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An introduction to post-crash response

Wed 27, Jan, 2021

I want to start by introducing myself; I am Claire, I am the Post-Crash Response and Resilience Officer for UK based charities; the Eastern Alliance for Safe and Sustainable Transport (EASST) and the Coordinator for FIRE AID and International Development.

I started working for EASST 3 years ago; although I have extensive experience working in the charity sector and managing projects I had not worked in road safety before. Immediately I was horrified by the statistics, 1.35 million people die on the world’s roads every year. Road traffic injuries are the leading cause of death for children and young adults between 5-29 years of age but yet road traffic incidents are often brushed aside as an unpreventable accident. However, in the road safety community it is well known that these deaths are preventable, improving post-crash care is just one of many ways these harrowing statistics can be reduced. The full tragedy and importance of improving road safety was summarised for me on the World Health Organisations website:

I have always worked in an area where data is readily available so when I started my research into post-crash response, in particular immediate post-crash response (the emergency services) I was surprised that globally very little data is available showing the importance of immediate post-crash care. Every 10 minutes of delay in extracting a severely injured person from a crashed vehicle reduces survival chances by 10%, so why isn’t post-crash a priority for campaigners, funders and governments?

In most high-income countries like the UK, data is recorded to assist in strategic planning and delivery of post-crash care. This data includes time taken to reach an incident, equipment used, time taken to reach hospital (if needed), number of people extricated using road traffic extrication procedures etc. although it is not readily available to the public, it is used internally to form strategic direction.

However, in many low and middle-income countries (LMICs), much of this data is not even recorded. Post-crash response efforts are under-resourced, underfunded and poorly coordinated. Improved post-crash response starts with the collection and evaluation of data, so that first responders can target priority locations, ensure adequate equipment and training, avoid duplication with other agencies, and learn from any mistakes. Without data, it is difficult to argue for improvements in funding and resourcing the emergency services when public finances are limited.

The challenges facing post-crash responders in LMICs came home to me during my first project visit overseas. In 2018 I visited Transnistria, an area of conflict officially part of the Republic of Moldova, but self-declared as an independent state. Working alongside FIRE AID’s international experts, I learnt that firefighters are often first at the scene of a crash and that it is their responsibility to extract and stabilise the casualty. I witnessed firsthand a lack of coordination between services (including ambulance and police), modern equipment and training. Firefighters had no access to road traffic extrication gear, and were often required to pull casualties out of vehicles using hammers and crowbars. The firefighters themselves had no personal protective equipment (PPE), meaning they risked their own safety whilst responding to incidents. Old and damaged vehicles (some over 30 years old) elongated their response times and therefore the chances of saving the causality.

This is just one example; I have since seen the same issues across most of the EASST partner countries – for example in Ukraine and Tajikistan. Whilst training rescue services in Ukraine on the value of good post-crash interagency protocols, one firefighter’s testimony had a lasting effect on me. He said:

The techniques shown are new to us but will undoubtedly be very useful. Just last week we attended an incident where a bus driver was trapped in his cab. Using this technique and having the benefit of this new equipment, we would likely have been able to save the drivers life.”

I haven’t been able to forget this statement. It continually motivates me to raise the profile of post-crash response and to advocate for well-coordinated, well-equipped and well-trained emergency services.

Through this blog I will share my experiences and learning in the area of post-crash response drawing upon real life examples from EASST and FIRE AID’s projects. In September 2020 the United Nations agreed a new UN Decade of Action on Road Safety 2021-2030. The UN Road Safety Collaboration Group (of which both EASST and FIRE AID are members) will be campaigning for actions to reduce road death and injury in every country by 50% over the next 10 years. As this new ‘decade of action for road safety’ starts right now, what better time for me to start on my quest to raise the profile of post-crash response and its role in saving lives. Watch this space!