Do Riders In A Video Game Need Helmets? March 27, 2006Posted by scan man in Life in India, Medicine.
Thanks to Abs* and Philip K. Dick** for inspiring the title of this post.
*Abs is a friend from the US who visited India for the first time a few months ago. When asked what she thought about the traffic on Indian roads, she exclaimed "Traffic!! What Traffic? Its like a Video Game!!"
**I may not have done a good job of titling my post in the style of the author Philip K. Dick ('Do Androids Dream of Electric Sheep?', the book on which the movie Blade Runner is based). I wish the subject was something as abstract as an android exploring the meaning of life.
As a radiologist who has worked for some years in a Tertiary Referral Hospital which specializes in Trauma Care, I have seen
more than what I consider my share of head injuries caused by vehicular accidents [RTA-HI in our referral forms: Road Traffic Accident – Head Injury]. A large percentage of the victims who I scanned have been riders or passengers on motorized two-wheelers who might have escaped unhurt if they had worn helmets.
My 'share' would seem microscopic if compared with the number of RTA-HI's that occur in our country. Like anything else that deals with India and her multitudes, the numbers would be mind-boggling.
India has the second largest road network in the world with over 3 million km of roads of which 46% are paved. These roads carry an estimated 60% of freight and 80% of passengers and they make a vital contribution to India’s economy. The road traffic contains an incredible mix of pedestrians, animal drawn vehicles, bicycles, motorcycles, cars, buses and trucks. On the whole the facilities for the large number of non-motorised road users are poor and the 40 million vehicles using the roads have a terrible toll on human life, killing over 80,000 people with over one third of a million victims requiring hospital treatment. These crashes not only cause considerable suffering and hardship but they also have a major impact on the country’s economy, costing an estimated Rs 300 billion or more than 3% of India’s GDP every year. (source)
Today one person dies every 6 minutes on Indian roads; by 2020 the rate is expected to be more than 1 every 3 minutes. According to the India Injury Report 2005, Injury is the third cause of mortality in India. The financial cost of road traffic injuries in direct and indirect socio economic losses amounts to Rs. 55000 crore (550 billion) or 3% of GDP. Trauma victims occupy 10-30% of India’s hospital beds (WHO SEARO January 2001) and trauma care systems can be improved in many ways. (source)
Given the abysmal status of public health record-keeping in many parts of our country, I believe that the numbers may be even more than what has been stated above.
Mandatory helmet usage for riders of motorized two-wheelers is included in the Indian Motor Vehicles Act of 1988. However, implementation of the law has been left to the states. Only a few states have even attempted to implement the law.
As can be seen from the pictures alongside, the authorities cannot control the number of people that are allowed to ride on a two-wheeler designed to carry two people. Forget about getting them to wear helmets.
This disregard for personal safety is pervasive throughout the country without regard to factors such as literacy, socio-economic background, etc. As proof, I would have to present myself as Exhibit A.
I confess. My behaviour on the road is less than exemplary. In fact, I have no right to be writing this because I don't wear a helmet when I use my motorized scooter. In my defense I have to state that I use it only to travel between my house and the hospital which are less than a kilometer apart and I don't go beyond 30 km per hour.
I conducted an informal survey, the results of which are more telling. There are ten other doctors in my hospital who use motorized two-wheelers (mopeds, scooters or motor cycles) for short commutes between home and hospital. None of them – old or young, men or women – use helmets. There are about twenty others who come to work at our hospital on two-wheelers. None of them use helmets.
We are healthcare workers. Most of us care for patients with horrendous head injuries which probably would have been less severe if helmets had been used. We supposedly know the preventive value of helmets.
Medice, cura te ipsum! – Physician, heal thyself!
Here is the plain language summary of a scientific review titled 'Helmets for preventing injury in motorcycle riders'.
Helmets shown to reduce motorcyclist head injury and death.
Motorcyclists are at high risk in traffic crashes, particularly for head injury. A review of trials concluded that helmets reduce the risk of head injury by around 72%. The risk of death is also reduced, although it is not possible to estimate a percentage figure for this reduction from the available evidence. It is likely that the protective effect of the helmet may depend on other factors, such as speed. There is, so far, insufficient evidence to compare the effectiveness of different types of helmet. Some studies have suggested that helmets may protect against facial injury and that they have no effect on neck injury, but more research is required for a conclusive answer. The review supports the view that helmet use should be actively encouraged worldwide for rider safety.
Perhaps we Indians with our profound belief in fate and karma do not feel the need for such preventive measures.
And of course there are those who argue about the existence of traffic rules, Indian style, which are beyond the comprehension of people who adhere to the western concepts of traffic rules.
The rationale could be less complicated….
'If you believe you are in a video game, you don't need a helmet'.