Road Safety
Need for Integrated Emergency Response
Vanam Jwala Narasimha Rao
The Hans India (13-12-2016)
There is an absolute requirement to
establish Integrated Emergency Response
Centers (IERC) in each State covering all National Highways and major State
Highways. This is according to a report by a Multi-stake
holder partnership leading to the successful implementation of Highway
Emergency Response and Accident Mitigation (HERAM) with the participation of
Insurance Regulatory and Development Authority (IRDA) and the General Insurance
Council (GIC). Dr AP Ranga Rao who was the chief
architect and who conceptualized the highly successful “108 Ambulance” services
headed a study group and piloted a
project leading to this evidence based and data supported conclusion.
India is suffering from a huge burden of
road accidents and fatalities. The number of road accident deaths in India is
the highest in the world and road safety has become an issue of national
concern. Road accidents are a human tragedy, which cause great suffering to our
people. Compound Annual Growth Rate (CAGR) of number of road accident
fatalities in India, increased from 3.7 per cent during the decade 1994 -2004
to 4.4 per cent during 2005-2015.
The
total number of road accidents increased by 2.5%, deaths by 4.6%, Injuries by
1.4% in one year from 2014 to 2015. In 2014 out of 4, 89, 400 accidents the
deaths recorded were 1, 39, 671 and 4, 93, 474 were injured. As against this the
accidents in 2015 were 5, 01, 423, the deaths were 1, 46, 133 and injured were
5, 00, 279. The increase in accidents was 12, 023, deaths 6, 462 and injuries
6, 805. Thus, about 1,374 accidents and 400 deaths take place every day on
Indian roads, which further translates into 57 accidents and loss of 17 lives
on an average every hour in our country.
About
54.1 per cent of all persons killed in road accidents were in the 15 – 34 years
age group during the year 2015. Out of total road accidents, 28.4 per cent,
24.0 per cent and 47.6 per cent of road accidents took place on National
Highways, State Highways and Other Roads respectively in the country in 2015.
National Highways (NHs) accounted for a share of 35.0 per cent in total number
of persons killed during the calendar year 2015. Road accidents on National
Highways have gone up by 3.2 per cent from the year 2014 to 2015. Persons killed on National Highways have also
gone up by 7.5 per cent in same period. A study by the
Planning Commission in 2002 estimated the social cost of road accidents in
India at Rs. 55,000 crore annually (Yr 2000 prices), which constitutes about 3
per cent of GDP.
Against
this background IRDA directed GIC to design a pilot project along a National
Highway to mitigate accidents, provide immediate relief and medical assistance
to the victims of accidents to reduce mortality and to enable timely and
accurate documentation for efficient claim settlement. A study group headed by
Dr AP Ranga Rao submitted its recommendations on a pilot project on 1st
September 2012. The report suggested interventions in four crucial areas.
Firstly, accident mitigation would
require effective enforcement of the provisions relating to driving licenses,
speed limits, not driving while under the influence of alcohol, the use of seat
belts and helmets, etc. Secondly, ambulances designed and equipped to provide
lifesaving assistance manned by trained personnel must be stationed at places
from where they could be quickly deployed to accident sites so that the injured
could be transported within the ‘golden hour’ to appropriate medical
facilities. Thirdly, quick reporting of accidents must be enabled such that the
ambulances could be immediately deployed for succor to the victims and the
rapid evacuation of the injured to appropriate medical facilities. Fourthly,
the immediate recording of the accident event by the police must be enabled.
The report noted that a unique three
or four digit number would need to be assigned which would remain unchanged and
over time become known to all. Finally a call and dispatch center would need to
be established which would receive all emergency calls along the stretch and
deploy the ambulances as required.
The GIC considered the report and
prepared a comprehensive, replicable, cost-effective Highway Emergency Relief
and Management system (HERAM) and submitted a Pilot Project to the IRDA to be
implemented along 230 km from Vijayawada to Hyderabad on NH 65. Dr. A.P. Ranga Rao was selected as Principal
Consultant to implement the project. The IRDA approved the Project for a period
of two years at a layout of Rs.885 lakhs against which only Rs 574 lakhs have
been utilized.
The project set up an integrated emergency
response system with five ambulances supported by a call centre, using 1033,
the unique number allotted to NHAI. The project reduced the number of deaths
during the two-year period. Some of the features that have contributed to the
reduction in the number of deaths are Specially designed Ambulances, One ambulance per 50
Kms, Trained Emergency
Management Technicians (EMT), Call
centre Physician, Structured reports from EMTs, Alerts to Police, Crane
Operator, Toll plaza staff and hospitals and Use of automated unique accident and victim ID.
The functioning of the EMRS, that is the
combination of modern ambulances and the round-the-clock call centre, was able
to reduce the Severity Index from 42.7 during the pre-project year, to 39 in
2014-15, and further to 38.1 during 2015-16.
In addition to providing for ambulance
services and emergency medical care, the project also had a component for
assisting the police in preventing accidents through better checking of
vehicles and drivers. The police authorities
and officials on the road took a lot of interest in implementing accident
prevention measures. The
activities covered by police patrolling officers included Attending accidents, Checking alcohol
levels, Speed check of vehicles, Wearing of
helmets etc.
It is observed that 14.8% of accidents were
caused by drivers under influence of alcohol. 27.3% were caused because of
over-speeding, and in 29.19% of cases the drivers were drowsy. That is about
70% of all accidents are preventable. The NH 65 passes through many
habitations. Though liquor outlets on the road are not permitted, liquor is
easily available on the side streets of the NH; the ban is not effectively
implemented. In view of this there is a need for highway patrol vehicles. There should be a strategy of making schemes for awareness and
education (and where necessary, training) of people in local areas and
regulation of drivers/vehicles in such areas. NHAI & State Governments should jointly plan and provide trauma
centers.
There should be provision for timely release of some amounts to accident
victims by insurance companies.
The impact of the combination of ambulance
operations and accident prevention measures has contributed to a significant
decline in the number of accidents, fatalities and injured persons during the
project period.
According to Dr Ranga Rao, against this
successful implementation of pilot project it is recommended that integrated emergency response centers should
be established in each State to cover all National highways in the State and
also cover major State Highways. These call centers would use "1033"
national number only. End
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