Faces of Public Health: Rochelle Sobel

Aug 24, 2012, 6:28 PM

Faces of Public Health is a recurring editorial series on NewPublicHealth featuring individuals working on the front lines of public health and helping keep people healthy and safe.

Rochelle Sobel, Association for Safe International Road Travel Rochelle Sobel, Association for Safe International Road Travel

According to the U.S. Centers for Disease Control and Prevention (CDC), each year 1.3 million people are killed and 20 to 50 million are injured in car crashes around the world. Most of the crashes happen in low- or middle-income countries, and 25,000 of the deaths are among tourists. In fact, nearly half of medical evacuations back to the United States, which can cost $100,000 or more, are the result of a car crash.

According to the CDC, reasons for an increase in crashes in foreign countries include:

  • More people driving cars and other motorized vehicles
  • Poorly maintained roads
  • Insufficient traffic laws and poor enforcement in some countries
  • Insufficient emergency response capabilities in some countries

Rochelle Sobel knows the worst possible outcome of these crashes first hand. She founded the Association for Safe International Road Travel (ASIRT) in 1995, after her son, Aron, was killed in a bus crash in Turkey along with 22 other passengers from many countries, just two weeks before his graduation from the University of Maryland Medical School. The bus Aron was traveling on was speeding down the wrong lane of a narrow, poorly maintained road with no guard rail. The bus hit oncoming traffic and plunged down an embankment, landing on its side. Emergency medical crews were slow to respond, likely a factor in at least some of the deaths. After the crash the U.S. Ambassador to Turkey recommended the creation of a road safety organization to protect both American citizens abroad and residents of countries around the world.

NewPublicHealth spoke with Rochelle Sobel about ASIRT.

NewPublicHealth: ASIRT was started out of personal tragedy, the loss of your son Aron, in a bus crash in Turkey. How did you get started?

Rochelle Sobel: The first thing I did was talk to the U.S. embassy in Ankara, and I asked them if they could please tell me when such crashes occur again, and they said, “Mrs. Sobel, we’d be calling you constantly.” That led me to understand that this is indeed a health issue that was not getting the kind of public attention that it deserved. So I started to call different organizations, and unfortunately, it was not yet recognized as a health issue. So we decided to become the organization that would bring attention to the issue. We got help from the embassy; we got a lot of help from the State Department. We asked the State Department to start collecting data on the numbers of Americans who die abroad in road crashes by country, and they discovered that it was the single greatest cause of death for healthy Americans traveling abroad.

NPH:  Is that still the case?

Rochelle Sobel: Yes. Even more so because more and more Americans travel to developing and mid-economic countries for business, for pleasure, for study, for humanitarian purposes and for medical tourism.

NPH: How have international organizations responded more recently?

Rochelle Sobel: The World Health Organization started to recognize this as an issue, and the United Nations has passed, over the last few years, five road safety resolutions. Unfortunately, this death rate is going to escalate dramatically unless action is taken because of the increased number of young people traveling and because of the roads, which are not keeping up with the increased vehicles that are coming on. And often the vehicles being used in these countries are not necessarily road worthy.

What’s really frustrating is this is really a preventative health issue; essentially unlike so many diseases, we know what the cures are. We know how to dramatically reduce the death rate and what we have to do is push – we have to push governments. We need political will and we also need funding organizations to recognize this as a preventative health issue, which it indeed is.

NPH: And what progress have you seen recently?

Rochelle Sobel: They’re working on this, which is really good. We’re trying to actually get them to give us more data on particular roads. We issue detailed road travel reports on over a 150 countries because we want all travelers to know the status so that they can make wise decisions. ASIRT is involved in data collection, and we’re also working with the study abroad community. A bill was passed in Congress not long ago encouraging students to study abroad, including in developing countries. That’s a wonderful thing, but everyone needs to know there’s a road risk and we need to invest in solving that.

We work with the corporate world because they send people abroad more and more. We’ve been asked by many corporations for our road travel reports and to come and talk to their employees, and we work with the U.S. embassies in every country that we possibly can because we would like the embassies to take a proactive role in road safety in the host countries in which they work.

We also helped form a congressional caucus on global road safety because congressional constituents are at risk when they go abroad and we work with Foreign Service employees to educate them and so they can educate visitors to their countries. We think we should be educating people about road risk in foreign countries just as we educate about terrorism. And, if you look at the relative risk, it is so much higher for road crashes.

NPH: What’s next for ASIRT?

Rochelle Sobel: We’re expanding the countries in which we work on road safety; we have a strong goal to grow the Congressional Caucus, and also to push the issue of prevention. We’re very excited that the United Nations has declared 2011-2020 the Decade of Action for Global Road Safety, and countries have been pushing the agendas that they want to fulfill within this ten year period. And it’s not just words. There are status reports that are coming out every few years on how well countries are doing and what improvements have been made in such things as seat belt use and child safety seat use.

In foreign countries, road crashes actually kill more people than HIV/AIDS, more people than malaria, and certainly more people than plane crashes. I always say to myself what would happen if ten jumbo jets would crash every single day somewhere in the world? There would be hysteria. But that’s essentially what’s happening in road crashes and yet the world is quiet. So really drawing attention to it is one ASIRT’s messages.

We’re also honored to be part of a consortium of six organizations that are working on road safety in the ten countries where 40 percent of road deaths occur, funded by the Bloomberg Philanthropies. Together we are going into these ten countries and pushing governments. ASIRT has the additional job of bringing my personal story into it and putting a face on crashes, and also working with the tourism sector because tourism is really a sector that impacts upon the economy of all of these countries. If I invite you to my home I do everything I can to keep you safe and comfortable. Certainly you owe me that when I’m invited to your country.

NPH: And you’ve also gotten funding from the Centers for Disease Control and Prevention.

Rochelle Sobel: Yes. We had received World Health Organization funding for a project called “Faces behind the Figures.” We interviewed people from all over the world who had lost loved ones in road crashes or themselves been injured to show how – as I always say, road crashes do not respect borders. Everybody is vulnerable. We’re doing the same through CDC with a “Faces” project for Latin American countries. One goal is to reach policy-makers because the decision-makers are the people that can help us. ASIRT’s other goal is working with NGOs. So through the “Faces” in Latin America, we’re able to impact both ends of the spectrum, the grassroots as well as the policy-makers.

NPH: What do you see as your chief accomplishment so far?

Rochelle Sobel: When we first started this, the world did not recognize this as a global issue because two people died, three people died, but the impact – the huge impact, was not recognized. Well, now it is and now it’s really a time to really effect major change. So, the chief accomplishment, I think, is awareness. I think the recognition that this is an issue, and most of all, that it’s a preventable issue has been a huge contribution.

Road safety is not an accident. It’s predictable and it is preventable and it is one of the most serious health issues that face our globe.

This commentary originally appeared on the RWJF New Public Health blog.