In July 2015, veteran Bollywood star Hema Malini, now a politician, was involved in a car crash in Rajasthan. She was being driven at high speed in a Mercedes along a highway notorious for accidents. Her Merc crashed into an Indian-made Alto—a tiny box of a car—as the latter was turning into a road from the highway. The daughter of the Alto driver, a little child, died, and a massive row followed over what was perceived to be the star’s callous response to the highway death.
Immediately after the Rajasthan accident, Hema Malini, who sustained minor injuries, was rushed to a major hospital in the state capital, Jaipur. The two-year-old girl, on the other hand, was taken to the local hospital in Dausa, a small town, where she died. Her father said later that she may have survived had she, too, been taken to the Jaipur hospital.
Avoidable road deaths are far too common in India, where it is rare for anyone travelling in the back seat to strap on their seat belts, where there are no specific child safety rules and where it is not unusual for cars to make a diagonal turn—even a U-turn—on highways. It is a country where hospital standards vary massively.
Lastly, emergency services are often said to be shambolic and ill-equipped by those who have tried to access them. Some years ago, said a journalist in Delhi, a friend, suffered a road accident. As he lay visibly injured on the sidewalk, he saw police cars pass him by.
In large metropolitan centres such as Delhi, roads tend to be choked during rush hour, making it difficult for fire engines, police or ambulances to get to emergency spots. Until very recently, drivers rarely gave way to emergency service vehicles despite sirens. It is still not uncommon to see a police car on emergency duty, its sirens wailing, waiting patiently behind a long queue of cars—or, strangely, even at traffic signals. No one gives way.
There’s a confusing array of emergency services, each with its own telephone number—including 100 for police; 101 for fire; 102 for ambulance, 108 for disasters, 181, a helpline for crimes against women; 1097, an AIDS helpline; 1098, a child abuse hotline and a mobile number for air ambulance.
Now, the government has said that it will combine all of these services into one emergency phone number—112. It’s a year down the line—but the move comes not a day too late. According to a UN-Habitat report released this month, seven Indian cities count among 47 globally that have the highest proportion of people killed in road accidents. Chennai ranks second in the world with 26.6 people killed in road accidents for every 100,000 population, after Fortaleza in Brazil. The other Indian cities are Jaipur (fourth), Indore (16), Kolkata (23), Delhi (24), Bengaluru (25) and Mumbai (40). In overall terms, the volume of fatal road accidents is phenomenally high, even though the figures vary. The World Health Organization said last year that more than 200,000 people died in road accidents in India in 2014. This figure is 46% more than the 141,000 estimated by the National Crime Records Bureau (NCRB) in July.
And these are just deaths from road accidents. Health emergencies, caused in part by dietary habits, air pollution and sedentary lifestyles, are another major killer. Heart attacks and respiratory diseases are the two biggest killers in India, in rural as well as urban parts of the country. Yet, ambulance services are practically non-existent in many rural parts and crippled by traffic jams in cities.
In 2014, police dealt with nearly 3.1 million “distress calls received over phone/dial 100, etc.,” in the nation’s 29 states and seven Union territories, according to the home ministry. It’s a mind-boggling number and that’s just the police.
Then there’s rape—around 37,000 rapes took place in 2014, according to the home ministry. That’s 101 rapes a day, or over four every hour—an epidemic of sexual violence that grabbed the nation’s attention after the gang-rape and sexual torture of a young woman in a moving bus in 2012. The woman subsequently died in hospital, sparking nationwide protests.
One of the more concrete results from the protests was the launch of an emergency number, 181, for crimes against women. I spoke to a man, an engineer, who was deeply involved in its launch and now helps run the service. It falls under the ministry of women and child development but it is a decentralized service, whose operation is the responsibility of each state and Union territory.
According to the engineer cited above, one of the best services at the moment is being offered in the small state of Delhi, where the 181 helpline is the direct responsibility of the Delhi Commission for Women, a statutory body.
According to him, one problem with the 112 emergency line proposal is that it hasn’t really been thought through enough. “At the moment, the states are doing it themselves (with 100, 101, etc.,). The centre gives them money and technology, but if a state doesn’t do the job properly, there’s nothing you can do about it.” Under 181, some 12-18 people have been trained in each state to lead the operation, but in 112 “those people are not in place yet”.
Counter-intuitively, he thinks the problem lies in the over-centralized design of the 112 initiative. “There should be 36 centres in the 36 states and Union territories,” he said.
I have seen how emergency services work in some of the richest countries in the world. The world’s first emergency number, 999 in the UK, saved the life of a family member while the operator talked me through the crisis, calming me for those harrowing minutes it took the ambulance to reach my home.
There’s the whole issue of the infrastructure that is available, and the culture of care that needs to be inculcated—starting with the basic idea that every life, no matter how poor or rich, is a life worth saving.
Every year, on 26 January, India’s republic day, the nation honours bravehearts who save others’ lives. In many other countries, this notion of honouring the unsung men and women of the emergency services has been institutionalized. There, the equivalent of the Padma awards also go to nurses, doctors, ambulance drivers, police constables and firemen.
Dipankar’s Twitter handle is @Ddesarkar1