The Economist February 19th 2022 Asia 51PublichealthA million ways to
die in the east
L
istencarefullyandagentlesound
can be heard across India: a collective
sigh of relief. The third wave of covid19 to
hit the country is ebbing fast. On February
15th Mumbai, where cases rose first, re
ported zero deaths for the first time in over
a month. Unlike the second wave last year,
which was fuelled by the Delta variant and
killed over 2m people in just a few weeks,
according to The Economist’s estimates, the
Omicron outbreak passed without enor
mous loss of life. Official numbers suggest
its peak daily toll, in early February, was
only a quarter of last year’s.
Indians, like people around the world,
are allowing themselves the hope that the
worst of the pandemic may be over. Yet
there remain a million more mundane
ways to die in India, few of which attract
the attention or resources of an exciting
new disease.
Consider the fate of Pratikkumar Dubey
of Ahmedabad, a big city in the prosperous
state of Gujarat. On January 14th, a day cele
brated as Makar Sankranti, a kiteflying
festival marking the sun’s passage into
Capricorn, the 28yearold was riding his
motorbike down a busy street when the
string from a fallen kite caught him in the
throat. Known as manja, the twine is dust
ed with powdered glass for a fighting edge.
Effective at cutting rival kite strings, it can
also slash skin, which is why several states
ban its use. Mr Dubey was one of four peo
ple killed in motorbikemanjaencounters
in India that day.
Or take the innocent chore of commut
ing. Before the pandemic, an average of
nine people died every day on the subur
ban rail network in Mumbai, India’s com
mercial capital. In normal times the heav
ing system moves 7.5m passengers daily.
By way of comparison, the London Under
ground moves 5m commuters a day, of
whom only two per year die in accidents.
On India’s railways overall, the annual
death toll of around 25,000 is about 25
times that of China, a country with a simi
lar population and a busier rail network.
Travelling by road is even riskier. Although
the government puts the death count from
traffic accidents at around 150,000 in a
normal year, independent estimates sug
gest the true figure is closer to 220,000,
three times the number in China. About a
third of victims are motorbike riders.
India also offers more exotic exits. Ti
ger, elephant, lion and leopard attacks
claim perhaps 500 human lives in a bad
year. Less advertised are the immensely
greater risks of dying from rabies or from
snake bites. Of the 300 snake species found
in India, the 60 that are highly venomous
do away with nearly 60,000 people every
year, the highest percapita rate in the
world. The weather can be deadly, too.
Lightning strikes kill over 140 times as ma
ny people in India—2,876 in 2019—as they
do in America. Many victims are farmers
wading in rice paddies. But last July a sin
gle bolt killed 16 youths taking selfies atop
the ramparts of a fort.
India also suffers some deadly social
ills. The overall murder rate is lower than
America’s. But an average of 92 Indians are
killed each year after being accused of
witchcraft. The country’s suicide rate, at
12.9 per 100,000 people in 2019, is lower
than average for countries in its income
group (14.1) but high for its region (10.2) and
above the global average (9), according to
the World Health Organisation.
What is striking is that the rate for
women (11.1) is among the highest in the
world, reflecting a disturbing level of do
mestic misery. Socalled “dowry deaths”
remain common: women are killed or dri
ven to suicide by inlaws who think the
dowry they brought when they married
was too small. The shocking number of In
dians who die every year from falling into
sewers—142 in 2020—has a telltale twist,
too. Most victims are men at the bottom of
the caste hierarchy, condemned to the
drudgery of cleaning other people’s waste.
As everywhere, the vast majority of the
10m Indians who die each year succumb to
more ordinary ailments, the leading one
being plain old heart trouble. Life expec
tancy in India today, at 69.6 years, is just
three years short of the world average. But
it is worth considering what that number
might be if India’s government were to pay
as much attention to addressing, say, tu
berculosis, which has killed some 2m peo
ple in the past five years,orairpollution,
whose fiveyear death tollisestimated to
exceed 8m, as it has to covid.nD ELHI
The Omicron wave recedes from India,
but not the risk of a premature deathGrave situation
Deaths per 100,000 people, 2019Source:GlobalBurdenofDiseaseStudy2019,
InstituteforHealthMetricsandEvaluation *Includes railwaysOthertransportaccidents*InterpersonalviolenceAnimalcontactSuicideRoadaccidentsTuberculosisUnintentionalinjuries
(falls,fires,etc)403020100World Lower-middle-income countries IndiaTurkmenistanCut-rate khanate
I
t is truethat he is two years past his
country’s official retirement age. But at
64 Gurbanguly Berdymukhamedov, Turk
menistan’s president, is still a spring
chicken by the standards of his contempo
raries. Islam Karimov ruled Uzbekistan
until his death at 78 in 2016. Nursultan Na
zarbayev, the former president of Kazakh
stan, was the same age before he made way,
in 2019, for a younger leader. Vladimir Pu
tin, Russia’s 69yearold president, shows
no sign of slowing down.
So it was a shock when, in a speech on
February 11th marking his 15th anniversary
as president, Mr Berdymukhamedov an
nounced the “difficult decision” he had
made. It was time, he said, to give “young
leaders” a chance, as long as they “have
been brought up in a spiritual environ
ment and in accordance with the demand
ing needs of modern times”. A snap elec
tion will be held on March 12th.
The crushing of anything resembling
an opposition, the suppression of even
mild dissent, and the fact that the presi
dent won the last poll with 98% of the vote
suggest that such youths might be hard to
find. But the ruling party did not have far to
search. It immediately nominated as its
candidate Serdar Berdymukhamedov, the
president’s 40yearold son. The stage has
been set for Central Asia’s first hereditary
succession since the era of the Khans.
The younger Berdymukhamedov (pic
tured), an engineer by training, has long
been groomed for the role. After stints in
the foreign ministry and as a diplomat, heA LMATY
Gurbanguly Berdymukhamedov finds
a worthy successor: his sonYes we Khan