Political Geographies of Human Accidents and Trauma Care in Mumbai's Commuter Railways

Traffic-related trauma is now a leading cause of preventable death (WHO, 2009-2018), especially in low and middle income countries (LMICs), and is gaining increasing attention in policy, planning and scientific research. Scholars working on both prevention and access to trauma care in the global south have underscored persisting challenges in the form of multiplication of legislation, lack of co-ordination between planning agencies, fragmentation of statistics and severe resource deficits (Bhalla et al., 2017, 2019; Mohan, 1984; Sanghavi et al., 2009). While existing scholarship concentrates mostly on road-fatality, this study contributes insights on railway-trauma in the context of Mumbai, where hundreds of lives are lost or incapacitated yearly in track-related incidents across the city. Nearly a third of the dead remain untraced.
The research combines archival data and legal and policy analysis with a multi-sited ethnography of accident-work with a range of people - emergency response, medical care, investigation and case closure, and adjudication for compensation - as well as those involved in health and death care activism. Through this multi-focus on law, policy and practice, the research develops a nuanced, historical and systematic account of state response to human accidents in Mumbai. The findings offer extremely valuable insights for efforts in reducing the number of deaths and injuries in railways in India, addressing the needs and concerns of frontline agents in performing their roles in trauma and death care, and in securing appropriate support and justice for victims and their families.
A key finding of the dissertation is how 'accident-care' is produced as 'accident-al care', and the effects it has on both accident-victims and accident-attendants. On the one hand, human accidents are marginalised through abstracted systems of legal classification and jurisdictional fragmentation between the railway and the city. Legal classification of human accidents as outcomes of individual deviant behaviour within railway administrative law serves to depoliticise accidental injury and absolve the railways of accountability. It also severely undermines the scope of justice for victims and family. At the same time, the codification of accidents as medico-legal cases within criminal law expands the role of police and other state agents in their after-life. However, within the broader political economy of trauma care in India with its absence of a robust pre-hospital system, the police start to become less of the keen investigators and more of victim-carers in this encounter with the accident, what I call the 'accident-al' accomplishment of accident-care. Considering that a large number of accidents result in death and several of the dead remain unidentified/untraced, the involvement of the police is extended further into the domain of social management of death too. During the fellowship, I will consolidate my existing research on this topic, making its findings available to academics as well as policy makers, practictioners, and the wider public.
This will be achieved via written pieces for both academic and non-academic audiences in the form of journal papers, blog articles and presentations at conferences; and development of a manuscript project proposal. In addition, two stakeholder engagement events will be held to share my research findings and address the key opportunities and challenges facing institutional actors who are at the front lines of public health and deathcare provisioning in India.This will also promote the value of knowledge exchange. A period will also be spent back out in the field to undertake new research in institutional archives. Additionally, the fellowship will contribute to career and personal development through offer of advanced skills and methods training, mentorship for developing future research grant proposals, as well as opportunity to build wider networks and collaboration.