SINGAPORE — It would have taken her seconds to fasten her seat belt in a private-hire car, but she did not do so, as she felt Singapore's roads were very safe.
Nurul Azimah Mas'Ot's complacency nearly got her killed when the vehicle collided with a taxi on the Bukit Timah Expressway (BKE) on May 30.
The 21-year-old was catapulted from the rear seat to the car's dashboard, causing her to suffer head and spinal injuries.
She was in a coma for three days at Khoo Teck Puat Hospital's (KTPH) intensive care unit, underwent brain surgery and was hospitalised for over a month.
While therapy has helped Azimah recover her motor skills, she struggles with doing simple things like alighting from a bus or making digital payments.
This is because most of her memory from the last 15 years were wiped out after she regained consciousness.
The Singapore Civil Defence Force said that on May 30 at about 8.05pm, it was alerted to a road traffic accident along the BKE towards Woodlands before the Mandai Road exit.
Five people were sent to KTPH.
Police said a 69-year-old male taxi driver is assisting with investigations.
Azimah returned to work as an auditor on Sept 4. As she lost a large chunk of her memory, she has to relearn many things, including some aspects of her job.
She said: "It's as though I've never lived those years of my life. I can't recall the people I've met, the places I've been to, or the skills I've learnt.
"Even simple things like how to tap out when I'm getting off a bus or how to use Microsoft programmes, I have to relearn them."
Traffic Police statistics show the number of violations for failing to wear a seat belt, or wearing it improperly, have fallen recently.
Such violations went down from 5,863 in 2021, to 4,763 in 2022 and 3,559 in 2023.
Data from three hospitals, however, show more patients were not wearing seat belts in a traffic accident.
Figures from the National University Centre for Trauma showed the number of traffic accident patients in the western region who were not wearing seat belts and got severely injured rose from 20 in 2022 to 25 in 2023.
The centre at the National University Hospital was launched in July and focuses on improving safety and trauma care for children, older adults, and migrant workers.
At Tan Tock Seng Hospital, 12 rear seat passengers with moderate to severe injuries were admitted each year in 2022 and 2023. Of these, five were unbelted in 2022 and nine in 2023.
Of the 10 motor vehicle crash patients KTPH admitted each year in 2022 and 2023, four were unbelted in 2022 and six in 2023.
Doctors said accident patients who do not wear seat belts tend to suffer more severe and varied injuries, as they can get thrown out of their seats and flung out of the vehicle.
Citing medical literature, director of NUH's trauma centre, Adjunct Assistant Professor Raj Menon, said wearing a seat belt reduces one's risk of mortality by 40 to 60 per cent.
He said: "Without a seat belt, people can be flung against the doors, dashboard and windshield, or even be ejected out of vehicles. There is a much higher energy transfer to the body and this can result in more severe injuries to the head, neck and torso."
KTPH's head of general surgery, Dr Jerry Goo, said the most common cause of death in a traffic accident is brain injury, followed by internal bleeding.
"When a person hits his head against any part of the car, there is a high chance of death, or neurological damage where he can become paralysed or fall into a coma," he said.
He added the force of the collision may cause organ damage and internal bleeding, which can be hard for doctors to treat in severe cases.
Dr Goo highlighted a case several years ago where a woman was travelling to Changi Airport with her parents in a taxi when they were hit by another vehicle.
Dr Goo said the woman, who was sitting in front, suffered minor injuries and was discharged that day, while the taxi driver was hospitalised for a week. Both were wearing seat belts.
Her parents were unbelted in the rear seats. One of them died and the other was hospitalised for nearly two months.
Said Dr Goo: "Though the impact of the crash may have been different for each of them, this case shows that wearing a seat belt can make a huge difference between life and death."
Dr Koh Shao Hui, a consultant at Sengkang General Hospital's Department of Emergency Medicine, said being belted up reduces the risk of getting ejected out of the vehicle by at least twice.
"Belting up minimises the movement of passengers and helps to distribute the forces of impact across more resilient parts of the body, such as the pelvis and rib cage," he added.
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Ten passengers who did not belt up often, whom The Straits Times spoke to, gave three broad reasons why.
It was uncomfortable, the journey was short, and the driver was not speeding.
Singapore Road Safety Council chairman Bernard Tay said everyone should be belted up, even during a five-minute journey, as accidents can happen within seconds.
He said: "Even if your driver is driving safely, others may not be. The only reason for not wearing a seat belt is if you have a medical exemption."
It became compulsory for front seat passengers to be belted up in 1983. For rear seat passengers, this came into force in 1993.
Offending passengers can be fined $150, while the driver can be fined the same amount and get three demerit points.
The seat belt rule is also enforced in countries like Australia and the United Kingdom.
On July 26, a Singapore permanent resident was fined A$1,106 (S$1,000) by the Queensland authorities for not wearing a seat belt properly.
Criminal lawyer Rajan Supramaniam said not wearing a seat belt can affect insurance claims and compensation amounts in an accident.
He said: "While no insurance claim can be rejected if seat belts are not worn, it may reduce the compensation available due to what's known as contributory negligence, or your share of fault in the severity of injuries."
With the encouragement of her family, Azimah is soldiering on in her recovery process.
She said: "It was a painful lesson for me, but I'm very fortunate to have survived. I hope my story reminds everyone not to take any chances and to always wear your seat belt."
This article was first published in The Straits Times. Permission required for reproduction.
