Sunday, July 2, 2017

5 reasons on why you should be scared of Indian highway accidents

Picture for illustration
On Monday the 26-Jun-2017, we were approaching an intersection on the 6 lane highway in my Honda and noticed a small crowd gathered near the median. There were few (mostly) men and women, about 10 of them, some were holding the median railing.  I noticed that they were looking at an old woman lying motionlessly on the road.   It appeared to be an accident.  With a slight shock and shiver, my body suddenly started reacting to that situation.  I was getting ready to stop my car at a safe place and preparing myself to respond.  I was getting impatient.

My wife and I went to Chennai to deliver a 2 days weekend workshop for runners and we were returning back home. We chose to drive down this time to Chennai and we left at 8.30 am and were on our way back to Bangalore.  The ride until that moment was filled with plenty of conversations between us. We spoke about our passionate journey with our fitness academy since December 2016, and also how the past 2 days had probably passed flawlessly engaging with the participants.  Probably for the first time, on such a long drive, we never played any music or even radio. We had so much to talk. I was suffering from a sore throat and was constantly sipping hot water from a flask. There was a moment of satisfaction in what we did in Chennai and the air inside the car was filled with a sense of accomplishment.

I was slightly stressed when I realized that my automatic was running low on fuel and the fuel gauge range indicator was reading 29 km to go. I was cursing myself for not refueling on time. Meera opened the Google Maps to locate a nearby fuel station. We were approaching a place called Barugur and I was a bit relieved to find a petrol bunk located on our way in about 9 km. By this time, I had already turned off the A/C and lowered the windows, cut down the speed and was driving on the left most lane to save some fuel.

I just crossed the crowd and looked in the rearview mirrors for vehicles behind me before stopping.  It was safe to stop the car and I quickly slammed the brakes.  While stopping I was constantly looking at the crowd and the motionless women lying on the road through the rearview mirror.  I brought the car to a complete stop, turned off the engine, turned on the hazard lights, grabbed my cell phone and asked Meera to wait inside the car, quickly opened the door and in the next wink of the moment and sprinted towards the crowd which was roughly 80 meters ahead of me.

While sprinting towards the crowd, I started to assess the situation.  The first thing that I noticed was that there was no one attending her.  She was left alone on the road. Secondly, there were two policemen in khakis, slightly away from her, one talking on the phone and another was waving hands to warn the approaching vehicles and directing them away from the crowd. During that time of the day on the 6 lane expressway, the traffic was very thin. I was hurriedly praying the God to keep the women alive and give her enough strength to hang in there.   As I was approaching her, I was able to understand the magnitude of the situation.  The lady was lying on her back, there was a pool of blood below and around her head, her eyes were looking up the sky and was fixated, there were rice grains strewn all around that spot and there was a torn yellow bag (probably the lady was carrying the rice in that).  The spot was looking very messy.

Exactly a year back on the same day, 2nd of July, with the help of my family and friends, I had launched the campaign "Be Safe! Be there to Save!" & #424242running.  The trigger to the campaign was an accident that I responded in April last year 2 days after I completed my first-aid and CPR training.  I've attended training on Basic Life Support multiple times a.k.a first-aid and CPR and have been a first responder in various accidents.  Thanks to my association with my friends from Alert-We-Care, an NGO based out of Chennai & Bangalore, the last one year I have been exposed to this subject in depth and this has become embedded part of my life now.
The "first responder" in me woke up and I wanted to put all that I've been learning and teaching about BLS (Basic Life Support) to the best use at this time.  The old women appeared to be in a bad shape. The first thing in a Basic Life Support procedure is to check for the scene safety.  She was already lying closer to the median and the accident scene was safe for me to attend to.  Unfortunately, there was no one in charge of that situation.  I quickly assumed the responsibility and requested few men to go and support the police to control the speeding vehicles.  I also asked if anyone had already called an ambulance and a man pointed to me and said one of the policemen has already done.  I heard a whisper from the crowd that the old women was already dead and how unfortunate she was.

It was a broad daylight and I bent towards the old women to check her carotid pulse, kept my two right-hand fingers on her soft and fragile neck.  I could feel my finger slowly plunging into her skin with an instant sense of relief.  I was able to feel her pulse in her neck.  Yes, she was alive!  But her eyes were fixated towards the sky and my attempts to tap her shoulder by calling "Amma! Amma!" to wake her up went in a vain.  I heard a sympathetic voice telling that she was probably dead.  She was not responding to my calls.  I immediately announced to the crowd that "She is alive! and needs help! and the next step was to control her bleeding".  I loudly asked the crowd to get me a strip of clean cloth. Since no one was immediately moving, I then got up and picked the yellow torn shopping bag and tried to tear it with my hands and then with the help of my teeth, it was really tough and I was not getting the right material to tie her up. 

My mind was hunting for reasons why was no one coming forward to help? I managed to make a long strip of cloth from the bag and I was bending down to tie her head.  Damn! it wasn't long enough to wrap her around her head!  I wanted some help from the crowd, I called for people to come and hold and lift her head but no one was moving there and help me with tying her head.   At this moment, I heard the blaring siren of an ambulance approaching us. 

I've been campaigning about road safety and conducting short workshops and sessions to highlight the importance of first-aid and CPR.  Even today, I distribute safety pledge cards to many.  Out of the 13000+ cards that I have already distributed since the launch of the campaign every single card has the simple safety pledge and the need for everyone to respond and help the accident victims.  It also has a line to call for an ambulance in case of an emergency.  
Safety pledge cards from SahayaLRTS
I was instantly relieved when I heard the ambulance siren.   I was hoping to get first-aid and felt that the women would be alright.  The ambulance came dashing towards us and stopped. As I was bending down I could hear one of the policeman's words "lift her lift her… let's take her to the hospital".   The ambulance had only the driver and after stopping the ambulance he opened the rear door and pulled down the stretcher.  I asked him to bring the first aid kit.  He had his own idea and said - "Sir! Let's take her, quick, quick… lift her, lift her…" in Tamil. 

The ambulance driver was nervous, rushing and was hurrying to take the old women to the hospital. I was shouting and telling everyone not to move her without arresting her bleeding and also stabilizing her neck.  I started losing control of that situation when 3-4 people including the police pushed me aside and wanted to lift her at once.  The first-aid procedure also teaches the proper techniques to lift and move a victim in a stretcher.  The stretcher was not folded and brought down to the road level to carefully roll the victim into it.  She was still bleeding and my attempts to tie her head was incomplete.  I was helplessly trying to hold her head and put her in the stretcher carefully with the hope to get the bleeding arrested before she was taken to the hospital.  I kept shouting “let's tie her head… let's arrest the bleeding” the police came close to me, tapped my shoulder and said “Thambi (brother)relax! she will be alright and you don't be the reason for any more delay!”.  I tried to complete the first-aid but within the next moment, the stretcher was dragged closer to the door.  The lady was lifted and kept on the stretcher, the stretcher was dragged inside the ambulance, the door was shut and the ambulance sped away from that place.   I was feeling the smell of iron in my hand and I knew that some blood was still dripping from her head.

There was no one else in the ambulance to support her or to hold her.  She already started making her lonely drive towards the hospital.  The ambulance siren was slowly fading away from that place.

I was completely frozen and standing there without knowing what further to do.  I was totally blank by the sequence of events happened within that short span of time.    I surely felt I had the control of the situation but within a wink of time, I lost it.  I started praying to the God to give the lady a lot of courage and hold on to her life till she reached the hospital.  

I felt like crying.

5 reasons on why you should be scared of Indian highway accidents

Yes, this was a total failure and I have the strongest reasons to believe so.  I've been under tremendous shock since that incident.  I'm really unable to understand why our emergency response system is so immature and incapable of dealing with accidents wholeheartedly.

This is probably a typical scene that keeps happening in the length and width of Indian highways.  Most of the victims are innocents and are helpless.  Golden Hour care is a joke and many such victims die on the road unattended or on their journey to the hospitals without the right care.

Why should you be scared about this?

1.  Crowded accident scene doesn't necessarily mean someone is getting the right support

From the initial sighting of the accident to me arriving at the spot, there was easily about 2-3 minutes and the police were nowhere near the victim. One of them was busy on the phone (assuming giving instructions to the ambulance driver) and the other was directing traffic

I learned that the lady was knocked down by a speeding bus and she was lying there for easily about 10 mins.  The ambulance was called, perfect.   It's completely understandable that the villagers and the onlookers did not know anything about first-aid, maybe they were scared of the legal system, feared the unknown's and the repercussions.  They had no clue to understand the victim's needs and they all appeared to be frozen.

2.  Ambulances? surely be worried about them - they may not have the paramedic team  in it or even the Basic Life Support equipments

This is the second such scene where I find the Ambulances are just any other vehicle but comes with a siren, nicely painted as ambulances, driven by just drivers, unfortunately not carrying any paramedics or the right first-aid equipment in it.  The presence of an ambulance doesn't necessarily increase the survival rate of an accident victim.

Its a shame to know that the NHAI ambulance did not even have the first aid kit or skillful paramedics.

3.  Do not expect the police or ambulance drivers to know Basic Life Support

It is understandable that the villagers and the bystanders were not knowledgeable enough and also were worried about the system, let's excuse them.  But, I'm not able to accept that the two policemen present in the scene were doing nothing to provide the old women the required first-aid.  

What can the police department learn from this experience and ensure that in the future no one is left to die on the road in the presence of a policeman?

Secondly, I suspect that the ambulance drivers only have their jobs cut out to rush and pick up something (dead bodies) or to rush someone (still hanging on to their life) to the nearest hospital.  I have my greatest respects for what they do especially inside the crowded city streets.  

Do they really even know the first-aid terms and are capable of stabilizing the victims before they are shifted to the hospitals for getting the victims Advanced Life Support?

4.  Lack of accountability

Who is monitoring the ambulance movements? 
Who is checking in what conditions the victims are brought to the hospitals? 
Who is providing the leadership and guidance to the ambulance drivers?  
Why there are no trained paramedics in an NHAI ambulance?  
Who's neck should be on the line of fire for having such a broken up system?

Final thoughts,

For the first time, I'm feeling totally exhausted and extremely scared to be part of such a system in India. 

My views towards the ambulances and the way the emergency response is being dealt are changing from bad to worse.  I was delighted with the way the modern day 108 services were launched and made to work efficiently replacing the olden-day-unconnected and poorly-equipped-ambulances.  I was witness to a similar experience of finding a poorly equipped ambulance when I responded to a road accident in October inside the Bangalore city and this is just not getting better.

On Monday morning, I saw the emergency response system was collapsing in front of my eyes. I was part of it and even I failed to execute my role as a first-responder.  I was not able to lead and provide directions to the highly immature driver, the policemen and the crowd (who thought she was already dead) who all believed that rushing her to the hospital was the only best thing to do even without completing the first-aid procedures.

Since Monday, whenever I close my eyes, the accident scene just flashes in front of me; the old women's helpless face, her fragile body, the pool of blood on the road, the scattered rice on the road, the feeling of her pulse in the tips of my fingers, and the dripping blood from her head when I was holding her, the chaos, the siren of the ambulance and the leaving the scene.  These memories will be haunting me for a long time.

I only wish I had the courage to do something different and better on that day.

I wish and pray all the first-responders get to complete their job and be assured that the system is there to strengthen their good intentions.

I wish and pray that the old women is still alive to see her family members, son, grandson or her caretakers.

I wish and pray there are no more accidents.

God! please save that lady!

God save all the victims in this country!

I wish every single reader of this blog takes effort in getting trained on Basic Life Support skills (First-Aid and CPR training)

Be Safe! Be there to Save!

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