road traffic accidents
The choice between rail and road:perspectives from Delhi
This week I started a 3-week research trip to India, based at the Centre for Chronic Disease Control in New Delhi. Yesterday I rediscovered the joy of train travel. My morning began with a ride on the efficient Delhi metro at 6.15am. The service is state-of-the-art in South Asia, and in my view, compares very well with similar services in many high-income countries. Alongside the option of driving, sitting on the train from Delhi to Chandigarh was not only much more relaxing, but I actually had the time to take in the views as we travelled through colourful North Indian villages.
Contrast this with the situation on India’s roads. Even in urban centres such as Delhi, the chaos of road traffic makes you wonder at how survival statistics are not worse. India has a higher rate of road traffic accidents (RTAs) than anywhere in the world, according to the World Health Organisation’s report last year, with 14 people dying every hour on the road. Globally, RTAs make up a third of unintentional injury deaths, with double the death rate and three times the burden of disability in low-middle income countries compared with high-income countries, which are less able to cover the huge economic and social costs. Children are more likely to be victims, and RTAs are projected to be fourth leading cause of death in 2030.
One recent post-mortem study from Kolkata found that a staggering 63.1% of deaths were due to accidents, mostly on the roads. The dire circumstances which can result from RTAs are shown by a case report from Jaipur, India, simply titled, “An unusual presentation of head injury: teeth in brain”.
Interestingly, an analysis from the UK estimated that walking to and from stations accounted for 65% of the overall door-to-door risk of being killed on rail journeys; with the rail system itself accounting for only 21% of the risk. In other words, it is the risk of the road which causes deaths on trains in England as well. There are calls for better data globally, since only 20 countries have the high-quality data needed to accurately estimate mortality from RTAs but I think I have read enough. I will use the train whenever possible. The urgent message for Indian policymakers is that a comprehensive policy for road safety is required and fast.