When Piyush Tewari took to the stage in April to accept an award at the Skoll World Forum in Oxford, England, the applause was rapturous. But his story was somber.
“On 5th April 2007, my cousin Shivam had a serious crash. He asked passersby for help, but nobody did anything that would save his life. After waiting for help, he passed away on the scene.
The trauma that I experienced following the incident got me to start looking at the issue very closely. Something had to change. I took time to travel across India to understand what really was happening in the country, and I fundamentally learned three things.
I learned that road crashes are a public health issue that kill 1.35 million people globally each year.
The second thing I discovered was that nearly 50% of those killed in crashes in India died despite having treatable injuries.
And the third thing I discovered was that the public inaction was not apathy. It was a very profound fear of being blamed for the incident itself.”
This was tragically all too true for Shivam. “I discovered that the death occurred not necessarily because of the severity of the crash, but because of a very profound delay in help that my little cousin could never get,” Tewari says now.
The year after Shivam’s death, Tewari started the SaveLIFE Foundation, focused on road safety. The need is pressing: in India in 2022, there was roughly one death from a road crash every three minutes. While road safety is a complex combination of urban design, traffic policies, enforcement, and habits, early on the SaveLIFE Foundation honed in on a specific aspect: the freedom to help crash victims, without fear.
The Long Path to a Good Samaritan Law
Good Samaritan laws are not the same as duty to rescue laws. The former provide legal protection to helpers, while the latter require people (usually health workers or authority figures) to provide aid in certain circumstances.
Traditionally, Indian bystanders didn’t get involved in connecting road crash victims to formal emergency services, Tewari says. This was partly a historical legacy of colonialism.
“The treatment meted out to Good Samaritans is a bit of legacy from the British Raj in India,” Tewari explains. The British mandated that not only Indian independence fighters, but also those bringing them to hospitals, were recorded by police. After India gained independence, this practice became part of standard operating procedure at hospitals. The name and contact details of the person transporting the victim were noted down in a form.
This made it easier to identify perpetrators or witnesses. But it also led people to fear being involved in legal processes, or perhaps even unfairly being blamed for the collision.
The SaveLife Foundation commissioned a compendium of Good Samaritan laws around the world. Tewari explains, “What we learned from those laws was that while in many countries Good Samaritan laws existed to protect Good Samaritans from civil liability, in India it was required to protect them from criminal liability.”
To remove that criminal liability, the foundation and others worked on new guidelines for bystander protection, which were brought to India’s Supreme Court. It took about four years for the Supreme Court to turn the guidelines into law, and another three years for Parliament to pass the Motor Vehicles (Amendment) Act, 2019, which included a Good Samaritan section.
With the law, Good Samaritans do not have to face police questioning, be detained in hospitals, pay fees, undergo lengthy court procedures, or provide personal information.
Tewari sums up these protections: “It addresses the fear aspect.”
After the Law
As with so many regulations, passing the Good Samaritan Law, as long as this took, is only half the battle. The other half is ensuring that it is respected. Tewari recalls the challenge they faced in 2016: “How do you tell 1.4 billion people that they have a new right?”
Media, social media, and government communications all played a part in spreading knowledge of the new law. Information about the law has been included in school curricula and commercials. However, “We still have some way to go,” Tewari acknowledges.
One gap is the absence of a procedure for dealing with grievances, if a bystander is harassed despite being protected under the law. Another is a need for more first-aid training.
“The implementation of Good Samaritan Law is still very poor,” reports Dilip Kumar Panda, the president of the NGO SAFE India. He believes that further training is needed to ensure that Good Samaritans don’t continue to face harassment, owing to authorities’ limited knowledge of the law.
For instance, in 2021 SAFE India ran trainings for 540 doctors and paramedics in Cuttack, in the state of Odisha. Panda was astonished by what the attendees reported. Fewer than 10% were aware of the Good Samaritan Law, and none had learned about it at work. 95% said that they collected the personal information of road crash bystanders.
This applies to other authorities as well. According to Panda, “The awareness level of police is little higher than doctors.” If these key groups don’t know what the law is, they can’t spread the knowledge to others.
Panda says that drivers, volunteers, and others have helped to save lives by taking victims to hospitals. “But the thing is that when they take accident victims to hospitals they are facing problem from doctors or hospital staff and also police reach there and start questioning.” SAFE India has intervened in cases like these, by communicating the issues to higher-ups. More broadly, the government needs to conduct further training to ensure that people in positions of responsibility, especially, are aware of the law.
But overall, there are indications of a sea change in public attitudes. Tewari says that in 2012, the SaveLife Foundation conducted a nationwide survey, which found that roughly three out of four people were unwilling to help a person injured on the road. In 2023, the figures have reversed: three out of four people surveyed were now willing to come forward to help.
Beyond the Law
The Good Samaritan Law is necessary but not sufficient to address the scale of road traffic violence in India. From making cities more walkable to designing safer intersections to simply marking lanes on highways, there are many opportunities to save lives through road design.
SAFE India also works on encouraging safe driving behavior. And the SaveLife Foundation has been advocating for stronger emergency care overall. This requires addressing fragmentation across states and across systems.
Having an all-purpose emergency phone number is an example. Tewari says that while there is a universal emergency number, 112, only a few states have been able to integrate it. Then there’s the question of what happens after a bystander calls for help. Both the equipment and the personnel need to be equipped for trauma care. Yet according to Tewari, a basic patient ambulance doesn’t have life-saving equipment. The equipment problem is easier to solve than the human resource problem, including bureaucratic hurdles like accrediting paramedics. “That’s a piece that is fractured and that needs to be addressed as part of the right to trauma care law that SaveLife is advocating for,” Tewari says.
The foundation began advocating for this right to trauma care law in 2023. There has been support from the transport and health ministries, but the challenge is to make state governments integrate it and to allocate resources to it, Tewari says.
When musing on what other countries can learn from India’s road safety journey, Tewari says, “I think the biggest lesson that we have is around cultural empathy. We got a lot of guidance from the West around how to address road crashes over the last many years. That guidance misses the some of the ground realities that countries like India face; it takes into assumption that certain things that are available in the West will also be available in the global South.”
For instance, guidance from some UN agencies that focuses on things like child seats and seatbelts are not so relevant, Tewari argues. As “40% of all deaths on Indian highways are rear-end collisions,” aspects like driver fatigue are more pertinent.
The good news, Tewari says, is that “a lot of people see this as a resolvable issue, as a solvable problem.”
