Journal of Tropical Pediatrics Advance Access published May 20, 2015 Journal of Tropical Pediatrics, 2015, 0, 1–2 doi: 10.1093/tropej/fmv031 Editorial
EDITORIAL
Drowning – The Preventable Killer has to be aimed for in preventing drowning, using strategies that are relevant in the local culture. The risk factors for drowning are known. They are: lack of physical barriers between water bodies and children, for example open irrigational wells with no surrounding wall, abandoned rock quarries which collect rain water and open buckets at homes. Other risk factors include risky behaviour, such as swimming alone with no awareness of safety norms, such as boys swimming in open wells with no idea whatsoever of how to institute rescue efforts. In addition, lack of knowledge and lack of availability of personal flotation devices; local transport in many areas is by waterways, and the transport vessels are overcrowded and poorly maintained. Children are particularly vulnerable. Very young children, toddlers, can drown in very little water, in containers such as open buckets, which mothers do not perceive as dangerous water bodies. In LMIC, drowning largely affects the poor and marginalized. The threat of drowning can be reduced. Intersectoral cooperation and research focus are needed. The strategies that have worked in high-income countries need adaptation and implementation in the local setting. These strategies are: to implement creation of barriers that prevent people from falling into open water bodies. Promote and provide safe places for supervised care of young children, for example cre`ches. Work to promote swimming skills in school-age children. Work with the community to create a rescue protocol in the event of an incident in their area, their village. Strengthen public
C The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] V
1
Downloaded from http://tropej.oxfordjournals.org/ at Northeastern University Libraries on May 26, 2015
In November 2014, the World Health Organization released a Global Report on Drowning, to draw attention to the magnitude of the burden of drowning as a leading cause of death in all regions of the world. The report addresses the problem of drowning globally, but focuses on low- and middle-income countries (LMIC) where over 90% of these deaths occur. The rates of death due to drowning are 50–60% as that due to malnutrition and malaria. However, drowning lacks the visibility that the other two conditions have. This fact needs to be publicized, and drowning must be added onto the list of issues that need prevention strategies. The World Congress of Drowning in 2002 defined drowning as ‘The process of experiencing respiratory impairment from submersion or immersion in liquid’. Over 370,000 people the world over die every year by drowning. The death toll due to drowning is likely to be higher, as deaths due to drowning as a method of suicide and homicide and drowning deaths due to natural disasters such as floods and due to water transport mishaps are officially not categorized as drowning. A child can drown within minutes. The chances of rescue and subsequent survival are largely dependent on how quickly help reaches the person, and how effectively the resuscitation is done. Prevention of drowning is critical. There have been some successes of preventive strategies, such as barriers to swimming pools, but they are mostly in high-income countries. In many LMIC, targeted public health attention has resulted in impressive declines in mortality in conditions such as diarrhoea. A similar focus
2
Editorial
awareness of the burden of drowning and the vulnerability of children. Conduct research into the feasibility of local prevention strategies, for example using local adaptations, such as inner tubes of bicycle tyres as personal flotation devices. As paediatricians, what should we do? Is it not our mandate to be involved in drowning prevention strategies? Drowning is a leading, and largely
preventable, killer. It affects the age group that we serve. It needs visibility. It needs inter-sectoral cooperation. It needs political will. It needs our attention, and the time to act is now. Anuradha Bose Editor, Journal of Tropical Pediatrics E-mail
Downloaded from http://tropej.oxfordjournals.org/ at Northeastern University Libraries on May 26, 2015
EDITORIAL
Drowning – The Preventable Killer has to be aimed for in preventing drowning, using strategies that are relevant in the local culture. The risk factors for drowning are known. They are: lack of physical barriers between water bodies and children, for example open irrigational wells with no surrounding wall, abandoned rock quarries which collect rain water and open buckets at homes. Other risk factors include risky behaviour, such as swimming alone with no awareness of safety norms, such as boys swimming in open wells with no idea whatsoever of how to institute rescue efforts. In addition, lack of knowledge and lack of availability of personal flotation devices; local transport in many areas is by waterways, and the transport vessels are overcrowded and poorly maintained. Children are particularly vulnerable. Very young children, toddlers, can drown in very little water, in containers such as open buckets, which mothers do not perceive as dangerous water bodies. In LMIC, drowning largely affects the poor and marginalized. The threat of drowning can be reduced. Intersectoral cooperation and research focus are needed. The strategies that have worked in high-income countries need adaptation and implementation in the local setting. These strategies are: to implement creation of barriers that prevent people from falling into open water bodies. Promote and provide safe places for supervised care of young children, for example cre`ches. Work to promote swimming skills in school-age children. Work with the community to create a rescue protocol in the event of an incident in their area, their village. Strengthen public
C The Author [2015]. Published by Oxford University Press. All rights reserved. For Permissions, please email: [email protected] V
1
Downloaded from http://tropej.oxfordjournals.org/ at Northeastern University Libraries on May 26, 2015
In November 2014, the World Health Organization released a Global Report on Drowning, to draw attention to the magnitude of the burden of drowning as a leading cause of death in all regions of the world. The report addresses the problem of drowning globally, but focuses on low- and middle-income countries (LMIC) where over 90% of these deaths occur. The rates of death due to drowning are 50–60% as that due to malnutrition and malaria. However, drowning lacks the visibility that the other two conditions have. This fact needs to be publicized, and drowning must be added onto the list of issues that need prevention strategies. The World Congress of Drowning in 2002 defined drowning as ‘The process of experiencing respiratory impairment from submersion or immersion in liquid’. Over 370,000 people the world over die every year by drowning. The death toll due to drowning is likely to be higher, as deaths due to drowning as a method of suicide and homicide and drowning deaths due to natural disasters such as floods and due to water transport mishaps are officially not categorized as drowning. A child can drown within minutes. The chances of rescue and subsequent survival are largely dependent on how quickly help reaches the person, and how effectively the resuscitation is done. Prevention of drowning is critical. There have been some successes of preventive strategies, such as barriers to swimming pools, but they are mostly in high-income countries. In many LMIC, targeted public health attention has resulted in impressive declines in mortality in conditions such as diarrhoea. A similar focus
2
Editorial
awareness of the burden of drowning and the vulnerability of children. Conduct research into the feasibility of local prevention strategies, for example using local adaptations, such as inner tubes of bicycle tyres as personal flotation devices. As paediatricians, what should we do? Is it not our mandate to be involved in drowning prevention strategies? Drowning is a leading, and largely
preventable, killer. It affects the age group that we serve. It needs visibility. It needs inter-sectoral cooperation. It needs political will. It needs our attention, and the time to act is now. Anuradha Bose Editor, Journal of Tropical Pediatrics E-mail
Downloaded from http://tropej.oxfordjournals.org/ at Northeastern University Libraries on May 26, 2015
