January 22, 2012Dear Sir,As a former Road Safety Council Chairman, I found the headlines “Dr. Froncioni: Don’t hide the problem” and “Phone ban not the solution” related to the recent ban on the use of hand-held cell phone ban in the January 19 issue of The Royal Gazette extremely troubling and irresponsible. I found the accompanying article to be deeply counterproductive possibly further eroding any respect or trust the public may have for the laws of Bermuda and the Bermuda Police Service (BPS) that enforces it. The inflammatory headlines and Dr Froncioni’s editorial appeal to the lowest common denominator in Bermudian society: where lawlessness and distrust of the police is commonplace. Public confidence in the Government and Police are eroded by this type of reactive negative journalism. Perhaps unwittingly, these headlines and the accompanying article by Dr. Froncioni do nothing more than undermine attempts by the Government and the Bermuda Police Service to improve road safety on this island.Dr. Froncioni’s article is far too long and exhaustive to respond to every debatable issue; in fact, as I read it, I was reminded of Henry James’ critique of Tolstoy’s “War and Peace” as a “loose and baggy novel”. Whilst several interesting points were raised by Dr Froncioni, the bottom line is that experts really don’t know if banning hand-held cell phone use whilst motoring saves lives or not. The statistics are complicated and confounding, many times involving multivariate analysis; often comparing jurisdictions with varying restrictions on hand held devices. Add to this, that data collection is severely affected because very few individuals will admit to using a hand-held device during a collision. Dr Froncioni believes that “money is being wasted targeting drivers who use cell phones when the real killers remain drunk-driving, speeding etc”. Stopping motorists who use hand held phones while driving does not preclude the Police from enforcing drink driving, helmet, or other traffic laws. It simply gives the BPS more latitude in dealing with one of the highest traffic fatality rates in the world. No doubt the BPS will arrest drunk drivers and other criminals who also use cell phones as they drive.I am proud to state that in 2009, whilst I was the Chairman of the Bermuda Road Safety Council, we produced the initial research that was eventually presented as a Cabinet paper. It gives me great joy to congratulate the Premier Cox and Deputy Premier and Minister of Transport Derrick Burgess on making this legislation a reality. For the record, I personally salute the efforts of the present government in diminishing road traffic injuries and fatalities with this type of innovative and courageous legislation. Without reservation, I support the efforts of the Bermuda Police Service in enforcing these laws that may well save lives on the roads of Bermuda. I also strongly believe that the BPS has increased in roadside presence in myriad ways; the current implementation of random roads checks are a welcome sight to those of us who depend on the BPS to keep us safe.Furthermore, Bermuda is a unique place with its own set of challenges for motorists, eg:1. High Population Density: According to the UN, Bermuda is one of the most densely populated places on with 3,175 inhabitants per square mile The United States of America and the United Kingdom show significantly lower population density; 83 and 660 inhabitants per square mile respectively.2. One House/ One Car: A large percentage of the private population of Bermuda must ride mopeds and motorcycles due to regulations set out in the Motor Car Act of 1951, section 16. This high percentage of the population riding mopeds and motorcycles makes this particular cohort more vulnerable to injuries and fatalities on the road. A Transport Control Department Study suggested that in 2008 there were 4,397 privately-owned cycles under 55cc, 1,582 livery cycles (rent units), 15,677 motorcycles over 50cc, 22,600 private cars, 4,074 trucks, tank wagons and 600 taxis. More recently, it was speculated that there are over 50,000 total cars in Bermuda.3. High Density Device of Mobile Hand Held Devices: In 2009, 75.2 percent of the population was connected to the internet. Internet Usage in the US and UK are stated at 78 percent and 82 percent, respectively. The majority of persons in Bermuda own cell phones and other mobile hand held devices.4. Treacherous Road Conditions: Bermuda has 150 miles of private paved roads; 130 miles public paved roads. Many of the roads are narrow, with blind entrances on to main thoroughfares. There are hairpin turns, narrow precipices that border steep descents to the water. Weather can play a major factor in many traffic collisions. Particularly tourists with little experience with motoring on the left side are at risk for injury on the roads of Bermuda.5. High Proportion of Drinking and Drug Usage Whilst Motoring: Drinking and substance abuse are common in Bermuda. There is no argument that they play a major role in road traffic morbidity and mortality.6. Paucity of Bermuda Traffic Collision Statistics: Despite the number of computers and actuaries in Bermuda, data on road traffic injuries and deaths are woefully inadequate, making comparison theoretical and speculative. Whilst Bermuda Road Safety Chairman, I advocated without success for created a Road Traffic Trauma Registry (this is required by Level 1 and Level 11 Trauma Centers in the US). This type of registry is capable of generating prospective data that can be easily monitored to assess the effectiveness of interventions. Sadly, Dr Froncioni opposed the acquisition of this vital tool.The challenges noted above are a recipe for major injuries and deaths on the roads of this beautiful island. Malcolm Gladwell, the author of “Outliers” and other novels wrote “Truly successful decision making relies on a balance between deliberate and instinctive thinking”. Gladwell repeatedly makes the point that believing that interventions based on statistics and “science” may not always be the best approach. Bermuda, in my opinion, needs a novel and unique “Outlier” approach to solve this vexing problem of road deaths and injuries. When Rudy Giuliani controversially banned homeless people from Manhattan, little did he know that it would also lead to a major decrease in overall crime. Similarly, the “Broken Window” theory of crime proposes that an unrepaired broken window will make a building look disused or uncared for and will attract vandals to break all the other windows. Broken Window Theory suggests that the prevention of crime will be accomplished by undertaking preventive measures like painting over graffiti, keeping buildings in good condition, maintaining clean streets and parks and responding effectively to petty street crime.Dealing with small misdemeanours and antisocial behaviour diminishes major crimes. Therefore, a tool that allows police to give citations to motorist who use hand-held devices may have additive effects on crime in general. I urge the Bermuda community to support the efforts of the Bermuda Police Service and our present Government in banning hand-held cell phone use whilst motoring; we may be surprised at the outcome.Moreover, I make the following constructive recommendations to the legislators and people of Bermuda:1. Respect and abide by this law prohibiting the use of cell phones whilst motoring. In fact abide by all the traffic laws.2. Introduce a Road Traffic Trauma Registry at KEMH to follow the statistics of this public health epidemic.3. Institute obligatory drug and alcohol testing for all traffic-related injuries.4. Mandatory Alcoholics Anonymous or similar programmes for persons arrested for driving while intoxicated.5. Speed Cameras to assist the BPS in decreasing speedCHRISTOPHER L JOHNSON MD, MSc, FACSConsultant Plastic and –Reconstructive SurgeonFormer Road Safety –Chairman 2006 2011NB I understand that the Bermuda Road Safety Council was given the opportunity to respond to Dr Froncioni’s article prior to its publication. I believe that the Bermuda Road Safety Council missed an opportunity to educate the public on this complicated issue.