Child Drowning
Child Drowning Child Drowning
interventions required a variety of communications channels and a focus on trans-generational behavioural change. Changing harmful resuscitation responses will require the same scope and scale of investment. Increasing access to primary education, embedding health messaging in educational curricula and broader penetration of new communication technologies will be helpful; however changing behavioural norms is a difficult and time-consuming process and will require a lengthy and comprehensive effort. Significant health and social investments are lost when a child drowns Drowning rates are highest in early childhood, at which stage most health investments for the young child have already been made. Examples are antenatal care and immediate postnatal care delivered to mothers and infants, and vitamin A, zinc and other micronutrient supplementation. At the point where child drowning rates are highest in the countries surveyed (16-24 months), a young child has received almost all immunizations and many have benefited from early child development and other child enrichment programmes. Figure 20 shows the percentage of children 1-4 years old in Bangladesh, Cambodia and Thailand who had been immunized prior to their fatal drowning. Figure 20: Immunization status of drowned children (aged 1-4) in Bangladesh (2003), Cambodia (2007) and Thailand (2004) 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Bangladesh Cambodia Thailand Immunization status unknown Fully immunized according to EPI schedule Partially immunized according to EPI schedule Source: Authors’ calculations from the Bangladesh Health and Injury Survey 2003, the Cambodia Accident and Injury Survey 2007 and the Thai National Injury Survey 2004. The loss of the health and social investments made in these young children by their drowning deaths represents a major indirect cost, as well as the loss of their future potential. Given that drowning is also a leading cause of child death among primary and secondary school-aged children, educational investments are also lost when older children drown. Drowning during floods is an unrecognized or unstated cause of mortality While it might seem self-evident that drowning is a cause of child death in floods, commonly drowning is not mentioned as a cause of death. Usually the major health threats identified with floods are infectious diseases. Even UNICEF has been somewhat short-sighted in its coverage of this issue. An example is the story in the The State of the World’s Children 2011 report on climate change in Pakistan where the threat of infectious disease following flooding is discussed but there is no mention of 46
drowning. It states: “Unprecedented heavy rains gave way in July 2010 to devastating floods. The initial death toll was approximately 1,600 people, but many more are unaccounted for. An estimated 20 million men, women and children have been affected by the floods, and huge numbers are stranded, waiting for help....This drowning nation now faces a further disaster: The floods are threatening to decimate Pakistan’s youth. One of the biggest threats is the outbreak of water-borne diseases such as cholera and diarrhoea.” 31 Similarly, guidance for staff in flood emergencies in the UNICEF Emergency Field Handbook states: “The most common health threats for flood-affected populations will be diarrhoea from dysentery or cholera, acute respiratory infections, fever, eye or skin diseases, and conjunctivitis...In tropical and sub-tropical regions, floods can easily lead to an increase of malaria and other diseases associated with still water, such as dengue fever.” 32 In fact, drowning is a leading cause of child death in floods and other natural aquatic disasters, both in the acute stages and in the aftermath. Figure 21 shows the causes of child death during severe flooding in Bangladesh in August and September 2007, with drowning the primary cause of mortality. Figure 21: Causes of death among 0–17 year old children in severe floods, Bangladesh 2007 Pneumonia 2% Drowning 89% Snake Bite 9% Diarrhoea 3% Source: Disaster Monitoring Cell, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh. Note: Due to rounding, the total percentage is greater than 100. Drowning was responsible for almost 9 out of 10 child deaths in the floods, with the breakdown of causes of death as follows: Drowning caused 729 of 820 child deaths (89 per cent), all of which were among very young children. Snake bites caused 70 of 820 child deaths (9 per cent). Rising waters force people and animals to share the remaining dry ground, thus bringing them in close proximity to snakes. Young children are at greater risk of bites as they do not understand the danger posed by snakes, have higher contact rates, and have a low body mass that makes them more vulnerable to snake venom than adults. Moreover, flood relief efforts do not include provision of snake anti-venom. 31 United Nations Children’s Fund (2011). The State of the World’s Children 2011. New York: UNICEF, p. 76. 32 United Nations Children’s Fund (July 2005). Emergency Field Handbook: A guide for UNICEF staff. New York: UNICEF, p. 81. 47
- Page 1 and 2: UNICEF Office of Research Child Dro
- Page 3 and 4: THE UNICEF OFFICE OF RESEARCH In 19
- Page 5 and 6: TABLE OF CONTENTS Executive Summary
- Page 7 and 8: EXECUTIVE SUMMARY Childhood drownin
- Page 9 and 10: Household survey findings Drowning
- Page 11 and 12: Loss of health and social investmen
- Page 13 and 14: INTRODUCTION Children living in dev
- Page 15 and 16: (iii) Methodology: Most surveys ha
- Page 17 and 18: Proportion of drowning Figure 1: Dr
- Page 19 and 20: In high-income countries (HICs), be
- Page 21 and 22: Table 2: ICD-10 drowning (1997) W65
- Page 23 and 24: - had no data reported, or none rep
- Page 25 and 26: data from multiple sources includin
- Page 27 and 28: A combination of these approaches i
- Page 29 and 30: Mortality rate/1,000 Drownng propor
- Page 31 and 32: Figure 7: Mortality among children
- Page 33 and 34: A second conclusion is that the cur
- Page 35 and 36: Cumulative proportion Drowning rate
- Page 37 and 38: Table 6 shows the severity of the n
- Page 39 and 40: Bangladesh Jiangxi China Cambodia B
- Page 41 and 42: 1. Drowning risks are higher when c
- Page 43 and 44: Rate per 100,000 Figure 17: Cause o
- Page 45: Figure 19: Resuscitation received b
- Page 49 and 50: esult, children fall in and drown,
- Page 51 and 52: Drowning rate per 100,000 2.6 LEVEL
- Page 53 and 54: 3. EVIDENCE FOR PREVENTION It is of
- Page 55 and 56: drowning is a leading but preventab
- Page 57 and 58: Mortality Rate (per 1,000) Figure 2
- Page 59 and 60: The analysis allowed examination of
- Page 61 and 62: Table 9: Number of children needed
- Page 63 and 64: The intervention developed a formal
- Page 65 and 66: immediate resuscitation is discusse
- Page 67 and 68: 2011) has 107 indicators, but does
- Page 69 and 70: systems and standards, and manageme
- Page 71 and 72: 5.3 STIMULATING AND SUSTAINING INVE
- Page 73 and 74: effective against ‘other diseases
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- Page 77 and 78: STAFF AND VOLUNTEERS OF THE ROYAL L
drowning. It states: “Unprecedented heavy rains gave way in July 2010 to devastating floods. The initial<br />
death toll was approximately 1,600 people, but many more are unaccounted for. An estimated 20<br />
million men, women and children have been affected by the floods, and huge numbers are stranded,<br />
waiting for help....This drowning nation now faces a further disaster: The floods are threatening to<br />
decimate Pakistan’s youth. One of the biggest threats is the outbreak of water-borne diseases such as<br />
cholera and diarrhoea.” 31<br />
Similarly, guidance for staff in flood emergencies in the UNICEF Emergency Field Handbook states:<br />
“The most common health threats for flood-affected populations will be diarrhoea from<br />
dysentery or cholera, acute respiratory infections, fever, eye or skin diseases, and<br />
conjunctivitis...In tropical and sub-tropical regions, floods can easily lead to an increase of<br />
malaria and other diseases associated with still water, such as dengue fever.” 32<br />
In fact, drowning is a leading cause of child death in floods and other natural aquatic disasters, both in<br />
the acute stages and in the aftermath. Figure 21 shows the causes of child death during severe flooding<br />
in Bangladesh in August and September 2007, with drowning the primary cause of mortality.<br />
Figure 21: Causes of death among 0–17 year old children in severe floods, Bangladesh 2007<br />
Pneumonia<br />
2%<br />
<strong>Drowning</strong><br />
89%<br />
Snake Bite<br />
9%<br />
Diarrhoea<br />
3%<br />
Source: Disaster Monitoring Cell, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh.<br />
Note: Due to rounding, the total percentage is greater than 100.<br />
<strong>Drowning</strong> was responsible for almost 9 out of 10 child deaths in the floods, with the breakdown of<br />
causes of death as follows:<br />
<strong>Drowning</strong> caused 729 of 820 child deaths (89 per cent), all of which were among very<br />
young children.<br />
Snake bites caused 70 of 820 child deaths (9 per cent). Rising waters force people and<br />
animals to share the remaining dry ground, thus bringing them in close proximity to snakes.<br />
Young children are at greater risk of bites as they do not understand the danger posed by<br />
snakes, have higher contact rates, and have a low body mass that makes them more<br />
vulnerable to snake venom than adults. Moreover, flood relief efforts do not include<br />
provision of snake anti-venom.<br />
31 United Nations <strong>Child</strong>ren’s Fund (2011). The State of the World’s <strong>Child</strong>ren 2011. New York: UNICEF, p. 76.<br />
32 United Nations <strong>Child</strong>ren’s Fund (July 2005). Emergency Field Handbook: A guide for UNICEF staff. New York: UNICEF, p. 81.<br />
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