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Last Updated: Monday, 2 August, 2004, 06:34 GMT 07:34 UK
Indian doctor's road safety revolution
Bus crash in India near Sumbal village in July
India's roads can be lethal
Five years since being injured in car crash, an Indian doctor is celebrating the first successes in his campaign to revolutionise roadside medical treatment in the country.

Since 1999 Dr Subroto Das has already managed to establish a Highway Rescue Project in his home state of Gujarat that goes to accident victims and takes them to the nearest medical centre.

And he is now working to establish a network that will help road accident victims receive attention within 60 minutes - the so-called "golden hour" which is crucial to helping victims survive.

Dr Das told BBC World Service's Health Matters programme that unlike in Western Europe, where the impact of the accident kills nearly 50% of travellers on the spot, in India only 20% are killed outright.

"This means 80% can be saved if some sort of transportation is made available to them," he said.

Milk float rescue

Mr Das began his project when he and his wife were involved as passengers in a road traffic accident in 1999.

They lay injured at the side of the road for four hours until help arrived - in the form of a milk float.

Hospital treats victims of Indian bus crash
Mr Das plans to get accident victims to hospital quicker
"For four hours we tried to stop vehicles, with bleeding faces, damaged knees, a forearm very badly hurt," Dr Das recalled.

"It was finally a milkman who saw us. A brave man - we have no idea who he was - he put his vehicle across the road so the next bus had no option but to stop.

"This was one of the most important highways in India - it connects Delhi to Mumbai - and for four hours there had been absolutely no way to get in contact with anybody."

Later, as they recovered, they realised they had been lucky to survive - and decided to help others involved in accidents on India's notoriously dangerous roads.

Partly because India is such a vast country and partly because it is very economically poor, there is no national helpline number such as 999 or 911.

As a result, people involved in accidents are often left for dead and emergency services are rarely sent for by anyone.

Even if a call is made, ambulances are often not geared up to respond quickly and adequately.

"Infrastructure-related" schemes have been tried, but quickly collapsed because they were too costly or ill-thought out.

Dr Das said that, for example, Traffic Aid Posts established every 100 km on the highway in Gujarat were not working - partly because the medical staff posted there had little motivation, and partly because when they did respond to an accident they had to work at the side of the road and not in a specialised treatment centre.

But this is changing.

'No driving sense'

Dr Das explained that the first step was to ensure that distress calls go to the nearest hospital and ambulance able to respond.

"We started upgrading the existing providers - hospitals, ambulances, trauma centres," he said.

"We started networking them, we started pooling in all the resources that were already developed."

As well as responding in the "golden hour," Dr Das has also pioneered a universal access emergency phone number, efficient transportation and communication, upgrading of emergency departments in hospitals, and training of doctors and paramedics.

He also said the attitude of most Indians to an accident blackspot would be to simply put up a sign, but that he wanted to do something practical and sustainable to save lives.

"Indian roads are getting better and better, and so are the cars and the vehicles, unfortunately there's no driving sense," he said.

Meanwhile he also highlighted a widespread fear amongst people of reporting accidents, as they are afraid of police harassment. Dr Das said this had resulted in a "general apathy" towards victims.

And he criticised films and television for portraying a negative image of the consequences of helping.

He said they reinforced an image from before1989, which was when a landmark court ruling ordered that hospitals must, by law, help accident victims.

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