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Ahmedabad's roads are full of herds of animals, motorcycles, scooters, rickshaws, bicycle-pulled carts, and pedestrians.

Three-lane roads expand into seven or even 10 lanes. Bicyclists fill any gap. At train crossings, when the safety gates are lowered, hundreds of motorbikes and scooters jockey for position along the front, gunning their engines for the moment the gates lift. At that moment, a few shoot across, most inch, and passersby cover their faces with scarves against exhaust clouds.

Late last year, Gujarat state, of which Ahmedabad is the capital, became the fourth of India's 31 states to enact a federal helmet law for motorcyclists and scooters. The law, which exempts women and children passengers after an outcry from groups about the cost of helmets, has been slowly catching on. A recent informal count by a reporter of 300 motorcycle and scooter operators and passengers -- excluding women and children -- found 172 wearing helmets, or 57 percent.

Dr. Manjul Joshipura, director of Academy of Traumatology in Ahmedabad, attempted to cut down on traffic fatalities with another approach -- creating an emergency response team to try to get those injured to hospitals earlier. The city's eight hospitals agreed to take in road accident victims, and Joshipura set up an emergency call center.

The new system has started slowly. It receives only about one call a day. ''We could be 10 times busier," Joshipura said. ''Public awareness is our biggest problem -- they don't know yet to call us." Other developing countries, however, have recorded progress on prevention efforts. In Thailand, a national statistical evaluation of acute trauma care at hospitals found that traffic injuries were the biggest problem; the results led to new campaigns against drinking and driving. Ghana recently installed speed bumps on crash-prone sections on highways. And Colombia reduced traffic fatalities in Bogotá by half from 1995 to 2002 by increasing patrols for drunk drivers; promoting seat belt use and observation of pedestrian crossings; and constructing pedestrian bridges and a mass transportation system, the TransMilenio.

In New Delhi, Dinesh Mohan, a white-bearded, US-trained professor and specialist on road safety, said that villagers frustrated by the slow pace of government action often act on their own to improve safety.

''Each time a child is killed, people put up speed bumps," said Mohan, 60, coordinator of the Indian Institute of Technology's transportation research and injury prevention program. ''And that has probably saved thousands of lives."

He said India's road safety problems are mirrored in such countries as Iran, El Salvador, and Malaysia, which share some of the highest rates of road fatalities in the world. The problem, he said, is that many countries fail to plan adequately to ensure safety.

''We don't have the option of two parallel roads like the United States has," he said. ''In the US, you have the expressway and the slow road. Our present highways are violating all safety norms because cars, buses, and trucks are speeding on them with no concern for how local people are also using those roads."

Even when Indian officials improve public transportation, it often increases the risk on the roads. Outside St. Stephen's Hospital in central New Delhi, Dr. Mathew Varghese, the hospital director, took a visitor to a busy road just outside the institution. He pointed to an elevated Metro system. In building the Metro, he said, the city took down a traffic light, which had allowed pedestrians to cross safely to the hospital.

Now, because of concrete barriers, pedestrians must walk an extra half-mile to get to the hospital, or gamble and cross the busy street.

''I lost one of my nurses here," Varghese said, barely controlling his anger. ''She was hit by a vehicle and killed. I've had mothers hit on two-wheelers here. I've had stillborns delivered at my hospital because the mother was hit. The city is building a Metro system, saying how wonderful it is, but they are not looking at what is happening right underneath it. And they think we are progressing."

By: John Donnelly, Globe Staff
Date: April 1, 2006
Source: http://www.boston.com/news/world/asia/articles/2006/04/01/
spike_in_road_deaths_stirs_alarm_in_india/

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