45-54 yrs 29 29 29 73 (3) 57 55-64 yrs (10) 153 1 (17) 36 (11)65,+ yrs 807 165 557 792 290 627 TOTAL 66 (5) 50 74 7 58

Female injured ranged 12%-37% with the max in age group

under 5 yrs. among age groups, 21-44 old had 57% injured.

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Karachi, Pakistan - Karachi, Pakistan - A PerspectiveA Perspective

1993-01: 21% of all RTIs involved children < 15 yrs. 15% died at incident or during transport to hospital;

54% heavy vehicle involvement. 1994 – Police / Ambulance records: 56% / 35%

deaths, 4% / 11% serious injuries. 2003 RTIs – 89.6% males; 10.4% females; 24.9%

peds., 20.9% MTWVs, 21.9% PT. 27% of cases had missing data, 67% of age-related

data unavailable. 1993-94 and 2003 road user characteristics are

similar (males, age, mortality); not much changed.

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Karachi – Karachi – RTIs among ChildrenRTIs among Children

RTI children < 15 years: 81% males; avg. age = 9.6. 26% were peds., 21% minibus riders. Passengers: 9% MTWVs, 7% bus, 6% car, 5% van,

truck 3%, rickshaw 1%, bike 2%. 14% died on site or during hospital transport. 57% of peds died prior to reaching hospital. Ped. children at 3 times more mortality risk than non-

peds. Majority of RTI vehicles were buses, minis, heavy's.

Source: The potential of Ambulance Records for a Road Safety Agenda in Low Income Countries; Razzak.

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Bangladesh - A PerspectiveBangladesh - A Perspective Motor vehicles annual growth: 8% to 10%. Vehicle volume to double in 7 years with a large

share of NMV. Demand for private transport modes is on the

rise; first impact on urban areas. 70% of urban fatalities are pedestrians. Med. sized cities: 43% to 73% ped. fatalities. 1986-87 to 1991-92: ped. share increased from 43%

to 67%.

Source: Urban Transport Issue and Improvement Options in Bangladesh; Hoque et. al

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Bangladesh – Bangladesh – RTI vis-à-vis ChildrenRTI vis-à-vis Children

Bangladesh Health and Injury Survey [Rahman et. al., 2005]: Urban incident of non-fatal RTIs: 118.2 per

100,000 children aged 1 to 17 years RTI incidence twice in rural than in urban areas Death rate of 6 per 100,000 children aged 1-17 Disability rate of 2.4 per 100,000 children Males at higher risk than are females.

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Afghanistan – Afghanistan – An Empirical SurveyAn Empirical Survey Survey of 40 Medical Doctors in 2008. Methodology: written survey; verbal interviews. Most doctors witness 2 to 200 traffic injury cases

per month with several attending to 50 to 100. 40% felt that children are at risk of traffic injury. Of those, primary children risk group age 5 to 10. High risk groups: 20-25; 31-40; some 26-30 yrs. Most agreed that

children risk increasing due to incremental school attendance

Women at low risk now but need attention in future

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Afghanistan – Afghanistan – An Empirical SurveyAn Empirical SurveyUnanimous agreement that

Road safety problems are on the rise; Urban areas at greater RTI risk; Medical professionals see a significant increase in

crash numbers and injuries; Mostly injury crashes but fatalities on the rise; Speeding, due to better roads, is on the rise; Women not at direct traffic risk since they are only

recently beginning to ride or drive; Need for developing policy on road safety. Privately-owned vehicles is on the rise.

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Afghanistan – Afghanistan – An Empirical SurveyAn Empirical Survey Opinion on severity index varied – range of 5% to

60% with several pointing to 30%. Media reports and speaks on road accidents. Educational component of road safety is absent. Most incidents are reported to traffic police. Traffic police handle basic reporting but lack

training in incident management. Improvement suggestions ranged from:

‘Fix the potholes, traffic signals, TV Programs’ to ‘Warning systems, design, enforcement’

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Vulnerable CategoriesVulnerable Categories Young drivers; most susceptible to:

Crash involvement especially in heavy modal mix High speed, alcohol usage, youth-factor, design defect If road is available, reckless driving is observed;

Else, weaving through dense traffic on MTWVs Access to emergency care post-incident

Low income, middle-aged to senior women; susceptible to: Riding on IPT modes; if RTI, multiple deaths occur Travel on non-public transport heavy vehicles

Disabled and the Handicapped: Roads are practically designed without consideration Traffic junctions rarely have disabled-friendly features

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Conclusions …Conclusions … Preponderance of pedestrian and MTWV RTCs consistent in

most parts of SA. Males 20 to 40 years of age are the most susceptible; most

MTWVs in this age group. Most pedestrians are women or children. Risk of school-going children in RTCs on the rise in several

UAs; lack of pedestrianization. Overloading of children in IPT modes. Women in overloaded minibuses at risk. Women and children at risk but little data to support the

assertion. Ambulance records better than police FIRs or medical notes -

EMRI / 108 in India.

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ChallengesChallenges No single-championing entity; if present command and

control unclear or curtailed. Most literature from public health perspective; little attention

regarding road engineering. PH pros better geared to understand the RTI problem. More women in SA entering work place; need for studying

RTI incidence for preventive action. Children increasingly at risk due to lack of ped. facilities in

UAs and overloading; need action. More young children driving private vehicles; need

enforcement action and education. Disabled and urban poor at high risk due to lack of

transportation system facilities and access.

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Needs of the Hour…Needs of the Hour… Better engineered roads:

Dedicate space for peds/bike tracks/NMVs; BRTS Traffic demand; Access management

Result-oriented safety education Inclusion in curriculum; safety at schools Driving/ped. etiquette; NGO activity in Hyd. Vehicle maintenance; licensing processes

Focused enforcement: Overloading of minibuses (women at risk); Overloading of IPTs (school children, women); alcohol use; reckless driving by middle-aged men

Life-saving emergency management: Recent trends - EMRI 108 similar to 911; need for better record-

keeping; data access

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Needs of the HourNeeds of the Hour Planning and implementation of road Projects

Ensuring road are strictly designed to standards Designing transport systems for the disabled and seniors Strict monitoring of works to ensure safety’s included Building roads in full conformity with designs Emphasis on multimodalism despite JnNURM Mandatory landuse, TIAs, sidewalks, NMV lanes… PPP projects a step in the correct direction

Strategic prioritization of road safety projects From transport comes economic development, vice-versa UAs under immediate threat of degrading further Rural and sub-urban areas not immune Basics – pedestrianization, pavement mgmt, non-variable SLs (not

the speed but variation that kills)

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Issues and OpportunitiesIssues and Opportunities NEED Road Accident Reporting System

No unified data structures across states Aggregate data; no opportunity for inference/correl. Under-reporting of data, esp. near-miss / MI cases Police FIRs ► District SPs ►State Crime Bureaus ► National

Crime Bureau ► Dissemination NEED a quality Road Accident Reporting System

Road infrastructure and design Landuse based planning; ROW dedication Conceptualization and detailed engg. design Focus on ped., bike, NMV and PT modal safety Projected-demand based capacity needs for design Construction according to plans; QA/QC; PMC (BRTS)

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Issues and OpportunitiesIssues and Opportunities O&M

Poor road maintenance impedes vehicle movement and inefficient use of road capacity

But mainly causes crashes – inclement weather and night-time conditions; rains; water-logging

Worse in rural areas; UAs not immune Institutional issues

Legal system should expedite RTI cases; witnesses and good samaritans should be protected

Commitment to TIA; New PPP/BOT initiatives help Access Management – lack of control; conflict points;

encroachments; need National Policy Single empowered authority; engineering, academia &

research, police, emergency response

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Issues and OpportunitiesIssues and Opportunities Vehicle maintenance; registration; licensing

MV acts in some states require re-registration after 15 years! Vehicle maintenance in question

Method of issuing driving licenses sometimes questioned; less/untrained drivers on the rise

NGOs actively working to address the problem Education

Curriculum in schools; esp. since children at risk Adults need driver education; almost no to low penalty for

poor driving; middle-aged at high risk Violation points ► in-class defensive driving; need a system

similar to the US Traffic police need incident mgmt. capacity bldg.

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Issues and OpportunitiesIssues and Opportunities Enforcement

Reasonable to say Traffic Police carry the most weight despite criticism from all quarters

Manage traffic junctions with and without traffic signals Work with RTAs to enforce entry limits, overloads Collect data in FIRs; do not receive feedback Traffic police understaffed; safety one of many jobs

Etiquette People’s way of life needs to change; awareness Traffic safety should become a cultural aspect Post-crash professionalism; wait for the cop!

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Issues and OpportunitiesIssues and Opportunities Emergency response

A new ‘108’ ‘EMRI’ system operations in Hyderabad since 2005 EMRI synonymous with ‘911’ – lifesaving! Minus EMRI, no emergency services; initiatives in many states Mostly in UAs; not fully available in rural areas RTIs on highways and rural areas at high risk

The 5 ‘E’s Good road engineering first education and enforcement next emergency response etiquette governs

Things ARE getting better in the country; More remains to be done; Policies to Reality.

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Most crashes CAN be mitigated through institutional commitment

and concerted effort of the industry comprising

traffic engineers, consultants, designers, and road contractors;

researchers, academicians and school administrators;

safety- focused law-enforcement;and

active emergency rescue units

Thank YouThank You

Raj V Ponnaluri, P.E.Raj V Ponnaluri, P.E.

(currently)(currently) (on lien)(on lien)Associate Vice-PresidentAssociate Vice-President ProfessorProfessorSREI Infrastructure AdvisorySREI Infrastructure Advisory Admin Staff College of IndiaAdmin Staff College of IndiaHyderabad, INDIAHyderabad, INDIAHyderabad, INDIA Hyderabad, INDIA

hponnal@yahoo.comhponnal@yahoo.com rvp@asci.org.inrvp@asci.org.in