Asia's Latest Public Health Crisis? Dangerous Drivers

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Crack Palinggi / Reuters

Indonesian police investigate the scene of a traffic accident in Jakarta on February 10, 2006

In a country once marked by genocide, even the battle-hardened police were aghast at last month's scene of carnage and mayhem. Outside the southern beach town of Sihanoukville on March 4, a speeding truck driver slipped off a slope and smashed head-on into a minivan crammed with 25 wedding revelers. The result? One of Cambodia's worst traffic crashes in history, say authorities: nineteen bodies were strewn around dead at the scene, including the truck driver, many of them crushed and mangled under the flipped-over white van.

The wreckage was the latest of several tragedies on National Highway 4, a 140-mile trade artery connecting the country's only deepwater port to the capital, Phnom Penh. Officials say the road, along with many others partially funded by foreign governments, is hazardous because it's wide, paved and thus allows for reckless speeding in a country where safe driving is rarely practiced. As Cambodia and other poor nations pump up their economies, they're building more dangerous highways like this one, often without the policing and road safety education that should come with them. "In Cambodia, we're seeing more road crashes in outskirt areas, where there are more trucks and speeding. The situation has become very dangerous," says Socheata Sann, a Phnom Penh-based road safety specialist at the NGO Handicap International Belgium. At the same time, Sann says, city streets are becoming more crammed with a lawless surfeit of motor scooters and cars, contributing even more to accidents in urban areas.

It's a dilemma that only recently entered the parlance of humanitarian do-gooders, whose agendas have more popularly included HIV/Aids and malaria. But all over the developing world, porous urbanization, lax enforcement of traffic laws, crumbling infrastructure and crowded streets have led to what the World Health Organization calls a "road safety crisis," and what the International Federation of the Red Cross and Red Crescent has labeled a "disaster." Every year around the world, traffic accidents claim 1.3 million lives, 90% of them in low- and middle-income countries. Southeast Asia is among the hardest hit regions, where crashes overwhelmingly affect young and poor motorbike drivers by putting them out of work and stripping support for their families.

In the past decade, the numbers have soared. In Cambodia, traffic-related fatalities have leaped by more than four times since 2000, culminating in 1850 deaths last year. That makes road crashes the most common cause of death in the country, surpassing HIV/AIDS. Other countries have witnessed similar long-term rises as they urbanize: in Vietnam, 11,500 people died as a result of crash injuries last year, amounting to 31 people a day. In Indonesia, more than 20,000 people die as a result of traffic crashes every year.

The problem has become such a scourge that, next month, the United Nations will launch the Decade of Action for Road Safety for the years 2011 to 2020, a move that's rousing more funding and attention for road safety groups. Some victims say they're happy about the interest. "The NGOs didn't help me with my troubles, but now they're definitely paying more attention," said Cheng Heng, 32, a garment factory worker who broke his clavicle last November on the perilous National Highway 4 outside Phnom Penh. "My family earns $300 a month, and we have 10 people. It took three months to pay off the debt" of $250, he said, requiring his children had to skip meals and forgo school. Cheng's story is common of a young urban laborer. "The loss of the breadwinner due to death or disability can be catastrophic, leading to lower living standards and poverty," said Ryan Duly, a Bangkok-based program manager at the Global Road Safety Partnership, a Geneva-based network of road safety groups.

These crash woes don't only affect individual families, but bring with them confounding economic harm. For the 10 member states of the Association of Southeast Asian Nations (ASEAN), a regional bloc, traffic crashes cost $15 billion a year, according to the Philippines-based Asian Development Bank (ADB). In the region's poorer countries, such as Burma, Cambodia and Laos, road crashes cost equal to 2-3% of gross domestic product (GDP), Duly says. Cambodia is among the hardest hit. Last year, road accidents cost the country $248 million against $116 million in 2003, according to a study by Handicap International Belgium and Hasselt University in Belgium.

Some experts argue that Southeast Asian countries could take a cue from Malaysia. The country experienced a similar pattern of population growth and urbanization from the 1970s to 1990s, causing traffic fatalities to triple to 6,870 in 2010 from 2,300 in 1974. Even though casualty numbers themselves continue to rise, in the mid-1990s authorities curbed the upward trend in the death rate by overhauling its policing standards, street engineering and safety education programs. Today there are fewer than 4 deaths per 10,000 vehicles each year — the statistically important marker, sitting slightly above the world safety standard of below 3 deaths per 10,000 vehicles. "We used to have a serious problem with motorcycles, but now we have more cars on the streets, along with helmet laws," says Law Teik Hua, a civil engineer at the Putra University Malaysia in Selangor, Malaysia. "We had good political support."

Across the region, that political support is gaining for an issue whose statistics were, ten years ago, scantly documented and underestimated. Cambodia, for one, hopes to reduce fatalities by a third by the end of the decade to 2,240 deaths from the 3,200 deaths that authorities predict. Traffic safety groups have proposed a number of ways to tame the raging streets. Among them are to limit speeds, wear seatbelts and helmets, improve street quality, better enforce laws and educate the populace.

It's not certain, however, what implementing those changes will require. The helmet laws passed in Cambodia and Vietnam in the past five years, for example, have seen mixed results. In Cambodia, police don't enforce the law consistently, and only drivers — not passengers — are required to wear helmets, says Sann of Handicap International Belgium. In Vietnam, where enforcement is more stringent, popular and affordable helmets simply don't meet safety standards. Law, who consults governments on road safety, says the task of curtailing fatalities won't be easy; it requires more than simply tinkering with laws and street pavements. He says, "It takes a generation to change peoples' perceptions."