Child Drowning

The analysis allowed examination of fatal drowning rates disaggregated by age. For each year of age in
the children participating, there were significant reductions in drowning rates among children in the
SwimSafe intervention group compared to the control group. Both boys and girls were protected at the
three sites. This evidence shows SwimSafe is effective among all ages receiving the training and protects
both sexes in the normal drowning environments of rural LMICs in Asia.
From a public health perspective, it was important to show that SwimSafe is effective in the most
common drowning environments encountered by children in Asian LMICs, and that swimming
techniques could be taught in all settings available, such as ponds, lakes, reservoirs, rivers and beaches
as well as pools. From an implementation perspective, it was important to show that it could be taught
in the shortest time period possible, given the resource-constrained environment.
It was important to define the norms of protection, the time required for training and venues for the
training. However, some drowning scenarios could not be tested in PRECISE. For example, would
SwimSafe training protect a participant on a ship sinking several kilometres from shore? The surveys
were conducted among representative populations and designed to cover 95 per cent of drowning
scenarios in Asian LMICs – of which the above scenario was never encountered. The public health
approach balances the need for protection with the equally important need for a short implementation
time and low implementation cost. To protect the millions of children at risk of drowning, protection
needs only to be sufficient for the great majority of drowning environments and to be cheap and simple
enough to facilitate the large training volumes required.
The design criteria used for the SwimSafe intervention was consistent with that of the tsunami study
cited earlier. It is therefore likely that SwimSafe may protect participants against cataclysmic flooding. In
the survivor interviews from Aceh following the tsunami, there were no reports of needing to swim long
distances. The only swimming that was required was to reach floating debris or a nearby structure.
2. Is the intervention safe?
Safety was a major concern, given the circumstances in which SwimSafe would be implemented.
Hundreds of ponds in rural villages were used to teach tens of thousands of very young children how to
swim, potentially putting very young children in a hazardous environment.
To develop the SwimSafe training curricula, an anthropologic study examined the process of acquisition
of natural swimming ability. 49 The process was categorized into practices used to teach individual skills
and the chaining process used to link the individual skills into natural swimming competence.
International experts in swim teaching and water safety classified the processes according to whether
they met the criteria for good practice, best practice or harmful practice. The structured SwimSafe
curriculum was developed to provide children aged four and above with swimming ability and with basic
knowledge of water safety and safe rescue. Risk management, quality assurance and objective
validation were built into the process. 50
The programme was found to be safe. Over the four-year operational research activity, SwimSafe in
Bangladesh scaled up from 2 to 650 ponds, currently with over 200,000 graduates aged 4-17 years,
49 Harun, A. et al. ‘The Process of Learning Natural Swimming’. In: Scarr et al (eds) World Conference on Drowning Prevention,
Danang, Vietnam, 2011. International Life Saving Federation, Leuven, p 78 accessed at:
www.worldconferenceondrowningprevention2011.org
50 Rubin, T. et al.‘SwimSafe – A survival swimming curricula’. In: Scarr et al (eds) World Conference on Drowning Prevention,
Danang, Vietnam, 2011. International Life Saving Federation, Leuven, p 86 accessed at:
www.worldconferenceondrowningprevention2011.org.
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