Make
Lanka a ‘Highway Code nation’
This is the concluding part of the inaugural address
made by Professor A.H. Sheriffdeen FRCS, FRCSE as President of the
Sri Lanka Medical Association last month on the spectre of motor
accidents in Sri Lanka
Motor traffic injuries are predictable and can thus
be prevented.
The WHO recommends a four-systems approach to be considered under
speed control, good road design, traffic management and interventions
in driver behaviour. Note the shift in emphasis of the onus of an
accident from the driver to the authorities. Controlling driver-behaviour
comes last on this list of priorities.
In
our study just about every risk factor known to be responsible for
motor traffic injuries was encountered. Excessive speed, alcohol,
not wearing seat belts and helmets, using mobile phones while driving,
fatigue, driver illness, young male drivers, poorly trained self-taught
drivers, driving without valid licences, poorly maintained vehicles,
unprotected vehicles, pedestrians not using pedestrian crossings,
driving without lights after dusk and pedestrians wearing dark clothes
after dusk.
Speed
control
Most drivers, whatever the vehicle, enjoy driving at excessive
speed. This is more so among 20 to 40-year-old males who in this
study formed the largest group injured in the driver category. Whatever
the disincentive, this category enjoys every form of high-risk behaviour.
The
other group is the bus driver who has a mandate to earn the maximum
in the shortest possible time. A little less than half the injured
had been victims of a speeding bus, some even by swerving to avoid
the speeding bus which probably drove away unscathed and probably
oblivious to the fact that an accident and injury were caused by
careless driving.
The
solution that comes to most people's minds is high-tech speed detecting
cameras and speed detecting guns. The evidence is that considering
the investment, the return does not justify the expense.
Three
solutions are suggested:
Buses and similar heavy vehicles should compulsorily be fitted with
speed- limiting governors, which would necessarily limit their maximum
speeds.
Limiting
speeds to 40 km/h in urban areas and to 80 km/h on highways. Road
signs at frequently placed intervals should be displayed on all
roads. A remarkable phenomenon of Sri Lankan roads is the paucity
of roadside signs indicating the speed limit. People would be surprised
if they were to be told what the speed limit is on Magazine Road
and Elvitigala Mawatha, by far the only highway that deserves to
be called one in Sri Lanka. The local law enforcement officer must
be given a mandate that it is entirely his responsibility to enforce
this rule. Police patrol vehicles like distinctively coloured motorcycles
are important disincentives for fast driving.
Engineers
should be given the task of constructing "speed unfriendly"
roads. eg. bumps, rumble strips and road narrowing when approaching
major intersections. Barriers rather than double white lines should
be used in the middle of the road to prevent overtaking at blind
corners.
Driving
licences
In the study conducted by our team 12% admitted to driving
without valid licences, while 78% of the drivers had been self-taught.
Driving should be considered a science. It cannot be learned by
trial and error. It is an established fact that 90% of accidents
occur due to human error. It must be made compulsory that all future
applicants for driving licences should have followed a course at
an authorized driving school. Apart from teaching the Highway Code,
these schools should be provided with a manual containing the curriculum
which would have a core of essentials for safe driving. It should
include a section on the courtesies of safe and civilized driving.
These would, as a few examples illustrate, help to develop a different
culture of driving.
1.
Slowing down at every pedestrian crossing whether there is a pedestrian
on it or not and not tooting the horn and accelerating even when
there is a pedestrian on the crossing.
2.
Allowing a vehicle which is reversing into your path to do so and
not tooting your horn and driving faster to beat him to it.
3.
Slowing down and allowing a driver to cross your path rather than
tooting the horn, speeding and staring menacingly at the driver.
There are many more.
The evidence that higher fines and stronger punishments act as deterrents
is not strong. Fines have been increased recently and we can await
the outcome. Newspapers have carried stories that all efforts are
being made to make it easier for fines to be paid.
We
wonder whether the opposite should be tried i.e. to make the hassle
of paying the fine itself a punishment. Moreover it was found in
this study that only about half of the drivers or riders were familiar
with the Highway Code. Offenders should be made to sit for the examination
on the Highway Code that new applicants are required to sit.
Legislation
should be enacted urgently to issue new driving licences with central
computer records. As in Australia, UK and USA, a “points scheme"
for different offences must be drawn up. Points will be accumulated
for such offences and when they reach a certain value eg: 12 points,
the licence would be suspended for a year.
These
offences would include such dangerous driving practices like driving
after alcohol, driving at excessive speed, driving through red lights
etc. The focus is on "prevent accidents by punishing not punish
after the accident".
Only
two of the injured drivers in the study had been tested for alcohol.
Here again prevention strategies are better than punishment after
the event. It is a heartening sign to see police officers patrolling
the roads late at night when drunken driving is commoner.
Seat
belts are the greatest success story of injury prevention. Wearing
seat belts minimises injury by 40 to 45%. In spite of this statistic
only 4.7% in the study were wearing seat belts. It is time to make
seat belts, from an optional status, to compulsory for both the
driver and the front seat passenger.
Helmets
worn by motorcycle riders and pillion riders reduce the risk of
head injury by 20 to 45%. In our study 20%and 38% of these groups
did not wear helmets. This obviously needs to be rectified.
The
question of implementation of the law without fear or favour springs
to most people's minds. Politicization of the bureaucracy including
the Police Force would raise serious doubts in one's mind whether
these plans can be implemented. This becomes a predicament when
politicians with their back-up vehicles speed through roads without
any consideration for the road-user. A recent news item highlighted
how France's Minister of Justice was ticketed for speeding. If politicians
need to get about in a hurry, special patrol cars should be sent
in advance to create a lane without the present system of rude shouting
and gesturing by officers in these back-up vehicles, at motorists
using the road.
Driver
fatigue and long hours of driving are further examples of the human
factor in causing accidents, injuries and death. The frailty of
human behaviour and perhaps vanity make most drivers deny that they
are sleepy when driving although they probably are. Public awareness
is essential. Drivers should be educated to take adequate rest before
driving long distances. If one needs to drive in spite of this,
our advice to drivers is to chew something; keeping chewing gum
in the glove compartment should be encouraged.
Education
The importance of educating the public and potential drivers
cannot be emphasised enough. However, education has to take place
at various levels. The Highway Code should be taught at school level,
in universities and to all categories in the government and private
sector. We should be dubbed the "Highway Code nation".
In
Australia there are mini-parks simulating roads and busy intersections
where the culture of proper road behaviour is inculcated in young
minds.
Pedestrians
The analysis of mortality rates for different categories
of road users reveals that in 2002 and 2003, the largest of number
of deaths was in the pedestrian group. Our study too shows that
the largest category injured was pedestrians.
Adequate
publicity should be given in all media on the real danger to the
pedestrian. Fifty percent of those injured were after alcohol. One
third were walking on the wrong side of the road i.e. with the flow
of traffic. The majority wore dark clothes after dusk. The wearing
of luminous arm-bands should be encouraged, more so for push cyclists
and they should be made available freely at a reasonable price.
Jay walking or walking outside the pedestrian crossing should be
penalised. Pedestrians should be cautioned against standing on the
middle of the road at night since visibility against the lights
of oncoming cars is virtually nil.
A
paradigm shift: Vision Zero
Education has shown to be effective with sustained advocacy.
The Swedish model of Vision Zero (1997) recognizes the primacy of
human well-being and human life, overriding one’s desire to
get there quickly (mobility).
Safety: Minimise opportunities for error.
Change: Research and change provided by enforcers, co-operation
by road users.
Ethics: Priority of human life and health over mobility.
Responsibility: Shared by providers and users.
I stood on this very stage on the occasion of the induction of the
President of the College of Surgeons and spoke of the primacy of
patient welfare being the first concept of the Physicians' Charter.
Safety of the human Vs convenience and pleasure of the driver. This
is a social responsibility that has to be ingrained in every driver's
mindset before he gets behind the wheel of any type of vehicle.
Respect for road rules, speed limits, pedestrian crossings etc will
make roads safer for the human.
The
responsibility for safety and for accidents has to be shared by
providers and enforcers, not only users. An accident is a failure
of the system. Humans are equated with errors -- from errors of
judgment to errors of function. Every possible precaution should
be taken to reduce or better eliminate the opportunity for errors.
There should be a paradigm shift. The police officer in charge of
a particular area should be entrusted with the responsibility of
achieving the goal of a percentage reduction of accidents every
month when compared to the figure recorded for that month the previous
year. Incentives for achievers and reprimands for non-achievers
should be worked out.
Scant
regard is given in Sri Lanka to the role of the vehicle in the evolution
of events that leads to an accident. Around 16.5% of the vehicles
in which the injured were travelling in had serious defects and
14.8% of three-wheeler drivers had tampered with a safety mechanism
in the handle lock that facilitated a smaller turning circle but
increased the chances of the vehicle toppling over. Legislation
has to be brought in for spot inspection of vehicles and for certification
of road worthiness for older vehicles.
Preventive
measures
There is in Sri Lanka, the Ceylon Association for the
Prevention of Accidents and the National Road Safety Strategic Plan.
They have outlined some of the issues I have also raised. These
include: more traffic courts, independence of the Police Force,
incentives for the traffic police, harsher punishments including
suspension of driving licences including punishments to jay walkers,
more devices to detect traffic offenders including Alcometers and
elimination of alleged corruption in the Police Force.
Will
it work? If implemented, yes.
Yet accidents happen and more accidents continue to happen. Newspaper
headlines continue to scream out to the country the continuing carnage
on our roads. The police are sceptical that this has any effect
apart from just arousing curiosity and cursory interest.
Our
study confirms what we already know. There are no startling revelations.
Some would even say, "Here is a clear example of reinventing
the wheel". However the study reveals one stark fact. That
fact is that in spite of knowing the problem, in spite of doing
what has already been done, the situation has not changed, the problem
continues with all its terrible consequences. These consequences
include the loss of 40,000 lives in the next 20 years and the lives
of one million people affected, not to mention the enormous economic
burden to the country.
As I mentioned earlier the effect of a tsunami on humans once every
20 years! We need to act now since the cost of this problem will
add over Rs. 11.6 billion to our already strained economy.
Hence our recommendations include:
*
Strong central control i.e. traffic police to be under the President
or the Prime Minister.
* High status for traffic police.
* Empowerment of private sector and whole population. Participation
in the exercise of safe driving and in helping authorities to enforce
traffic rules.
* Institutionalized driver training and standard curriculum.
* Harsh punishment, legislation for driving licence disqualification
on accumulated points.
* Highway Code re-testing for offenders.
* Developing a manual of core knowledge and courtesies of driving
* Discouraging motorcycles/three-wheelers
* Checking vehicle safety and roadworthiness.
* Legislation to revise speed limits.
* More speed limit signs displayed at frequent intervals.
* Re-location of pedestrian crossings away from bus halts.
* Encouraging luminous arm-bands for pedestrians and push cyclists.
* Each traffic policeman be given a mandate to reduce accidents
in his area by a percentage each month compared to the number of
accidents for that month in the previous year
If
these recommendations are implemented, not only will there be a
reduction in the number of accidents every year but the stage will
be set for a different culture, of an orderly society. And no fear
of the effect of a tsunami in 20 years from now! |