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Driving Risks in Asia

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  • Driving Risks in Asia

    The roads are scary, downright scary. And it differs from country to country.

    Thailand (Phuket): Most people pass a road test, which is an experience in and of itself. The road test is performed in this back lot miniature road creation monstrosity where you drive around in circles, and stop at fake stop signs. There is no testing done on public roads. A written test, and some eyesight tests complement the process. However, most Thais tend to drive in a considerate and legal manner. The wild exception is the group called "taxi drivers"; a group sometimes referred to by the foreign expats as primates. These drivers tend to be from the lower socioeconomic scale, tend to be Muslim, and tend to be illegal, not only with respect to a taxi license but also with respect to a driver's license and insurance as well. They tend to have little regard for the rules of the road, the law, and other drivers around them. A great deal of them can just be considered to be downright dangerous. Be careful when using them. And consider this one little fact: one person dies every day on a motorbike in Phuket.

    Thailand (Bangkok): Most drivers do fairly well, taxi drivers and otherwise. The roads are crowded, and, a bit complicated, as traffic directions change throughout the day depending upon what rush hour it is. You don't get the madness and extreme incompetence on the roads like you do in the south of Thailand; then again, the demographics of the population are different (Bangkok 95% Thai Buddhist, Phuket 50% Thai Buddhist).

    China: What can you say about a country where people watched their parents drive bicycles? Expecting these people to understand the concept of driving is just absurd; they're totally new at it. I've had some of my most dangerous experiences on the road, in China, with taxi drivers who not only had no understanding of the rules, but had no understanding of the limits of their cars. But, when dealing with completely uneducated people, what do you expect. The Pakistanis in New York City do a much better job. Driving in China is just downright dangerous; the people are imbeciles when it comes to the concept of face (tell a driver to slow down because he's speeding out of control, and more than likely he'll speed up, to prove to you that he's capable of driving fast, out of fear of "losing face"). Be very careful about choosing taxi drivers in China; those with meters tend to be more competent than those that approach you with private cars.

    Vietnam: The biggest danger as I remember in Hanoi and Ho Chi Minh, are prostitutes on motorbikes. They're everywhere. Streets, sidewalks, every thorough fare imaginable. It's comical walking the streets of some cities in Vietnam, motorbikes galore. And with motorbikes, the usual risks. Remember, motorbikes can cause significant damage to a human body, just as much as a car sometimes. They're everywhere, and they go everywhere, including the sidewalks.

    Here's a little summary of the WHO report on international driving.

    In a recent report released on November 18, 2011 by the WHO which I have pasted below and this highlights the enormous burden and public health challenge hazardous driving conditions pose . For example when ever I travel to Asia, Africa I am struck by the hazardous traffic patterns and the disregard for road safety. over the summer when I visted India I saw 4 people riding a 2 wheeler on the crowded streets of the old city area in Hyderabad and no one including the driver was wearing a helmet.

    The threat posed by drunk drivers has increased as the laws and consequences as not as stiff in developing countries.

    School children are transported to school in 3 wheel auto rickshaw and these vehicles have no doors or safety belts and this vehicle which can hold 3 people has 7- 8 kids riding in them which gets me wondering about the safety of these kids as they go to and from school everyday.

    Key facts
    • About 1.3 million people die each year as a result of road traffic crashes.
    • Road traffic injuries are the leading cause of death among young people, aged 15-29 years.
    • Over 90% of the world's fatalities on the roads occur in low-income and middle-income countries, even though these countries have less than half of the world's vehicles.
    • Nearly half (46%) of those dying on the world's roads are "vulnerable road users": pedestrians, cyclists and motorcyclists.
    • Without action, road traffic crashes are predicted to result in the deaths of around 1.9 million people annually by 2020
    • Only 15% of countries have comprehensive laws relating to five key risk factors: speeding, drinking and driving, and the use of motorcycle helmets, seat-belts and child restraints.
    • Every year the lives of almost 1.3 million people are cut short as a result of a road traffic crash. Between 20 to 50 million more people suffer non-fatal injuries, with many incurring a disability as a result of their injury.

    Road traffic injuries cause considerable economic losses to victims, their families, and to nations as a whole. These losses arise from the cost of treatment (including rehabilitation and incident investigation) as well as reduced/lost productivity (e.g. in wages) for those killed or disabled by their injuries, and for family members who need to take time off work (or school) to care for the injured.

    There are few global estimates of the costs of injury, but an estimate carried out in 2000 suggest that the economic cost of road traffic crashes was approximately US$ 518 billion. National estimates have illustrated that road traffic crashes cost countries between 1-3% of their gross national product, while the financial impact on individual families has been shown to result in increased financial borrowing and debt, and even a decline in food consumption.

    Road traffic injuries have been neglected from the global health agenda for many years, despite being predictable and largely preventable. Evidence from many countries shows that dramatic successes in preventing road traffic crashes can be achieved through concerted efforts that involve, but are not limited to, the health sector.

    Who is at risk?

    Socioeconomic status

    More than 90% of deaths that result from road traffic injuries occur in low- and middle-income countries. Road traffic injury death rates are highest in the low- and middle-income countries of the African and Middle Eastern regions. Even within high-income countries, people from lower socioeconomic backgrounds are more likely to be involved in a road traffic crashes than their more affluent counterparts.


    Children and young people under the age of 25 years account for over 30% of those killed and injured in road traffic crashes. Road traffic fatality rates are higher in younger age groups.


    From a young age, males are more likely to be involved in road traffic crashes than females. Among young drivers, young males under the age of 25 years are almost 3 times as likely to be killed in a car crash as young females.

    Key risk factors and what can be done to address them

    Road traffic injuries can be prevented. Governments need to take action to address road safety in a holistic manner, that requires involvement from multiple sectors (transport, police, health, education) and that addresses the safety of roads, vehicles, and road users themselves. Effective interventions include designing safer infrastructure and incorporating road safety features into land-use and transport planning; improving the safety features of vehicles; and improving post-crash care for victims of road crashes. Interventions that target road user behavior are equally important, such as setting and enforcing laws relating to key risk factors, and raising public awareness about these. Below are some key risk factors.


    An increase in average speed is directly related both to the likelihood of a crash occurring and to the severity of the consequences of the crash. Some other facts are below.
    • Pedestrians have a 90% chance of surviving a car crash at 30 km/h or below, but less than a 50% chance of surviving an impact of 45 km/h or above.
    • 30 km/h speed zones can reduce the risk of a crash and are recommended in areas where vulnerable road users are common (e.g. residential areas, around schools).
    • Apart from reducing road traffic injuries, lower average traffic speeds can have other positive effects on health outcomes (e.g. by reducing respiratory problems associated with car emissions).


    Drinking and driving increases both the risk of a crash and the likelihood that death or serious injury will result.
    • The risk of being involved in a crash increases significantly above a blood alcohol concentration (BAC) of 0.04 g/dl.
    • Laws that establish BACs of 0.05g/dl or below are effective at reducing the number of alcohol-related crashes.
    • Enforcing sobriety checkpoints and random breath testing can lead to reductions in alcohol-related crashes of about 20% and have shown to be very cost-effective.

    Motorcycle helmets
    • Wearing a motorcycle helmet correctly can reduce the risk of death by almost 40% and the risk of severe injury by over 70%.
    • When motorcycle helmet laws are enforced effectively, helmet wearing rates can increase to over 90%.
    • Requiring helmets to meet a recognized safety standards is important to ensure that helmets can effectively reduce the impact of a collision to the head in the event of a crash.

    Seat-belts and child restraints
    • Wearing a seat-belt reduces the risk of a fatality among front-seat passengers by 40-50% and of rear-seat passengers by between 25-75%.
    • Mandatory seat-belt laws and their enforcement have been shown to be very effective at increasing seat-belt wearing rates.
    • If correctly installed and used, child restraints reduce deaths among infants by approximately 70% and deaths among small children by between 54% and 80%.

    Distracted driving

    There are many types of distractions that can lead to impaired driving, but recently there has been a marked increase around the world in the use of mobile phones by drivers that is becoming a growing concern for road safety. The distraction caused by mobile phones can impair driving performance in a number of ways, e.g. longer reaction times (notably braking reaction time, but also reaction to traffic signals), impaired ability to keep in the correct lane, and shorter following distances.
    • Text messaging also results in considerably reduced driving performance, with young drivers at particular risk of the effects of distraction resulting from this use.
    • Drivers using a mobile phone are approximately four times more likely to be involved in a crash than when a driver does not use a phone. Hands-free phones are not much safer than hand-held phone sets.
    • While there is little concrete evidence yet on how to reduce mobile phone use while driving, governments need to be proactive. Actions that can be taken include adopting legislative measures, launching public awareness campaigns, and regularly collecting data on distracted driving to better understand the nature of this problem.

    WHO response

    Coordinating the Decade of Action for Road Safety

    In 2010 a United Nations General Assembly resolution proclaimed a Decade of Action for Road Safety (2011 to 2020). This Decade was launched in May 2011 in over 110 countries, with the aim of saving millions of lives by improving the safety of roads and vehicles; enhancing the behaviour of road users; and improving emergency services. WHO, in collaboration with the United Nations regional commissions, is the secretariat for the Decade and plays a key role in guiding global efforts by continuing to advocate for road safety at the highest political levels; compiling and disseminating good practices in prevention; sharing information with the public on risks and how to reduce these risks; and drawing attention to the need for increased funding.

    Monitoring progress through global status reports

    WHO will provide one of the tools for evaluating the global impact of the Decade of Action for Road Safety through the development of Global status reports on road safety. The first Global status report on road safety, published in 2009, provided the first comprehensive assessment of the road safety situation globally, while the second report - which will serve as a baseline for the Decade of Action for Road Safety - will be released in 2012.

    Providing technical support to countries

    WHO works across the spectrum in countries, from primary prevention work through to rehabilitation of those who have been involved in road traffic crashes. As such, WHO works in a multisectoral manner, in partnership with national stakeholders from a variety of sectors (e.g. health, police, transport, education) as well as with other parties involved in road traffic injury prevention, such as nongovernmental organizations and academics.

    In 2010, WHO and five other consortium partners received funding from Bloomberg Philanthropies to further road safety in ten countries. The "Road Safety in 10 Countries (RS10) Project" supports the governments of Brazil, Cambodia, China, Egypt, India, Kenya, Mexico, the Russian Federation, Turkey and Viet Nam by focusing on selected key risks for road traffic crashes. Efforts are focused on strengthening legislation and enforcement, capacity development, and educating the public through social marketing campaigns. WHO also supports road safety efforts in other ways - for example, in improving safety around schools in Malawi and Mozambique, and in helping improve emergency services in Kenya and India and improving data collection systems (both in the health and police sectors). Over the Decade, WHO will continue to support these and other national road safety initiatives leading to sustainable government programmes.

    WHO also provides guidelines that highlight good practice in road traffic injury prevention, and then supports governments to implement the suggested programmes or policies. For example, a good practice manual on increasing motorcycle helmet use and reducing drink-driving has been implemented in a number of ASEAN countries, while a guide to improving pre- hospital care will be used in Kenya and India. Capacity within countries is developed through the implementation of these guides as well as through direct training in different areas of injury prevention (for example, through courses on injury surveillance and on improving trauma care services).

    ( Source: WHO, 2011 )
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