Afghan Troops Lose an Airlift Lifeline — U.S. Crash Victims Lose Lives, Limbs, and Livelihoods Too

Afghan Troops Lose an Airlift Lifeline — U.S. Crash Victims Lose Lives, Limbs, and Livelihoods Too

May 22, 2013

Dear Care for Crash Victims Community Members:


May 21, 2013 is the anniversary of the day Clara Barton , Nurse, Humanitarian, held the first meeting in 1881 of what was to become the American Red Cross.


On May 20th this week, the front page Washington Post carried an important article from Afghanistan by Kevin Sieff that is relevant to all people concerned with timely, optimal, emergency medical care.


Tragic Losses of Withdrawal from Afghan War

KANDAHAR, Afghanistan — As soon as the Taliban bullet struck 24-year-old Afghan Sgt. Nazir Moradi’s leg, the men in his unit began brainstorming a way to get him off the battlefield.

The roads were too dangerous for an army ambulance. The Afghan soldiers, in several calls to their commanders, repeated one plea: They needed a helicopter.


The Afghan air force didn’t have any working aircraft available. The U.S. military, in the midst of drawing down its air support, denied a request for help. Instead, Moradi was carried for miles and eventually put in an unarmored ambulance impeded by rough terrain and the threat of roadside bombs.


By the time Moradi arrived at the Kandahar Regional Military Hospital, more than three hours away, he had bled to death from a minor wound. Hospital workers carried him to the morgue in a flag-draped coffin, the ritual they perform each time a soldier arrives too late.


“We kept waiting for a helicopter, either American or Afghan. But it never arrived,” said Pvt. Morabuddin, Moradi’s best friend. “He did not have to die.”


Source:Without U.S. helicopters, Afghans struggle to save wounded

The tragedies in Afghanistan and the many crash victims in the U.S. each year that also do “not have to die” have something in common — lack of timely, optimal, emergency medical care.


Tragic Losses from the Invisible War on Crash Deaths

There has been an invisible war going on at least since Nixon held secret, but taped, meetings with Henry Ford II and Lee Iacocca fighting against safety and auto pollution regulations in the White House on April 27, 1971.


Source:Nixon And Detroit – Transcript | Rollover | FRONTLINE | PBS

I have worked on these issues since 1966 and served in this Invisible War on the side of safety. In the 1970s I fought against gutting pollution standards. In the 1980s I fought the Reagan Administration’s rescission of the air bag regulations and the cut of NHTSA staff by 300 workers — one third the agency. Thirty years later NHTSA still operates at that reduced staffing level. As a NHTSA veteran I can use the word war without exaggeration. The 1983 Supreme Court also used the term war.


In 1983 the U.S. Supreme Court ruled in a rare 9 to 0 decision that NHTSA’s rescission of its passive restraint standard had been arbitrary and capricious. In fact, the Court stated that: “For nearly a decade, the automobile industry waged the regulatory equivalent of war against the airbag and lost — the inflatable restraint was proved sufficiently effective.”


Since 1978 when I joined NHTSA, the number of crash victims who died of injuries counted in the U.S. now exceeds 1,500,000 Americans. In addition, the number seriously injured is estimated at about 6 million Americans.


Since 1991, I have worked to improve care for crash victims at NHTSA until 2007, and subsequently as an actively retired citizen researcher. I find that the numbers of crash victims who die of their injuries in the U.S. each year are both tragic and not covered by the media as well as was done by the Post in Afghanistan.


In the attached spreadsheet of crash deaths by year, we find that NHTSA counted 32,315 crash victims died of their injuries in 2011 with emergency medical treatment that too often, was too little, too late. Of that number of crash fatalities there were 17,972 Americans (56%) that were “Not Taken to Hospital” . The number of crash fatalities that year that died after transport to some facility for some level of medical treatment was 14,343 Americans (44%). Source: Fatalities by State attached.


In 2012, crash fatalities increased to a daily rate of nearly 100 per day and 400 serious injuries.

NHTSA crash fatality statistics do not count the number of survivors who live with serious disabilities caused by brain injuries, spinal cord injuries (paraplegia and quadriplegia), amputations, burns, and disfigurements.


It is DOT policy to attribute dollar values to a statistical life lost and serious injuries. Applying those figures to the current rates of American crash losses of life and serious injuries amount to about $1 Billion per day.


Lessons from Afghanistan

During President Obama’s first term, 132,250 Americans died of crash injuries in the U.S.A. — more than died in the Afghanistan, Iraq, and Viet Nam wars combined.


As I wrote in my attached January 2013 Report, President Obama needs to apply the lessons learned in Afghanistan right here in America.


“Imagine a goal that the nation will achieve Golden Hour medevac for serious crashes of 1 hour or less by the year 2020 here in the U.S.A. President Obama’s Secretary of Defense Robert Gates has already set and met that goal in Afghanistan.


“JIM LEHRER: Mr. Secretary, much has been written and said about your last four and a half years as secretary of defense. And a lot of people have been assessing your performance. What do you think of the way you’ve performed as secretary of state the last – secretary of defense the last four and half years?


ROBERT GATES: “I will say that I think that the thing I’m proudest of is what I’ve been able to do for our troops, giving them these heavily armored vehicles, these Mine Resistant Ambush Protected vehicles; giving them one-hour medevac or less in Afghanistan… trying to do whatever was necessary to help them accomplish their mission and come home safely.” (Emphasis added)” Source:


We can do this in America. NHTSA published a paper in 2005 on what we can do to improve emergency care for crash victims. See


But as can be seen by the recent reports the President seems to have lost his “juice.” And despite the gun violence tragedies — legislation has stalled. Thus citizens need to arm themselves with facts and reasons to gain more bipartisan support for helping crash victims.


Citizen Action Tool

To help citizens gain congressional support for doing more to help crash victims receive timely, optimal, emergency medical care I offer a free new tool.


We just published a new Crash Death Mapping Tool for citizens to easily learn how many people have died of crash injuries in their 2013 Congressional District over the past decade. This enables citizens to show their representatives, with just a click, the magnitude of the problem of crash deaths in their District. The Crash Death Mapping Tool is available at under U.S.A. Crash Death Clock. ESRI also published the tool under the title Mapping Traffic Fatalities by Congressional District at


I hope this tool helps us reduce the number of tragedies of people who “do not have to die” because the emergency medical care they receive is too little, too late. When crash victims are seriously hurt, we have a moral obligation to care enough to send the very best rescue resources — in time to save lives and prevent disabilities.


NHTSA Reports on Increasing Injury Vulnerability of Crash Victims as We Age

NHTSA Reports on Increasing Injury Vulnerability of Crash Victims as We Age

May 22, 2013

Dear Care for Crash Victims Community Members:

NHTSA has put one of its finest statisticians to create a very detailed major report on the effects of aging and gender on fatality and injury risk of vehicle occupants in crashes. NHTSA is now seeking public comment with the following notice. In a nutshell as we age we become more vulnerable to crash forces.


Injury Vulnerability and Effectiveness of Occupant Protection Technologies for Older Occupants and Women (DOT HS 811 766):

This report quantifies the effects of aging and gender on fatality and injury risk of vehicle occupants, based on statistical analyses of crash data. Fatality risk, given similar crashes, increases by about 3 percent per year that people get older, starting around age 21. Risk is, on average, 17 percent higher for a female than for a male of the same age, but the added risk for females has substantially diminished in recent vehicles. Older people are susceptible to thoracic injuries, especially multiple rib fractures. Women are susceptible to neck and abdominal injuries and, at lower severity levels, arm and leg fractures. All of the major occupant protection technologies in vehicles of recent model years have at least some benefit for adults of all age groups and of either gender; none of them are harmful for a particular age group or gender.


You may view the Federal Register notice in PDF format at or in text format at Comments are due on September 25, 2013 and should be sent to Docket No. NHTSA-2013-0072. The notice explains how to send comments.

If you have any questions about this report, please feel free to contact the author and Chief of the Evaluation Division, Charles J. Kahane, Ph.D., 202-366-2560,

In a nutshell as we age we become more vulnerable to crash forces.


In a paper I co authored in 2005 published by NHTSA I tried to address how we could use occupant age in URGENCY software to expedite appropriate emergency medical care. See click on URGENCY.


One more comment as I skimmed this Report is I wish NHTSA would not refer to potentially fatal crash forces as “insults”.


See p. 43

TABLE 2FATALITY RISK, GIVEN SIMILAR PHYSICAL INSULTS, RELATIVE TO A 21 YEAR OLD OCCUPANT OF THE SAME GENDER IN THE SAME SEAT POSITION DRIVERS AND RF PASSENGERS, ALL CARS AND LTVs, BY OCCUPANT AGE Hopefully the next NHTSA Report will address potential remedies for all crash victims who are aging every year — and not use the word “insults” for injurious crash forces.