November 23, 2017

The Golden Hour – The Typical Public Response – and Why ?

 Continued 

  1. An accident occurs; a person is injured (see timeline illustration in Topic 6 supra); a crowd gathers. What is the ‘typical’ response – and why?
  1. A typical response on seeing an accident is more often, not one of ‘I couldn’t care’, but:

Dil to karta hai ki isko apni gadi main hospital le jaun, lekin agar maine ye kiya to main khud hi fas jaunga.

(I do want to take him to hospital in my vehicle, but if I do so, I will be hauled up for the accident or even summoned as a witness a number of times.) The result is that the victim bleeds to death.

  1. The problem being acute and widespread, a root cause analysis showed that apart from lack of adequate systems by the Government, there was ‘reluctance’ by the public to come forward and help. There are several reasons for this.
  1. First, there is general lack of awareness of the importance of the Golden H Second, there is lack of awareness of what to do in such cases. Third, more importantly, the public perception of police behaviour and court involvement is negative. So much so that in majority of the cases, it overrides the human instinct to help by taking the victim to the hospital. Such stance is not out of diminishing humanity in us, but the problems that one has to then face.
  1. Whether it is arranging for immediate removal to a hospital or informing the family, we have to look at it from the viewpoint of the victim and minimise all factors – every factor – that works against his immediate removal to a hospital with public help.
  1. Surely, an injured victim on the road would want to be taken to a hospital at the earliest. He may be saying to himself:

I would prefer that the man who injured me takes me to the hospital, and takes care of me till my family arrives, rather than letting me die; for the former means more to me than punishment for the one who injured me.

Knowledge, of at least those in the crowd that gathers, should include:

How to interact at an accident scene ? What are the emergency numbers to be called ? How to provide first aid ? Their perception about whether ambulances would arrive on time also influences the quality of the interactions.

  1. At accident sites, the police on arrival, at times, is more concerned with taking statements. Though that is also important for insurance and legal purposes, it should not be done at the cost of the victim’s life. This task wastes precious time and delays the transportation of the victim to the hospital. Also, there are insufficient ambulance services and this further results in delayed transportation.
  1. Law, as also argued for in Chapter 10 of JC&D, has to strike a balance. The letting go of a few ‘wrongdoers’ who have the conscience to help, i.e., those who transport their victims to the hospital and save their lives, is a lesser evil than to allow the victim to bleed to death for want of assistance by someone from those in the crowd that gathers.
  1. To correct the public perception, and draw upon the cooperation of, and help from, the public, there needs to be a concerted effort through print and electronic media. It is imperative that the Government carry out public awareness programmes aimed at meeting such eventualities.
  1. The instances where lives were saved through active and timely help rendered by the public should be highlighted in the media. These persons should also be given commendation certificates and cash awards as incentives in well-attended seminars, rather than put to harassment.2 Unless we correct the public perception, we will continue to deny justice to those who could have been removed immediately to a hospital with public help.
  1. It may be noted here that the assistance of the public is required mainly to: (1) inform the emergency services and the family; and (2) help remove / transport the victim to a hospital at the earliest where the medical system can take over.
  1. Much of what needs to be done here is part of administrative reform in respect of emergency response services, removal to trauma centre, information to the family, adequate attention at the trauma centre, reference in case of need for advice to a Central Medical Research Institute, some insurance payment forthwith, and so on.
  • The author has had actual experience over the years, particularly between 1990 to 2000, of transporting in his car, dozens of victims to the hospital where he has been subjected to undesirable treatment, which, but for his position, would have meant being held up till the evening.
  1. The Supreme Court directives (next sub-topic) have been a welcome step. In 1994, Section 134 of the Motor Vehicles Act, 1988 was amended, but (now) it needs recasting. The psychology of the typical public response must be analysed and appropriate solutions – to care for the victim – found.

….to be continued. Next topic “The Supreme Court steps in”.