KUALA LUMPUR (Reuters) - Malaysia's neurosurgeons, bartenders and nightclub bouncers all have something in common: they are all busiest on weekends.

Every weekend, neurosurgeons here operate on hundreds of motorcyclists, car drivers and passengers brought into hospital emergency rooms with head injuries suffered on some of the world's most dangerous roads.

"Cancer and HIV-AIDS might hog the headlines but road accidents are the biggest killer in Malaysia," Kuala Lumpur neurosurgeon Professor Vickneswaran Mathaneswaran told Reuters.

That figure translates to an average of 4.2 deaths per 10,000 registered vehicles and ranks Malaysia as the 30th most-dangerous country in terms of fatal road accidents, according to U.N. data.

Malaysia has built a web of high-speed motorways over the past 20 years as it races toward its goal of developed-country status by 2020, but road safety is still stuck in the slow lane.

Over-crowded cars hurtle along roads at more than 100 kph. Rarely are the occupants buckled. Toddlers often crawl around unrestrained in the front passenger seat.

In 2005, 6,188 people died in road accidents in Malaysia, 60 percent of them motorcyclists. In the first half of 2006 alone, 3,137 people were killed with 1,818 being either motorcyclists or pillion riders.

"It is exhilarating to race down a road. All I need is just a few ringgit for fuel and I can have the time of my life," dispatch rider Amir Fairuz told Reuters as he prepared for an illegal street race on a Friday night.

He is among the hundreds of motorcyclists who gather every weekend in Kuala Lumpur to race each other or just roam in packs along expressways and city streets, performing dangerous tricks at high speed, some of them without helmets.

For some of these hard-core dare-devils, taking drugs is standard before pushing their cheap bikes beyond the limit, reaching speeds of around 160 kph.

Some of these young men end up in the care of neurosurgeon Mathaneswaran, whose facility treats about 100 accident cases a month. He is frustrated at such preventable suffering.

An immediate plan to drive down the death rate is to issue a million crash helmets to youths and those too poor to afford them, particularly in rural areas where enforcement is low.

The government has also launched an awareness campaign on television, print media and billboards to get motorists to belt up in vehicles and to strap on helmets while astride motorcycles.

The awareness campaign is among 52 programmes for road safety over the next five years, Singh said, adding a nationwide camera surveillance system was also planned for early 2007 to get motorists to obey traffic rules.

Research from Malaysia's Universiti Putra shows most road-users only complied with traffic rules to avoid being caught by police rather than for safety concerns.

"We want to change the road users' mindset," Singh said, adding the ultimate goal was to reduce the number of road deaths from 4.2 per 10,000 registered vehicles in 2005 to 2.0 in 2010. Malaysia had 14.8 million registered vehicles in 2005.

He said authorities had noticed a change in behaviour when enforcement was stepped up, particularly during festive seasons when the daily death rate dropped slightly. Other strategies included higher insurance premiums for high-risk road users.

The statistics also show that most of those injured or killed are youths aged between 16 and 25, the most productive time of life, he added. Each death, he said, cost the country about 1.2 million ringgit and totalled some 9 billion ringgit a year.

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