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A doctor seeks a life-saving law

G. Ananthakrishnan

The growing number of patients with head injuries sustained in two-wheeler accidents makes it imperative for all States to make wearing of crash helmets compulsory.

INDEFTAGABLE CAMPAIGNER: Neurosurgeon Dr. K Ganapathy.

Over five million new two-wheelers added to the roads in a single year, a mere 850 qualified neurosurgeons for the entire country and a complete disregard for the crash helmet. This combination of factors is leaving a trail of dead or severely crippled accident victims in all States.

It is a frightening reality, one that should prompt all States to enforce a provision in the Motor Vehicles Act that makes wearing of helmets compulsory. Yet few State Governments have displayed such forward-looking resolve. For K. Ganapathy, a Chennai-based neurosurgeon and president-elect of the Neurological Society of India and Secretary-General of the Asian Australasian Society of Neurological Surgery and an ardent campaigner for compulsory wearing of helmets by riders as well as those on the pillion, the crisis is growing.

Missionary zeal

With missionary zeal and palpable impatience at Governments that do not enforce the helmet rule, he asserts that two-wheeler riders involved in an accident away from most major cities simply have no opportunity to get proper treatment, because a neurosurgeon may not be available. Even if a qualified surgeon is at hand, only a helmet could reduce the possibility of irreversible head injury.

The need today, he says, is not just to build sophisticated hospitals and buy helicopter ambulances, but to compel people to wear a helmet, "the cheapest, cost-effective means available to reduce the severity of injuries likely to be sustained in a two-wheeler mishap." None of the arguments against the helmet, be it officials apprehending negative public opinion, or riders fearing headache, hair loss and loss of hearing, has any scientific evidence to support them, he asserts.

There is a "massacre on the roads" involving all manner of vehicles that takes toll, on an average, of 250 people everyday. Such carnage — equivalent to a plane crash a day — does not appear to stir policymakers and the media, he laments. India has at least five million people living with some form of head injury sustained in two-wheeler accidents.

"I have been involved in the management of head injuries in Chennai for 29 years. In those years, on an average I would have seen at least 7,500 to 8,000 head injuries. Ninety per cent of these are related to accidents. I can recall only three patients who were wearing a helmet and yet died of head injuries," says the neurosurgeon who is attached to two hospitals in Chennai.

Dr. Ganapathy, who lost two of his brothers in two-wheeler accidents, is an indefatigable campaigner, ever ready to explain the benefits of scientifically designed helmets that are worn properly. "There is enough scientific evidence published around the world to show that giving additional protection to the skull reduces the severity of the brain injury. I want to emphasise that by wearing a helmet, we are not going to prevent head injuries. We can, however, reduce the incidence of severe head injuries."

In his view, few people who ride motorcycles, scooters and mopeds realise the impact of an accident. Dr. Ganapathy explains: "Let us say I am moving on a vehicle. I am suddenly stopped by something when I am travelling at 20 kmph or so, which can in some cases generate the force equivalent to being hit by a 50 tonne truck. When you hit against something, your body stops. But every part of your body does not stop. The skin over the skull moves at a certain speed, the grey matter and white matter and the blood vessels in the brain all move at different speeds. That is why rupture occurs. Small blood vessels rupture and damage the brain. The blood vessels under the skull tear and cause direct damage to the brain."

He adds ominously: "Brain cells once primarily damaged ... we do not have the technology to reverse the damage."

That knowledge prompted him, when he was secretary of the Neurological Society of India, to enter a plea in a petition filed in the Madras High Court in 1999 by the Accident Victims Association and AASI (W. P. No.19587 of 1999) demanding that Section 129 of the Motor Vehicles Act be implemented in Tamil Nadu. The petition is pending in court and awaiting further hearings.

`Involve civil society'

While a legal solution may still not be at hand, it is possible to make a qualitative difference by involving civil society, starting with the organised sector to compel riders to wear helmets, he says. Citing the example of the Apollo Hospitals to which he is attached, Dr. Ganapathy recommends that managements allow entry to two-wheelers of staff only if they wear a helmet. "This is a good model for all companies, not just hospitals."

The members of corporate India who are part of such flagship associations as the Confederation of Indian Industry (CII) and the Federation of Indian Chambers of Commerce and Industry (FICCI) should adopt such a safety code. Chartered accountants, police, engineers and advocates can all lead by example, he says, admiring the way the armed forces enforce the helmet rule for their members. No two-wheeler should be registered by the RTO if its owner does not present himself with a helmet, he says.

Finally, there is no economic statistic or study that can express the agony of a family that has lost a kin in an accident, Dr. Ganapathy says, recalling the anguished cry of the father of a victim. "There ought to be a law that parents must die first. When I was lighting the funeral pyre of my son I thought, should it not have been him lighting mine instead," the father had said. With a compulsory helmet rule there would be fewer such cries. But will Governments act, he wonders.

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