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Safety as a Human Right by Dinesh Mohan, Transportation Research
and Injury Prevention Programme, Indian Institute of Technology, Delhi
INTRODUCTION
Safety of individuals is increasingly interlinked with societal arrangements
and design of products we use and the environment in which we use them.
William Haddon wrote seminal pieces on the folly of focussing on "human
error" as the main cause in the occurrence of "accidents"
(Haddon, 1968, 1970, 1972, 1973, 1974, 1980). He did not like the use
of the word "accident" as he thought that this leads a feeling
of inevitability in the occurrence of these incidents. Further, he was
also convinced that the term "accident prevention" was too limiting
and prevented the evolution of other safety countermeasures useful in
limiting the severity of injury and in injury management after the event.
Instead, he insisted that it is the responsibility of governments and
civil society to ensure that individuals are enabled to live a life safe
from injury by designing safer products and the environment. But, he did
not address the issues of ideology and the power of elites that the societies
are influenced by.
Perrow (1994,1999) on the other hand, agrees with Haddon that individuals
cannot always be held responsible for "human error" under the
system they operate in but provides a more sophisticated model of systemic
imperatives: "I wish to point away from the basic and pervasive sin
identified by those who casually examine organizational failures, that
of operator error; this is given as the cause of about 80% of the accidents
in risky systems. I would put it at under 40%. I will suggest that what
is attributed to operator error stems primarily from the structure they
operate in, and thus, stems from the actions of elites. Elite errors and
elite interests stem from their class and historical power positions in
society, and changes in these positions are glacial." (Perrow,1994).
Obviously, societal responsibility in the control of injuries becomes
paramount when the problem is stated in these terms. Morbidity and mortality
due to injuries have always existed in the past but their recognition
as a public health problem is a phenomenon of the mid-twentieth century.
Policy makers and safety professionals in every country find it very difficult
to institute changes that actually result in a dramatic decrease in fatalities
due to injuries. This is partly because for many unsafe situations we
still don't have solutions and access to alternative designs. But the
problem persists mainly because we have not recognised the right of individuals
to a safer life in consonance with principles of public health.
NEED FOR A CHARTER ON RIGHT TO SAFETY
Systems that ensure a life safe from injury cannot be put in place unless
there is a societal and political understanding about the ethical and
moral responsibility of the state and civil society to ensure the right
to life of all its citizens. This right to life includes living in good
health according to currently available knowledge and technology. A document
prepared by safety professionals summarises some of these issues as follows
(Maurice, P. et al., 1998):
- Safety is a fundamental human right.
- Safety is a state in which hazards and conditions leading to physical,
psychological or material harm are controlled in order to preserve the
health and well-being of individuals and the community. It is an essential
resource for everyday life that an individual and a community need in
order to realise their aspirations.
- There are two dimensions to safety : one is objective and assessed
by behavioural and environmental objective parameters and the other
is subjective and appreciated according to the feeling of safety of
the population. Both dimensions can influence each other either positively
or negatively. It is therefore necessary to consider these two dimensions
to improve the safety of the population.
- Safety is a pre-requisite to the maintenance and improvement of the
well-being and health of the population. It is the result of a dynamic
balance that is established between the different components within
a specific setting.
It is impossible to ensure safety of individuals by "educating"
them and there is a wide variation between people's knowledge and their
actual behaviour (Robertson, 1983). This is particularly true for those
situations where we cannot select the people who will be involved in a
particular activity like homes, road space and most working environments.
On any given day a population would include individuals with any of the
following problems:
- Those who cannot concentrate on the job at hand because they have
suffered a personal tragedy recently - death of a loved one, loss of
a job, failure in an important examination, monetary loss, etc.
- Those who are disturbed because of problems in personal relationships
with a spouse, parent, sibling or close friend.
- Persons taking medication or drugs which alter behaviour and perceptual
abilities, or those who are under the influence of alcohol.
- Children whose cognitive and locomotor abilities make it difficult
for them to understand or follow instructions given to them.
- Elderly people whose motor and cognitive functions are impaired
- Psychologically disturbed persons who may not be able to function
as desired but who cannot be singled out from participation in a specific
activity.
If we add up the number of individuals who could be included in the above
categories on any given day it would amount to a significant proportion
of people on the road or work place (20-30 percent?). These individuals
cannot always be identified or prevented from participating in these activities.
It is also a fact that their presence on the road or work place is not
out of choice, but a compulsion. In our modern ways of living we have
to use products and do things at places and at times which are determined
by someone else or by the society at large. A large number of us have
little choice in the design of the home we live in, the design of the
tools we use, or the work place where we spend a major part of the day.
We also don't know the potential hazards of many of products we use and
in many cases it is impossible to find out the nature of the hazard on
our own.
Therefore, we have a societal and moral responsibility to design our
products, environment and laws so that people find it easy and convenient
to behave in a safe manner without sacrificing their needs to earn a living
and fulfil their other societal obligations. The systems must be such
that they are safe not only for "normal" people but also for
those individuals who might belong to any of the groups listed above.
These kinds of designs, rules and regulations would reduce the probability
of people hurting each other or themselves even when they make mistakes.
PEOPLE'S RIGHT TO SAFETY
In cognisance of the above facts and aware of our responsibility for moving
toward a world where the right to life has to be ensured for all, a workshop
on people's right to safety was organised jointly by the Transportation
Research and Injury Prevention Programme (TRIPP) of the Indian Institute
of Technology, Delhi, and the South Asia Forum for Human Rights (SAFHR)
in association with the Fifth World Conference on Injury Prevention and
Control, held in Delhi, India, in March 2000. Following the discussions
at the Workshop, the participants of the Conference adopted the Delhi
Declaration On People's Right to Safety on 8th March 2000. A draft of
the Charter on People's Right to Safety was circulated to all participants
and put up on the websites of TRIPP and SAFHR for discussion among human
rights groups. Based on comments received a Draft Convention on People's
Right to Safety was prepared. This draft was discussed at a pre-conference
Workshop on People's Right to Safety in Montreal on 11th May 2002 before
the 6th World Conference on Injury Prevention and Control held in Montreal
12-15 May 2002. The draft was finalized at the workshop and circulated
to all participants at the Conference and comments invited. The draft
was finalized based on comments received and put up for adoption at the
closing ceremony of the conference. The participants of the conference
adopted the document as a declaration at the closing session.
The declaration is now available for discussion and refinement. For injury
control to become a serious public health issue internationally this document
needs to be recognised as a starting point for establishing people's right
to safety as a fundamental right endorsed by individual states and the
United Nations jointly.
REFERENCES
Haddon W. Jr. (1970). On the Escape of Tigers: An Ecologic Note, Am J
Public Health, 60(12):2229-2234.
Haddon W. Jr. (1972). A logical framework for categorizing highway safety
phenomena and activity. J Trauma, 12(3):193-207.
Haddon W. Jr. (1973). Energy damage and the ten countermeasure strategies.
Hum Factors, 15(4):355-66.
Haddon W. Jr. (1980). Advances in the epidemiology of injuries as a basis
for public policy. Public Health Rep, 95(5):411-21.
Haddon W. Jr. (1974) Editorial: Strategy in preventive medicine: passive
vs. active apprroaches to reducing human wastage. J Trauma, 14(4):353-4.
Haddon, W. Jr. (1968). The changing approach to the epidemiology, prevention,
and amelioration of trauma: the transition to approaches etiologically
rather than descriptively based. Am J Public Health, 58(8):1431-8.
Maurice, P. et al. (1998). Safety and Safety Promotion :Conceptual and
Operational Aspects. Quebec WHO Collaborating Centre for Safety Promotion
and Injury Prevention, Quebec, Canada.
Perrow, C. (1999). Normal Accidents : Living With High-Risk Technologies,
Princeton University Press, Princeton NJ, USA.
Perrow, C. (1994). Accidents in High Risk Systems. Technology Studies,
1(1):1-38.
Robertson, L.S. (1983). Injuries: causes, control strategies and public
policy. Lexington Books, Lexington, MA, USA.
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