July 25 is the World Drowning Prevention Day. Drowning is a serious and neglected public health threat claiming the lives of over 220,000 people a year worldwide. More than 90% of these deaths occur in low- and middle-income countries.

In 2019, over 144 000 people drowned in the Asia Pacific region, accounting for 61% of global drowning deaths, according to the first World Health Organization (WHO) regional assessments on drowning prevention released ahead of World Drowning Prevention Day. Drowning claimed the lives of an estimated 70,000 and 74,000 people in the WHO South-East Asia and Western Pacific regions, respectively.

In Sri Lanka, over 800 people die annually due to drowning the second leading cause of accidental death in Sri Lanka.
According to WHO report, a data collection and analysis of drowning cases between 2004 and 2009, identified risk factors for drowning as daily living such as bathing, working in agriculture or in construction, and recreational activities. Adults aged 25–44 years were at greatest risk, and males were four times more likely to drown than females. Alcohol consumption, lack of lifejacket use on boats, poor supervision practices, flooding during monsoon and unprotected wells and open reservoirs were identified as contributing factors.

Drowning Interventions
* Install barriers controlling access to water
* Provide safe places (for example a day-care centre) away from water for preschool children, with capable child care
* Teach school-age children swimming and water safety skills
* Train bystanders in safe rescue and resuscitation
* Set and enforce safe boating, shipping and ferry regulations
* Build resilience and manage flood risks and other hazards locally and nationally

Strategies
* Strengthen public awareness of drowning through strategic communications
* Promote multisectoral collaboration
* Develop a national water safety plan
* Advance drowning prevention through data collection and well-designed studies

The United Nations General Assembly passed its first-ever Resolution on Global Drowning Prevention during the seventy-fifth session and announced 25th of July as the world Drowning Prevention Day.
Every Year an estimated number of more than 220,000 people die due to drowning around the world. About 1/3rd of these victims are from South Asian countries. Globally, the highest drowning mortality rates are among children aged 1-4 years and is often reported as the leading cause of mortality among children between 1-9 years. Every year about 800 Sri Lankans are killed due to drowning. It is the second cause for unintentional injury deaths. Most of the victims are belonged to the age group of 21-60 years which is the economically productive group.

Image – WHO / World Drowning Prevention Day

Other than deaths, lack of oxygen to the brain after a non-fatal drowning can lead to long- term disabilities ranging from memory problems and learning disabilities to complete loss of basic function. Moreover, drowning is not only public health issue but also a socioeconomic development challenge. Human behavior has been identified as a key risk factor for occurrence of drowning. Further
including a water safety culture within the country is crucial. Hence, it is necessary to educate the public on water safety, establish barriers, improve swim skills, rescue and resuscitation training etc. Further, need to identify new laws and regulations to improve the water safety in the country.
There has been a reduction of number of drowning cases reported to the hospitals as a result of restriction of public movements as part of the Covid 19 prevention strategy. In the present experience, with the relaxation of the Covid 19 related regulations, the uncontrolled increase in human activity may also increase the risk of droning. Hence, with the current pandemic situation, the strategies to prevent Covid 19 can be challenged if individuals at particular risk for Covid 19 are unnecessarily caused injuries due to drowning. Therefore, it is vital to retain focused on the importance of preventing and protecting ourselves from injuries, including drowning, during this global pandemic.

This WHO guide provides practical steps to reduce drowning – one of the world’s most preventable, neglected and pressing public health issues.

The two WHO reports, Regional Status Report on Drowning in the Western Pacific and Regional Status Report on Drowning in South-East Asia, also warn that climate change, to which the Asia Pacific region is particularly vulnerable, places already vulnerable communities and individuals at increased drowning risk. More frequent and extreme weather events can lead to more regular and intense floods, increasing populations’ exposure to potentially hazardous interactions with water.

Non-fatal drowning – where individuals are rescued and/or resuscitated – also results in a substantial number of hospitalizations in the two WHO regions, and can cause severe brain damage that may result in long-term disabilities such as memory problems, learning disabilities and permanent loss of basic function.

“Despite many lives being lost each year, drowning remains a largely unrecognized threat to health and well-being,” said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia. “We need to work across all sectors to develop national water safety plans and policies and implement tested and low-cost water safety interventions to prevent drowning and save lives. No child or adult should lose their life to drowning.” 

The new reports provide countries with WHO-recommended best practices on drowning prevention interventions and policies, including day care for children, the use of barriers for controlling access to water, public awareness campaigns focused on behaviour change, and policies and legislation on water safety, including regulation of recreational boating and maritime transport.

“We are proud to be able to highlight, through these two reports, examples from our Member States of leadership, innovation and strong partnerships within and beyond the health sector on drowning prevention,” said Dr Takeshi Kasai, WHO Regional Director for the Western Pacific. 

Image – WHO / World Drowning Prevention Day

In the South-East Asia Region, most drowning deaths occur among children and men

Of the 70 000 drowning deaths in the WHO South-East Asia Region in 2019, more than 33% were among children aged under 15 years. On average, men were three to four times more likely to drown than women.

There have been pockets of success towards reducing drowning in countries of the Region. Among the 10 out of 11 countries in the Region that contributed to the report, four reported having national or subnational strategies, policies or plans to reduce drowning. Yet, only Thailand has set targets to measure progress towards its goals.

Reflective of the diversity of the Region, the impact of drowning and effective approaches to its prevention differ across and within countries. While some governments have well-developed water safety strategies and well-established national mechanisms for drowning prevention, other countries are at an early stage of developing and expanding drowning prevention interventions.

Efforts, especially for at-risk groups such as children, include: survival swim and water skills training in Bangladesh, India, Nepal, Sri Lanka and Thailand; community-based day care/creches for young children in Bangladesh, India and Thailand; and improved information systems and public awareness campaigns focused on behaviour change in Thailand.

In the Western Pacific Region, males and people aged 65 and older at greatest risk of drowning

Older people accounted for 34% of drowning deaths in the WHO Western Pacific Region in 2019. Men are at higher risk than women– in 2019, 66% of drowning deaths in the Region were among men.

There are large disparities in drowning rates across the Western Pacific, with rates in lower-middle-income countries nearly four times higher than those in high-income countries. For example, The Federated States of Micronesia has the highest drowning death rate at 15.1 per 100 000 population compared to Australia where the rate is 0.7 per 100 000.

Twenty of the Region’s 37 countries and areas participated in the report, of which eight reported having either national or subnational strategies, policies or plans to reduce drowning. Additionally, 15 countries reported having systems in place to capture national data on drowning and implementing mass media campaigns on drowning prevention.

The Western Pacific Region reported a wide range of drowning prevention interventions: 14 nations provide childcare/child supervision programmes to keep children safe from water, 17 teach children water safety skills, 19 teach bystanders safe rescue and resuscitation, and all countries have early warning systems for disaster risk reduction preparedness.