In this short piece, I highlight that road traffic accidents are a major public health problem in Bangladesh and argue the critical need to address this issue, and present an evidence-based approach to support my argument.

Every day thousands of families have to cope with the unexpected loss of a loved one as a result of a road traffic accident (RTA) worldwide. Over 1.2 million people are killed each year in RTAs (World Health Organisation [WHO], 2009). The Organisation for Economic and Corporate Development (OECD) defines a RTA as “an accident with occurred or originated on a way or street open to public traffic; resulted in one or more persons being killed or injured, and at least one moving vehicle was involved” (OECD, 2012). It has been estimated that without concerted global effort, road traffic injuries (RTIs) are predicted to escalate from the ninth leading cause of death in 2004 to the fifth by 2030 (WHO, 2009).

Alarmingly, 90% of road traffic deaths occur in low-income and middle-income countries, despite owning less than 50% of the worlds registered motor vehicles (WHO, 2009). According to the Global Burden of Disease Study 2010, road injury is the eleventh leading cause of disability-ability adjusted life years (DALYs) in South Asia (Murray, 2012).

Road traffic crashes occur on a daily basis in Bangladesh, and yet there are no planned medical emergency services in the country. According to the police reported road traffic accident database, there are at least 3,000 road traffic fatalities in Bangladesh each year, with direct costs of road traffic accidents estimated to be 76 million US dollars (Mashreky, 2010). However, the World Health Organisation (WHO) estimates the road traffic death rate to be 12.6 per 100,000 persons with around 20,038 fatalities per year (WHO, 2007).

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Guardian Angels in Rural India

Today it is not hard to find references in the media and elsewhere to individuals, groups and communities that are described as empowered. One place to observe achievement of women’s empowerment is in the semi-arid rural villages of Maharashtra in India. It was back in mid-January 2011, Asif the representative from Comprehensive Rural Health Project (CRHP) who was born in the CRHP Hospital, and Ismail the designated driver, picked me up from Pune. The 200km drive from Pune to Jamkhed was surprisingly a smooth ride. As we drove through sun-down I could see communities living in scanty homes, herding goats and cows, travelling by oxcart and growing sorghum (staple food).

It’s a sunny Thursday morning, and a stream of 50 high-spirited women draped in brightly coloured saree’s wearing red ‘bindis’ at the center of the forehead, carrying knapsacks make their way by bus, in rickshaws, on foot, or by hitching a ride to CRHP’s training centre in Jamkhed taluka (block level), in Ahmednagar district, Maharashtra State, India. At first glance these women seem like ordinary village women in their mid-thirties who sell fruit, vegetables and spices at the local bazaar (weekly market) or work assiduously on farmland, but they are remarkably different from their village peers. You realise this when they make eye contact with visitors like myself and greet with a sincere, ‘namaste’, when they talk in ‘marathi’ (Mother tongue) amongst themselves, and the confidence they exude while speaking in the weekly training sessions. These women, many of whom have been coming to CRHP for over two to three decades, are the respected village health workers (VHWs).

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