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Developed world drownings exceed expectations

Roughly a million children die from drowning each year. The high mortality rate came as a surprise last year, when surveys in Asia were conducted by the World Health Organization (WHO). The estimates of these surveys put drowning ahead of car crashes as the leading form of fatal injury for minors worldwide.

This is news to the public health world, which thought it had identified the causes of infant mortality during the “Child Survival Revolution”. A movement led by UNICEF in the eighties, the Child Survival Revolution was meant to address the major preventable causes of child mortality, like infection and malnutrition. It worked; researchers studied hospital records to identify the main causes of death, created programs that would save lives, and by the end of the decade 12-million children were saved.

But drowning went unnoticed. Hospitals had no record of drowning deaths, because the families of drowned children didn’t report their loss. According to Dr. Steve Beerman, president of the International Life Saving Federation, the new surveys of Asia have dramatically revised the WHO’s 2007 world drowning report estimate of 400,000 deaths per year.

“Our most recent estimate with new data from Asia places the global drowning burden over one million per year,” Beerman said.

Little has been done to solve the problem. Beerman said that there is an acute lack of funding for anti-drowning initiatives.

“As an example of the lack of resource allocation to drowning, Malaria has a global mortality of 1.2 -million per year, and of those about 20 per cent are children. Malaria gets $4.5- billion for programs of reduction, control, and study. Drowning gets less than $400,000 globally,” Beernman said.

Canada has been a key player in exposing this imbalance, and through its own surveys pioneered the methodology that made today’s clearer picture of the drowning burden possible. The country’s involvement has been partly motivated by the drowning burden within Canada: aboriginal and ethnic populations suffer high drowning rates, and in total, over 400 Canadian children drown each year.

Solutions to the global drowning crisis are simple. In developed nations, drownings usually occur in recreational settings like pools. Fencing pools, teaching children to swim, and raising public awareness may have all contributed to the 30 per cent decline in drowning deaths within Canada since 1990.

In undeveloped nations, on the other hand, drowning is a danger of daily life. According to the recent report called Drowning in the Developing world, published by the Alliance for Safe Children, most Asian and African children are exposed to a huge number of drowning risks every day.

“There are extraordinarily high exposure rates to potential drowning hazards that occur on a daily basis in almost every child’s daily activities,” the report stated.

Despite the toll infant drownings take on families and society in much of the developing world, a culture of water safety and swimming hasn’t evolved. Beerman remarks that such an evolution is hindered by beliefs regarding water held by some people in poor nations.

“There are many mythical and cultural beliefs in Asia and Africa about drowning. For some, if you save someone from the Goddess of the sea, you will be the next to die. Others believe drowning is their god’s wish,” he said.

Pilot projects to reduce drowning deaths are underway in Bangladesh, Indonesia, and Vietnam. The initiatives focus on teaching survival swimming, which increases survival rate by 50 per cent, and social awareness of the drowning problem. With support from rich nations, the pilot projects will soon be scaled up to national and regional levels.