Nearly two-thirds of global drowning deaths occur in the Asia Pacific

On the eve of observing the first-ever Global Drowning Prevention Day on the 25th of July, WHO has published the first-ever regional reports on the status of drowning in the West Pacific and the South East Asia region. 

The reports find that more than 144,000 peopl drowned in the Asia Pacific region, which is equivalent to 61% of global drowning deaths. Drowning claimed the lives of an estimated 70,000 and 74,000 people in South-East Asia and Western Pacific regions respectively, according to a recent study supported by The Royal National Lifeboats Institutions (RNLI).

Public health researchers from across the globe have identified multiple factors that trigger drowning deaths such as insufficient or lack of physical barriers between people and water, particularly close to home; lack of (or inadequate) supervision of young children; uncovered or unprotected water supplies and lack of safe water crossings; lack of water safety awareness and risky behaviour around water, such as swimming alone; travelling on water, especially in overcrowded or poorly maintained mal-standard ferries. 

The two WHO reports published recently have also warned 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 exposure to potentially hazardous interactions with water. Unfortunately, compared to the adversity of drowning, communities, governments and non-government actors at large are not aware of the harshness of drowning. 

Between 2014 and 2018, eight of the Region's 11 countries reported no significant reduction in fatal drownings. The Region is vast, spanning 11 countries and encompassing a wide range of social and economic settings. 

As a result, exposure and interaction with water vary across the Region, giving rise to different drowning-related risk factors between countries. This introduces a wide range of challenges – and opportunities – for improving water safety in different parts of the Region.

During the year 2019, the South-East Asia Region has experienced around 70,034 drowning deaths, which is the second-highest number of deaths from across all regions of the World Health Organization (WHO). Over 33% of these deaths occurred among children under the age of 15 years. 

WHO has been supporting multiple agencies advocating governments across the region to scale up the tested interventions of drowning prevention. The following figure represents the number of drowning deaths by WHO region in 2019. 

The report on South-East Asia found that the rate of drowning death per 100000 population in Bangladesh is 4.6 while Timor-Leste counts 5.8 followed by Thailand at 5.5 and Nepal at 5.4. In terms of the World Bank Country Classification of Income Level Matrix 2020-21, 55% of the drowning deaths occurred in lower-middle-income countries like Bangladesh, Bhutan, India, Myanmar, Nepal, Sri Lanka, and Timor-Leste.

TBS Illustration

Drowning can be prevented through the implementation of evidence-based, cost-effective approaches. The WHO Global Report on Drowning (2014) outlines four strategies and six interventions for drowning prevention. Strategies focus on developing strong national mechanisms to ensure a coordinated and effective approach to addressing drowning, while interventions promote community action. 

A comprehensive response to drowning requires a multi-sectoral approach that champions health beyond the health sector and draws on the knowledge, reach and capacity of other agencies and organisations. 

Effective strategies and interventions must respond to local needs, consider available resources, and build on the progress already made. Drowning prevention efforts must be underpinned by a gender, equity, and human rights lens, to ensure the SDG spirit of "no one is left behind". Drowning prevention programmes and interventions mustn't increase health inequities. 

Referring to the WHO factsheet 2019, the report on the South-East Asia Region suggests that most drowning deaths occur among children and men. Out of the 70 000 drowning deaths in the WHO South-East Asia Region, more than 33% were among children aged under 15 years where on average, men were three to four times more likely to drown than women. 

In the Western Pacific Region, males and people aged 65 and older are at the greatest risk of drowning. Older people accounted for 34% of drowning deaths. Men were at higher risk than women in 2019, which stands at 66% of drowning deaths in the Region.

Many successful attempts have been marked during the reporting period towards reducing drowning among the countries in the Southeast Asia 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 while 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 differs 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 daycare/creches for young children in Bangladesh, India, and Thailand; and improved information systems and public awareness campaigns focused on behaviour change in Thailand. Having analysed the drowning prevention interventions among the South East Asian countries, the reports however recommended to:

Designate a lead agency, or support establishment of a coordination body, to drive drowning prevention efforts. 

Develop and implement a national water safety plan that has national indicators for drowning prevention. 

Formalize multisectoral mechanisms to address drowning prevention and water safety through establishing partnerships across sectors and assigning clear roles and responsibilities. 

Document and share knowledge gained in drowning prevention efforts. 

Perform a comprehensive review of drowning prevention legislation to ensure that best practice laws are developed and that appropriate resources for implementation and enforcement are available. 

Evaluate intervention plans for drowning prevention from the outset, ensuring that evaluation is adequately planned for and funded. 

Strengthen data systems that capture drowning incidents while improving the availability and quality of reporting. 

The two regional reports also suggested countries abide by WHO-recommended best practices on drowning prevention interventions and policies, including daycare 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. The same appeal has been echoed by the UNGA resolution on Global Drowning Prevention adopted on April 28, 2021. The resolution has stipulated the 25th of July 2021 to observe the Global Drowning Prevention Day 2021 with the theme "Anyone can drown, No one should". The Directorate General of Bangladesh Health Services (DGHS) has planned to observe the Day engaging all multi-sectoral stakeholders to develop consensus and raise voices to adopt the national drowning prevention strategy.

Sadrul Hasan Mazumder is a Policy Activist and can be reached at [email protected]

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.