Highway accidents are no accident in Nepal

• BREAKING: Seven people were killed and 30 injured when a bus collided with a parked truck on the East-West Highway in Banke at 9pm on Friday night.
• A Beni-bound bus veered off the Prithivi Highway on 23 August and plunged into the Trisuli River, killing eight passengers and injuring many more (pictured above). 
• Less than 24 hours later a bus carrying Indian pilgrims from Kathmandu to Janakpur swerved off the road in Bara district, killing seven passengers.
• A week earlier a jeep heading towards Butwal was hit by a rockslide in Palpa. Three people were killed.
• On 3 September, a jeep heading to Mugu from Jumla fell off the road, and rolled 300m down the steep mountainside. The driver and a passenger were killed. 

These deadly accidents all took place within a fortnight across Nepal, and do not include pedestrians killed by vehicles. They have become so frequent that the mishaps do not even make headlines anymore. 

Road Traffic Accidents (RTAs) take more lives annually in Nepal than floods, landslides, plane crashes, and other accidents and natural disasters combined.

A total of 2,320 people lost their lives in road traffic accidents between April 2022 and April 2023, while 28,856 people were injured, many of them impaired for life.  

In that same time frame, floods killed 19 people and injured 17, while landslides took the lives of 96 people and injured 88. There were two aircraft accidents in that period that killed 79 passengers and crew.  

Most RTA are concentrated in the Kathmandu Valley and the Tarai, where urbanisation and better quality roads and expressways have led to over-speeding and reckless driving. But in accidents in the rural mountains it is usually the poor condition of the roads that is the main factor.  

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Nepal’s topography and weather make it difficult to build and maintain roads. Highways and rural roads wrap around mountains, traverse cliffs, follow narrow river gorges. Entire sections of Nepal’s arterial highways are in a permanent state of disrepair during the monsoon, like the landslide-prone Mugling-Narayanghat Highway. 

Poor highway engineering is a major factor in deadly accidents, says transport expert Chandra B Shrestha, now a consultant with the Asian Infrastructure Investment Bank. The rockslide in Palpa, he notes, was caused by an inability to properly stabilise the slope.

“Most accidents happen when the curves on the road and the speed of vehicles do not match,” adds Shrestha. “We also have a lot of blind spots along our highways which makes driving difficult.”  

Nepal’s motorable roads are classified into Strategic Road Networks, which include major highways under the purview of the Department of Roads, and Local Road Networks which are built and maintained by local governments. 

While the main highways have to follow engineering parameters to be approved for construction, local roads are built without adequate engineering, making them more dangerous. 

“Local governments have taken charge of the construction of rural roads without fulfilling any of the required technical criteria,” says transport expert Madhu Sudan Acharya, adding that they are built without an understanding of road geometry or slope geology. 

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Shrestha agrees that rural road networks are not only sub-engineered, but are being dug across fragile slopes by excavators at breakneck speed on a massive scale without oversight. “Such roads have become death traps,” he warns.

Political interference and collusion between local contractors and their governments (in many cases the same person) to haphazardly build roads near private property has not helped matters.

Some major highways face similar problems. The Nepal Road Standard 2013 stipulates that highways, feeder roads, and district roads must have a Total Right of Way of 50m, 30m, and 20m respectively, but that rule has not been followed.  

As land value increases, encroachment along Prithivi, Siddhartha and Arniko Highways by buildings is rampant and that increases the chances of human-vehicle collisions.

“Nepal’s highway network does not have Right of Way, and the concept is not even discussed during the construction of projects,” says Shrestha. “There should be extensive study into the road and land-use interface, and guidelines must be followed.”

Yet, driver negligence and poor vehicle maintenance play a bigger role in road accidents than climate, weather, or the way Nepal’s highways are constructed. Reckless driving on poorly built roads then turn things deadly.

Read also: Nepal’s deadly roads take their toll, Gopal Gartaula

Acharya is part of a seven-member task force created by the Ministry of Physical Infrastructure and Transport earlier this year to study vehicular pollution, safety and accident reduction.

He says, “Nepal’s highways would be much safer if drivers were properly trained or if vehicles were better maintained. But they have little understanding of highway traffic rules, reading signage or basic mechanical knowledge.” 

The Land Transportation agency has also been lax in licensing and training drivers, especially those who seek to operate trucks, buses and long-haul four-wheelers. Fines for speeding and other traffic infractions, especially for two-wheelers, have not brought down the fatality rate. Motorcycles cause most of the road accidents in Kathmandu Valley and the Tarai. 

In a recent example in Kathmandu, two people died and several were injured when a speeding bus collided with a Bolero as it swerved to avoid a motorbike coming from the opposite direction. 

“Nepal’s existing road safety practices and protocols make it pretty clear that transport management authority is unable to govern properly, and needs massive overhaul,” Shrestha explains. 

Acharya adds: “The result is that the wrong people are behind the wheel.”  

Read also: 6 years of road traffic accidents, Sunir Pandey

Treating trauma

A motorcycle was hit by a car along the East-West Highway one recent evening, and the driver was writhing on the road, bleeding profusely. 

Bystanders gathered, taking videos of the injured man with their mobiles to post on TikTok. No one helped for fear of being involved. Police took an hour to arrive. The driver bled to death while being taken to hospital.

In a similar case, a motorcyclist was hit by a car on his way to work and he felt pain in his arms, legs, and neck but it did not seem too severe. Bystanders gathered and carried him to hospital on their back. 

Well-meaning as they were, they were not trained in handling the injured. The patient was eventually examined by Raju Dhakal of the Spinal Injury Rehabilitation Centre in Sanga, but the rescue attempt itself worsened the trauma and he will now suffer life-long physical complications. 

Trauma care is inaccessible to a larger number of Nepalis as the road network expands across the country. Specialised surgery and emergency treatment are centralised in Kathmandu or main cities, and the cost of rescue, ambulance, airlifting and treatment are too costly for most.

But even at hospitals, there is a lack of trained rescue and emergency first responders, which means untrained bystanders step in and inadvertently make injuries worse. 

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“There is a weakness in the life-saving mechanism that brings patients from accident sites to hospitals, and there are not many trained emergency responders,” says Dhakal. “Even not-critical injuries become life-threatening because police and rescuers do not reach accident sites on time.” 

Traffic authority Sitaram Hachhethu agrees that the role of traffic police and police personnel in case of road accidents on highways is limited to reaching the site which itself takes time due to distance and road conditions, adding to the number of casualties. 

Moreover, the police do not even have proper equipment to rescue those who have been in accidents, such as metal and seat cutters. Says Hachhethu: “We use whatever we have to get them out, all the while not knowing the protocol of rescuing an injured person.”

He adds: “90% of RTA deaths would be prevented if we had proper emergency and first response services and trained medical professionals on standby. Until then traffic police, police and rescue personnel need to be trained to provide first aid and basic emergency medical care.”

The state needs to identify which hospitals are primary, secondary, or tertiary to help doctors to direct trauma patients to relevant hospitals. That way, first responders can triage so that the resources of tertiary hospitals can be directed towards the critical patients. Additionally, basic first aid and emergency training can also be provided at the local levels so that people seeking to help accident victims have a basic knowledge of what to do and what not to do.

Read also: Highways of death, Sunir Pandey

A 2023 study by the Emergency Department of the College of Medical Sciences and Teaching Hospital over a six-month period from January to June 2022 revealed that 9.58% of the 7,654 patients had been admitted to the emergency unit for Road Traffic Accidents, and 65% of the cases had occurred along highways.

The study in the Journal of the Nepal Medical Association found that 38% of total patients admitted for RTA had soft tissue injuries, while 31% had suffered head injuries.

The situation is dire in the remoter parts of Nepal where medical facilities are few and far between, and the roads are all sub-standard. At Achham’s Bayalpata Hospital, orthopaedic surgeon Mandeep Pathak has seen an increase in mass casualties from bus and tractor accidents.

“Hospitals along highways need trauma centres and ICUs so serious patients do not need to be referred to the city,” Pathak says, adding that many do not survive the long bumpy journeys in poorly equipped ambulances.  

People are also not aware that the healing process does not end after hospital treatment. Rehabilitation is just as crucial to ensuring there are no long-term complications. 

Says Dhakal: “Deaths, critical injuries and long-term disabilities can be prevented provided emergency services and trained professionals reach accident sites on time, identify what level of care victims require, and there is rehabilitation after hospital treatment.”  

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