Mean Streets

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He won't admit it, but Nadarajah Shan-Mugam's vanity saved his life. The 49-year-old Malaysian handyman was riding his motorbike to work in Kuala Lumpur one morning last year when an irritating drizzle suddenly billowed into a blinding tropical downpour. Spotting a flyover a few hundred meters ahead on the highway, Raja raced for shelter. A dozen fellow bikers were there already. As three lanes of rush-hour traffic continued to roar past, more bikers squeezed in, huddling together and turning their backs to the windblown rain and the heavy spray from passing vehicles. Raja lit a cigarette, then tilted one of his rear-view mirrors to check just how bedraggled he looked.

Instead, he glimpsed something horrifying: a speeding truck was hurtling toward him, the driver wrestling with the wheel as the vehicle skidded over the slick tarmac. Raja vaulted to safety over a steel road divider just as the truck plowed into the other bikers. Four were killed instantly and a dozen were injured. "All I got was a cut from the hitting the divider," Raja recalled the next day. "The others never saw the truck coming. They didn't have a chance."

For millions of other Asian motorists, the odds aren't a whole lot better. One of the dismaying side effects of the region's economic growthand the accompanying boom in motor-vehicle purchases by the newly prosperoushas been a staggeringly high traffic-fatality rate. With just 16% of the world's cars, trucks, buses and motorcycles, Asia accounts for more than half of the roughly 1.2 million traffic fatalities that the World Health Organization (WHO) estimates occur globally every year. More than 600,000 Asians are killed and another 9.4 million are severely injured in traffic accidents annually.

Those statistics make Asia's highways the meanest streets in the world. In Thailand, for example, road accidents are now the third leading cause of death after aids and heart attacks, according to the country's Ministry of Public Health. In China and India, where members of expanding middle classes are taking to the roads in record numbers, crash rates are growing out of control. Car ownership in China jumped 41% between 1999 and 2002, while over the same period accidents increased twice as fast, by more than 83%. P.K. Sikdar, director of the Central Road Research Institute, a New Delhi-based traffic consultancy, ranks the carnage in India right up there with his country's natural disastersexcept that "earthquakes and cyclones don't come every year. Road accidents come routinely," he says. "Like clockwork, more than 80,000 people [a year] simply get wiped out on our roads."

Asia's motorists are plagued by hazards faced by travelers everywhere: drunk drivers, bad weather, heavy traffic. But developing countries harbor a host of other factors that heighten the peril. With car and motorcycle sales rising fast, deficit-ridden governments are hard-pressed to build wider, safer highways to accommodate swarms of new commuters. In poorer nations, existing road systems are often badly maintained and lack basic infrastructure such as stop signs and traffic signals. Traffic in Asia is frequently a tumultuous and deadly mix of pedestrians, affordable (but highly vulnerable) motorcycles, cars, pickup trucks ferrying loads of passengers, and heavy trucks that feed the region's voracious economic engineall vying for places in line along the same overburdened stretches of blacktop.

To this mix add lax law enforcement, a flood of inexperienced drivers, and a marked indifference to safety on the part of many motorists, and it's little wonder that Asia's highways sometimes resemble a Mad Max movie set. Shanghai resident Huang Wei, a recent graduate of a Chinese driving school, recalls how during one training session her instructor scolded her for using her turn indicator to signal her intention to change lanes: "He shouted at me, 'What are you doing? Never use your turn signal for changing lanes! If you let the car behind you know what you are doing, he will never make way for you. He'll speed up!'" Fang Shou'en, director of China's National Traffic Accident Prevention Committee, says such offensive driving behavior is nearly universal among China's aggressive, me-first motorists. "There is no concept of right-of-way," he says. "It is like survival of the fittest."

And, sometimes, the luckiest. At an intersection of Bangkok's busy Pattanakarn Road in June, the driver of a gray Hilux pickup lost patience waiting for an interminable red light and attempted a quick U-turn into oncoming traffic. He was rammed by a Toyota sedan; the impact spun one vehicle into six motorcycles whose riders were waiting at the light, while the other was propelled into two other motorcyclists turning into Pattanakarn Road. Although nine people were injured, no one died. Others have not been so fortunate. "This road is the worst," says Sommai Nutang, a 46-year-old truck driver whose home is nearby. "There are lots of accidents every night, especially weekends after 8 p.m. There's no policeman stationed here and people are always running red lights. People just drive so carelessly, and too fast. We're always running out to see what's going on." A billboard looming over the intersection urges: "Drive Safely. Turn On Your Lights. Wear Your Helmet. Best Wishes from the Bang Mod Police Office."






Thailand's road safety Operations Centerunofficially known as the "war room"is where the country's authorities are trying to bring the national accident rates down to the level of many Western countries. (With an average of 36 deaths a day, Thailand ranks sixth in the world in road fatalities, according to the WHO.) Workers at the center, located in government offices in Bangkok, collate reports of casualties coming in from police, hospitals and rescue workers around the country. The war room is also the staging area for the various programs established to make highways safer, particularly during holiday periods when fatalities spike. The government earlier this year set up extra checkpoints to get drunk drivers off the road, launched public-service ad campaigns urging people to stay sober and drive safely, and even rounded up young road racers and took them on a tour of morgues, autopsy rooms and prisons to impress upon them the dangers of reckless driving.

So far, gains have been negligible. "We've declared war on road accidents, but we've lost the first four battles in that war," says Nikorn Jamnong, Deputy Minister of Transport and Communications, referring to the lack of a meaningful reduction in the death toll during four preceding major holidays. Soft-spoken and unassuming, Nikorn is the point man for the government's road-safety campaign. For Nikorn, the effort has a personal dimension. Raising his right hand from the leather blotter on his dark wooden desk, he traces a faint crease in his skin running from his left temple down to the corner of his mouth. "Thirty-four stitches," he says, then spreads his jaws and taps his upper teeth. "Not real." The scars are reminders of a 1988 Bangkok accident in which Nikorn's car was sideswiped by a drunken 18-year-old driving a pickup truck.

Nikorn isn't expecting his campaign to win easy victories. The causes of accidents are so variedpoor roadway design, unsafe vehicles, and human error among them. There are no quick-fix solutions. Yordphol Tanaboriboon, a transportation-engineering professor at the Asian Institute of Technology in Bangkok, says one of the few generalizations that can be made is that the high proportion of motorcycles on Thailand's roads (of the country's 26 million registered vehicles, 12 million are two-wheelers; according to Nikorn, there are another 6 million unregistered motorcycles) is linked to a higher death rate. As many as 80% of all fatal accidents in Thailand involve motorcycles, which are light, tricky to control, and leave riders exposed to injury even in the slightest brushes with heavier cars and trucks. They are also wildly popular in many parts of Asia because almost anyone can afford one. "We really need motorcycle-only lanes on our roads" to keep riders from tangling with heavier forms of vehicles, Yordphol says. But with existing roads already hopelessly congested, the measure seems too expensive to undertake and nearly impossible to enforce.

Indeed, authorities throughout Asia have discovered how difficult it can be to persuade motorists to obey the rules of the road or to take even the most obviously beneficial safety precautions. In Vietnam, where 95% of the vehicles on the road are motorcycles, helmets are mandatory. Yet only 3% of riders wear them, according to the WHO. Riders contemptuously refer to helmets as "rice cookers," too uncomfortable to wear in the country's steamy weather.

Too often, they pay an appalling price to feeland lookcool. Among the 30 patients in the head-injury ward at Hanoi's Viet Duc Hospital, doctors say 70-80% are there due to motorcycle accidents. Dr. Nguyen Kim Lien, a steely eyed woman in her 40s who runs the ward, estimates that a third of her patients wouldn't be there if they had been wearing helmets. For her part, Dr. Lien says she sticks to a bicycle, always wears a helmet and insists that all her family members do, too. But old habits are hard to change, even for the best informed. Another doctor on the ward, Nguyen Duy Tuyen, also specializes in head injuries and spends most of his time treating motorcyclists. Does he wear a helmet himself when riding a motorbike? "No," he confesses with a sheepish smile.

If he needs more convincing, Dr. Tuyen could walk a few blocks down the street to meet Bach Dinh Vinh. Now 30, Vinh was studying for a degree in information technology in 1993. A top student in his class, he could speak fluent English and Russian and was learning French. One night, while riding his bicycle back from class, he was struck from behind by a motorbike. He hit his head on the concrete road and was knocked out. Doctors managed to save his life, but he was almost completely paralyzed. Vinh struggled through an agonizing six years of rehabilitation to regain control of his right hand. He has this advice for his fellow commuters: "Go slowly and obey the law."

Besides the prevalence of motorcycles, there appears to be another universal truth underlying Asia's soaring highway death rates: fatalities increase when business is booming. "It's the dark side of economic growth," says Hisashi Ogawa, a regional environmental-health adviser for the WHO. He notes that rates begin to ease only after countries become rich enough to put in place costly measures to moderate the slaughter. Sadly, this means that Asia's statistics are bound to get uglier. India and China, the most populous countries in the world, have exploding middle classes whose members are reaching for the car keys for the very first timeyet it will be years before those nations are able to fully afford the costs of safer highways. According to a World Bank study last year, if India's current rates of economic growth continue uninterrupted, the country won't hit the critical point at which road death rates begin to improve (per capita income of $8,600) until 2049. Today, one person dies every 6 1/2 minutes on India's roads; by 2020, that figure is projected to reach more than one every 3 minutes.

If one city epitomizes the perfect storm engulfing Asia's roads, it is surely India's capital, New Delhi. Swarming the city's potholed streets are 4 million cars and trucks, 600,000 motorized two- and three-wheeled vehicles and innumerable bicycles and nonmotorized forms of transport ranging from trishaws to ox carts. There are also animals, everything from sacred cows to dogs, cats, monkeysas well as countless pedestrians. The latter do not fare well in this free-for-all. New Delhi's newspapers recently labeled the city a "pedestrian graveyard." According to the capital's transport department, nearly half of the 1,700 people killed in traffic in the city last year were on foot.

Of course, being surrounded by sheet metal is no guarantee of safety. Poorly maintained vehicles, as well as a large number of tinny, cheap cars on New Delhi's roads, also contribute to accidents and injuries. Many domestically made cars do not undergo crash testing, and until a few years ago, economy models often lacked even rudimentary safety equipment such as seat belts. "These cars are designed for city traffic and people will take them out onto our 120 km/h highways and get splattered," says Sikdar, the Central Road Research Institute director.

And those lucky enough to survive an accident often find that their problems are just beginning because of the lack of emergency-medical services. An ambulance team sponsored by the New Delhi government has only 35 vehicles for a city of 15 million people. Up to half of those hurt in road accidents die on the way to the hospital. "In India, the victim of a road accident goes through three kinds of trauma," says Dr. Shakti Gupta of AIIMS hospital in New Delhi. "First is the accident itself, then the trip to a hospital. And if they manage to survive both of those, then they still have to survive negligent emergency-room doctors."






The cost in human suffering is incalculable, but plenty of economists have tried to estimate the financial impact of traffic accidents. The World Bank puts annual losses worldwide due to traffic injuries at 1-2% of global GDP. In Asia, that figure might climb much higher, partly because three-quarters of those injured in the region are younger than 45, which means that Asia's most productive workers are being decimated. According to a recent Asian Development Bank (ADB) paper, the 11 country members of the Association of Southeast Asian Nations (ASEAN) saw a total loss of some $11 billion in 2000 due to the 73,000 road deaths and 1.8 million injuries the ADB estimates their citizens suffered that year.

Authorities in countries such as China appear to be waking up to the high cost of doing nothing to improve road safety. On May 1, China's first road-safety laws came into effect. The new legislation tightens rules governing such offenses as speeding and drunk driving, and also raises penalties significantlyfor example, imposing a lifetime driving ban on drivers who flee the scene of an accident, and sentences of up to seven years in prison for those who kill someone while driving drunk. Something had to be done. While mainland China possesses just 1.9% of the world's vehicles, last year it accounted for 15% of total global traffic accidents. (More than 100,000 people died on China's roads in 2003.)

With millions of new cars and fledgling drivers clogging mainland China's transportation systemthere were 16.7 million new vehicles and 11 million new motorists last yearstrict enforcement of new traffic laws is crucial. Unfortunately, as is often the case elsewhere in Asia, enforcement is the weakest link in the road-safety chain. "Police corruption is widespread in China. That's no secret," says Liu, a crew-cut, 37-year-old traffic cop who declined to give his full name. "It's especially true in the traffic section. If you help spring a murderer, you're going to feel a heavy psychological burden. But if you help a friend beat a traffic fine, you feel nothing." The Beijing cop says most policemen he knows have helped get friends or acquaintances off the hook for traffic violations. "It's become part of our culture," Liu says. "China has plenty of laws. It's the enforcement that's lacking."

The measures that will make Asia's highways safer are well known. Laid out in a range of studies emanating over the years from the ADB and other multilateral institutions, they include: stricter legislation in critical areas such as speeding and drunk driving; wider use of seat belts and helmets; more money to improve highway infrastructure; improved driver education; improved treatment for accident victims; and greater commitment to providing police with the salaries, equipment and training needed to ensure they will scrupulously enforce the law. The ADB, in particular, conducted a regional road-safety study in 1997 that provided detailed guidelines to each of ASEAN's 11 countries.

But a follow-up report written in 2002 concluded that "very few of the recommendations ... appear to have been implemented." Programs that were initiated were usually halted by governments when foreign aid for them dried up, the ADB report said. Indeed, the size and complexity of the challenge they face seems to produce resignation in some officials. "This city has more vehicles than Madras', Bombay's and Calcutta's put together," sighs New Delhi's traffic-police commissioner Qamar Ahmad. "If you combine this with the burgeoning population and outmoded road system, problems are inevitable."

This fatalism is mirrored in Asia's motoring society as a whole. Bangkok-based professor Yordphol says many Thai motorists believe that no matter how defensively they drive, their fate is predetermined. "We are trying to persuade them that accidents are not an act of God," Yordphol says, "that you can avoid them if you are careful, obey the laws, and not speed or drive under the influence."

Convincing drivers will not be easy. "This kind of thing is an occupational hazard," shrugs Pichet Sorpoon, a Bangkok cabbie who has stopped to watch as victims of the crash on Pattanakarn Road are carted away on stretchers. His sentiment is shared by Ahmad. When it comes to intractable road hazards, he says: "You just have to live with it." In the coming years, it seems inevitable that millions of Asians will have to die with it.