Sir,
Every day, one reads pr hears, tragic tales of road traffic accidents taking the toll of young and useful lives. Nearly ten times more are injured and some of them may be permanently disabled. Today, trauma is considered as a surgical epidemic. One of the common concepts amongst people is that the accident is an inevitable entity, beyond human control and could not be prevented. Recent studies have shed more light that if proper precautions, legislation and effective early transport and manage­ment to accidental victims was offered, quite a number of lines could be saved. This has now become a subject for research and enquiry. There is a chain of injury events and if properly tackled at each stage one could get reduction in both morbidity and mortality.
Opportunities for injury control could be sum­marized as:
Going through the statistical data of road traffic accidents of the city of Karachi over past 10 years one finds some definite risk factors which could be minimized: of the total cases, whereas in developed countries constitute less than 10%. Health education, safe pedestrian crossing especially around schools, hospi­tals or busy market areas would help.
b) Compulsory use of seat belts, helmets for motor cyclists could reduce fatal injuries and speed control.
c) Accidents occur more frequently at rush hours. Around 8.00 to 9.00 A.M. in the morning and 5.00 to 6.00 P.M. in the evening. Special arangements of flow of traffic avoiding slow vehicles like camel carts, etc., on busy roads or intersections and trucks carrying heavy loads should avoid these rush hours.
d) Early and immediate transport of injured and passage to ambulances should be provided as the first hour is the Golden Hour to save the injured lives if given immediate care.
e) Legislation of R.T.A. to be registered as R.T.A. as in UK, rather than MLC to avoid delay in treatment and resuscitation could be given by most nearby hospitals (public and private) to save lives and doctor’s attendance at courts should not be compulsory.
Hospitals both private and public having facilities for care of injured should be designed and known to public. There can be many more suggestions but this needs now a serious study and research to prevent avoidable deaths and disabilities.

Ali Mohammad Ansari
Mehran Clinic, Sindhi Muslim Society, Karachi.

1. Road traffic accidents data by courtesy of Traffic Engineering Bureau; 1992.
2. World Development Report, 1993.