A presentation about the epidemiology of road trauma in India. Also how innovative use of technology like GIS when combined with the trauma epidemiology can help prevent these cases in developing countries like India.
During a recent seminar on tourism, one of the foreign delegate when asked about his most memorable experience about India, he hesitantly proclaimed that what shocked him was the way, road accident victims die in India without any medical aid even in metroes like Mumbai.
Road Accidents in India: A GIS Epidemiology study
ROAD ACCIDENTS IN
Dr Vaibhav Bagaria
MB MS, D Orth, FCPS.
‘I keep six honest serving man,
they taught me all I know.
Their names are what, why, when, how, where and who’
What does epidemiology follow?
Incidence – new cases at certain time in
certain area (country, etc.)
Causes, mechanisms, severity
Prevalence (morbidity)– total no. of cases at
any given time and certain area
TRAUMA - World
Leading cause of deaths, hospitalizations
and disabilities in 15 – 44 years.
In 1990’s- 9th
leading cause of death, by 2020
leading cause after IHD
Responsible for 9.1% deaths.
Occupy 10 – 30% hospital beds.
TRAUMA - India
Rapidly increasing in India- each day 300 Indians
killed, 1 every 12 sec injured seriously.
1% world vehicles and 10% deaths.
80 % in rural and district areas in low and middle
Severe socioeconomic losses to the emerging
economy of the country: 550 bill =3% GDP
Significantly affect the poorer communities of the
Incidence of Trauma Cases
‘As a general rule, the most successful man in life
- is the man who has the best information’
Auto Accident Statistics from the
year 1994 to 2004:
2004 (Provisional) 429.8 92.5 464.6
2003 406.7 86.0 435.1
2002 407.5 84.7 408.7
2001 405.6 80.9 405.2
2000 391.4 78.9 399.3
1999 386.4 82.0 375.0
1998 385.0 79.9 390.7
1997 373.7 77.0 378.4
1996 371.2 74.6 369.5
1995 348.9 70.6 323.2
1994 320.4 64.0 311.5
Department of Road Transport and Highways.
Ministry of Shipping, Road Transport and Highways.
Government of India.
Rising Trends in accident
statistics for the years
2005 and projections for 2015
Year No of
No Of Minor
2005 1,10,300 22,06,000 77,21,000
2015 1,54,600 30,92,000 108,22,000
Causes, Mechanisms and Severity
‘Epidemiology is a means of learning or asking questions…
and getting answers that lead to further questions’
Causes, mechanisms, severity
Causes & mechanisms:
MVAs – leading cause of TBIs
Falls – second leading cause
Alcohol – major factor in many TBIs
Severity: mild, moderate, severe
WHO identified Risk Factor in
Alcohol or drugs
Youth driving together
Vulnerable road users
INDIA is a world Apart?-
BAD Traffic Sense.
No Pre Hospital phase.
Not many dedicated Trauma Units.
No formal or compulsory trainings in Trauma
Care & Resuscitation.
No Money – No Medicare.
What has not changed?
‘Those who fail to learn from history are
bound to repeat its mistakes’
Awareness regarding the issue.
Attitude of Government.
Apathy towards the issue.
Absence of any concerted effort.
Available resources, finance and Data.
Disease –related Mortality and Plan
m), Ministry of Shipping Road Transport and Highways (2006) & Tenth Plan Document(
Disease No of Deaths Scheme Fund (Cr Re)
T B 37,639 National TB
Malaria 638 NVBDC 1370
AIDS 1094 NACP 1270
Accidents 92, 618 No major
Where is the hope?
PUBLIC PRIVATE PARTNERSHIP
FOCUS ON EDUCATION AND TRAINING.
DEDICATED TRAUMA UNITS
CONFERENCES LIKE THESE.
GOOD COMMUNICATION SYSTEM.
Better tech: WHAT IS GIS?
GIS is a computer based digital information
system which analyzes the events with respect
to the earths geography.
MATERIALS AND METHODS
Creation of a trauma registry
All non fatal vehicular accidents recorded
Mode of injury, Type of vehicle involved (bicycle,
two wheeler or four wheeler), Location and Nature of
Trauma was recorded over a period of six months.
MATERIALS AND METHODS
45 variables collected and plotted against
the location map using the GIS software.
JT Maps, an indeginously (Indian) developed
Other available software: Arc view, Map info,
ARC/Info, AutoCAD Map, etc.
166 trauma cases recorded over six
Plotted against the data analytical software
Clustering of cases with similar attributes
Clustering of six lower end radius fractures at
a particular location.
All victims were male in age group 20 – 35
All accidents involved motorised two
Other injuries were evenly distributed over
the entire data location map
Personal inspections revealed
A “Speed breaker” where most of the
“Absent street light” around the
All accidents occurred during “Evening
and night time”.
Study data used to impress upon local
authority the need of adequate illumination at
the identified location.
Resulted no accidents being reported over
the next three months
Public Private Partnership
Govt Involved with private sector to set up
basic trauma set ups on National Highways.
Many private trusts and NGOs are taking up
Some efforts are also to increase the
awareness among people to follow traffic
Advanced Trauma Life Support (ATLS)
National Trauma Management Course (NTMC)
Definitive Surgical Trauma Course (DSTC)
Essential Surgical Skills (ESS)
Primary Trauma Care (PTC)
Trauma Nursing Core Course (TNCC)
Trauma Team Training (TTT)
Why us Clinicians?...
We are not epidemologists !
Eyes donot see what mind
How we trauma surgeons and
clinicians can contribute….?
Suggesting locations for setting up the
trauma care centers.
Contribute towards town planning in the
perspective of trauma prevention.
Using data to assess the impact of certain
Monitor the epidemiological trends in trauma
over a period of time and suugest
appropriate govt. policies.
TAKE HOME MESSAGE
GET INVOLVED –
As health care
professionals as well as
‘Health is not mainly an issue of doctors, paramedics and hospitals.
It is an issue of social justice’