Road Accidents in India: A GIS Epidemiology study

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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.

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  • 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

    1. 1. EPIDEMIOLOGY OF ROAD ACCIDENTS IN INDIA Dr Vaibhav Bagaria MB MS, D Orth, FCPS. Orthopaedic Surgeon ORIGYN Healthcare Nagpur India WWW.DRBAGARIA.COM E: drbagaria@gmail.com
    2. 2. ‘I keep six honest serving man, they taught me all I know. Their names are what, why, when, how, where and who’
    3. 3. 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  Mortality  Health outcomes
    4. 4. TRAUMA - World  Leading cause of deaths, hospitalizations and disabilities in 15 – 44 years.  In 1990’s- 9th leading cause of death, by 2020 – 2nd leading cause after IHD  Responsible for 9.1% deaths.  Occupy 10 – 30% hospital beds.
    5. 5. TRAUMA INDIA
    6. 6. 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 income societies.  Severe socioeconomic losses to the emerging economy of the country: 550 bill =3% GDP  Significantly affect the poorer communities of the societies
    7. 7. Incidence of Trauma Cases ‘As a general rule, the most successful man in life - is the man who has the best information’
    8. 8. Auto Accident Statistics from the year 1994 to 2004: YEAR ROAD ACCIDENTS (IN THOUSANDS) PERSONS KILLED (IN THOUSANDS) PERSONS INJURED (IN THOUSANDS) 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 Sourced From: Department of Road Transport and Highways. Ministry of Shipping, Road Transport and Highways. Government of India.
    9. 9. Rising Trends in accident statistics for the years
    10. 10. 2005 and projections for 2015 Year No of Deaths No of Serious Injuries No Of Minor Injuries. 2005 1,10,300 22,06,000 77,21,000 2015 1,54,600 30,92,000 108,22,000
    11. 11. Which group is bearing the maximum Brunt?
    12. 12. Causes, Mechanisms and Severity ‘Epidemiology is a means of learning or asking questions… and getting answers that lead to further questions’
    13. 13. Causes, mechanisms, severity Causes & mechanisms:  MVAs – leading cause of TBIs  Falls – second leading cause  Work-related TBIs  Firearms Alcohol – major factor in many TBIs Severity: mild, moderate, severe
    14. 14. Modes of Road accidents
    15. 15. Severity of RTA’s
    16. 16. Factors Responsible for RTA’s ‘The study of disease is really the study of man and his environment’
    17. 17. Causes of Road Accidents
    18. 18. WHO identified Risk Factor in RTA  Speed  Alcohol or drugs  Fatigue  Male  Vehicle defects  Youth driving together  Vulnerable road users
    19. 19. INDIA is a world Apart?- Incredible INDIA  BAD Roads  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.
    20. 20. What has not changed? ‘Those who fail to learn from history are bound to repeat its mistakes’
    21. 21. 5 A’s  Awareness regarding the issue.  Attitude of Government.  Apathy towards the issue.  Absence of any concerted effort.  Available resources, finance and Data.
    22. 22. Disease –related Mortality and Plan Allocation IndiaStat.comhttp://www.indiastat.com/India/ShowData.asp?secid=16&ptid=0&level=1 m), Ministry of Shipping Road Transport and Highways (2006) & Tenth Plan Document( http://planningcommission.nic.in/plans/planrel/fiveyr/10th/volume2/v2_app.pdf) Disease No of Deaths Scheme Fund (Cr Re) T B 37,639 National TB Control 680 Malaria 638 NVBDC 1370 AIDS 1094 NACP 1270 Accidents 92, 618 No major Scheme 187
    23. 23. Can You identify these men?
    24. 24. What may be changing for good?
    25. 25. Where is the hope?  BETTER TECHNOLOGIES  PUBLIC PRIVATE PARTNERSHIP  FOCUS ON EDUCATION AND TRAINING.  DEDICATED TRAUMA UNITS  CONFERENCES LIKE THESE.  GOOD COMMUNICATION SYSTEM.
    26. 26. Better tech: WHAT IS GIS? GIS is a computer based digital information system which analyzes the events with respect to the earths geography. Acronym for: Geographic Information System
    27. 27. 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.
    28. 28. MATERIALS AND METHODS  45 variables collected and plotted against the location map using the GIS software.
    29. 29. SOFTWARE  JT Maps, an indeginously (Indian) developed software.  Other available software: Arc view, Map info, ARC/Info, AutoCAD Map, etc.
    30. 30. RESULTS  166 trauma cases recorded over six months.  Plotted against the data analytical software map.  Clustering of cases with similar attributes were analysed.
    31. 31. Results  Clustering of six lower end radius fractures at a particular location.  All victims were male in age group 20 – 35 years.  All accidents involved motorised two wheelers.  Other injuries were evenly distributed over the entire data location map
    32. 32. Analysis Personal inspections revealed  A “Speed breaker” where most of the accidents occurred.  “Absent street light” around the bend.  All accidents occurred during “Evening and night time”.
    33. 33. IMPLEMENTATION  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
    34. 34. 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 the cause.  Some efforts are also to increase the awareness among people to follow traffic rules.
    35. 35. TRAINING AVAILABLE  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)
    36. 36. Conferences like these!
    37. 37. Good communication systems!
    38. 38. Million Dollar Question?
    39. 39. Why us Clinicians?... We are not epidemologists ! Because…..
    40. 40. Because… Eyes donot see what mind doesnot know…
    41. 41. 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 interventions.  Monitor the epidemiological trends in trauma over a period of time and suugest appropriate govt. policies.
    42. 42. TAKE HOME MESSAGE GET INVOLVED – As health care professionals as well as Human being ‘Health is not mainly an issue of doctors, paramedics and hospitals. It is an issue of social justice’
    43. 43. www.drbagaria.com

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