Limited Funding and investments into road safety:
The cities in Pakistan such as Islamabad, Rawalpindi, and Karachi are escalating with the influx of people, goods, vehicle ownership, urbanization, and motorization. However, the number of deaths related to accidents on the road tremendously surges as a response. In 2018 alone, there were more than 27,000 fatalities in Pakistan (WHO). With the increase of population, congestion, disability, and deaths from RTIS the investments into road safety must increase and the healthcare system needs to advance.
The main reason behind the existence of road safety is that there is inadequate funding and little to no investments are devoted to road safety. There is an avoidance of the general public to pay taxes and further underinvestment can be credited to corruption, government, incompetent civil services and etc. Pakistan undergoes a high level of RTI morbidity and mortality but the government only spends as little as US$0.07 and $0.09 per capita annually, on prevention and regulation of RTIs, which is 0.015 percent of GDP.
The fundamental obstacle in implementation is the lack of funding for RTIs, which is roughly 1 percent of public spending on health. Until appropriate investment is made the health care sector will be inadequate in movements to stop and treat RTIs. At present there is a poor post-accident response system since their investment in healthcare is “null point”, at the extreme of zero (Murray et al. 2000). According to Dr.Adil Haider, a trauma surgeon at Agha khan stated, “every five minutes we have a fatality due to a road traffic accident”. Currently, hospitals and emergency systems in Pakistan fall short with fully equipped ambulances, trained bystanders, and doctors. According to the Lancet, there is a lack of teams of specialists, where there are scarcer than 20 specialists’ surgeons, anesthetists, and obstetricians per 100,000 people. Large decreases in morbidity and mortality are prospective if funds in road safety and the health care emergency system are increased.
The effects of a lack of road safety:
Health, social, and economic consequences of accidents:
In this day and age, road traffic injuries and deaths are one of the most significant public health challenges and are predicted to be the fifth leading supplier to the global burden of epidemics by 2030. The leading consequences of Road traffic accidents (RTA) is a soaring number of fatalities on the roads, road traffic injuries (RTI), and disability. According to WHO,146,000 deaths and 2.8 million injuries occur from road traffic in Pakistan. Furthermore, a study was conducted from 1990 to 1993, in which autopsies in the slums of Karachi were examined to understand mortality patterns and the autopsies cited that RTIs as the second foremost cause of death amid men at 30 per 100,000, which was tied with tuberculosis. RTIs 46 percent of 23,445 deaths are the result of road traffic which mostly affects 20-39-year-olds which are typically the most productive that provide so much human potential for the economy is simply lost. Not only that but these people have potentially left their families behind as well, in other words, they were taken too soon due to road accidents.
This is not only alarming but the fact that we lack primary data banks that record as well as provide the most recent statistics about RTAs only makes matters worse. This raises numerous issues on the underreporting of the available data. The economic and social consequences of accidents are apparent. As the low income, afflicted by poverty make up the majority of millions of those most severely affected by RTAs. They affect the lower class immeasurably causing many families to be pushed further into poverty by the loss of breadwinners. Moreover, RTIs that result in disability place a huge financial burden on the lower class. A study showed that the health care expense is USD 271 while the income of those households was around USD 67.
This showed that the health care cost post accidents were much greater than average monthly household income which was seen in more than 80 percent cases. Which leads families not only heartbroken but literally broke. They lose not only someone close to them but all their income and are left with absolutely nothing. That is why it is absolutely necessary for change to take place since even injuries are now the leading cause of death among children and young adults in developing countries. In fact, 50 percent of neurosurgical beds are occupied by people that have been hospitalized due to RTIs and 25 percent of emergency room visits are related to RTA’s. Throughout the developing world, injuries together with tuberculosis, cardiovascular diseases, and cancers are the major causes of adult mortality. This puts a great burden on the health care sector and economic toll. The projected cost of road traffic injuries per year is USD 1.6 billion, which is 1.3 percent of total GDP. Which puts a grave burden on Pakistan’s economy. It is crucial for Pakistan to stop the deaths of healthy civilians from these accidents especially those who are poor, young, productive, and elderly. A critical step to meet this challenge would be an appreciation of the problem by policymakers from all sectors concerning—transport, health, law, and the police.
Proposals to resolve traffic problems:
It is crucial to understand and identify the underlying transportation in order to properly initiate road safety improvements. There have been solutions previously enacted by Pakistan, for example, National Highway Safety Ordinance 2000 where people on highways had to wear seatbelts and motorcyclists were required to wear helmets. However, these laws lacked proper enforcement and the implementation of these previous solutions that’s why they were fruitless. Another factor is that these so-called laws have not been amended in decades. The Motor Vehicle Ordinance 1965 which essentially addresses the process of licensing, vehicle maintenance, inspection, registration, and manufacturing hasn’t been amended in decades and falls short in addressing the ticketing system, speed limits and violation punishments. This ordinance is present but currently is not adapted and enforced by traffic police. In order to address the growing concerns of safety proper initiative and enforcement are needed. Traffic rules need to be enforced and viable punishments need to be made but how?
In a corrupted system such as that of Pakistan, we need proper surveillance. Installing cameras establishing proper fines and having a strict surveillance system could be the very solution the country needs to adapt. “The Road traffic Injury Study of Pakistan stated that police under-report 18 percent of roadside fatalities and 72 percent of RTI. These surveillance systems would require police to report accurately since they would be monitored, thus helping to enforce the law. A surveillance system is also needed in emergency departments in hospitals in Pakistan. Another factor to take into account is institutional issues such as traffic police who need to be trained and well equipped. The traffic police, government, ambulance services, doctors, nurses, hospital administrations, engineers should all work together as an interconnected team to address road safety issues.
The surveillance system on the engineering side could possibly help identify areas where most crashes occur and address the problem from the root. Engineers need to follow proper audits while constructing roads and highways. Moreover, proper pedestrian crosswalks need to be developed to make its roads safe for the elderly, young, and children. In fact, driving licensing and vehicle inspection systems must be enforced and surveil lanced to ensure that adequate drivers are on the road. In addition, to fix the implementation awareness programs must be initiated where the public is informed about safety regulations such as the proper usage of helmets, seatbelts, speed control, and etc. This combination of steps if implemented properly would ultimately bring change to Pakistan’s road safety crisis.
The RTI surveillance system mentioned before will help save lives by implementing traffic regulations and addressing areas with high accidents. The execution of the law and strict speeding guidelines will prevent disability, fatalities, and injuries. Enhancement in road traffic safety not only benefits the civilians but the economy as a whole. For example, in South Asia if there is even a 50 percent reduction in road fatalities there is a predicted benefit of $1.2 trillion. By prioritizing road safety poverty would in turn reduce and would bring forth an advancement of prosperity. By simply addressing road safety and improving traffic, the flow of goods, agriculture, and businesses would improve therefore it is critical to increasing investments in such sectors. The only way to bring forth change to Pakistan would be to take drastic measures. Road safety laws must be prioritized for the benefit of the people in Pakistan and the economy.
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