Cyrus Mistry Crash: Stop Victim Blaming, Design Safe Highways, Says Top Road Safety Expert
Road safety should be designed by people who understand the science behind road accidents.
India needs to stop blaming victims and learn from "hardcore science" to improve highway safety, according to the country's foremost road safety expert as the focus turns on the world's deadliest roads after Cyrus Mistry's death in a car crash.
"Even rash, negligent and overspeeding people should be protected. That can be done only through modern technology," said Mathew Varghese, an orthopaedic surgeon who has worked closely on road safety for decades. "[We] need to stop blaming the victim in a road accident. Instead need to find the real cause of the tragedy."
Varghese highlights the real problem of unsafe infrastructure in a nation that reports the highest number of road accidents in the world even though penetration of cars is lower than developed countries. In 2021, more than 1.55 lakh people died on Indian roads.
Mistry, along with another person sitting on the rear seat, died in an accident near Mumbai. Both were reportedly not wearing seat belts.
"In this crash [Cyrus Mistry], the emphasis is all about seatbelts ... But is that the only reason why the person died? No," Varghese said. "That is not the reason and that's what needs to be understood. We have a victim blaming going on here that he didn't wear the seatbelt."
The Times of India reported citing unnamed people that a forensic team found the design of the bridge faulty, contributing to the car crash. The findings are not public yet.
Road safety is not "a commonsense science, it is hardcore science", he said, adding that the policymakers do not understand the details. "No one deservers to die due to his errors of commission and omission."
Varghese said everybody on the road, inside a vehicle or outside a vehicle needs to be protected. "How do you protect them? Not by changing behaviour" as education has not worked even in the developed countries.
"Road infrastructure should be designed to be forgiving," he said. "In India its unforgiving—a slight mistake can leave your severely injured or even dead."
Watch the full conversation here
Edited excerpts from the interview:
I want to know how close we are in terms of policy making that is backed by science and not by fancies of some diplomats' rhetoric?
Dr Mathew Varghese: It's amazing! You asked me how close we are to the science? We are far away from science when it comes to policy. The policymakers do not understand the details.
In this crash [Cyrus Mistry], the emphasis is all about seatbelts. People not wearing seatbelts is being highlighted. So, you will have a law enforcing seat belts in the back seat, which is good. But, it is already recommended by the law, only it is not enforced. It is good that it will, now, be enforced. But is that the only reason why the person died? No. That is not the reason and that's what needs to be understood. We have a victim blaming going on here that he didn't wear the seatbelt. Therefore he died.
No one deservers to die due to his errors of commission and omission. That understanding is what is needed in traffic safety. In traffic safety everybody on the road, inside a vehicle or outside a vehicle needs to be protected. How do you protect them? Not by changing behaviour.
High income countries such as Europe and the U.S. have all tried education to change behaviour. But changing human behaviour is very difficult. People say it is easy, but it's not easy. Education leading to behaviour change, leading to safety, is a low-low win game. Actually, you cannot win that game. You cannot get safety by education.
Educating and enforcing people to wear seatbelt does not guarantee safety. What happened that day is happening every day. Not only with vehicles with seatbelts but with motorcycles, with non-motorised people. Getting on road means interacting with speed differentials.
In Delhi or Mumbai or any metropolitan cities you have three lanes narrowing onto two lanes and a divider in between. Or there is this wide road narrowing down and a divider in between. These dividers are supposed to be forgiving, but instead they are made of reinforced concrete. Nobody is supposed to jump over it. Why it should not be a forgiving environment? It should have been a softer cushioning. The signages, too, are always just at that interjection.
Go to any high-income country, the signage starts one kilometre away. 'Exit 213, one kilometre down the line'; 'Exit 213, half a kilometre down the line'; 'Exit 213, 200 metres down the line'; and so on. There is enough warning on the road. That is how the road, the environment, the infrastructure is designed. But, the speed encouraged is 100-120 kilometres per hour. At that speed, if you crash there is very little anyone can do.
There is a need to have traffic [???] at interaction between high speed and non-motorised traffic, between high speed and traffic infrastructure. That is what is important.
It is important to understand that road safety is not a commonsense science. It is hardcore science.
Only experts should decide what is to be done. In this particular situation, there is full investigation which will guide you to all the mistakes there are—not just at the place of accident—but all over the country.
There are so many factors at work here and so many things have gone wrong and many that has not worked—the signages, the road design, the infrastructure among others. Would you say that we have heard a little about death by design? Do you think that all these factors are contributing to that design, leading to so many deaths?
Dr Varghese: Earlier the recommendation was you died or you got injured because you were careless.
In India, every traffic crash is a police case. What does the police write on the report—rash and negligent driving. Who is to be blamed? The person driving the vehicle may not be rash and negligent, it may have been that the environment of the road that caused him to suddenly swerve. Or the person may have probably trying to save somebody, but the police report will say rash and negligent driving or over speeding, or something like that.
Even if it is rash, negligent and over speeding, still we need to protect people. That can be done with modern technology.
In high-income countries, they tried educating people and changing the road safety norms to reduce deaths. In Sweden for example, you have Vision Zero, where they say that the individual can make mistakes. In such a case, the environment has to be designed to be forgiving. So that even if he makes a mistake, he doesn't ends up been seriously injured or getting killed. That is what is important—a forgiving environment. This means in traffic you have road infrastructure that helps in reducing speed plus an exterior of the car designed in a way it doesn't kill pedestrian in an event of an impact.
In a country like India, there are more people outside of cars than inside. If you are driving in the U.S., for miles you can ride without encountering a single human being. Here you move one meter, and there will be 10 people. Our cities are made car friendly and not people friendly. Unless we make our cities people friendly, we are going to kill people and continue having high death and injury rates.
NCRB data shows that 45% of the deaths are from two-wheeler drivers and so in that scenario, how important is the Golden Hour? First, explain what is Golden Hour and how significant it is for reducing the deaths caused by road accidents?
Dr Varghese: Golden Hour is not based on hard science, but it is based on the understanding that early definitive care, in a definitive care hospital can save life. For example, a head injured patient needs a neurosurgical assessment and treatment. He also needs a CT scan. So, if he goes to a hospital without a CT scan, there's going to be a problem. So, in this delay, assessment becomes a problem, he needs to be transferred to another hospital with a CT scan and then to a hospital with a neurosurgeon. In those delays you can loss life.
The concept of early definitive care is important. They are dependent on the type of injury. Some injuries may not be salvageable, even in half an hour. The Golden hour only emphasises the need for early definitive care. What he needs, he gets it; what she needs, she gets it, at the appropriate time, in a facility that can take care of everything. That is why it is important to have early definitive care.
It's not just the ambulance that is supposed to be good. Once the ambulance takes the person to the hospital, the hospital should have all the facilities. The concept is trauma team concept of having a team in the hospital with neurosurgical facilities, an orthopaedic surgeon, and a general surgeon for the patient. Multi-system hospital that can take care of road accident victims should be developed in every district in the country.
According to data from World Bank and many other organisations, we don't have much penetrations of automobiles in our country still the number of deaths is staggering. This is surprising, if compared to any other country. How do we reduce these deaths?
Dr Varghese: If we look at the statistics from the U.S. or Europe during the 50s, 60s or 70s, the road traffic injuries kept rising even though they were campaigning hard. All kinds of campaigns were used right from 'speed thrills, but kills' to 'you know, be safe' and 'careless driving, drunken driving' among others as kind of education. None worked. It was only after they changed the focus from education and campaigns to actual infrastructure change that helped in reducing speeds, create road infrastructure did the number of death started to decline.
We create high medians. Go to any road in India, people climb the median and jump down. Oh! that is bad behaviour! No, it isn't. He is jumping down because we made it difficult for him to walk across to the other side, but easier for the car to drive at 100 kilometres. That is our problem. We have designed roads for the car that just needs a push to the pedal a little bit, whereas the pedestrian has to be climbing up and down. He is not allowed to walk.