Drowning newly emerging as a leading killer of children and young people worldwide

WHO Global Report on Drowning
By Dr Akjemal Magtymova, WHO Representative to the Republic of Maldives

16 November 2014

Dr Akjemal Magtymova, WHO Representative to the Republic of Maldives

Water. It’s life enabling. It’s life enhancing. Yet it can also be life threatening. Every hour more than 40 lives – most often young lives – are cut short by drowning. Children drown in bathtubs, watering holes and rivers; fishermen are carried out to sea; migrants lose their lives in perilous crossings, and capsized ferries result in the drowning of scores of passengers.

Released today, the World Health Organization’s Global report on drowning highlights that drowning takes the lives of 372,000 people each year, and is among the ten leading causes of death for children and young people in every region of the world. In fact, half of all drowning deaths occur in people under the age of 25 years. According to the report, more than 90% of drowning happens in low- and middle-income countries, where rates are over three times higher than in high-income countries.

Fatality from drowning in the South-East Asia is the world’s second highest, after the African Region followed by the Western Pacific Region. One person drowns every 8 minutes in India, resulting in a particularly high drowning death rate of 6.6 per 100,000 population per year. The two large nations - India and China- together lose 41% of the global DALY lost due to drowning.

Access to water is an increased risk factor for drowning. Every Maldivian community has inherent relation with the sea and close daily contact with water, which means an increased risk of accidents. In 2011, 1.9% of the total deaths were due to drowning in the Maldives, and age-adjusted death rate was 7.33 per 100,000 of population.

Worldwide, children are at higher risk: accidents occur when the adult supervisor is distracted and in the absence of physical barriers to water. Travelers, including daily commuters, laborers, migrants and asylum seekers bear the consequences of overcrowded and unsafe vessels lacking in safety equipment and operated by untrained personnel. And the number of people exposed to hazards such as flood disasters is rising globally, and they suffer an inability on the part of authorities to warn, evacuate and protect them from such disasters. In the majority of circumstances, the possibility of rescue is scant.

Reducing rates of child mortality is a vital component of the Millennium Development Goals, but as progress had been made in reducing infectious disease and malnutrition, drowning has emerged as a leading killer of children and young people. In Bangladesh, for example, thirty years ago drowning accounted for around 5% of deaths among children 1-4 years of age, but it now accounts for a staggering 43% of deaths among children of this age group. Unless urgent action is taken to address this issue, progress will not be made in terms of better protecting our children and young people in the post-2015 era.

The good news is that a range of measures exists which could save many lives from drowning. At local level, these include the installation of barriers controlling access to water, provision of safe places such as day care centres for children, teaching children basic swimming skills, and training bystanders in safe rescue and resuscitation. At national level, interventions should include adoption of improved boating, shipping and ferry regulations; better flood risk management.

Such efforts have been achieved in many high-income countries where a culture of safety already prevails. These have resulted in substantial gains. For example, in the last two decades, rates of drowning deaths in children under 5 years of age have decreased by over two thirds in Australia and hospitalization rates for paediatric drowning have dropped by almost half in the United States during the same time period. Drowning is a needless loss of life. To prevent drowning, national and local governments worldwide should substantially scale up action and resources in order to save lives. Maldives has a creditable culture of water safety. This needs to be cultivated further for the safety of the next generations, by placing preventive measures at the community level supported by education, comprehensive transport system and policies.