Fatalism, superstition, religion, and culture : road user beliefs and behaviour in Pakistan

Road traffic crashes have emerged as a major health problem around the world. Road crash fatalities and injuries have been reduced significantly in developed countries, but they are still an issue in low and middle-income countries. The World Health Organization (WHO, 2009) estimates that the death toll from road crashes in low- and middle-income nations is more than 1 million people per year, or about 90% of the global road toll, even though these countries only account for 48% of the world's vehicles. Furthermore, it is estimated that approximately 265,000 people die every year in road crashes in South Asian countries and Pakistan stands out with 41,494 approximately deaths per year. Pakistan has the highest rate of fatalities per 100,000 population in the region and its road crash fatality rate of 25.3 per 100,000 population is more than three times that of Australia's. High numbers of road crashes not only cause pain and suffering to the population at large, but are also a serious drain on the country's economy, which Pakistan can ill-afford. Most studies identify human factors as the main set of contributing factors to road crashes, well ahead of road environment and vehicle factors. In developing countries especially, attention and resources are required in order to improve things such as vehicle roadworthiness and poor road infrastructure. However, attention to human factors is also critical. Human factors which contribute to crashes include high risk behaviours like speeding and drink driving, and neglect of protective behaviours such as helmet wearing and seat belt wearing. Much research has been devoted to the attitudes, beliefs and perceptions which contribute to these behaviours and omissions, in order to develop interventions aimed at increasing safer road use behaviours and thereby reducing crashes. However, less progress has been made in addressing human factors contributing to crashes in developing countries as compared to the many improvements in road environments and vehicle standards, and this is especially true of fatalistic beliefs and behaviours. This is a significant omission, since in different cultures in developing countries there are strong worldviews in which predestination persists as a central idea, i.e. that one's life (and death) and other events have been mapped out and are predetermined. Fatalism refers to a particular way in which people regard the events that occur in their lives, usually expressed as a belief that an individual does not have personal control over circumstances and that their lives are determined through a divine or powerful external agency (Hazen & Ehiri, 2006). These views are at odds with the dominant themes of modern health promotion movements, and present significant challenges for health advocates who aim to avert road crashes and diminish their consequences. The limited literature on fatalism reveals that it is not a simple concept, with religion, culture, superstition, experience, education and degree of perceived control of one's life all being implicated in accounts of fatalism. One distinction in the literature that seems promising is the distinction between empirical and theological fatalism, although there are areas of uncertainty about how well-defined the distinction between these types of fatalism is. Research into road safety in Pakistan is scarce, as is the case for other South Asian countries. From the review of the literature conducted, it is clear that the descriptions given of the different belief systems in developing countries including Pakistan are not entirely helpful for health promotion purposes and that further research is warranted on the influence of fatalism, superstition and other related beliefs in road safety. Based on the information available, a conceptual framework is developed as a means of structuring and focusing the research and analysis. The framework is focused on the influence of fatalism, superstition, religion and culture on beliefs about crashes and road user behaviour. Accordingly, this research aims to provide an understanding of the operation of fatalism and related beliefs in Pakistan to assist in the development and implementation of effective and culturally appropriate interventions. The research examines the influence of fatalism, superstition, religious and cultural beliefs on risky road use in Pakistan and is guided by three research questions: 1. What are the perceptions of road crash causation in Pakistan, in particular the role of fatalism, superstition, religious and cultural beliefs? 2. How does fatalism, superstition, and religious and cultural beliefs influence road user behaviour in Pakistan? 3. Do fatalism, superstition, and religious and cultural beliefs work as obstacles to road safety interventions in Pakistan? To address these questions, a qualitative research methodology was developed. The research focused on gathering data through individual in-depth interviewing using a semi-structured interview format. A sample of 30 participants was interviewed in Pakistan in the cities of Lahore, Rawalpindi and Islamabad. The participants included policy makers (with responsibility for traffic law), experienced police officers, religious orators, professional drivers (truck, bus and taxi) and general drivers selected through a combination of purposive, criterion and snowball sampling. The transcripts were translated from Urdu and analysed using a thematic analysis approach guided by the conceptual framework. The findings were divided into four areas: attribution of crash causation to fatalism; attribution of road crashes to beliefs about superstition and malicious acts; beliefs about road crash causation linked to popular concepts of religion; and implications for behaviour, safety and enforcement. Fatalism was almost universally evident, and expressed in a number of ways. Fate was used to rationalise fatal crashes using the argument that the people killed were destined to die that day, one way or another. Related to this was the sense of either not being fully in control of the vehicle, or not needing to take safety precautions, because crashes were predestined anyway. A variety of superstitious-based crash attributions and coping methods to deal with road crashes were also found, such as belief in the role of the evil eye in contributing to road crashes and the use of black magic by rivals or enemies as a crash cause. There were also beliefs related to popular conceptions of religion, such as the role of crashes as a test of life or a source of martyrdom. However, superstitions did not appear to be an alternative to religious beliefs. Fate appeared as the 'default attribution' for a crash when all other explanations failed to account for the incident. This pervasive belief was utilised to justify risky road use behaviour and to resist messages about preventive measures. There was a strong religious underpinning to the statement of fatalistic beliefs (this reflects popular conceptions of Islam rather than scholarly interpretations), but also an overlap with superstitious and other culturally and religious-based beliefs which have longer-standing roots in Pakistani culture. A particular issue which is explored in more detail is the way in which these beliefs and their interpretation within Pakistani society contributed to poor police reporting of crashes. The pervasive nature of fatalistic beliefs in Pakistan affects road user behaviour by supporting continued risk taking behaviour on the road, and by interfering with public health messages about behaviours which would reduce the risk of traffic crashes. The widespread influence of these beliefs on the ways that people respond to traffic crashes and the death of family members contribute to low crash reporting rates and to a system which appears difficult to change. Fate also appeared to be a major contributing factor to non-reporting of road crashes. There also appeared to be a relationship between police enforcement and (lack of) awareness of road rules. It also appears likely that beliefs can influence police work, especially in the case of road crash investigation and the development of strategies. It is anticipated that the findings could be used as a blueprint for the design of interventions aimed at influencing broad-spectrum health attitudes and practices among the communities where fatalism is prevalent. The findings have also identified aspects of beliefs that have complex social implications when designing and piloting driver intervention strategies. By understanding attitudes and behaviours related to fatalism, superstition and other related concepts, it should be possible to improve the education of general road users, such that they are less likely to attribute road crashes to chance, fate, or superstition. This study also underscores the understanding of this issue in high echelons of society (e.g., policy makers, senior police officers) as their role is vital in dispelling road users' misconceptions about the risks of road crashes. The promotion of an evidence or scientifically-based approach to road user behaviour and road safety is recommended, along with improved professional education for police and policy makers.

Schools' guide : How to select providers of road safety education programs for senior school students

Road safety education is not just about safe driving. Best practice road safety education seeks to improve knowledge and change attitudes relating to being safe, and making sure others are safe on the road. Typical topics might include: • Strengthening attitudes toward safe road use behaviours and avoiding risks • Supporting behaviours to ensure others are safe • Promoting knowledge of traffic rules.

Vulnerable road user groups : a review of younger drivers, motorcyclists and older drivers

Scientific efforts to understand and reduce the occurrence of road crashes continue to expand, particularly in the areas of vulnerable road user groups. Three groups that are receiving increasing attention within the literature are younger drivers, motorcyclists and older drivers. These three groups are at an elevated risk of being in a crash or seriously injured, and research continues to focus on the origins of this risk as well as the development of appropriate countermeasures to improve driving outcomes for these cohorts. However, it currently remains unclear what factors produce the largest contribution to crash risk or what countermeasures are likely to produce the greatest long term positive effects on road safety. This paper reviews research that has focused on the personal and environmental factors that increase crash risk for these groups as well as considers direction for future research in the respective areas. A major theme to emerge from this review is that while there is a plethora of individual and situational factors that influence the likelihood of crashes, these factors often combine in an additive manner to exacerbate the risk of both injury and fatality. Additionally, there are a number of risk factors that are pertinent for all three road user groups, particularly age and the level of driving experience. As a result, targeted interventions that address these factors are likely to maximise the flow-on benefits to a wider range of road users. Finally, there is a need for further research that aims to bridge the research-to-practice gap, in order to develop appropriate pathways to ensure that evidenced-based research is directly transferred to effective policies that improve safety outcomes.

Successes and challenges in managing illegal road user behaviours

- The role of illegal behaviours in road crashes - Three case studies in managing illegal road user behaviour: an Australian perspective - Current and emerging challenges, including the need to: -reduce punishment avoidance -identify and manage recidivist offenders -address community attitudes and perceptions - Countermeasure implications

Sleepiness : how a biological drive can influence other risky road user behaviours

The Safe System approach to road safety utilises a holistic view of the interactions among vehicles, roads and road users. Yet, the contribution of each of these factors to crashes is vastly different. The role of road users is widely acknowledged as an overwhelming contributor to road crashes. Substantial gains have been made with improvements to vehicle and roads over a number of years. However, improvements of the road user’s behaviour has been (in some cases) less substantial. A road user behaviour that is relatively unregulated is driver sleepiness, which is part of the ‘fatal five’ of risky road user behaviours. The effect of sleepiness is ubiquitous – sleepiness is a state that most, if not all drivers on our roads has experienced, and is habitually exposed to. The quality and quantity of daily sleep is integral to our level of neurobehavioural performance during wakefulness and as such can have a compounding effect on a number of other risky driving behaviours. This paper will discuss the potential influence of sleepiness as an interceding factor for a number of risky driving behaviours. Little effort has been given to increasing awareness of the deleterious and wide ranging effects that sleepiness has on road safety. Given the wide ranging influence of sleepiness, improvements of ‘sleep health’ as a protective factor at the community or individual level could lead to significant reductions in road trauma and increases of general well being. A discussion of potential actions to reduce sleepiness is required if reductions of road trauma are to continue.

Using the Event Analysis of Systemic Teamwork (EAST) to explore conflict between different road user groups when making right hand turns at urban intersections

Collisions between different types of road users at intersections form a substantial component of the road toll. This paper presents an analysis of driver, cyclist, motorcyclist and pedestrian behaviour at intersections that involved the application of an integrated suite of ergonomics methods, the Event Analysis of Systemic Teamwork (EAST) framework, to on-road study data. EAST was used to analyse behaviour at three intersections using data derived from an on-road study of driver, cyclist, motorcyclist and pedestrian behaviour. The analysis shows the differences in behaviour and cognition across the different road user groups and pinpoints instances where this may be creating conflicts between different road users. The role of intersection design in creating these differences in behaviour and resulting conflicts is discussed. It is concluded that currently intersections are not designed in a way that supports behaviour across the four forms of road user studied. Interventions designed to improve intersection safety are discussed.

Review of the ACT Road Ready and Road Ready Plus Novice Driver Road Safety Education Course Material

This report documents research that was commissioned in order to review the materials used in the Road Ready program for relevancy and acceptability to the target audiences as part of the implementation of the ACT Road Safety Strategy Action Plan. Relevant literature on young driver crash risk and best practice principles in driver education was reviewed as a first step (Section 2). The evidence for effectiveness of driver education programs in Australia was summarised (Section 3) and a separate review of the use of incentives in relation to driver education was performed. The brief called for an expert review of the materials and delivery design for both the Road Ready and Road Ready Plus programs. This is reported in Section 5, along with the overall recommendations for program improvement. More specific comments on individual modules in the Road Ready program are listed at the end of Section 5. Lastly, feedback from stakeholders, specifically the facilitators and teachers of the programs, as well as former students who have completed the Road Ready program, was sought. Interviews and surveys were conducted with these groups. Summaries of the methods and findings are contained in Section 6.

The role of university research centres in building road safety capacity : implications for China

In recent decades, highly motorised countries, such as Australia, have witnessed significant improvements in population health through reductions in fatalities and injuries from road traffic crashes. In Australia, concerted efforts have been made to reduce the road trauma burden since road fatalities reached their highest level in in the early 1970s. Since that time, many improvements have been made drawing on various disciplines to reduce the trauma burden (e.g., road and vehicle design, road user education, traffic law enforcement practices and enforcement technologies). While road fatalities have declined significantly since the mid-1970s, road trauma remains a serious public health concern in Australia. China has recently become the largest car market in the world (Ma, Li, Zhou, Duan, & Bishai, 2012). This rapid motorisation has been accompanied by substantial expansion of the road network as well as a large road trauma burden. Road traffic injuries are a major cause of death in China, reported as accounting for one third of all injury-deaths between 2002 and 2006 (Ma et al., 2012). In common with Australia, China has experienced a reported decline in fatalities since 2002 (see Hu, Wen & Baker, 2008). However, there remains a strong need for action in this area as rates of motorisation continue to climb in China. In Australia, a wide range of organisations have contributed to the improvements in road safety including government agencies, professional organisations, advocacy groups and research centres. In particular, Australia has several highly regarded and multi-disciplinary, university-based research centres that work across a range of road safety fields, including engineering, intelligent transportation systems, the psychology of road user behaviour, and traffic law enforcement. Besides conducting high-quality research, these centres fulfil an important advocacy role in promoting safer road use and facilitating collaborations with government and other agencies, at both the national and international level. To illustrate the role of these centres, an overview will be provided of the Centre for Accident Research and Road Safety-Queensland (CARRS-Q), which was established in 1996 and has gone on to become a recognised world-leader in road safety and injury prevention research. The Centre’s research findings are used to provide evidence-based recommendations to government and have directly contributed to promoting safer road use in Australia. Since 2006, CARRS-Q has also developed strong collaborative links with various universities and organisations in China to assist in building understanding, connections and capacity to assist in reducing the road trauma burden. References Hu, G., Wen, M., Baker, T. D., & Baker, S. P. (2008). Road-traffic deaths in China, 1985–2005: threat and opportunity. Injury Prevention, 14, 149-153. Ma, S., Li, Q., Zhou, M., Duan, L., & Bishai, D. (2012). Road Traffic Injury in China: A Review of National Data Sources. Traffic Injury Prevention, 13(S1), 57-63.

Traffic safety education and health promoting school : a metropolitan and rural pilot study

Traffic Safety Education (TSE) is an important part of a school's program; however, it competes with many other components of schooling such as literacy, numeracy and a number of health areas. Hence TSE provision in Victorian schools has been somewhat fragmented and haphazard in its delivery. This small pilot study involved two metropolitan and two rural schools which attempted to link TSE into mainstream school activities through the new Victorian Essential Learning Standards (VELS) utilising the internationally accepted Health Promoting Schools (HPS) framework.
The findings of the pilot study showed that though schools face many demands, understanding and ownership of TSE is possible when administrative support, professional development and adequate planning time are made available. The report outlines several key recommendations to improve the delivery of Traffic Safety Education in Victorian schools.

Report on the Workshop on User Education Techniques for Use in Special Libraries

Informe del Taller efectuado para identificar una definicion de educacion del usuario que sea apropiada para las bibliotecas especializadas del Sistema de Informacion del Caribe; para analizar el punto de vista del usuario de los sistemas de informacion; y para revisar algunas tecnicas que permitan el uso de los medios de comunicacion para llegar al usuario.

Developing a model of library user education for freshman science students

Discusses the cooperative effort between librarians and science faculty at Bucknell University in developing an effective library use education course for incoming undergraduate science and engineering students. Describes course structure and activities, and includes a library instruction bibliography. (five references) (EA)