1.1 Key Facts on Drowning
Drowning is a serious and neglected public health threat claiming an estimated average of 372,000 people a year worldwide. More than 90% of these deaths occur in low and middle income countries. This death toll is almost two thirds that of malnutrition and well over half of that of malaria – but unlike these public health challenges, there are no broad world wide prevention efforts that target drowning (Global Report on Drowning, 2015).
1.2 Young People at Risk
Alarmingly, drowning is the leading cause of death of children and young people in EVERY region of the world, with children under 5 years of age being disproportionately represented. Those countries with a warm climate and relatively large coastlines are particularly vulnerable, examples include Vietnam, Bangladesh, Australia and many of the Pacific Islands (Global Report on Drowning, 2015).
1.3 Four Major Risk Factors
Based on the body of research available, the following risk factors have been identified:
1. Young children – the highest rates of drowning occur in under 5 year olds
2. Living on or around water – whenever there is a body of water, the risk of drowning increases
3. Flood disasters – extreme rain, storm surges, cyclones, tsunami and flash flooding
4. Transport on or via water – especially on poorly constructed, often crowded water vessels, without sufficient PFD’s for all passengers.
It should be noted that in many low-income countries, data collection is minimal. This makes the monitoring and subsequent planning of drowning prevention efforts difficult. Successful monitoring of drowning statistics requires a coordinated multi-disciplinary approach involving Police, Hospitals and Mortuaries, Government and Life Saving Societies.
Drowning prevention strategies will have many synergies with other public health agenda’s such as safe water supply, rural development, disaster management and childhood health.
The global community must use this as leverage to attract donors and prioritise drowning prevention.
1.4 Prevention IS the Cure
In the World Health Organisation’s most recent Global Report on Drowning, the following steps were suggested to prevent drowning. Many of the strategies are based on what has been successful in reducing the burden of drowning in high-income countries. Therefore, the onus is still on each individual nation to adapt to their unique circumstances.
In many developing nations this will mean significant ingenuity and some financial investment will be required.
Anecdotal evidence suggests developing a national water safety plan, coordinating drowning prevention efforts with those of other governmental and non-governmental sectors, as well as addressing priority research questions and undertaking well-designed research studies will enhance the program of prevention.
1.5 Drowning Statistics by Region
(Global Report on Drowning, 2015)
The graph above shows that high income regions of the world fare better than low income regions. This lower drowning rate is likely due to better data collection, ongoing water safety education and legislation in place to prevent risk-taking behaviours in and around water.
1.6 Africa at a Glance
Africa as a continent has the highest drowning rate per capita in the world. It has a number of risk factors making drowning prevention all the more challenging.
Many member nations are in a state of political instability, meaning coordinated, organised responses to the issue are near impossible. Instead, there are only small pockets of ad-hoc and often reactive preventative programming. In short, drowning prevention is just one of a long list of worries.
Africa has a largely rural population who suffer through extreme poverty and often have no access to education, including water safety education.
Much of the population does not have access to clean drinking water in their home and as a result have to visit wells, dams and other water bodies in order to source clean drinking water. These sites are often unmarked and have no fencing or protective barriers. It is often young girls who are sent to fetch water.
Similarly 80% of all coastline is unpatrolled and often no signage is in place to indicate this.
According to the World Health Organisation (WHO), 46% of all drownings are alcohol-related.
Despite its popular image as an arid Desert, the African continent is home to some of the world’s largest bodies of water. These include portions of the Nile River, Congo River, Zambezi River, Lake Victoria and Lake Tanganyika to name a few. Many African citizens rely on Lakes, Rivers and the Atlantic and Indian Oceans for their livelihoods, for commercial fishing, irrigation of crops and tourism. In recent times piracy has become an issue, especially along the coast of Sudan.
- Improve protective barriers at drinking water sources
- Improve signage near bodies of water
- Increase education about basic water safety, including in the work-place
1.7 Americas at a Glance
The Americas are home to some of the world’s richest AND poorest citizens, yet drowning related deaths is a problem at both ends of the spectrum. Trends in Northern America are similar to those in other developed nations, whilst reliable statistics from Central and South America are vague at best.
Increasingly this region is suffering from more extreme weather events, especially in those countries that straddle the equator including the Southern States of the USA, The Bahamas, Cuba, Haiti and The Dominican Republic. One such notable event was Hurricane Katrina in 2005, in which 1,250 people perished due to storm surges, flooding and resultant chaos.
In many communities, children lack basic swimming skills or a desire to acquire them. According to the Centre for Disease Control minorities are over-represented in drowning statistics. A child of African-American or Latino descent is almost 5.5 times more likely to drown than his/her white peers in the USA.
Boating is a popular recreational pursuit in the USA, Canada and the tourist meccas of The Bahamas and Jamaica. In 90% of cases, those who drowned while boating were not wearing a personal flotation device (life jacket), 40% were also drinking alcohol while operating their vessel.
Commercial fishing is also a high-risk area of concern. The occupational mortality rate in Alaskan commercial fishermen is 116 per 100,000. Approximately 90% of these deaths are by drowning.
- Increase promotion of swimming and water safety to minority groups
- Increase awareness of the importance of wearing a PFD when participating in water sports
- Address concerns surrounding work-place safety in the commercial fishery industry
- Undertake further study in Central and South America to quantify the scale of drowning fatalities in these regions
1.8 Eastern Mediterranean at a Glance
Up until around 2014 the statistics out of this area of the world were very similar to those in the Americas and Australia, however in recent years the advent of the political instability in Syria, Eritrea, Somalia, Libya, Afghanistan and Iraq has prompted mass movement of refugees across the Mediterranean en-route to Europe. Unfortunately the only mode of available transport for these migrants is overcrowded and barely sea-worthy vessels. As a result many, many people have drowned. Given the nature of the crisis no concrete statistics are available as to the true magnitude of this problem, although as a minimum it is estimated to be at least several thousand in 2015 alone. Crossings peak in the warmer Summer months.
Apart from the current refugee crisis, this area of the world is home to some of the most stunning Islands and attracts locals and tourists alike who travel between islands on Ferries and other leisure craft. Ageing vessels and lack of sufficient PFD’s result's in the occasional tragedy.
- Increase awareness of the importance of only riding in sea-worth vessels with sufficient PFD's for all passengers
- Provide assistance to those governments receiving refugees by sea to increase their capacity in terms of Coast Guard/Surf Lifesaving/Navy
1.9 Europe at a Glance
Over 8,000 drowning deaths are recorded each year in Europe with eastern European countries such as Lithuania, Latvia, Romania and Estonia leading the way. Death rates in the three countries with highest rates (Lithuania, Latvia and Belarus) are 23 times higher than in the safest three countries (Germany, United Kingdom and Netherlands).
Drowning death rates are falling but are still 5.7 times higher in Commonwealth of Independent States (CIS) compared to the European Union (EU).
In Great Britain, where statistics are very carefully collated, it is noted that for every drowning that occurs there are another 3 non-fatal near drowning victims with an average of 5 days hospitalisation. The highest causes of adult drowning were falls, diving and jumping in to water followed by water-craft accidents.
Sadly in Ireland more people die by drowning from suicide than as a result of drowning by accident. In 2003, 51 drownings were accidental but over 100 were due to suicide. This unique situation has led to specific intervention strategies being developed, which are estimated to have prevented over 1000 attempted suicides between 2003 and 2010.
- Increased investment in water safety education and prevention in lower socio-economic regions of the continent
- Increased awareness of the risks associated with falls, dives and jumping into unknown bodies of water
- Specific suicide-related interventions in Ireland
1.10 South East Asia at a Glance
Drowning is a huge problem in the South East Asian region. With the exception of Singapore most of the countries in the region have a relatively low Gross Domestic Product (GDP), young population and very few citizens who can swim to save themselves. Couple this with a virulent monsoon season resulting in large-scale annual flooding and increasing extreme weather events and you have a recipe for disaster. The Boxing Day Tsunami of 2004 killed more than 230,000 people across 14 countries, many of whom drowned.
The Philippines, who sit astride a typhoon belt suffer through an average of 20 severe storms each year. In November 2013, Typhoon Yolanda claimed 6,800 lives and injured a further 20,000.
Much of the economic activities in these countries are based in and around the water. The Mekong River which flows through Laos, Cambodia, Thailand, Vietnam and Myanmar is one of the world’s most productive inland fisheries. Small-boat subsistence fishing in low-income countries is associated with many drowning deaths.
In these low-lying countries, where many people live on or near bodies of water, floating markets are common-place, exposing families to increased risk. Most children who fatally drown are within 20 metres of their place of residence, whilst in Vietnam this reduces to around 10 metres from home.
The WHO estimates the South-East Asian region has in excess of 90,000 drownings each year with the highest proportion of male to female drownings of any region - males are 5 times more likely to drown than females.
Pleasingly in recent years Vietnam and Bangladesh have begun to recognise the issue and start large scale coordinated prevention and learn to swim programs.
- Increase awareness of water safety
- Increase basic swimming skills of the population and in particular children
- Improve disaster readiness
1.11 Western Pacific at a Glance
This diverse region of the world encompasses highly developed countries such as Australia, New Zealand and Japan who prioritise drowning prevention highly. It also includes a range of very small island nations with little or no resources to direct toward drowning prevention efforts.
Drowning is the LEADING cause of death of children aged 5 – 14 years in this region of the world.
In this region there are many small island nations such as Kiribati and the Federated States of Micronesia who are increasingly being exposed to flooding as a result of sea-level rise. The quality of dwellings and flood management planning is not currently sufficient to prevent loss of life.
Males are especially at risk of drowning, with twice the overall mortality rate of females. They are more likely to be hospitalized than females for non-fatal drowning. Studies suggest that the higher drowning rates among males are due to increased exposure to water and riskier behaviour such as swimming alone, drinking alcohol before swimming alone and boating.
In the this region of the world we are seeing a growing expatriate community and middle to upper class, with high disposable income and children attending private schools equipped with a full compliment of sporting facilities. This has increased the delivery of competitive based swimming programs and thus results in an increasing delivery of basic swimming and water safety programs also.
- Take action to combat climate change and provide support for low-lying nations to strengthen their disaster management planning
- Increase awareness of the dangers of drinking alcohol and swimming or boating when intoxicated
- Increase support to smaller island nations to improve water safety education
1.12 CALD Communities and Drowning in Australia
“Australia is an island nation surrounded by iconic beaches and filled with other beautiful aquatic environments. Currently there exists an over-representation of Culturally and Linguistically Diverse (CALD) Communities in drowning statistics within these environments.” (The Aqua English Project, 2015).
24% of Australia’s population were born overseas. The folklore of aquatic activity and “rules” has not been passed on to these newer Australians as occurs inter-generationally within Australian raised families. As a result, a disproportionate number of them drown, mainly as a result of undertaking activities that may have been safe and common practise in their birth country. Activities such as rock fishing, mollusc collecting and boating without the required knowledge of different conditions in a new country has led many to take unacceptable risks.
Building awareness of hazards, risks and the role of secondary and tertiary prevention measures is a significant factor in addressing drowning in high risk populations. Although the situation is improving, lifesaving systems are not as common in developing countries and even some high income countries (especially if they are land-locked), meaning that tourists and recently arrived migrants are at a greater risk of drowning due to lower levels of awareness and foundation aquatic skills.
Reaching CALD communities with strategies to address drowning prevention and water safety is often difficult and these groups are far less likely to access programs via traditional modes. Participation rates in aquatic education programs are much lower among CALD communities and strategies to address this through community development should be encouraged. This can be beneficial both for achieving a reduction in drowning and in promoting greater social cohesion across Australian communities. (Australian Water Safety Council, 2012).
1.13 Positive Steps
The Australia Water Safety Council has identified CALD communities as a “High Risk Group” and specific area of focus in their Australian Water Safety Strategy 2016-20.
Stakeholders within this national council are encouraged to create programs to help reach CALD communities. One example is Surf Life Saving Australia’s On the Same Wave program to encourage engagement in Surf Life Saving by an ethnically diverse range of the population and enhance enjoyment of the coast by all Australians.
Other successful programs offered engage CALD communities, tourists and International students via community advocacy in swimming and water safety education through flexible and non-traditional modes, with the first goal being gaining trust. Their offerings include:
· Aussie Lifeguard for a Day
· Aussie Beach Passport
· Swimming for Women of all Cultures
Several other groups offer free-of charge swimming and water safety lessons to newly-arrived migrant and refugee children and remotely located indigenous children.
Through the delivery of this course, ASCTA is doing its part to increase understanding of the issues that affect the level of participation of people from a multi-cultural background in our sport. It is our hope that by providing practical strategies to recruit and retain this target group not only will drowning statistics be positively influenced, but a whole new group of the Australian population will benefit from lifelong enjoyment of the water. It follows too, that if this is the case, they may then choose to give back to the sport by becoming Swimming and Water Safety Teachers, Coaches and Administrators both in Australia and perhaps even in their country of origin.
Assessment - True/False Q1
- Drowning is the leading cause of death in 0 - 24yr olds in every region of the world.
Assessment - True/False Q2
- 24% of Australians were born Overseas
Assessment - True/False Q3
- Females are more likely to drown than Males.
Assessment - True/False Q4
- Alcohol is a key risk factor in drowning deaths.
Assessment - True/False Q5
- South East Asia has the highest drowning rate per 100,000 of population
Assessment - True/False Q6
- Travelling to school or work on or via water is a key risk factor in drowning deaths.
Assessment - True/False Q7
- Severe weather events are NOT a risk factor in drowning deaths.
Assessment - True/False Q8
- Australia's CALD communities are at a LOWER risk of death by drowning than the rest of the Australian population.
Assessment - True/False Q9
- Minorities (African American and Latino) in the USA are 5.5 times more likely to drown than caucasians.