May 15, 2020

Road Traffic Accidents as a Public Health Issue in Bhutan

Rationale

Road traffic injuries are projected to increase as rising income level in developing countries leads to increased vehicle ownership. Nearly 3500 people die from road traffic accidents every day in the world (Martin, 2013). This is one of the top ten Global Health Challenges in the world today.

Bhutan, a small landlocked country in the Himalayas, is set to graduate from being a Least Developed Country (LDC) by 2023 (Gyelmo, 2018). But like any developing country Bhutan still has her share of public health issues to tackle. And one issue that is seldom looked at from the lens of a Public Health concern is road traffic injuries. This essay will attempt to look at the road traffic injuries, and how its increase will affect the public health, and present some recommendations for change which will lead to reductions in road traffic accidents.

Background

Bhutan is a 38,394 km2 landlocked country in the Himalayas with a total population of 734,374 in 2018 (National Statistics Bureau, 2019). There are 1,08,573 registered vehicles as of March 2020 in Bhutan (Road Safety and Transport Authority, 2020), while the number was 92,008 as of December 2017 (Dorji, 2018), and 68, 173 in 2014 (World Health Organization, 2016).

Bhutan’s development journey began with the start of the first Five-Year-Plan in 1961 (Gross National Happiness Commission, 2017) when 179 kilometre of paved road was constructed to connect the bordering town of Phuentsholing to Thimphu (Department of Roads, 2003). Today Bhutan boasts of more than 18,282 kms of road (National Statistics Bureau, 2019).

The number of cars imported over the years has not decreased despite the various stringent measures put in place by the government. With more than 8,000 cars imported within one year between July 2014 and July 2015 (Bhutan Broadcasting Service, 2015) there are certainly serious implications on the safety of the average driver and pedestrians.

Road Safety and Transport Authority (RSTA) is the highest body in the country which is designated to frame rules and regulations for the road safety.  Their 2019 ‘Rules and Regulation of RSTA’ is an improvement of the ‘Road Safety and Transport Act’ which was updated in January 2019.

The country had also banned the import of vehicle in 2012 during the Rupee Crunch in India, which was lifted in 2014. Stringent legislations meant that a steep increase in the taxes to import vehicles, some even going up to 100%. But at the same time, the surge in number of driving license holders 1,44,701 in 2020 indicates a different image.

Thimphu's main traffic circle is manned by Traffic Police. Photo: Google

The Issue

With a greater number of vehicles hitting the roads, and a greater number of driving licenses issued, the infrastructure is always pressurized. Couple that with slower improvements in the roads conditions there is certainty for accidents to happen.  Also, there are less public transport system in place, along with slow respond time by medical personnel during accidents.

2018 saw the highest recorded case of motor vehicle accidents in the past seven years, with 1,360 registered cases (Kuenselonline, 2019).

“According to the police, of the 942 people were involved in vehicle accidents, 807 people were injured and 135 died in 2018.  Human error was the major cause of accidents, followed by road and weather conditions.” (Kuenselonline, 2019)

GDP per capita was Nu. 223815.17 (2,909.60 USD) in 2017 (National Statistics Bureau, 2019), while it costs almost Nu. 21,000 to treat an accident patient in hospital. For a poor country this is a heavy cost, incurring major dent in the national budget.

Related Burden

Along with the accidents, there is the related burden on other aspects of the country. Firstly, the health facility of the country is compromised. Care during the accident and later during the rehabilitation will surely cost a lot. Resources and time which could have been used to treat other life-threatening infections, pandemics and diseases have to be readjusted to treat the accident victims.

The already struggling people in LDC Bhutan are again burdened with looking after the accident victims as a post-accident care.

If we look at the population, vehicles and accident ratio, then one out of seven Bhutanese owns a car. This is a very significant number considering the fact that there is only 18,282 kms of road network in the entire country. Comparatively, Switzerland which has almost the same area as Bhutan, has over 71,546 kms of road (Statista Research Department, 2020).

And in 2017, Bhutan’s road fatalities exceeded those in Europe, North America and Australia by almost 3. Bhutan’s was 13 for every 10,000 vehicles while theirs was only 10 for every 10,000 vehicles (Seldon, 2017).

Economic and Social Cost

The main economic cost will be the direct ones, when hospitals would need to use more resources to treat the accident victims. Also, there is the redirection of funds to health care which could have been used for other aspects of development in the country. In Bhutan, healthcare is completely free, so there is added pressure on the government.

Other than that, the transport and road safety sector will be hit hard, as they are responsible for the maintenance of the road network. In Bhutan, the parties responsible are the Road Safety and Transport Authority (RSTA) under Ministry of Information and Communications (MoIC), Traffic Police Division under Royal Bhutan Police, Department of Roads (DoR) under Ministry of Works and Human Settlement (MoWHS), and Department of Public Health under Ministry of Health (Dorji, 2016).

But Department of Public Health under Ministry of Health haven’t had their hand directly in addressing the issue that is discussed here. Road Accidents don’t feature in their mandates.

Measures already in Place

Nationwide ‘Zero Tolerance Friday’ is an initiative to deter the road users, and ensure safety to both the drivers and commuters. It was initiated in 2015 with support from the Traffic Police division, and has created a of positive impacts, with reduced accidents (Kuenselonline, 2015). There is marked reduction in drunk driving too. But the issue here is the shortage of modern equipment’s like breath analysers.

Another measure is the increase in the fines imposed on defaulters, though that does not deter the defaulters from repeating (Kuenselonline, 2018). The fines have increased almost 150%.

There are improvements to the road infrastructures, with safety features added. But for a major overall, it is a costly project and will incur millions which Bhutan does not have. The country having a geographically challenged landscape doesn’t help either.

Recommendations

The following are few recommendations to protect, promote and ameliorate the health of Bhutanese in relation to road accidents.

RSTA has formulated various Acts and legislations to protect the innocent commuters and drivers, while the government of the day has also signed legislations to curb the import of vehicles by imposing hefty taxes and trying some other measures. The following recommendations can also be part of the change needed to curtail road traffic accidents.

Firstly, there is need for stricter legislations to tackle the issue. Developed countries like Australia have strict seat-belt rules, which can be implemented in Bhutan. Along with that, the process of obtaining a license need to be made more stringent so that aspirants would be more prepared. Along with that newer public transportation legislation to protect commuters need to be in place, like having better road conditions.

Secondly, the availability of public transportation systems should be vast, so that commuters are encouraged to use them instead of private vehicles. This will remove the road congestions and leave room for smoother traffic flows. Efficient public transportation systems like buses and taxis would go a long way. There is also an option to put in new measures of transportations between heavily commuted lines, especially connecting the cities of Paro, Phuentsholing and Thimphu with short trains. Taking Victoria’s example of the Public Transport system which are so efficient that people prefer using that to travelling by private vehicles.

There are talks of starting an electric train line between Paro city and Thimphu city (Kuenselonline, 2020). A train line here will greatly reduce the number of vehicles plying between these two cities, and help to reduce road accidents there.

The third recommendations would be to have a better and faster medical response dedicated to road accidents. This can be catered by making First-Aid courses mandatory to all holders of driving licenses, and having trained volunteers in every locality. An option would also be to provide certified trainings to young people while in their senior years in high schools, and colleges. They will become part of the first-aid responders and will reduce the pressures to the Emergency Medical Teams.

Thus, the above three recommendations will certainly help to protect and promote safety on roads, which will certainly contribute to better Public Health in the nation.

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