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

创伤相关创伤现在是可预防死亡的主要原因（世卫组织，2009 - 2018年），特别是在低收入和中等收入国家（LMIC），并在政策，规划和科学研究中获得越来越多的关注。在全球南部从事预防和获得创伤护理的学者强调了持续存在的挑战，这些挑战表现为立法倍增、规划机构之间缺乏协调、统计数据分散和严重的资源短缺（Bhalla等人，2017，2019; Mohan，1984; Sanghavi等人，2009年）。虽然现有的奖学金主要集中在道路死亡，这项研究有助于在孟买的背景下，铁路创伤的见解，其中数百人丧生或丧失能力，每年在整个城市的轨道相关的事件。近三分之一的死者下落不明。该研究将档案数据和法律的和政策分析与事故工作的多地点民族志相结合，其中包括一系列人员-应急响应，医疗保健，调查和案件结案，以及赔偿裁决-以及参与健康和死亡护理活动的人员。通过对法律、政策和实践的多重关注，本研究对孟买的人为事故做出了细致入微、历史性和系统性的描述。研究结果为减少印度铁路伤亡人数的努力提供了非常有价值的见解，解决了一线代理人在履行创伤和死亡护理职责时的需求和担忧，并为受害者及其家人提供了适当的支持和正义。以及它对事故受害者和事故服务人员的影响。一方面，由于法律的分类和铁路与城市之间的管辖权分割的抽象体系，人为事故被边缘化。在铁路行政法中将人为事故归为个人越轨行为的结果，这一法律的分类有助于使意外伤害非政治化，并免除铁路的责任。它还严重损害了为受害者及其家人伸张正义的范围。与此同时，将事故编纂为刑法中的法医案件，扩大了警察和其他国家代理人在死后的作用。然而，在印度创伤护理的更广泛的政治经济中，由于缺乏强大的院前系统，警察开始变得不那么热衷于调查，而更多地成为事故中的受害者护理者，我称之为事故护理的“意外”成就。考虑到大量事故造成死亡，而且一些死者身份不明/下落不明，警察的参与也进一步扩大到死亡的社会管理领域。在奖学金期间，我将巩固我对这一主题的现有研究，将其研究成果提供给学者以及政策制定者，实践者和更广泛的公众。这将通过以期刊论文，博客文章和会议演讲的形式为学术和非学术受众撰写的书面文章来实现;并制定手稿项目提案。此外，还将举办两次利益相关者参与活动，分享我的研究成果，并解决印度公共卫生和临终关怀提供第一线的机构行为者面临的关键机遇和挑战。这也将促进知识交流的价值。还将花一段时间回到外地，对机构档案进行新的研究。此外，该奖学金将通过提供先进的技能和方法培训，指导制定未来的研究补助金提案，以及建立更广泛的网络和合作的机会，为职业和个人发展做出贡献。

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.