An interview with road safety expert,
Dr Varuni Tennakoon
For your PhD, you established a foundation for age- and disability-friendly road safety policies in Sri Lanka. Can you tell us about that?
In parallel with the context of low- and middle- income countries (LMICs), road traffic crash deaths and related injuries have become a major public health issue in Sri Lanka. Sri Lanka is a lower-middle income country and challenges to safe transportation is escalating with increased urbanisation and motorisation.
Vulnerable road users such as older people and people with disabilities are at higher risk of real and perceived risks of road traffic injuries (RTIs). A greater understanding of road safety risks among these population groups within the cultural contexts in which they occur can inform the prioritisation and implementation of equitable transport policies.
I am Sri Lankan and have been raised there. I am a medical practitioner and have been involved in hospital based health care services in Sri Lanka where I observed the burden of RTIs and related deaths on individuals, their families and health care settings.
This ignited my interest in gaining a better understanding of the associated risks, particularly among marginalised groups such as older people and people with disabilities to inform road safety policy development in Sri Lanka.
I pursued my doctoral degree at University of Auckland, New Zealand. Presently, I work as a senior lecture at Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.
Incredible work! What did you find during your PhD?
The overarching aim of this research was to identify risks relating to road safety and transportation among older people and people with disabilities living in Sri Lanka. The specific aims were to,
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1). Identify risks, needs and suggestions for road safety among older people and people with disabilities,
2). Determine the epidemiology of RTIs resulting in hospital admission, particularly considering relationships with older age and pre-existing disability,
3). Identify opportunities and provide research-based evidence to improve road safety for these vulnerable road users.
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A mixed-methods design was used. The data were collected during January, 2017 - November, 2017 in the Colombo district of Sri Lanka. The quantitative research approach included a household travel survey and a review of hospital-based RTI clinical data. The qualitative research approach included focus group discussions with older people and people with disabilities, a photo-voice and stakeholder key informant interviews.
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The older people and people with disabilities in this study setting were generally from poor socio-economic backgrounds and relied heavily on public transport and walking for travelling. They engaged in limited short distance travel trips and perceived that the existing road safety risks have adversely affected their daily lives and well-being. The hospital-based study revealed that compared to younger victims (< 60 years of age), older victims (60 years and above) were more likely to have sustained severe head injuries, fractures and die from their injuries.
There was minimal documentation regarding pre-existing disability (physical, sensory, learning, and psychological) in the reviewed hospital records. Lack of age- and disability-friendly road environment and transport modes, policy and institutional constraints, inadequate political will, ineffective law enforcement, and negative attitudes and lack of awareness of general public and transport service providers were identified by participants in the focus groups and stakeholder key informant interviews as threats to their road safety. The triangulated findings showed that inequities in socio-economic position, an unsafe built road environment, unsafe transport vehicles and services, inadequate and ineffective transport policy, and society’s perceptions of older people and people with disabilities increased the vulnerability to road safety risks and well-being of older people and people with disabilities.
Some fascinating and really important findings there. How do you see this contributing to Injury Prevention?
The findings of this research support the need for a national road safety strategy in Sri Lanka that ensures equitable opportunities for safe transportation by all. The key strategies towards such system include improving the structure and functionality of road systems and transport vehicles, developing an age- and disability-friendly transport policy, establishing a road traffic injury surveillance system, effective legislature and enforcement, multi-sectoral involvement with supportive work environments, along with the fostering favourable societal attitudes towards older people and people with disabilities.
What are your plans now?
At the completion of the PhD, the candidate is keen to:
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Engage in research dissemination activities including communication (through user-friendly formats) with relevant authorities, stakeholders and at community level, scientific conference presentations, and publications
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Networking with other researchers in the same filed in Sri Lanka and overseas to engage in further research and to build-up on the research capacity in the Sri Lankan context.