(Dr. Javid Iqbal, 64, was born in Srinagar. He attended the D.A.V. School, Srinagar, and graduated in Medicine from the Government Medical College (GMC). His professional service in medicine includes work in the Middle East for three decades. During his days at the GMC, he captained the cricket team. He enjoys writing and staying close to his children in far away lands.)
Deathly Dance on J&K Roads
There is indeed a deathly dance going on in J&K state, the one in focus is different, brought forth by Traffic-info 2010-annual publication of traffic department. It came to fore, as the present unprecedented political crisis erupted and called for a comment. Having done it, the crisis dawned on all and sundry, the comment on Traffic-info got relegated to back burner, nevertheless a file preserved in my laptop documents. The state is still in the grip of crisis; however two concurrent events brought it forth:
a. Unprecedented traffic chaos in Srinagar on off days-the days when civil disobedience in the form of complete shutdown is not on, added to which is the state imposed curfew, meant to convey that state exists-if at all! It made me cover the distance to my office in 3 hours, what normally is a 20-25 minutes drive. The management changed timings-0800 to 1500 hr's on off days, as all and sundry got delayed
b. The state of handling of emergency cases, resulting from vehicular accidents, termed 'Road Traffic Accidents' [RTA] in medical terminology, which form the number one cause of traumatic injuries, somewhere down in the list of other causes is listed 'Regional Conflicts' worldwide-the one we are face to face with in J&K State, claiming lives though much less than RTA's [as per available data in medical books]
'Traumatology' the branch of medical science, which deals with traumatic injuries, whatever the cause of sustaining the various forms of injury, has grown into a separate specialty in recent times, for obvious reasons-the high number of traumatic cases and recent advances in the subject. One of the reasons ascribed is fast changing life style-a result of rapid industrialization. Fast pace of life results in pressing the accelerator and then there is also the element of thrill, one gets from it. In J&K, as elsewhere, with the road network failing to spread in proportion to number of vehicles, the rise in RTA's and the mortality related is understandable. However understandability should not be taken to mean acceptability, in spite of number of vehicles multiplying in geometric proportions and everyone getting eager to get on wheels.
Traffic info 2010 reveals statistical data in the first 3 months (January to March) 2010, in 2009, 2008 and 2005, it works out as follows:
Let us compare it to country wide statistics of a few years back-number of accidents put at 2 lakh/annum, vehicles plying getting involved 10 % (as high as one out of ten vehicles) number of persons dead 60,000 (approximately one dying in 3.33 accidents) cause in 70 % of those is head injury-50 % of RTA head injury cases are brought dead to hospital, while as in 60 % of the total cases sustaining head injury RTA is the cause. 20 % of those involved in RTA's were found to be drunk.
a. Poor first aid facilities including poor training of paramedics
b. Transportation by uneducated non-medical personnel
c. Delay in transferring the patient, first hour being considered the 'Golden Hour' on the basis that lives could be saved by proper handling in first hour
d. Transportation in poorly equipped ambulances.
Maruti or any other vans converted into an ambulance is no substitute for purpose made vehicles, fitted to perfection to cater to the needs of an emergency traumatic injury, be it a RTA case or an injury resulting from regional conflict.
The poor handling of patient at the site of accident, improper transportation may in fact add to the injury sustained. I have had the opportunity to work with a trauma unit on the highway from Tehran to Turkey and onwards to Europe. The unit had three custom made ambulances, with Iranian paramedics specially trained in USA in first aid. They were all trained drivers too, while one would take to wheel, two would work on the case in an ambulance with a wide room. I have no hesitation in accepting that I got loads of tips in first aid from paramedics, whom I was supposed to command. There might be lacunas in training, even at the graduate level in our medical colleges. Theoretically, the training might be adequate, practical training in trauma units needs to be prioritized, if we are to get down the mortality to western levels in growing number of RTA or other traumatic cases in our state. And maximum concentration should be on training of paramedics and utilizing their services in professional handling of transportation.
Getting back to traffic info 2010, it says "There is no let up in the accidents in J&K. If the scenario of road accidents in India is grim, it is gory in J&K," Gory! J&K is getting in many respects-prevailing corruption [second amongst the most corrupt states] with Srinagar being [the fourth dirtiest city in the country] and now in traffic management! Traffic-info cites various reasons:
a. Poor road engineering and road geometry, lacking traffic orientation
b. Irrational transport policy
c. Poor enforcement of laws
d. Lack of mass education
e. Lack of manpower to handle traffic
g. Irrational land planning
h. Irrational growth between roads and vehicles
The pot holes appearing within months of asphalting a road cannot be ascribed to harsh weather conditions, as is often the plea taken for the valley and many other parts of the state, having a severe winter. Road engineering is definitely in a poor state, including road geometry, especially on approaches to intersections, where maximum choking occurs. In many European states, parts of Middle East-especially northern Iranian provinces of Gilan and Muzandaran and in Azerbaijan towards west, weather conditions are harsher than Kashmir, yet the roads survive for long. Adequate funding in Europe and oil rich Middle East and poor in Kashmir could not be ascribed as the reason. From a technical viewpoint purely, there cannot be different standards for road building in Europe and Kashmir, given similar weather conditions; hence estimates have to be same, may be with minor variations-no engineer would stick his neck out by submitting a sub-standard road estimate. Whether what is noted in paper vis a vis technical details translates into deliverance on ground is a matter of debate-there is a question mark over it? In maintaining roads, as often as we do, almost after every winter, the overall spending might work out to be proportionately higher than what Europeans spend on construction plus maintenance. A study might be worthwhile to reveal, what the report calls 'Gory' on more counts than one
Coming to intersections, every time I cross the Rawalpora bypass intersection, I do thank Almighty Allah for guiding me through. Even when the personnel are there, there seems to be mostly lack of concern in handling traffic, alertness however is surprising, as soon as soon as the wailing siren of VIP passage is heard. Hyderpora bye-pass is much better managed-VIP's go up and down the 'Airport Road' same is true of Maulana Azad road in summer, in winter VIP's shift to Jammu. Quite often Valleyites, abhorring it may sound though; wish our VIP's might serve us better by staying in Jammu round the year. Jammuites might have a similar wish, strictly vis a vis the VIP movement affecting the traffic. The way their escorts wave you off the road is insulting, never ever experienced during my three decades abroad.
Our woes are way beyond the ones related to scientific management of traffic narrated in the traffic info 2010. Ethical concerns abound in all walks of life; morality remains in question in traffic management too. However info 2010 is a decent effort, which should serve as an eye opener. It could have been a lot better with an element of self criticism, generally we lack that. Much needs to be done to manage traffic, improve roads, save lives-the police, the engineers; the medicos need to be involved in a multi pronged effort. Our society may not start and end with VIP's-they are the ones supposed to serve and not lord over the commoners. It has already come to a point, where the commoner may feel compelled to cry-where is my space?!