Thousands of lives are lost prematurely on the roads in Bangladesh every year. Some die when the crashes take place but many others in the critical hours when they are rushed to Dhaka, hoping to get specialised emergency care in time. Sadly, they often fail to make it before the tragedy strikes.
The highway and road network in the country has expanded rapidly over the past decades. With the expansion of infrastructure, road accidents have been rising steadily. The speed of the vehicles, volume of traffic, a lack of enforcement of traffic law and poor driving skills have virtually turned highways and roads into valley of death. While the infrastructure has been expanding, emergency medical care has not kept pace with the growth of infrastructure.
In a country of over 170 million people and long distances between cities and towns, the infrastructure for providing emergency care for victims of road accidents is woefully inadequate. At the moment, the facilities for providing specialised care for crash victims are located mainly in Dhaka city, particularly at the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) and Dhaka Medical College Hospital. The "golden hour" for providing emergency care for victims of road accidents to save lives and prevent disability is lost as patients are transported over vast distances through congested roadways.
This gap between road expansion and trauma preparedness was recognised two decades ago. Towards the end of its 2001-2006 tenure, the government led by the Bangladesh Nationalist Party took the plan to set up trauma centers in different parts of the country. The plan was simple and strategic in nature. The plan involved the construction of trauma centers in strategic locations such as major highways so that in the event of accidents, the victims are able to get immediate medical care at the accident site. If the patient needs to undergo any major surgery or be taken care of in any other way, they could be taken to the capital in a stable condition.
Under that plan, at least 21 trauma centres were constructed in 17 strategically important districts. The locations were chosen based on their proximity to busy and accident-prone roads and highways.
Years after the construction, most of these centres, however, have remained either inoperative or partially operative. Most of the ones partially operative lack trained personnel, equipment and administrative integration with the health system. Without these, the buildings themselves cannot save lives.
The lack of political will of the subsequent governments in making these centres operational is the major reason for the centres falling into disuse. And the human toll is quite high. Road accidents in Bangladesh claim several thousands of lives every year and leave many more permanently disabled. Road accidents, apart from the grief they cause, also have serious economic implications. Many victims are breadwinners in their prime working years. Their deaths or disabilities plunge families into poverty, disrupt children's education and put long-term healthcare burdens. For a developing economy like Bangladesh, such losses are not merely personal tragedies; they are national setbacks.
Now with the BNP assuming office after 16 years, chances have come again for the trauma centres to be fully operational and contribute to a decline in road fatalities. International experience suggests that if a well-equipped trauma management system is developed with emergency response teams, paramedics and referral facilities, it can significantly increase survival rates of crash victims.
We do not have to start from scratch. The physical infrastructure is already in place. If the existing centres are revived and adequately staffed, they could provide the foundation for a national trauma management network. What is needed now is enough political will, investment, and administrative commitment.
The loss of life of a crash victim on the road is a tragedy, but the death due to delayed treatment is a failure of the system. Bangladesh has an opportunity and a duty to ensure that the promise of its trauma centers is not left in abandoned buildings along its highways. Proper and urgent action taken today could mean countless lives saved tomorrow.
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