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25 Drowning – a neglected but preventable public health issue
  1. Aminur Rahman
  1. International Drowning Research Centre – Bangladesh (IDRC-B) at the Centre for Injury Prevention and Research, Bangladesh, House – B162, Road – 23, New DOHS, Mohakhali, Dhaka 1206, Bangladesh

Abstract

In 2012 WHO estimated that 372,000 people died from drowning, which has made it the world’s third leading unintentional injury killer. Over half of all drowning deaths occur among those aged under 25 years. 91% of the drowning deaths of all ages occur in LMICs. The fatal drowning rate in LMICs is several times higher than the HICs. Although drowning occurs in all ages, studies suggest that children aged 1–4 years are at the highest risk of drowning globally. Children of the LMICs are the worst victim. In Bangladesh drowning is the leading cause of death among children 1–4 years (86.3 per 100,000 children-years) which is followed by pneumonia, malnutrition and diarrhoea.

In the HICs there is evidence of long term reduction of drowning. These reductions are due to piped water and reduced exposure to open water. The other factors include safety standards, policies and legislations. The interventions of HICs are not readily applicable in the resource constraint settings. However, some interventions in the LMICs which are developed considering the country context are appearing to be effective in child drowning prevention. A recent research showed that child drowning is also preventable in a low resource setting Bangladesh utilising locally available low-cost resources. Two interventions – Anchal (community crèche) and SwimSafe (survival swimming teaching to children) were identified effective and cost-effective in preventing childhood drowning. A typical Anchal is a spacious room located in the house of a care-giver. The care-giver provides supervision of about 25 children aged 1–5 year-old 6 days a week within the hours of 9:00 a.m. and 1:00 p.m., the peak period when children are most at risk for drowning in rural Bangladesh. During this period, the care-giver addresses safety, development, hygiene, nutrition and other health issues of the children. The SwimSafe is a survival swimming teaching intervention for children 4 years and over. Trained community swimming instructors teach survival swimming to children in a local pond modified with submerged bamboo platform. In the similar settings these interventions could be applicable to prevent child drowning.

Data on drowning is essential for developing drowning prevention strategies, which is severely lacking especially in the LMICs. To improve the drowning situation in these countries a system of collecting data needs to be established. Moreover, all countries should implement proven drowning prevention measures considering their country context. All countries should have a national plan on drowning prevention. In order to achieve all these activities to prevent drowning a global partnership should be established.

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