India’s Zero Fatality Corridors: An Empathetic and Nuanced Solution for the Global Road Crash Epidemic
Mumbai Pune Expressway in Maharashtra * Credit: SaveLIFE Foundation
India holds the global top-spot in road crash fatalities and ranks third in road crash related injuries. India’s Crash Severity of around 38 [Crash Severity is an index that measures deaths per hundred crashes and is computed in accordance with international road safety guidelines] is the highest amongst the top 20 countries with the largest number of road crashes. In 2021 alone, India reported 4,03,116 road crashes and 1,55,622 fatalities. This is a massive loss of lives – approximately 426 people are dying on roads in India, daily. Of these deaths, 70% of the fatalities are people in the 18-40-year age bracket. Road crashes cost the Indian exchequer 3.14% of the national GDP. More importantly, there is a loss of these invaluable lives that leaves a huge vacuum both on the familial and societal level.
Even though more than 90% of the 1.35 million deaths globally are suffered by low- and middle-income countries, most of the road safety-related practices have emerged primarily from the West. Most of this guidance is focused on concerns specific to developed nations, primary among which are speeding and drunk driving. In terms of road safety-related issues, the World Health Organization (WHO) focuses on five broad concerns: speeding, drunk driving, distracted driving, driving under the influence of drugs and the failure to use safety equipment such as helmets, seatbelts, or a child restraint system.
Contrary to the WHO’s top five concerns relating to road safety, the road crash related data emerging from India tells a different story. Over and above global road safety concerns such as speeding and drunk driving, India’s road safety challenges bring to focus unique issues such as head on collisions due to driving on the wrong side into oncoming traffic, driver fatigue and rear-end collisions. The global guidance primarily focuses on driver behavior. However, in India, issues pertaining to poor road design and engineering and delayed trauma care have turned out to be major causal factors behind crashes and resulting deaths.
As the Indian situation and concerns are vastly different from those existing in the West, any existing knowledge, however good it might be, requires a contextualization followed by tailormade, homegrown solutions. For instance, the signages currently employed across India are from the multilateral treaty, the 1968 Vienna Convention on Road Signs and Signals, targeted primarily at Western road users. The consensus behind both the Vienna Convention and the 1949 Geneva Protocol on Road Signs and Signals, which it revised and extended, evolved primarily in Europe. A current urgent need includes modifying these signs to implore users, unique to low- and middle-income countries, to register them and modify their behavior accordingly. For this, the messaging on these signages must make sense to them and be appealing enough for instant behavior change.
Credit: Indian Roads Congress: Code of Practice for Road Signs (IRC: 067-2012)
One of the primary local challenges in India, is the severe dearth of ambulances and their long response timings. As per the 201st Law Commission of India Report, 50% of those killed in road crashes could have been saved had they received timely emergency medical care. A 2021 study by AIIMS, India’s premier health institute, found that while 91% of hospitals in secondary and tertiary level centers have ambulances, less than 35% of these have trained medical staff and paramedics to provide emergency medical care in the life and death situation following a road crash. With neither the adequate number of ambulances, Emergency Medical Technicians (EMTs) and paramedics nor the requisite amount of medical equipment for most road crash victims, the precious Golden Hour gets squandered away.
Another concern unique to India is the illegal roadside parking of vehicles on highways, especially heavy vehicles. Such acts often lead to devastating rear-end collisions. Without proper barricading or elements signaling their stalled presence, approaching vehicles – unaware of their presence – ram straight into them at high speeds. SaveLIFE audits for the government have revealed that rear-end collisions account for around 40% of fatal crashes on Indian highways.
Infrastructurally, certain concerns extremely unique to India include gaps in road median and exposed concrete structures. Both pedestrians and motorized vehicles use the gaps in the median for crossing the road at unauthorized spots and taking abrupt turns, respectively, based on the width of these gaps. Such openings are death traps for both faltering motorists and pedestrians as well as fellow road users approaching the spot at that moment, who then ram into those engaging in this unauthorized maneuvering.
Another often repeated activity on Indian roads, mostly seen in drivers of two and four wheelers, is the practice of driving in the wrong direction. Driving in the wrong direction gives rise to situations where collisions are near impossible to avoid as motorists navigating the traffic are forced to negotiate the road space not only with those traveling in the same direction, but also those approaching from the opposite direction.
Not adhering to the right lanes and using wrong lanes for driving or over-taking is another issue unique to India and other low- and middle-income nations. Flouting lane usage discipline has led to a significant increase in road crashes and fatalities. In 2020 alone, driving on the wrong side or lane indiscipline led to 20,228 road crashes, 19,481 injuries and 7,332 fatalities.
These unique concerns highlight the massive cultural difference in road safety-related requirements as well as the knowledge gap that exists between low- and middle-income countries and the West. While all countries suffer road crash deaths, it is not for the same reasons and do not involve similar types of road users. India’s unique issues require cultural empathy, a special dimension of empathy related to the ability to accurately understand experiences of those from other cultures and to then communicate accurate understanding effectively, with an attitude of concern. The Western perspective on road safety often misses an understanding of and empathy towards realities peculiar to countries lacking Western quality infrastructure, safe vehicles, emergency services and enforcement capabilities.
To overcome this barrier, the Government of India and SaveLIFE Foundation have employed evidence and empathy to create the Zero Fatality Corridor (ZFC) solution focused on concerns unique to India. The ZFC model factors in India’s unique issues to create nuanced solutions based on scientific investigation of road crashes and other contextual realities and requirements.
The ZFC solution employed data analytics for high-fatality zone-specific ambulance deployment. This helped overcome the dearth of ambulances by positioning them near the high-fatality spots identified. This intervention also helped reduce the average response time of the ambulances from 35 minutes to under 10 minutes. The program also tackled another India-specific road safety concern, illegal roadside parking, through the help of active traffic enforcement using high visibility patrol vehicles and drones. These helped preemptively identify casual parking on the expressway to actively discourage it, thereby deterring possible rear-end collisions. The same technology was used to identify parked or broken-down vehicles to safely barricade or remove them. The active traffic enforcement also significantly contributed towards deterring lane indiscipline and wrong side driving. To further strengthen the enforcement capacity of the police who are essential for monitoring adherence to road safety rules and best practices, speed enforcement cameras were deployed in known high-fatality zones.
The ZFC solution helped identify engineering errors and recommended corrections. Examples include unplanned gaps in the median which were to be closed, exposed concrete structures that were to be guarded using crash barriers and addition of some attenuation around vegetation such as large trees. Another example of molding Western knowledge to suit Indian requirements for maintaining lane discipline was the broadening of Tactical Edge Lines (TEL) [these are the partial rumble strips placed on the edge of the shoulder and are meant to alert distracted drivers] to create Tactical Shoulder Lines for discouraging drivers from misusing the TEL by going over it to the shoulder for the purpose of overtaking.
As of 2021, the ZFC program, deployed in 2018, has delivered a 61% reduction in road crash fatalities on the Old Mumbai Pune Highway, Maharashtra. On the Mumbai Pune Expressway, Maharashtra, where the model was deployed in 2016, it has delivered a 52% reduction in road crash fatalities up until 2020. ZFC’s capacity to provide nuanced, cost-effective solutions through scientifically backed suggestions and its capability to scale has led to its deployment on the top 15 most dangerous highways in India. This includes a highway each in the states of Uttar Pradesh, Maharashtra, Karnataka, Tamil Nadu, Telangana, Haryana, Madhya Pradesh, Punjab, Gujarat, Bihar, Chhattisgarh, Andhra Pradesh, Rajasthan, and West Bengal.
The solution has successfully demonstrated that cognizance of local realities is essential to design sensible and impactful solutions. While knowledge from the West is invaluable, it is required to be improvised in a context specific manner. This is especially true for countries where motorists and two-wheeler riders share the road space with vulnerable road users, economically disadvantaged citizens who are big users of these roads for their livelihood and living. The unsafe road conditions put them at elevated risk and create immense hardship. The ZFC model’s unique advantage of looking at conditions and realities specific to low- and middle-income countries, including complex settings and low resources, makes it highly culturally conducive to be applied at scale with the required adaptations in several countries with similar contexts.
About the Author:
Piyush Tewari is the Founder and Chief Executive Officer of SaveLIFE Foundation (SLF), a nonprofit organization committed to saving lives on roads in India. He is best known for leading the effort to secure a Good Samaritan Law for India and is also credited with developing an award-winning model for reducing fatalities on Indian highways.
Piyush holds an MPA from Harvard University and is a recipient of the Rolex Award for Enterprise. In 2019, he was recognized by the World Economic Forum as a Young Global Leader. In 2021, he was appointed by the Government of India as a Member of the National Road Safety Council. Piyush is an Ashoka Fellow, an Echoing Green Fellow, a DRK Fellow and a Rainer Arnhold Fellow.