Like every year, the International Day for the Eradication of Poverty was commemorated on October 17. Whenever men and women are deemed to live in extreme poverty, human rights are usually violated. We must come together and ensure that these rights are protected and respected. This day is marked to renew the commitment of people from all backgrounds, beliefs and social origins to show their solidity with the poor and down-trodden. The authors being orthopaedic surgeons have closely seen the social and financial suffering of the Road traffic accident (RTA) victims. We feel that road traffic accidents and increase in poverty are interlinked and therefore, we want to highlight the impact of RTA on the society and the nation.
More than a million people die worldwide every year on the roads after suffering from RTA. This situation is quite terrifying and serious in India. Almost 5 lakh accidents occur in our country annually. According to the World Health Organisation 2019 report, low and middle income countries account for more than 90% of road traffic related deaths, despite having only around 60 % of the world’s registered vehicles. Although our country is having only 1% of the world’s total registered vehicles it accounts for more than 11% of the world’s RTAs. One can imagine how grim the situation is likely to become in the near future as number of vehicles is increasing manifold in our fast growing economy.
As our country’s per capita income is rising, so is the number of accidents. Road accidents do not differentiate between the sections of the society, rich or poor, skilled or unskilled, old or young. However, statistics show that majority of those who are affected, are in the age group of 20-40 years and are usually the bread earners of their families.
Poverty and road traffic injuries are strongly interlinked. Poor people are more likely to be involved in a road traffic crash, and the economic impact on people with low incomes can be more significant, pushing people deeper into poverty or limiting their future potential to be economically stable. Given that RTA related deaths and serious injuries are largely preventable, road safety should be considered an issue that can contribute to poverty alleviation at national and household level.
According to a recent UN and World Bank report, almost one fourth of the people in India are still living below the poverty line. Those who cannot afford food three times a day cannot afford costly medical treatment. In India, 50-70% of the hospital expenses are met by the patient even in most of the government-funded hospitals and almost 100% from their pocket if it entails a private hospital.
After the traffic accidents, everybody’s financial condition becomes poorer than before. About 50% of the families either borrow money from someone or sell their meagre assets, like land, house, cattle, vehicle, ornaments etc for the treatment of their beloved. But unfortunately, in spite of the best available treatment in our country one-fourth to a half remain temporarily or permanently disabled and become liability to the family from being an asset at a point of time.
It is necessary for all of us to spread awareness on preventing these accidents, because they have taken the form of an epidemic. If something is not done it is bound to go out of control. We have delivered 193 free public awareness lectures and spread the message among thousand of students and other citizens in Uttarakhand and neighbouring states.
Poor people are more prone to traffic accidents because usually they are pedestrians or using cycles as the mode of their transportation because they cannot afford motorised vehicles. But whenever they meet with an accident they are usually hit by a motorised vehicle and the impact is usually fatal because they don’t have any protective shields or safety equipment as the motorised vehicles have installed in them. Once they sustain the accidents then it is difficult for them to get the best medical care due to their financial constraints and the associated poverty. Particularly in India these people usually go to the government hospitals which are mostly not well equipped to deal with such injuries.
Road accidents push families into the poverty through the loss of money spent on prolonged medical treatment which is common in orthopaedic injuries. We would like to cite an example of a 25 year old standing on the side of the road when he was hit by an SUV from behind and sustained open fractures of leg and thigh which was treated at multiple hospitals and developed complications. At this stage patient came to us to get treated and became well only after five years of the initial injury. This is not the only one but there are many such examples the authors have seen.
The incidence of RTAs can be reduced significantly if the number of vehicles on the road is also reduced. The Covid-19 pandemic has been a boon to reduce the road traffic fatalities as media report state that the incidence of traffic accidents and resultant fatalities has been reduced by almost 50% from March to September 2020 in comparison to last year.
According to our research, 90% of these accidents occur due to the driver’s negligence. The results of Motor Vehicles (Amendment) Act 2019 are visible as informed by Union Minister of Road Transport and Highways, Nitin Gadkari in Parliament in March 2020. If people follow the traffic rules the incidence of road traffic accidents and associated fatalities will reduce significantly and so will the associated poverty.
(The writers are orthopaedic surgeons based in Dehradun)