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Head Injury in Vietnam

Summary: Head injury in a developing country.

A Developing Country Struggles to
Cope with Head Injury in Traffic

Subject: VI:Traffic casualties in VN rise 300% each year

From: Vietnam Insight - vinsight@netcom.com

Date: Tue, 19 Aug 1997 16:08:41 -0700

The Vietnam Business Journal
August 1997

A Lesson in Driving

Like most cities, Hanoi has its tourist attractions, but to locate the pulse of the people and indeed the culture, one need only walk its streets.


Any of the meandering alleys or tree-lined avenues will be choked with vendors selling prickly, blood-red dragonfruit, pulpy mangoes or flopping, live fish from twin baskets. Flowers are sold from bicycles. Another sight is the cyclo driver pedaling a load of 20-foot copper pipes. At 3 p.m. chattering schoolgirls wash into the streets, five across on bicycles. In the early evening, after the rain, good-looking teenagers court continuously from their motorbikes, as they lap around Ho Chi Minh Park or Lenin Park.

Unfortunately, this placid imagery is also the scenery of death.

"The damage caused by traffic accidents stands just behind that caused by the war," said Colonel Tran Dao, traffic director for the Hanoi Police Department, at a recent seminar on the dramatic rise in traffic fatalities. According to Dao, in the last seven years moving traffic in Vietnam has accounted for 30,000 deaths and 94,000 injuries. In the first five months of this year alone, 2,463 people were killed and 9,182 injured. Each year the number of casualties increases by about 300%.

Yet presently Hanoi's density of vehicles is among the lowest in the world, as is the country's in general. These days are probably the twilight of a time virtually without traffic jams, where one could imagine that if most people drove according to basic principles, the feeling of this city of three million could be that of a village.

Instead, as the colonel implied, it often resembles a war zone. Motorbikes share the roads with seven other common types of road traffic, including oxen and pedestrians, who cannot be accommodated by narrow sidewalks separated from the streets by a system of open sewers. But the problem becomes crystal clear to any driver at one definitive moment: the intersection.

When the subject of traffic arises in a room of non-Vietnamese living in Hanoi, as it inevitably does, there are otherwise intelligent participants who offer, "The Vietnamese have an innate sense of traffic. They don't actually turn their head to look both ways, but the flow, if you watch carefully, is not unlike a graceful dance."

This reporter watched carefully the intersection of Hang Gai and Hang Hom, located in the city's old quarter, as bicycles and motorbikes continually collided with each other before continuing.

It wasn't dancing.

A complete lack of yield signs or lights, in combination with behavior that is contrary to traffic order, helps explain those sad statistics. Driving habits that are consistent, include making a left-hand turn from the right side of the lane, weaving, speeding, using high beams in heavy traffic, entering traffic without looking first, passing on the left and driving on the wrong side of the road.

Recounted a Hanoi-based lawyer who drives a car, "Three other cars and mine arrived at a roundabout [cement traffic circle] at the same time and blocked each other. For ten minutes, nobody moved. I sat and read the paper."

Dao reports that of 60,000 road accidents, 85% were caused by "people's subjective sensibility," including 32% by speeding, 29% by improper turning and passing, and 11.3% by drunk drivers. Dao observes that "a lack of traffic discipline and the law-breaking in society increases day by day."

The Law on Traffic Order passed by the Prime Minister in 1995 was meant to provide a solution, but one problem could be that few people seem to know its content, as the box on page 28 illustrates. Possible exceptions are those in the country who voluntarily purchased it from a government bookstore for $1.50 (1996 per capita yearly income: $300). Driving classes and comprehensive driving exams have yet to be introduced. Nonetheless, there are over 500,000 motorbikes and 60,000 cars on Hanoi's roads, and more than double that in Ho Chi Minh City.

Dao suggests that the mass media should take over and traffic law should become a subject in high schools, as is common in other countries. He noted that people should wear helmets, as most traffic fatalities are caused by "death from a broken skull." Dao also recommended that cement road curbs should be replaced with curbs coated with a soft material. But only by strict development and enforcement of traffic rules, he concluded, can the roadways become safer.

Of course, terrible driving does not alone explain the perils of the road.

The country's old, narrow streets were not designed for today's population, and sometimes other infrastructure failings pop up. In June drivers in Hanoi's Dong Da district were met with an oncoming manhole cover, which capped a column of mud and smoke expelled by a sewer main break.

Offers of help have come from several foreign corners. In preparation for the November "Francophone Summit," the French government funded a French firm's installation of 35 traffic lights and a traffic command center for the local police in Hanoi. The World Bank also proposed a $10 million traffic improvement project that would reorder traffic in Hanoi and HCMC. Although approved by the Ministry of Transportation a year ago, it has since been sent to the Prime Minister's Office, where it awaits his final approval. In the meantime, the picture gets worse.

So what kind of person owns a car in Vietnam? There are several immediate qualifications. First, you must have a chauffeur, preferably one who can handle the traffic and, of course, stand beside the car while you attend to your appointments. And while you sleep, unless your villa or apartment building happens to include a driveway. According to the Hanoi Peoples' Committee, the parking system today meets 0.12% of the city's demand, at 52,000 square meters. By 2000, they estimate, the city will require 1.5 million square meters of parking space.

Edgar Chiongbian, director of BMW's operations in Vietnam, theorizes that this matter should be taken up by Vietnamese architects and urban planners. "Leave room for a car park!" he said. "At least in the neighborhood! Overnight, you'd have a scenario where you could park your car and go home." Almost no Vietnamese houses have garages.

Some automakers suggest that more cars means fewer accidents. Cars, the argument goes, displace other more dangerous forms of transportation like bicycles and motorcycles. And you don't need a helmet to keep your skull intact. Yet a spin on city streets challenges those arguments, at least for the short term.

One executive, in Vietnam to market one of the world's most well-engineered luxury automobiles, owns one himself but doesn't dare drive it on the streets of Hanoi. "Can't do anything with it here," he laments.

Email: vinsight@netcom.com
URL: http://www.vinsight.org/

Update: November, 2000

The New York Times and the Washington Post have both published stories about Grieg Kraft, an American living in Vietnam who is promoting the use of motorcycle helmets there. Kraft has developed a well-ventilated design for a motor scooter helmet and they will be manufactured locally by the non-profit Asia Injury Prevention Foundation.

Kraft notes for the reporters that fewer than 3 per cent of Vietnamese motor cycle or motor scooter riders use helmets. On an average day 25 riders are killed and over 50 others suffer brain damage or other permanent disabilities there, although the country has only 8,500 miles of paved roads. Their injuries absorb more than 75 per cent of urban hospital budgets, necessitating the use of the old wartime triage system.

US Ambassador Pete Peterson has also gotten into injury prevention issues, and has been urging the Government of Vietnam to take measures to reduce motorcycle and motor bike injuries.

Reported reasons for resistance to helmet use include the cost and fashion issues, plus the heat buildup of non-ventilated helmets in Vietnam's climate. Kraft's non-profit will produce lightweight, ventilated helmets for under $10. He hopes to produce two million helmets per year, and has donations from Ford, American International Group and American President Lines for $750,000 of the $5 million capital he needs.

Nguyen Manh Hung, the vice chairman of the Road Transport Administration of Vietnam, was quoted as saying that reducing traffic-related fatalities was a leading priority of the government this year. A law now requires motorcycle riders to wear helmets on a few highways around the major cities, and will be expanded to most city streets in 2001.

And the good news: December 2007

Subject: Letter to Worldwide Partners- Vietnam Helmet Wearing Milestone / A Christmas Gift
Date: Fri, 21 Dec 2007 14:00:46 +0700
From: Greig Craft - greig.craft@aipf-vietnam.org

Dear friends, family and supporters:

December 15, 2007 marked an historic day for Vietnam and for road safety initiatives worldwide. Last Saturday, the enactment date of the country's mandatory helmet law, nearly 100% of Vietnam's motorbike users left home wearing a helmet.

It was an unbelievable sight with a near instantaneous effect. Major hospitals report the number of patients admitted for traumatic brain injuries in the two days after the law's enactment was much lower than on previous weekends. In Ho Chi Minh City alone, serious traffic accident injuries fell by almost 50 percent compared with pre-helmet weekends.

This incredible success comes on the heels of nine years of dedicated lobbying and program work by the Asia Injury Prevention Foundation (AIPF). Since 1999, we have worked hard to bring about this new law and, at the same time, cultivate an environment of traffic safety awareness and helmet acceptance in Vietnam and other Southeast Asian countries. These efforts have included a broad spectrum of programs:

This multi-faceted approach to the development of effective road safety initiatives and laws offers many lessons and examples for developing countries throughout world. The cooperation and support we have received from a vast spectrum of nonprofit, profit, government, and NGO organizations has been invaluable to these efforts, especially Atlantic Philanthropies, WHO, FIA Foundation, GRSP/GRSi and the UNRSC; and more recently, the Royal Danish Embassy Hanoi, the US Embassy Hanoi, AusAid, ADB, WB, Intel Vietnam and Michelin SEA. Many, many others have also contributed--too many to acknowledge here, but thank you all. Share with us the joy of knowing that tens of thousands of mainly young people will now survive crashes because of our collective efforts. What better Christmas gift than this?

Even with this momentous accomplishment, however, our work is far from finished. The experience of other countries shows that compliance rates for helmet laws can drop dramatically in ensuing months and years. Drops in 24/7 compliance have already emerged as an issue, with the vast majority of violations occurring in the evenings. Most post-December 15 brain injuries have been among riders who did not wear helmets; wore them incorrectly; or were wearing poor-quality helmets. With this in mind, AIPF's and other organizations' work is more important than ever. It is imperative that we not be lulled into a false sense of security

Although constant and proper motorbike helmet use is important, we must not forget other critical areas in the development of Vietnam's road safety. Anti-drink driving, anti-speeding, and pro-seat belt initiatives, expanded traffic safety education programs, and even efforts for a nationwide bicycle helmet law are all on the horizon.

The recent dramatic success of Vietnam's new motorbike helmet law has been nothing short of miraculous. Because of our collective efforts, traffic safety is one of the most visible issues in the country today. We cannot let this momentous opportunity slip away. With your continued support, we will work for a safer and more prosperous Vietnam and strive to export this model to other motorizing nations in the region.

Yours sincerely,

Greig Craft

PS: Please check our latest ads and summary results (pre Dec 15) at the following youtube sites:

English version of teaser

Vietnamese version of teaser

Ogilvy documentary

Greig Craft
Asia Injury Prevention Foundation
12B Ngoc Khanh Street
Hanoi, Vietnam
Tel: (84-4) 771 0700
Fax: (84-4) 771 0701
Email: greig.craft@aipf-vietnam.org
Backup email: inhanoi@gmail.com
Website: www.asiainjury.org; www.protechelmets.com.vn