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Cambodia Road Traffic Accident and Victim Information System

Annual Report 2005

HIB - Jean Van Wetter

Developed by:

Ministry of Interior

Ministry of Health

Ministry of Public Works and Transport

Handicap International Belgium

Notice: This report may be freely reviewed, abstracted, reproduced or translated in part or in whole, but not for the purposes of sale.

Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Table of Content
List of Figures ....................................................................................................................................................... 3 Foreword ............................................................................................................................................................... 5 Foreword ............................................................................................................................................................... 5 Note from the Minister of Public Works and Transport ...................................................................................... 5 Note from the Minister of Health ........................................................................................................................ 6 Note from the Ministry of Interior........................................................................................................................ 7 Note from Handicap International Belgium ........................................................................................................ 8 I. Introduction........................................................................................................................................................ 9 II. Executive Summary ....................................................................................................................................... 10 Introduction....................................................................................................................................................... 10 Key figures ....................................................................................................................................................... 11 Differences between Phnom Penh and provinces ........................................................................................... 15 III. System coverage ........................................................................................................................................... 16 Data sources .................................................................................................................................................... 16 Geographic coverage ....................................................................................................................................... 18 IV. Evolution of data ........................................................................................................................................... 19 V. 2005 data analysis.......................................................................................................................................... 21 Introduction....................................................................................................................................................... 21 Victim Information............................................................................................................................................. 22 Age............................................................................................................................................................... 22 Gender ......................................................................................................................................................... 24 Type of road user......................................................................................................................................... 25 Occupation ................................................................................................................................................... 28 Residence of casualty.................................................................................................................................. 28 Severity of injuries and hospital discharge .................................................................................................. 29 Nature of injuries.......................................................................................................................................... 30 Cost of treatment ......................................................................................................................................... 31 Driving license.............................................................................................................................................. 31 Accident Information......................................................................................................................................... 32 Day and time of accident ............................................................................................................................. 32 Time of accident........................................................................................................................................... 34 Causes of accident ...................................................................................................................................... 35 Human error............................................................................................................................................. 35 Weather conditions.................................................................................................................................. 36 Vehicle defect .......................................................................................................................................... 36 Road conditions ....................................................................................................................................... 36 Type of collision ........................................................................................................................................... 36 Cost of accident ........................................................................................................................................... 38 Location of accident ..................................................................................................................................... 38 Country level............................................................................................................................................ 38 Phnom Penh ............................................................................................................................................ 40 Siem Reap ............................................................................................................................................... 41 Kampong Cham....................................................................................................................................... 41 Type of road ................................................................................................................................................. 42 Road characteristics .................................................................................................................................... 43 Transfer to hospital ...................................................................................................................................... 44 Attendance of police .................................................................................................................................... 44 Appendix ............................................................................................................................................................. 45 Evolution of data during the year ..................................................................................................................... 45 Number of casualties reported at health facilities ............................................................................................ 47 Number of casualties reported at traffic police districts ................................................................................... 48 Data collection forms........................................................................................................................................ 50 Hospital data collection form........................................................................................................................ 50 Traffic police form ........................................................................................................................................ 51 Feedback form ................................................................................................................................................. 53 Contacts .............................................................................................................................................................. 54

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

List of Figures
Figure 1: Main road safety indicators - differences between Phnom Penh and provinces .................................. 15 Figure 2: RTAVIS data collection flow .................................................................................................................. 16 Figure 3: RTAVIS data sources, 2005.................................................................................................................. 16 Figure 4: Evolution of the number of casualties and health facilities data sources - January to December 2005 ..................................................................................................................................................................... 17 Figure 5: RTAVIS geographical coverage, December 2005 ................................................................................ 18 Figure 6: Evolution of road traffic accidents and casualties in Cambodia, 1995 2005 (base 100 = 1995) ....... 19 Figure 7: Road traffic casualties in Phnom Penh, 2005 compared to 2004 ......................................................... 19 Figure 8: Comparison of vehicle-ownership rates (motorized vehicles per 1,000 persons) most recent year available between 2003 and 2005 ............................................................................................................... 20 Figure 9: Comparison of paved road density (measured in km of paved roads per km2) ................................... 20 Figure 10: Traffic fatality rates calculated in comparison with the number of vehicles, the number of inhabitants and the length of the paved network most recent year available between 2003 and 2005 ... 21 Figure 11: Number of road traffic fatalities per 10 kms of paved roads Comparisons between selected countries most recent data available between 2003 and 2005 ................................................................ 21 Figure 12: Percentage of casualties and fatalities by age category - 2005.......................................................... 22 Figure 13: Number of casualties per 100,000 inhabitants for different age categories - 2005 ............................ 22 Figure 14: Age pyramid of casualties Phnom Penh versus the rest of the country - 2005 ............................... 23 Figure 15: Percentage of fatalities by age category in different regions of the world .......................................... 23 - 2002 for the world and SEA figures, 2005 for Cambodia................................................................................... 23 Figure 16: Number of casualties per 100,000 inhabitants by gender - 2005 ....................................................... 24 Figure 17: Percentage of casualties by gender for different age categories 2005............................................ 24 Figure 18: Percentage of casualties by type of transport - 2005.......................................................................... 25 Figure 19: Comparison of percentages of fatalities by type of transport - most recent year available between 2003 and 2005 ............................................................................................................................................. 25 Figure 20: Percentage of casualties by type of transport Phnom Penh versus the rest of the country 2005 26 Figure 21: Percentage of casualties by type of transport for different age categories 2005............................. 26 Figure 22: Proportion of vehicles versus proportion of casualties involved in accident - 2005............................ 27 Figure 23: Percentage of casualties by occupation - 2005 .................................................................................. 28 Figure 24: Percentage of casualties by severity of injury - 2005.......................................................................... 29 Figure 25: Hospital discharge - 2005.................................................................................................................... 29 Figure 26: Percentage of casualties and fatalities per type of transport - 2005................................................... 30 Figure 27: Percentage of casualties by category of trauma comparison between Phnom Penh and provinces 2005 ............................................................................................................................................................. 31 Figure 28: Percentage of car/truck/bus driver's casualties having a driving license 2005................................ 31 Figure 29: Number of casualties per day 2005 ................................................................................................. 32 Figure 30: Percentage of casualties differences between weekday and weekend 2005................................ 33 Figure 31: Percentage of casualties per day of the week 2005 ......................................................................... 33 Figure 32: Percentage of casualties differences between day and night 2005............................................... 34 Figure 33: Percentage of casualties per hour of the day 2005 .......................................................................... 34 Figure 34: Percentage of casualties by cause of accident General - 2005....................................................... 35 Figure 35: Percentage of casualties by cause of accident Focus on human errors 2005 ............................. 35 Figure 36: Percentage of casualties by cause of accident differences between age categories - 2005 .......... 36 Figure 37: Percentage of casualties by type of vehicle involved - 2005 .............................................................. 37 Figure 38: Percentage of accidents by type of collision - 2005............................................................................ 37 Figure 39: Percentage of vehicles involved in road traffic accident by type of vehicle manoeuvre - 2005.......... 38 Figure 40: Number of road traffic accidents per province, 2005 .......................................................................... 38 Figure 41: Number of road traffic fatalities by province 2005............................................................................ 39 Figure 42: Top ten Phnom Penh communes affected by road traffic casualties ............................................... 40 measured as number of casualties per inhabitant 2005..................................................................................... 40 Figure 43: Top ten Siem Reap communes affected by road traffic casualties .................................................. 41 measured as number of casualties per inhabitant 2005..................................................................................... 41 Figure 44: Top ten Kampong Cham communes affected by road traffic casualties ......................................... 41 measured as number of casualties per inhabitant 2005..................................................................................... 41 Figure 45: Percentage of casualties by type of road 2005................................................................................. 42 Figure 46: Number of fatalities per 100 million vehicles kilometers by national road 2005 ............................... 42 Page 3

Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Figure 47: Percentage of casualties by type of road design 2005 ..................................................................... 43 Figure 48: Percentage of casualties by type of transport to the hospital 2005 .................................................. 44 Figure 49: Duration to arrive at the hospital 2005 .............................................................................................. 44

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Foreword
Note from the Minister of Public Works and Transport

Today, road traffic accidents are a huge concern of the Cambodian Government, led by Samdach Hun Sen. Road traffic accidents have become the second largest killer after AIDS, causing fatalities, disabilities, injuries, damages and losses of public and private properties, moral distress to society and disrupt the government poverty reduction policy. Between 2000 and 2004 the number of road traffic accident increased by 15% each year, and on average there were 3 fatalities and 20 injuries every day. Particularly, in 2005, the number of road traffic accidents decreased by 7%, fatalities decreased by 13.25% and injuries increased by 1.34%. According to the Asian Development Bank in a 2003 report, the cost of road traffic accidents to Cambodia was estimated at 120 million dollars every year, which equals 3.21% of the GDP. Based on this observation, the Government has decided to establish the National Road Safety Committee aimed at coordinating resources and increasing cooperation, collaboration and facilitation between the Ministries and the related Institutions in order to prevent and reduce road traffic accidents to the lowest possible rate. At the same time, the national committee also drafted the road safety action plan, which consists of 15 action plans in order to achieve the goals. In fact, there are 4 causes of accidents: human error, road conditions, vehicle defect and nature of law and its enforcement. Human error is the main cause, which means if there is no participation from people, especially all drivers, the road safety action plan would not be effective. On this occasion, I would like to appeal to all people, especially drivers, to properly respect the traffic law and also maintain courtesy while driving in order to reduce accidents. Please be reminded that your family, parents, children, brothers and sisters are waiting for your safe return. Please do not let joy become sadness.

H.E. Sun Chann Thol Minister of Public Works and Transport Chairman of the National Road Safety Committee

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Note from the Minister of Health


Road traffic accidents and injuries have an enormous impact on the social and economic welfare of our country. They hinder development by killing and disabling the economically active population. In the absence of social security and insurance systems, the cost of prolonged medical care and long term rehabilitation, coupled with the loss of income due to disability or loss of a family "bread winner" can easily lead an affected household into poverty. . There is therefore an urgent need to tackle the road safety issue seriously. The Ministry of Health is proud to actively participate to the implementation of the National Road Safety Action Plan. In particular, I am delighted to collaborate with my colleagues at the Ministry of Public Works and Transport and at the Ministry of Interior, as well as at Handicap International Belgium, to develop RTAVIS, a unique data collection system on road traffic accidents and injuries. This is useful for our country. The Ministry is also keen to continue to collaborate with Handicap International Belgium and other partners to extend the current data collection system in hospitals and private clinics to cover other types of injuries and create a broader Injury Surveillance System. Injury in general is indeed an increasing health problem in our country and a good monitoring system does not exist yet. On top of the development of RTAVIS, the Ministry of Health also participate actively in awareness and education campaigns to promote helmet wearing and a safer behaviour on roads. Those campaigns have been so far very successful. In the coming years, the main challenge for the Ministry will be the improvement of the emergency assistance services and of pre-hospital and hospital trauma care. As this report will show, trauma care indeed plays an essential role in injury control. Finally, I would like to thank Handicap International Belgium and the World Health Organization for their support in preparing this report and emphasize again on the commitment of the Ministry of Health to reduce the burden of injuries in Cambodia.

HE Dr. Nuth Sokhom Minister of Health

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Note from the Ministry of Interior


Road traffic accidents increase every year in Cambodia and can be considered as a new humanitarian tragedy for the country. In 2005, 3 people were killed every day due to road traffic accidents, causing inestimable human and economic damages, refraining the poverty reduction process, the economic growth and peoples happiness. Police services have noticed that two main factors are responsible of traffic accidents: human error and vehicle defect. Today, a series of actions within transparent mechanisms are required to manage those issues: 1. Setting up the locomotive to lead the road safety actions with the creation of a National Road Safety Committee and related local committees (provinces and towns). These committees will make it possible for all competent institutions to issue a common policy and important guidelines and assign each competent officer for the implementation and the monitoring of the identified actions. Improving and strengthening the quality of road safety education at all levels of the population, focusing especially on people learning to drive, the vulnerable road users such as motorbike or bike drivers and the pedestrians. Having an effective and complete traffic law and strict enforcement mechanisms allowing to control the two factors that cause accidents: human error and vehicle defect. Studying and organizing the engineering of the road to improve safety. Studying and researching new modern technologies to control the traffic. If possible, we should absorb the good experiences from developed countries for the standard base to develop the traffic safety.

2. 3. 4. 5.

On top of the actions mentioned here below, there are many other tasks that need to be filled in to make the traffic accident demons disappear from the road and reduce the tragedy of people.

Traffic accident is not an incurable disease It is sure that the traffic accidents can be reduced and full safety be reached

National Police Directorate General Ministry of Interior

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Note from Handicap International Belgium


Handicap International Belgium (HIB) is very proud to have contributed to the achievement of this second Cambodia Road Traffic Accident and Victim Information System (RTAVIS) annual report. RTAVIS is a unique system to collect, centralize, analyze and disseminate data provided by public and private health facilities (hospitals, clinics, health centres) as well as by the traffic police in the whole country. As the number of road traffic accidents and casualties continues to increase dramatically in Cambodia, RTAVIS plays a crucial role in monitoring the current situation, evaluating existing prevention strategies and planning new actions. 2005 was a crucial year for the improvement of road safety in Cambodia: the creation of an inter-ministerial National Road Safety Committee will help strengthening the coordination of actions taken by stakeholders at all levels, while the approval of the first draft of the new land traffic law by the Council of Ministers reveals the preoccupation and commitment of the highest authorities of the state. This is promising for an issue that has too long been left unanswered. Yet, as the data and recommendations of this report will show, Cambodia is still at the beginning of its "motorization curve and many challenges are still ahead to make roads really safer. The coming years will be particularly critical with the progressive application of the new law and the active implementation of the National Road Safety Action Plan. This report could not have been possible without the cooperation of numerous people and institutions that have shown a keen interest in the improvement of road safety in Cambodia. Our particular thanks go to the Ministry of Public Works and Transport, the Ministry of Health and the Ministry of Interior which continued to share their experience and data, as well as to the Belgian Technical Cooperation and the World Health Organization, whose representatives in Cambodia and in headquarters have been very supportive. Sincere thanks are also due to the doctors and staffs of numerous hospitals, health centres, and private clinics as well as to all traffic police officers who devote time and enthusiasm to fill in the data collection forms every day. They are the key contributors in the success of the system. Special thanks as well are due to the Handicap International Belgium road safety team, and in particular to its new manager, Ms. Sann Socheata, and her colleagues, Mr. Meas Chandy, Mr. Sem Panhavuth, Ms. Ou Amra, Mr. Uy Math, Mr. Yorn Virak and Mr. Pea Kimvong, whose commitment and hard work made the publication of this report possible. Last, we are pleased to mention our generous donors, the Belgian and the French Cooperation as well as the World Health Organization, for their continuous support in this crucial issue. In the coming years, HIB hopes to continue to work with all those partners to further improve RTAVIS, while contributing to develop a broader Injury Surveillance System, including data on injuries due to road traffic, but also to various other causes, such as falls, domestic violence, and drowning. According to several recent studies, the multiplication of injuries is becoming an increasing public health issue and an effective monitoring system will help Cambodia to take proper action on due time.

Bruno Leclercq Country Director Handicap International Belgium

Jean Van Wetter Coordinator of Operations Handicap International Belgium

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

I. Introduction
The objective of the Road Traffic Accident and Victim Information System (RTAVIS) is to provide government and development stakeholders in Cambodia with accurate, continuous and comprehensive information on road traffic accidents and victims. It should allow them to better understand the current road safety situation, plan appropriate responses and evaluate impact of current and future initiatives. RTAVIS collects, centralizes, analyses and disseminates information provided by three different sources: - Public health facilities; - Private clinics; - Traffic police. The system has been progressively developed since March 2004 by the Ministry of Public Works and Transport, the Ministry of Interior and the Ministry of Health, with the technical support of Handicap International Belgium. In Siem Reap, Otdar Mean Chey and Kampong Cham provinces, the system is also supported by the Belgian Technical Cooperation. The system is developed in the framework of Action 2 (Road Accident Data Systems) of the National Road Safety Action Plan of the Royal Government of Cambodia. The present report analyses the information collected by RTAVIS for the year 2005. It is a synthesis of all the monthly reports that were published throughout 2005. The previous annual report (annual report 2004), as well as all monthly reports, can be found on the following website: www.cnctp.info In 2006, RTAVIS will continue to be developed and will progressively be integrated in a broader injury surveillance system, collecting data not only on road traffic injuries but also on other kinds of injuries such as falls, domestic accidents, violence and drowning.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

II. Executive Summary


Introduction
2005 was a crucial year for the improvement of road safety in Cambodia with the creation of the National Road Safety Committee, the adoption of a National Road Safety Action Plan and the elaboration of a new land traffic law. The National Road Safety Committee, which is chaired by H.E. the Minister of Transport and is composed of high level representatives from various ministries involved in road safety, will be key in leading and coordinating the efforts of various stakeholders to improve road safety. Cambodia is at the bottom of its vehicle-ownership curve but exponential growth of the number of road traffic casualties is expected in the coming years if no or little action is taken. 2006 will be another critical year with the foreseen adoption of the new land traffic law by the National Assembly. As the present report will show, human behaviour is indeed by far the leading cause of road traffic accidents in Cambodia and awareness and education campaigns alone are not sufficient to prevent them. Increased legal framework and enforcement procedures are now more than ever necessary to prevent road traffic accidents and make Cambodian roads safer. Recommendation 1: Adopt the new land traffic law The first draft of the new land traffic law has been approved by the Council of Ministers and will be now subject to public hearing. The new law will introduce key new elements that are expected to have a strong impact on the road safety situation: ! Every motorcyclist using a motorbike from 49 cc will need to have a driving license1; ! Helmet wearing will be compulsory for all 2-3 motorized wheelers drivers2; ! Fastening seatbelts will be compulsory for all car front seat occupants; ! Blood alcohol concentration limit will be provided; ! Fines and penalties will be better detailed and adapted to the gravity of the infraction. The new law will then need to be accompanied by several sub-decrees to describe the enforcement mechanisms and their timing. It is indeed, for example, unrealistic to make helmet wearing compulsory overnight. A transition period, accompanied by effective awareness and education campaigns, will be necessary. Recommendation 2: Improve law enforcement by training and motivating traffic police3. Law enforcement is still very weak. Experience in other countries shows that even if traffic laws are very stringent, they are useless without adequate enforcement. Traffic police officers should be trained on the new traffic law and receive incentives to enforce it correctly. Traffic police officers currently lack respect by the population. A campaign to improve their legitimacy and their image should be developed, simultaneously with clear changes in the way they operate. Recommendation 3: Provide the National Road Safety Committee with adequate funding4 The National Road Safety Committee will not function effectively if it does not have appropriate funding to perform its activities. Recommendation 4: Continue to establish a "culture of road safety" in Cambodia Besides the actions taken at the ministry level, the civil society has a very important role to play in improving road safety. Several actions can be taken simultaneously by victims' associations, NGOs, international organizations, private companies and individuals in a coordinated way. A particular emphasis should be put on the organization of national road safety campaigns and events, such as a National Remembrance Day of Road Traffic Victims5 in November and the United Nations Road Safety week in April.

Driving licenses are currently not compulsory for motorbikes below 100 cc and most motorbikes in use in the country are below 100 cc. Therefore, most motorcyclists in the country do not have to pass a theoretical and practical examination before driving a motorcycle and most likely do not know the traffic rules. 2 Ideally, motorbikes' passengers should also have to wear helmets. 3 Cf. Action 8 of the National Road Safety Action Plan: Law Enforcement. 4 Cf. Actions 1 and 3 of the National Road Safety Action Plan: Establishing a National Road Safety Committee and Road Safety Funding. 5 The same day of the International Remembrance Day of Road Traffic Victims.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Recommendation 5: Further develop the national road traffic accident data collection system at the national level, combining data coming from various sources6. Over the last 2 years, RTAVIS has been able to combine data coming from 3 different sources to produce detailed analysis on road traffic accidents and casualties. Such a system must be further developed in the future in order to: 1. Have a better understanding of the road safety situation; 2. Evaluate road safety actions and the implementation of the national road safety action plan; 3. Advocate for more action on road safety.

Key figures
General figures Notice: Although RTAVIS now covers the whole country geographically, traffic police data from the provinces have been integrated only in July 2005 and new hospitals, clinics and health centres have been progressively added to the system. The number of casualties and accidents provided in this report are therefore lower than the actual number. The Demographic and Health Survey 2000 indeed estimated the number of road traffic casualties at around 40,000, while RTAVIS reports 15,943 casualties. In 2005, 15,943 road traffic casualties were reported to RTAVIS, resulting from 6,301 accidents. Among them, 904 were fatalities and 4,097 were severely injured. More than 10,000 vehicles were involved in those accidents. The number of road traffic fatalities has doubled over the last 5 years. Road traffic accidents increased proportionally more than road traffic and population. Cambodia has one of the highest fatality rates in the region, compared to the number of vehicles in use in the country and the length of the paved road network. Compared to the number of inhabitants, the rate is however still below the ASEAN average.

Notice on 2006: The figures for the 4 first months of 2006 show a sharp increase of the number of fatalities: on average, during the first 4 months of 2006, 4 people died per day due to road traffic accidents in Cambodia. Age of casualties The average age of casualties is 29. 75% of casualties are among the active part of the population (age 20 to 64). People aged between 20 and 24 years old account for 24% of casualties although they represent only 10% of the population. Conversely, children (0-14) account for 9% of casualties although they represent 39% of the population.

Recommendation 6: Develop a specific strategy to address road safety issues among young drivers. The age pyramid of Cambodian population shows that almost 40% of the population is aged below 15 years old. It means that in the coming years, a growing number of young people will start to drive on Cambodian roads. Knowing that young people between 15 and 24 are currently associated with almost 40% road traffic casualties, there is a risk that this percentage will further increase in the future. It is therefore essential to target future road users by notably developing effective road safety education in primary and lower secondary schools. Gender of casualties Males account for 71% of casualties, although they account for only less than 50% of the population. This over-representation of males in the casualties is especially important in the workingage proportion.

Cf. Action 2 of the Road Safety Action Plan: Road Accident Data Systems.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Type of transport Motorbikes users account for the large majority of casualties (72%), followed by pedestrians (9%), car users (6%) and bicycle riders (5%). Although car drivers and passengers represent only 6% of road traffic casualties, cars represent 15% of the vehicles involved in accidents. The percentage of pedestrian and bicycle casualties is much higher among children and old people. Almost 50% of casualties below 5 years old are pedestrians.

Recommendation 7: Develop a road design that allows a better separation of 4-wheelers and 2/3wheelers7. Cambodian roads are characterized by a wide variety of types of traffic (motorbikes, cars, tricycles, tuk-tuks, minivans, trucks, oxcarts, etc). Separation between four-wheelers and two-wheelers on national roads and on main town streets would reduce the number of accidents, and at the same time it would improve traffic flows. Recommendation 8: Continue to implement a road safety curriculum in primary schools to educate children to adopt a safe pedestrian behaviour8. Most child casualties are pedestrians. Teaching them the basic rules and risks of the road can allow them to travel safer from home to school and elsewhere. Occupation of casualties
-

Students9 constitute the largest group of casualties (21% of casualties), followed by workers (20%) and farmers (19%). Motorbike taxi drivers constitute 5% of the total number of casualties.

Residence of casualties
-

17% of casualties are injured in a province other than their province of residence.

Severity of injuries and hospital discharge More than 25% of casualties are severely injured (requiring surgery or admission to intensive care). Car users and pedestrians suffer more fatalities than other types of road users. Although 82% of the casualties were fully treated and sent home, 6% were referred to another hospitals and 3% requested to be treated by a private clinic or a traditional healer.

Nature of injuries 31% of casualties suffer from head injuries, which is slightly higher than the world average of 28%. A higher percentage of head injuries is noticed in Phnom Penh compared to the rest of the country (more than 40%). The average cost of medical treatment is 96 US$ per casualty.

Recommendation 9: Further develop awareness and enforcement campaigns to increase helmet wearing10. A large number of head injuries could be avoided if people were wearing helmets correctly. Awareness campaigns organized so far by Handicap International Belgium in collaboration with the Ministry of Health and several other stakeholders have already allowed to almost double the helmet wearing rate in Phnom Penh (from 8 to 15%).

7
8

Cf. Action 5 of the Road Safety Action Plan: Road Environment and Road Design. Cf. Action 6 of the Road Safety Action Plan: Road Safety Education for Children. This action is supported by a program of Handicap International aiming at introducing a new road safety curriculum in the formal primary school curriculum. 9 Students are defined as follows: from first grade of primary school to last grade of university/higher education. 10 Cf. Action 12 of the Road Safety Action Plan: Road Safety Public Campaigns. This recommendation is strongly supported by the World Health Organization and Handicap International, which launched several campaigns to promote the use of helmets.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Driving license Only 55% of car/truck/bus drivers have a valid driving license at the time of the accident.

Day of accident On average, more than 40 road traffic casualties are reported every day by RTAVIS11. Several peaks (up to 150 casualties a day) are noticed, corresponding mainly to Khmer national holidays. Weekend (Friday 6 pm until Sunday midnight) accidents are responsible for 35% of casualties. A higher percentage of casualties is noticed on Saturdays, especially during the night. A lower percentage of casualties occur on Friday evenings.

Time of accident Nighttime accidents are responsible for 33% of casualties. One peak of casualties is observed between 6 pm and 8 pm.

Causes of accident "Hit and run" accidents12 represent 25% of accidents and are responsible for 24% of casualties. Only 32% of the casualties are responsible for the accident in which they have been injured. Human error is responsible for more than 90% of casualties. Road and weather conditions are responsible for less than 10% of casualties while vehicle defect is responsible for only 5% of casualties. Non appropriate speed is responsible for almost 40% of casualties, followed by alcohol (17% of casualties) and by non respect of rights of ways (14%).

Recommendation 10: Develop enforcement campaigns on driving rules and improve the driver training system13. Current road users' behavior in Cambodia is generally erratic, undisciplined and inconsistent. With the rapid increase of speed and traffic, the situation will worsen and awareness campaigns alone will not be sufficient. A strict enforcement of the law, a better driving examination system and a better control of the driving schools should be ensured. Recommendation 11:Develop awareness and enforcement campaigns targeting drunk drivers Type of collision (vehicles involved) Motorbike-motorbike collisions are responsible for 33% of the casualties, followed by motorbike-car collisions (14%) and motorbikes that fell alone (11%). Pedestrians are mainly injured by motorbikes rather than by cars. Motorbike-pedestrian collisions indeed represent 6% of casualties while car-pedestrian collisions represent only 1% of casualties. 34% of four-wheelers involved in road traffic accidents are right-hand drives. On average, 2.53 people are injured per accident.

Type of collision 23% of accidents are head-on collisions, followed by right-angle (21%) and read end (16%). 71% of vehicles were going straight ahead at the time of the accidents.

Cost of accident The average damage cost per vehicle involved in accident is 173 US$. Knowing that 10,397 vehicles were involved in accidents in 2005, the total estimation of damage cost is 1,798,681 US$.
All hospitals and private clinics do not yet participate to RTAVIS and the actual average daily number of casualties is therefore higher than 40. The Demographic and Health Survey 2000 indeed estimated the number of road traffic casualties at around 40,000. We estimate that this figure is more close to the reality, which would make an average daily number of road traffic casualties of 100. 12 Accidents where the driver of the vehicle causing the accident escapes after the accident. 13 Cf. Action 10 of the Road Safety Action Plan: Drivers Training.
11

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Location of accident More than 40% of casualties are injured in urban areas. Almost 25% of accidents occurred in Phnom Penh. In Phnom Penh, the top three communes affected by road traffic casualties (measured as number of casualties per 1,000 inhabitants) are Preak Lieb, Chaom Chau, and Chakto Mukh. The two first are located along major national roads.

Type of road 50% of casualties are injured in accidents occurring on national/provincial roads. In comparison with the volume of traffic, national road 4 is the most deadly, followed by national roads 2 and 7.

Road characteristics More than 75% of casualties are injured in accidents occurring on straight roads. 80% of casualties are injured in accidents occurring on paved roads.

Recommendation 12: Develop specific actions targeting the national roads14. There is a direct link between the length of the paved road network and the number of accidents. National roads have recently been rehabilitated and traffic volume, as well as speed on those roads, is increasing rapidly. The number of accidents on those roads is therefore expected to increase even more rapidly. Road safety action plans are urgently needed to accompany road rehabilitation and construction to ensure that: - Hazardous locations and black spots are clearly identified and marked; - Schools and markets are clearly identified and protected, notably with speed breakers; - Villagers are properly informed on the additional risks that the road brings; - Speed limits are clearly indicated and respected. Transfer to hospital
! ! !

Only 32% of casualties are transferred to the hospital or clinic by ambulance. This is mainly an issue in provinces where only 20% of casualties are transferred to the hospital by ambulance. 42% of casualties arrive at the hospital less then 30 minutes after the accident while more than 25% of casualties take more than 2 hours to reach hospital. In the provinces, 47% of seriously injured casualties take more than 2 hours to reach the hospital.

Recommendation 13: Improve emergency assistance to traffic victims15. This is one of the most urgent recommendations. The current Cambodian healthcare system is currently not capable of absorbing the current and expected number of road traffic casualties. The problem is especially serious in remote areas along national roads where casualties sometimes have to wait several hours before being taken to hospital. The equipment and competence of the district hospitals are generally not sufficient and casualties often travel from one district hospital to a referral hospital before being sent to Phnom Penh. Ambulance services should also be improved and people should be better informed of what to do in case they are victims or witnesses of accidents (who to call, what first aid they can provide, etc). Traffic police should as well be properly trained on first aid. Police attendance Police are present on the accident site in almost 60% of the cases.

14

This recommendation is supported by a program of Handicap International which is supporting local NGOs and village committees to initiate road safety actions in village located along national roads. 15 Cf. Action 11 of the Road Safety Action Plan: Emergency Assistance to Traffic Victims.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Differences between Phnom Penh and provinces


The key indicators mentioned here above are national averages. However, important differences are noticed between Phnom Penh and the provinces. The figure here below summarizes the main differences. Figure 1: Main road safety indicators - differences between Phnom Penh and provinces

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

III. System coverage


Data sources
Research shows that in most countries official accident statistics based on traffic police reports only underestimate the real number of road traffic casualties16. To avoid this underreporting, RTAVIS therefore collects data at three different data sources, as illustrated by the figure here below: Figure 2: RTAVIS data collection flow

In 2005, public health facilities reported 60% of casualties, followed by traffic police (26%) and private clinics (14%), as shown on the figure below. Figure 3: RTAVIS data sources, 2005
Casualties reported by private clinics 14% Casualties reported by public health facilities 60%

Casualties reported by traffic police 26%

Notice: To avoid double entries between health facilities and traffic police data, if a casualty is reported by a health facility as well as by the traffic police, it will be taken into account only once and reported as hospital data. Double entries concern around 7% of the casualties. Also, traffic police data from provinces has been integrated to RTAVIS only since July 2005. This explains why the percentage of cases reported by the traffic police is so low.

16

Recent research shows that statistics based on traffic police only report 60% of seriously injured road traffic casualties in developed countries.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Private clinics play a growing role in the treatment of road traffic casualties. In Phnom Penh, they have treated more than 34% of the casualties in 2005. Health facilities data sources have been progressively added into the RTAVIS coverage, as shown on the chart below. In December 2005, 69 health facilities (provincial hospitals, referral hospitals and health centers) were participating in RTAVIS and this number is growing every month. Full country coverage with hospital and traffic police data will be achieved in 2006. Figure 4: Evolution of the number of casualties and health facilities data sources - January to December 2005
2500 80

70 2,017 2000 1,730 Number of casualties 1,508 1500 1,339 1,143 1000 810 591 500 10 832 909 40 1,762 60 Number of health facilities data sources 1,887

50

875

30

20

0 Jan-05 Feb-05 Mar-05 Apr-05 May-05 Jun-05 Jul-05 Aug-05 Sep-05 Oct-05 Nov-05 Dec-05

Number of casualties reported to RTAVIS Number of health facilities data sources

Notice on Injury Surveillance In 2006, several workshops will be organized by the Ministry of Health and other interested stakeholders to extend the data collection system set up for RTAVIS to other types of injuries, such as falls, drowning, domestic violence,... Injuries in general are indeed estimated to be a growing cause of death and disability in Cambodia but there is currently no ongoing data collection system to monitor these issues17.

17

The Demographic and Health Survey performed in 2000 in Cambodia estimated that road traffic injuries represent 34% of injuries, followed by falls (13%).

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Geographic coverage
By the end of 2005, RTAVIS covered 23 Cambodian provinces with traffic police data and 18 provinces with health facilities data, as shown on the figure here below. Training of hospital and private clinic staffs is ongoing, in collaboration with the Ministry of Health. Figure 5: RTAVIS geographical coverage, December 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

IV. Evolution of data


Road traffic accidents, casualties and fatalities increase more proportionally than road traffic and population. Over the last 5 years, the number of accidents increased by 50% and the number of fatalities has doubled. In the meantime, population has increased by 12% and the number of registered motorized vehicles by 55%. Figure 6: Evolution of road traffic accidents and casualties in Cambodia18, 1995 2005 (base 100 = 1995)
1400 1200 1000 800 600 400 200 0 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Population Traffic Number of accidents Fatalities

Notice: RTAVIS has been recently created. Long period evolution charts or year to year comparisons at the national level are therefore not yet possible. The graph here above is based on figures provided by the traffic police only. The decrease of accidents and fatalities in 2005 is probably due to underreporting of road traffic accidents in some provinces rather than to a real decrease of the number of accidents. In Phnom Penh, the number of casualties has increased by more than 14% between 2004 and 200519. Figure 7: Road traffic casualties in Phnom Penh, 2005 compared to 2004
2500 2035 2000 1500 1000 500 0 Phnom Penh Sept - Dec 2004 Phnom Penh Sept - Dec 2005 1784

Although the number of casualties increased between 2004 and 2005, most indicators, as shown in the next chapter, remained similar.

Sources: Population: First Revision of Population Projections for Cambodia 1998 -2020, National Institute of Statistics, Ministry of Planning, June 2004; ! Traffic and accident figures: Ministry of Public Works and Transport. 19 Notice: This comparison is made between the 4 last months of 2004 and the 4 last months of 2005. New data sources had been progressively added in Phnom Penh in 2004. It is only since September 2004 that the number of data sources reached its current level. !

18

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

The Cambodian vehicle-ownership rate is still low compared to other countries in the region but is rapidly increasing, notably due to the relatively strong economic growth. If the Cambodian economy continues to grow (e.g. +13% growth in 2005), this vehicle-ownership rate will continue to grow as well. That, combined with a continued increase and improvement of the road network (allowing speed increases)20, will have a negative effect on the number of accidents and casualties, despite all prevention efforts and education campaigns currently going on. Figure 8: Comparison of vehicle-ownership rates (motorized vehicles per 1,000 persons) most recent year available between 2003 and 200521
Motorization rate (number of vehicles/1,000 people)

700 600 500 400 300 200 100 0 Developed Malaysia countries Thailand Vietnam Laos Cambodia

Figure 9: Comparison of paved road density (measured in km of paved roads per km2)22
0.18 Paved road density (km/km2) 0.16 0.14 0.12 0.1 0.08 0.06 0.04 0.02 0 Japan Malaysia Thailand Vietnam Cambodia

20 21

The paved road density of Cambodia is currently 15 times lower than in developed countries and 6 times lower than neighbour countries Source: Scale, Characteristics and Costs of the Road Safety Problem in ASEAN, presentation by Dr. Alan Ross, ADB Fourth ADB/ASEAN Regional Road Safety Workshop, May 2004, Malaysia.. 22 Source: Study of the Road Network Development in the Kingdom of Cambodia, JICA-MPWT, 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

V. 2005 data analysis


Introduction
Notice: Although RTAVIS now covers the whole country geographically, traffic police data from the provinces have been integrated only in July 2005 and new hospitals, clinics and health centres have been progressively added to the system. The number of casualties and accidents provided here below are therefore lower than the actual number. The Demographic and Health Survey 2000 indeed estimated the number of road traffic casualties at around 40,000, while RTAVIS reports 15,943 casualties. In 2005, 15,943 road traffic casualties have been reported by RTAVIS, resulting from 6,301 accidents. Among them, 904 were fatalities. The fatality rate, calculated in comparison with the number of inhabitants, is still low compared to neighbor countries such as Thailand and Vietnam. However, calculated in comparison with the number of vehicles in use in the country and the length of the paved road network, the fatality rate is already high, as shown on the figures here below. Figure 10: Traffic fatality rates calculated in comparison with the number of vehicles, the number of inhabitants and the length of the paved network most recent year available between 2003 and 200523

Figure 11: Number of road traffic fatalities per 10 kms of paved roads Comparisons between selected countries most recent data available between 2003 and 2005

Japan

Thailand

Vietnam

Cambodia

Fatality rates (number of fatalities/10 kms of paved roads)

23

Sources: Number of fatalities: Asian Development Bank, 2005 Number of vehicles: Asian Development Bank, 2005 Number of kms of paved roads: JICA, 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Victim Information
Age - The average age of casualties is 29. - The active part of the population is the most affected by road traffic accidents: 75% of casualties are among the active part of the population (age 20 to 64). Figure 12: Percentage of casualties and fatalities by age category - 2005
45% 40% 35%
42% 40%

Percentage

30% 25% 20% 15% 10% 5% 0% <5 5 - 14 15 - 19 20 - 24 25 - 44 45 - 64 > 64


3% 2% 6% 7% 2% 13% 8% 5% 15% 12% 24% 21%

Age Category Percentage of casualties Percentage of fatalities

People aged between 20 and 44 years old represent the highest ratios of casualties per inhabitants. In particular, people aged between 20 and 24 years old account for 24% of casualties although they represent only 10% of the population. Conversely, children (0-14) account for 9% of casualties although they represent 39% of the population. Figure 13: Number of casualties per 100,000 inhabitants for different age categories24 - 2005
350

Number of casualties per 100,000 inhabitants

300 250

289

208

200

150

1 35 19 1 1 22

100
62

50

33

27

0 <5 5 - 14 15 - 19 20 - 24 25 - 44 45 - 64 > 64 All ages

Age Category

Sources: RTAVIS and First Revision of Population Projections for Cambodia 1998 -2020, National Institute of Statistics, Ministry of Planning, June 2004.

24

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

The age pyramids of road traffic casualties vary a lot between Phnom Penh and the rest of the country. The proportion of young adults (age 20 to 24) is much more important in Phnom Penh (30% compared to 21%) while the proportion of children (age 0 to 14) is more important in provinces compared to Phnom Penh (11% compared to 7%). The proportion of people above 45 years old is also higher in provinces than in Phnom Penh. Figure 14: Age pyramid of casualties Phnom Penh versus the rest of the country - 2005

On average, the proportion of young adult casualties and fatalities is higher in Cambodia than the South East Asian or the world average. People aged between 15 and 29 years old account for indeed almost 45% of the fatalities in Cambodia while they represent around 25% of the fatalities in the rest of the world. Figure 15: Percentage of fatalities by age category in different regions of the world25 - 2002 for the world and SEA figures, 2005 for Cambodia
50% 45% Cambodia SEA World

Percentage of fatalities

40% 35% 30% 25% 20% 15% 10% 5% 0% <5 5 -14 15 - 29 30 - 44 45 - 59 60 +

Age category

25

Sources: RTAVIS and World Report on Road Traffic Injury Prevention, WHO , Geneva, 2004. Notice: Please note that the age categories used in the present graph are not exactly the same as in the previous graph. Please also note that the present graph shows the percentage of fatalities while the previous graph shows casualties.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Gender Males represent a higher ratio of casualties per inhabitants: they account for 71% of casualties26, although they account for only 49% of the population27. Figure 16: Number of casualties per 100,000 inhabitants by gender - 2005
Number of casualties per 100,000 inhabitants

200 180 160 140 120 100 80 60 40 20 0

173

122

67

Male

Female

Male and female

This over-representation of males is in line with what is observed in other cities in the region and in the world: - In 2004, males accounted for 69% of casualties in Vientiane and for 74% of casualties in Ho Chi Minh City28. - In 2002, males accounted for 73% of all road traffic deaths in the world29. This over-representation of males in the casualties is especially important in the workingage proportion of the population (25-44 years old), where males represent 75% of casualties. On the other hand, males and females are almost equally represented in the >64 age category. Figure 17: Percentage of casualties by gender for different age categories 2005

26 27

72% in Phnom Penh and 71% in provinces. Sources: RTAVIS and First Revision of Population Projections for Cambodia 1998 - 2020, National Institute of Statistics, Ministry of Planning, June 2004. 28 Source: Data collection systems developed by Handicap International and authorities in Vientiane and Ho Chi Minh City. 29 Source: World Report on Road Traffic Injury Prevention, WHO, Geneva, 2004.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Type of road user Motorbikes users account for the large majority of casualties (72%), followed by pedestrians (9%), car users (6%) and bicycle riders (5%). Figure 18: Percentage of casualties by type of transport - 2005

Those figures are similar to the ones from neighboring countries such as Thailand but are however far different from the situation observed in developed countries where the proportion of cars is much higher. Figure 19: Comparison of percentages of fatalities by type of transport - most recent year available between 2003 and 200530
USA

Malaysia

Thailand

Cambodia

20

40

60

80

100

Percentage of fatalities Motorized two-wheelers Pedestrians Motorized four-wheelers Cyclists Others

Source: RTAVIS and World Report on road traffic injury prevention, WHO , Geneva, 2004.. Notice: the present graph shows the percentage of fatalities while the previous graph shows casualties. The reason for that is that only fatalities data are available to make comparisons with the rest of the world.

30

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

The percentage of motorcycle and pedestrian casualties is much higher in Phnom Penh than in the rest of the country, while the percentage of bicycle casualties is much higher in provinces than in Phnom Penh. Figure 20: Percentage of casualties by type of transport Phnom Penh versus the rest of the country 2005

The percentage of pedestrians and bicycle casualties is much higher among children and old people: - Almost 50% of casualties below 5 years old are pedestrians. - 30% of casualties between 5 and 14 years old are pedestrians and more than 20% are bicycles riders31. Figure 21: Percentage of casualties by type of transport for different age categories 2005

31

It is also interesting to note that 45% of casualties between 5 and 14 years old are motorbikes riders and that 25% of them were driving the motorbike by themselves at the time of accident.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Although car drivers and passengers represent only 6% of road traffic casualties, cars represent 15% of the vehicles involved in accidents. Figure 22: Proportion of vehicles versus proportion of casualties involved in accident - 2005
80%
71% 72% 59%

70% 60% 50% 40% 30% 20% 10% 0% Motorcycle Car Truck Pick-up
15% 6% 5% 5% 3% 1% 1% 2%

4%

Proportion of vehicles involved in accidents for each category compared to the total number of vehicle involved in accidents Percentage of casualties Percentage of fatalities

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Occupation The active part of the population is the most affected by road traffic accidents. Students32 constitute the largest group of casualties (21% of casualties), followed by workers (20%) and farmers (19%). Motorbike taxi drivers constitute 5% of the total number of casualties. In 2005, 63 tourists/expatriates were reported among the casualties. Figure 23: Percentage of casualties by occupation - 2005

Again, there are important differences between Phnom Penh and the rest of the country: - Farmers represent the biggest category of casualties in provinces (26%) while they represent only 3% in Phnom Penh. - Workers represent the biggest category of casualties in Phnom Penh (24%) while they represent 16% of casualties in provinces. - Students represent 23% of casualties in Phnom Penh and 18% in provinces. Residence of casualty 17% of casualties are injured in another province that their province of residence.

32

Students are defined as follows: from first grade of primary school to last grade of university/higher education.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Severity of injuries and hospital discharge Almost 3% of casualties die immediately at the scene of the accident and more than 25% are severely injured. Figure 24: Percentage of casualties by severity of injury - 2005

Notice: In total, 904 fatalities have been recorded by the traffic police in 2005. Only 673 of those casualties were reported to RTAVIS in 2005. It is due to the fact that provincial traffic police offices started to collaborate to RTAVIS only as from July 2005. Although 82% of the casualties are fully treated at hospitals, 6% are referred to another hospitals and 3% request to be treated by a private clinic or a traditional healer. Figure 25: Hospital discharge - 200533

33

Notices: ! This graph only reports the casualties treated at health facilities. Many casualties reported by the traffic police are not taken into account in this graph. Those casualties either did not go to a hospital at all either were treated by a private clinic or a traditional healer that does not participate to RTAVIS. ! Patient will die at home refers to the cases where the victim is so injured that death is unavoidable (as diagnosed by the doctor), but the victim prefers to quit the hospital.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

A larger proportion of fatalities is noticed among pedestrian and four-wheeler casualties than among motorbike and bicycle casualties. Figure 26: Percentage of casualties and fatalities per type of transport - 2005

Nature of injuries In total, 31% of casualties suffer from head injuries, which is in line with the world average of 28%. However, a higher percentage of head injuries is noticed in Phnom Penh compared to the rest of the country. More than 40% of casualties injured in Phnom Penh suffer from cranial trauma. This is partly due to the fact that a larger proportion of motorbike's casualties is noticed in Phnom Penh (82% compared to 65% in province). 80% of casualties suffering from a cranial trauma are indeed motorbike users and only 3% are wearing a helmet at the time of the accident34.

This percentage is very low compared to the average helmet wearing rate in Phnom Penh which was almost 15% at the end of 2005. This average helmet wearing rate is measured regularly by the Ministry of Health, during 5 days, at different time and locations, to measure the effectiveness of helmet wearing awareness campaigns.

34

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Figure 27: Percentage of casualties by category of trauma comparison between Phnom Penh and provinces - 2005

In addition, 15% of casualties suffer from fractures and almost 40% suffer from serious cuts/wounds. Cost of treatment The average cost of medical treatment is 96 US$ per casualty. Driving license Only 55% of car/truck/bus drivers casualties have a valid driving license at the time of the accident. Figure 28: Percentage of car/truck/bus driver's casualties having a driving license 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Accident Information
Day and time of accident On average, more than 40 road traffic casualties are reported every day in Cambodia. Several peaks (up to 150 casualties a day) are noticed, corresponding mainly to Khmer national holidays. Notice: All hospitals and private clinics do not yet participate to RTAVIS and the actual average daily number of casualties is therefore higher than 40. The Demographic and Health Survey 2000 indeed estimated the number of road traffic casualties at around 40,000. We estimate that this figure is more close the reality, which makes an average daily number of road traffic casualties of 100. Figure 29: Number of casualties per day 2005 19th of May 2-4th October Tractor carrying many people overturned on a local road in Kampong Cham province, injuring 40. Private car overturned on Pchum Ben celebrations NR 4 in Kampong Speu province, killing 1 and injuring 9. 15-17th November Water Festival 14-16 of April Khmer New Year 10-12th of February Chinese New Year
th

18th of July Light truck overturned due to high speed on a local road in Kampong Cham province, injuring 17 and killing 2

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Weekend (Friday 6 pm until Sunday midnight) accidents are responsible for 35% of casualties. A higher proportion of weekend's accidents is noticed in Phnom Penh (40% of casualties, compared to 32% of casualties in the rest of the country). Figure 30: Percentage of casualties differences between weekday and weekend 2005

A higher percentage of casualties is noticed on Saturdays, especially during the night. A very low percentage of casualties occur on Friday evenings. Figure 31: Percentage of casualties per day of the week 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Time of accident In total, nighttime accidents are responsible for 33% of casualties. Here again, a higher proportion of nighttime's accidents is noticed in Phnom Penh (44% of casualties, compared to 27% of casualties in the rest of the country). Figure 32: Percentage of casualties differences between day and night 2005

One peak of casualties is observed between 6 pm and 8 pm, especially during the weekend. Figure 33: Percentage of casualties per hour of the day 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Causes of accident Almost one fourth (24%) of casualties are injured in "hit and run" accidents35 and only 32% of the casualties reported by the traffic police are responsible for the accident in which they have been injured. Human error is responsible for more than 90% of casualties. Road and weather conditions are responsible for less than 10% of casualties while vehicle defect is responsible for only 5% of casualties. Figure 34: Percentage of casualties by cause of accident General - 2005

Human error Non appropriate speed is responsible for almost than 40% of casualties and 42% of accidents, followed by alcohol (17% of casualties and 16% of accidents) and by non respect of rights of ways (14% of casualties and 12% of accidents). Figure 35: Percentage of casualties by cause of accident Focus on human errors 200536

35 36

Accidents where the driver of the vehicle causing the accident escapes after the accident. NA refers to causes of accident non related to human errors (road and weather conditions, vehicle defect).

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Speed is an issue mainly in provinces on national/provincial roads. Speed also concerns more students than other categories of casualties (speed is responsible 44% of student casualties compared to 36% for farmers and workers). Alcohol abuse is of course more a problem during the night than during the day, although 10% of accidents occurring during the day are due to alcohol. Alcohol abuse is more a problem among the 20 44 age category, as illustrated on the figure here below. It is however not a big issue for students (alcohol is responsible for 10% of student casualties, compared to 19% for farmers and workers). Figure 36: Percentage of casualties by cause of accident differences between age categories - 2005

Non-respect of rights of way is mainly an issue in Phnom Penh (20% of casualties compared to 10% in provinces). Weather conditions The percentage of casualties due to weather conditions varies between 0% and 25% according to the days of the year. It has reached for 5 consecutive days in early August 2005, characterized by heavy rains. Vehicle defect Break failure and tire blow out are responsible for 2% of casualties (respectively 1.1 % and 1%). Road conditions Potholes are responsible for 5% of casualties. Type of collision Motorbike-motorbike collisions are responsible for 33% of the casualties, followed by motorbike-car collisions (14%) and motorbikes that fell alone (11%). It is interesting to note that pedestrians are mainly injured by motorbikes rather than by cars. Motorbikepedestrian collisions represent 6% of casualties while car-pedestrian collisions represent only 1% of casualties. 34% of four-wheelers involved in road traffic accidents are right-hand drives. On average, 2.53 people are injured per accident.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Figure 37: Percentage of casualties by type of vehicle involved - 2005

23% of accidents are head-on collision, followed by right-angle (21%) and read end (16%). Notice: The data for the two figures here below come from traffic police only. Data might therefore slightly differ from the previous figure which is based on data coming from both health facilities and traffic police. Figure 38: Percentage of accidents by type of collision - 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

71% of vehicles were going straight ahead at the time of the accidents. Figure 39: Percentage of vehicles involved in road traffic accident by type of vehicle manoeuvre - 2005

Cost of accident The average damage cost per vehicle involved in accident is 173 US$. Knowing that 10,397 vehicles were involved in accidents in 2005, the total estimation of damage cost is 1,798,681 US$. Location of accident Country level More than 40% of casualties are injured in urban areas. The provinces most affected by road traffic accidents, according to traffic police data only, are Phnom Penh (23% of accidents), Bantey Meanchey and Kandal, as shown on the figure below. Figure 40: Number of road traffic accidents per province, 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

The provinces most affected by road traffic fatalities, according to traffic police only, are Phnom Penh, Kampong Cham and Kandal, as shown on the figure below. Figure 41: Number of road traffic fatalities by province 2005

Notice Those graphs are based on traffic police data only. Distribution of casualties based on RTAVIS data (including health facilities data) is not shown here because it would distort the analysis. Data coming from health facilities have been indeed progressively added to the data collection system. Health facilities in Kampong Cham and Siem Reap provinces participate to RTAVIS since the beginning of 2005, while health facilities in Battambang and Banteay Meanchey participate to RTAVIS only since the end of 2005. However, in 2005, RTAVIS had a perfect coverage of Phnom Penh, Siem Reap and Kampong Cham province. The following graphs show the distribution of casualties in those provinces.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Phnom Penh The top three communes affected by road traffic casualties (measured as number of casualties per inhabitant) in Phnom Penh are Preak Lieb, Chaom Chau, and Chakto Mukh. The two first are located along major national roads. Figure 42: Top ten Phnom Penh communes affected by road traffic casualties measured as number of casualties per inhabitant 2005

Notice on GPS use As from July 2006, GPS devices will be used by Phnom Penh traffic police to better locate accidents and identify black spots.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Siem Reap The top three communes affected by road traffic casualties (measured as number of casualties per inhabitant) are Nokor Pheas, Slakram and Svay Dangkum. Figure 43: Top ten Siem Reap communes affected by road traffic casualties measured as number of casualties per inhabitant 2005

Kampong Cham The top three communes affected by road traffic casualties (measured as number of casualties per inhabitant) are Memot, Koang Kang and Tramung. Those three communes are located along major national roads. Figure 44: Top ten Kampong Cham communes affected by road traffic casualties measured as number of casualties per inhabitant 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Type of road 50% of casualties are injured in accidents occurring on national/provincial roads. Figure 45: Percentage of casualties by type of road 2005

In comparison with the volume of traffic, national road 4 is the most deadly, followed by national road 2 and 7. Figure 46: Number of fatalities per 100 million vehicles kilometers by national road37 2005

Number of fatalites per 100 million vehicles kilometers

25 20 15 10 5 0 NR 4 NR 2 NR 7 NR 1 NR 5 NR 6 NR6A NR 3

37

Source for the number of vehicle kilometers: The Study on the Road Network Development in Cambodia, Interim Report, JICA, March 2006.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Road characteristics More than 75% of casualties are injured in accidents occurring on straight roads. Figure 47: Percentage of casualties by type of road design 2005

80% of casualties are injured in accidents occurring on paved roads.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Transfer to hospital Only 32% of casualties are transferred to the hospital or private clinic by ambulance. This is mainly and issue in provinces where only 20% of casualties are transferred to the hospital by ambulance. Figure 48: Percentage of casualties by type of transport to the hospital 2005

42% of casualties arrive at the hospital less then 30 minutes after the accident while more than 25% of casualties take more than 2 hours to reach hospital. In the provinces, 47% of seriously injured casualties take more than 2 hours to reach the hospital. Figure 49: Duration to arrive at the hospital 2005

Attendance of police Police is present on the accident site in more almost 60% of the cases. This percentage is the same during the day and the night and between Phnom Penh and provinces.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Appendix
Evolution of data during the year

Notice: the weighted average is not equal to the average of the monthly figures because the number of casualties differ from one month to another.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Notice: the weighted average is not equal to the average of the monthly figures because the number of casualties differ from one month to another.

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Number of casualties reported at health facilities

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Number of casualties reported at traffic police districts

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Data collection forms


Two different data collection forms are being used: the hospital data collection form, using the casualty as point of entry, and the traffic police data collection form, using the accident as entry point. Doubles entries are checked using the name of the casualty, the date and time of accident as well as the location. Hospital data collection form

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Traffic police form

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Feedback form
Please send back this form to the following address: ! By mail: Handicap International Road Safety Program Manager #18, Street 400 Phnom Penh ! By fax: +855 (0)23/216 270 " " Name of organization: Type of organization: Private company Other (please specify):..

NGO International Organization Ministry " Sector(s) of activity:

Health Education Transport Environment Disability and Rehabilitation " Name of respondent: Position: .. Email address: ... Postal address: ... Phone number: Quality of report:

Child welfare/rights Rural & Livelihood Development Press-media Research Institute Other (please specify):.

"

How would you rate this annual report? (please tick the corresponding box) Excellent Report presentation Quality of the data provided Quantity of the data provided Pertinence of the short analysis provided Would you like to receive this report by? Hard copy " Electronic mail copy Floppy Disk/CD copy Good Average Poor Please elaborate .. .. .. ..

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Cambodia Road Traffic Accident and Victim Information System Annual Report 2005

Contacts
Further analysis and additional information is available on request. Please do not hesitate to contact one of the following persons
!

For additional analysis/customized reports: Mr. Jean VAN WETTER Coordinator of Operations Handicap International Belgium Mobile: 012 307 650 E mail: jean.vanwetter@hib-cambodia.org Ms. SANN Socheata Road Safety Program Manager Handicap International Belgium Mobile: 012 563 172 E mail: sann.socheata@hib-cambodia.org

For information regarding the road safety situation in Cambodia: Mr. UNG Chun Hour Deputy Director General of Transports & Director of Land Transport Department Ministry of Public Works and Transport Mobile: 012 818 835 Email: chunhour@hotmail.com General CHAN Rithy Director of Order Department General Commissariat of National Police Ministry of Interior Mobile: 012 666 450

For information regarding emergency assistance in Cambodia: Dr. PRAK PISETH Raingsey Director Preventive Medicine Department Mobile: 012 862 022 Email: pisethsey@yahoo.com

For information regarding the technical aspects of the database: Mr. SEM Panhavuth RTAVIS Manager Handicap International Belgium Mobile: 012 545 334 E mail: rtavis@hib-cambodia.org Ms. OU Amra RTAVIS Developer Handicap International Belgium Mobile: 016 338 178 E mail: rtavis@hib-cambodia.org

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Editor Jean Van Wetter Handicap International Belgium # 18, Street 400, Phnom Penh Kingdom of Cambodia Phone: +855 23 217 298 Email: jean.vanwetter@hib-cambodia.org Website: www.handicapinternational.be

With the support of:

French Cooperation

Belgian Cooperation

World Health Organization