Child Drowning

Diarrhoea caused 22 of 820 child deaths (3 per cent) and pneumonia caused 19 of 820 child
deaths (2 per cent). The low percentage of both conditions is a validation of the effort
made in provision of clean water, sanitation and antibiotics in the flood-relief efforts.
Similar efforts need to focus on injury causes of death in floods.
The disaster risk management sector needs to recognize the contribution of drowning (and other
injuries such as snake bites) to the child mortality and morbidity burden associated with aquatic
disasters. There is a clear need to integrate drowning prevention into disaster risk management
programmes. An anticipated benefit would be a reduction of drowning in both disasters and everyday
life, due to a commonality of prevention measures such as community-based response skills that will be
beneficial in both scenarios.
2.4 CHILD DROWNING IN ASIAN LMICS COMPARED TO DROWNING IN HICS
Many common circumstances contributed to the high rates of child drowning in the countries surveyed.
These differ substantially from those surrounding child drowning in HICs. The main differences include:
(i) Drowning in early childhood:
Drowning in early childhood in LMICs occurs primarily from daily exposure to water, which is
everywhere in the child’s environment. Contributing factors are that homes generally have only one
room and lack space where children can be separated from water hazards; homes do not have piped
water and rely on nearby water bodies such as ponds and wells; bodies of water are rarely fenced or
covered to facilitate ease of access; and children’s direct caregivers are mothers with many household
chores to accomplish and little help. Since household sizes are generally larger in LMICs, mothers often
assign supervision of younger children to older siblings, who may not be capable of active supervision.
The combination of the factors above was the most common risk scenario found for early child
drowning across the countries surveyed.
In Jiangxi Province, China, where family sizes are small, the same phenomenon was seen, differing only
in two factors: 1) the one-child family policy resulted in a child not have siblings, and alternative
caretakers were primarily grandparents; 2) a child’s parents had often migrated for economic reasons.
As a result, the child was left behind with grandparents whose age and poor health status made active
supervision of the young child difficult. In both cases, the end result was a very young child escaping
supervision and drowning in a water body very near the home.
In HICs the environment that a child inhabits is dramatically different. Zoning ordinances, building
codes, laws requiring swimming pools to be fenced and other safety regulations mean that children are
rarely exposed to drowning hazards, whether in and near their homes. Some young children are able to
escape active supervision and drown, but such cases are rare. They result from a secondary failure of
barriers in place to prevent drowning. These often include fence gates left open around a pool, toilets
with lids left open, or normally used covers on a diaper bucket being left unlocked or open. Thus the
drowning in HICs requires two sequential ‘system failures’ – that which allows the child to escape close
supervision, and that which defeats the barrier between the child and the water source.
(ii) Drowning among older children:
Older children in LMICs are in constant proximity to water. Water sources are always nearby homes, as
water is necessary for drinking, bathing, cooking and other household uses, as well as watering livestock
and other animals. In rural areas, the need for convenient access as well as the large number of water
sites makes fencing and other barriers inappropriate and inconvenient in the context of daily life. As a
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