This digest highlights some hard facts about attitude of the society and the government towards victims of the road accidents. If we really want to improve our trauma care, we have to go into details to understand ground realities today.

1. Road Traffic Digest No. 7 In this digest we will discuss about some ground realities or present status of trauma care in India especially the attitude of Indian society towards road accident victims. www.tsunamionroads.org

2. It is an irony that in India a severely injured road accident victim lying in a pool of blood may fail to attract the attention of even a single person among commuters or spectators standing BARELY A FEW FEET AWAY. www.tsunamionroads.org

3. On the contrary a struggling human life 100 FEET DEEP in a bore well, may attract the attention of whole nation and becomes a “Breaking News” www.tsunamionroads.org

4. we don’t see a worse example of discrepancy in attitude of Indian society and of government [?media as well] towards struggling human lives in different disasters. www.tsunamionroads.org

5. We are not against this ‘rescue business for ‘bore well tragedies’ as human life no doubt is very very precious, regardless of the resources or money involved. we just want to stress that ‘EVERY STRUGGLING HUMAN LIFE’ is precious and all expect an equal treatment in terms of attention, resources, budget, etc. That’s all ! www.tsunamionroads.org

6. Similarly, even a few who are injured during a terrorist attack or communal violence, get much better care or attention so much so that even the top authorities feel it extremely essential [or rather politically compelled] to visit the victims and show their ‘serious concern’ . www.tsunamionroads.org Just for information: In India Deaths due to terrorism: 2/day Deaths due to communal violence: 0.36/day Deaths due to road accidents: 438/day !!

7. Though in reality, this ‘serious show of concern’, instead of helping victims, causes more problems for the treating doctors who, instead of giving actual treatment, are more occupied in maintaining law and order and providing medical bulletins to the media . www.tsunamionroads.org

8. On the other hand, dozens of accident victims may fail to get attention of even the local authorities and are treated like orphans Evidently, Emphasis must shift. Many a times they may not even be able to get a bed www.tsunamionroads.org

9. Though a large crowd gathers around the injured but it is just out of curiosity to see ‘how an injured looks like’ or to see if the victim is related to them or not ! www.tsunamionroads.org अजीब लोग हैं इस शहर में , कब्रों पर तो जान देते हैं I मगर सड़क की जिंदा लाशों का कोई दावेदार नहीं II

10. [1] The poor or the affluent? [2] The more educated or less educated ? - - one more question: Who has more sympathy with accident victims? Let us find an answer - - Instead of passing on every blame to the government, the so called civil society should also introspect! Why have we become like this??

11. [1] In urban areas in majority of cases[90%], relatively ‘less well off” people [auto & taxi drivers, poor pedestrians, etc] have helped and shifted the victims to hospitals. Results of survey by WHO[2009] are very surprising: [2] Similarly on highways also more frequently the poor and relatively less educated villagers have been found to be more prompt www.tsunamionroads.org

12. Why is it that the well off class does not sympathize with the accident victims? Yes, they may have a poor traffic sense BUT, generally they are the first ones to rush to your help! www.tsunamionroads.org

13. WHY this APATHY ?? Some of the answers from this ‘uncaring class’ are: [1] Legal hassles? At least after supreme court’s order, we should not use this reason as cover [2] Busy? Have no time? Probably this class believes “time is money” [3] Car seats may be spoiled? Some of them love the materialistic things more than humanity Is it true that a better education only helps us get better jobs & more money and adds more analytical power to the brain [ for example to assess ‘what problems we may face in helping such victims’] BUT does not help to instill more human values in our minds/hearts? Should we believe that education makes our brains better at the cost of our hearts? Or it makes us more practical and less emotional in making day to day decisions. www.tsunamionroads.org

14. Brain: Logic Heart: Emotions Make a blend of the two! Please don’t follow your mind always. Some times it is better to follow your heart . www.tsunamionroads.org

15. How to change the attitude of society? [1] Victim is helpless BUT not necessarily poor: He may be rich and able to afford expensive treatment, but here he is totally at your mercy. The injured person inside a vehicle or on the road may be alone and lying unconscious and may not be in a position to call relatives or use money. Accidents are a health emergency where society has THE GREATEST role TO PLAY as victims are totally dependent on passers by. Reason being: [2] He needs some initial help just to start treatment: One must understand that once his relatives arrive and take over he is not going to become a liability . Once we shift the victim to hospital, our involvement is over and the police is not supposed to make any enquiry or statement. www.tsunamionroads.org

16. On the contrary, when people close to us are involved in an accident, often either we do not know or come to know very late. There is a horrifying possibility that a loved one might be struggling for his life and we may be completely unaware and comfortably watching television at home. We may regret this fact lifelong that in spite of being able to afford the best treatment in the world, we could do nothing for him/her. If someone close to us gets a heart attack or stroke etc. in front of us at home, we promptly rush him to hospital to ensure the best medical aid. Even if he does not survive, we have the satisfaction that we did all we could. Think about this real possibility! www.tsunamionroads.org

17. We are sure each of us has memories of terrible accidents involving some loved ones or acquaintances that we feel could still have been with us, had they received timely medical help. www.tsunamionroads.org

18. Please come forward to help such victims ! Don’t think only a few people cannot make a change ! Each one of us can! www.tsunamionroads.org

19. Very soon others will follow you and - - - - - very soon it will become a culture in society to help such victims www.tsunamionroads.org

20. Helping road accident victims is different from other social works It is a ‘GIVE AND TAKE’ kind of thing. The fact is that your contribution will not only help others but you yourself may require such help at some point in time . It is a ‘UNIDIRECTIONAL’ flow of charity. Like when you help someone for some other type of charity or social work you never expect any thing from him in return except blessings. Other Social Work Helping Accident Victims www.tsunamionroads.org See how?

21. Nobody knows who will fall victim to road accidents next. Even VVIPs, have lost their lives in road accidents. Who knows whether at the time of accident you may be the victim or the rescuer? Don’t think that this may never happen to you www.tsunamionroads.org

22. If you help someone here, then someone else may help you or your kin at some other place some other time. Remember, this could be you lying on the road and you could die because of someone else's apathy.

23. In today's world [ kaliyug ] where people do not care for their own parents, can we expect that some moral preaching will cause a change in the attitude of society? If it does make a change then well and good. Otherwise, we should also think of some more practical solutions. Considering the very poor trauma care in India, we feel there is a tremendous scope for various charitable organizations to help accident victims www.tsunamionroads.org

24. This is a country Where a millionaire can buy an IPL cricket team auctioned at 3300 crores within 3 minutes! This is a country Where a person lives in the most expensive house of the world costing Rs 8000 crores! www.tsunamionroads.org

25. This is a country where the rich do not hesitate to donate bags of gold and jewellery for construction of a temple . So much so that the assets of some of the temples are around 50,000 to 100,000 crores - - and huge temples costing Rs 200-400 crores gets ready within a few years Just for information: The total number of places of worship in India [24 lakhs] is more than the combined number of schools, colleges and hospitals. Temple business is a very fast growing industry in our country !! Rs. 200 crores donated within 2 hours for a temple construction. ‘ Bellary king’ donates a gold crown of Rs. 45 crores to Tirupati ji www.tsunamionroads.org

26. It would be much better if this class also comes forward for construction of trauma hospitals. Building hospitals is in no way less than sponsoring a temple We have to learn some better ways of worshipping God ! Earning the blessings of God through serving crying helpless humanity is true worship ! www.tsunamionroads.org

27. Reason being that in India, even in DELHI it takes 23 years for the government to start a trauma centre [JPN Apex Trauma Center, 1984 to 2007 ] Instead of waiting for the government to think and rethink and then implement any firm policy as there is so much ‘red tapism’, it is better that we ourselves come forward for trauma care in and around our city. On the other hand Assembly complex buildings get ready within one year !! www.tsunamionroads.org

29. [A] Present status of Ambulance Services in India As compared to developed countries where average response time is eight minutes, in India, average response time is much longer. That is why 30-35% victims die at crash site, 20-25% on the way to hospital (BRSIPP). Thus, implementation of the ‘golden hour’ concept still appears a distant goal in India. The response time: In India pizza arrives earlier than an ambulance Their response time to the alert call should be like that of defense personnel or commandos! www.tsunamionroads.org

30. The Number of Ambulances: The total number of ambulances is less than 20,000 in our country and they mainly belong to private hospitals or NGOs. At present only 30% government hospitals have ambulances. The Need or patient load Considering the present death rate due to road accidents as 1.6 lakhs per year[2010], there are around 24 lakh injured people needing emergency help annually in road accidents alone. However, if we include all trauma cases, about 150 lakh injured people expect trauma care in India annually [besides other medical emergencies]. The Service: Even in metros having relatively better health care, only 14% of victims are transported by an ambulance. In India no one waits for an ambulance. A severely bleeding trauma victim and delivery of a distressed baby are among the few dire medical emergencies, where every minute or rather every second counts.

32. On the one hand the government talks of air ambulance services in and around Delhi - - - While on the other hand, in some rural areas people still depend on “bullock cart ambulances” !! Which of these facts is to be believed ? “ bullock cart ambulance” www.tsunamionroads.org

33. Are we prepared to deal with major disasters in cities? Probably NOT There is no clear-cut strategy or drill for the management of such disasters. Medical authorities in cities do not honestly evaluate their capability to handle trauma care in terms of response time, quality care in severe cases, and dealing with a sudden load of victims. www.tsunamionroads.org

34. See how the victims of a disaster [the most recent Mumbai bomb blast, July, 2011] are being taken to hospital. They were transported in a mini truck [like dead bodies]. If this is the status of Mumbai, despite suffering many such disasters in the past, we can imagine the plight of small towns ! www.tsunamionroads.org

35. Alarming Fact : A very high mortality rate even after reaching hospital: It is true that deaths occurring at the spot or with in few minutes are at present not under control even in developed countries. However, it is very very sad to find that even in metro cities out of total deaths, 48-64% victims die after hospital contact. There is little to imagine about the conditions in smaller towns or rural areas. So even if you shift or transport the accident victim to hospital in the best possible way, you cannot relax thinking that now things would move in order! Present status of Definitive care Thus, response time and pre-hospital care are not the only important factors determining good results, the quality of definitive treatment at the hospital also has a bearing on survival. www.tsunamionroads.org

37. Jai Hi nd