Special Report

Drowning Has Slowly Become The Leading Killer Of Children In Bangladesh Over The Last Decade. How Are We Tackling This Situation?

Bangladesh is the most populous deltaic country in Asia. Most of the country is made up of floodplain with an infinite swarm of lagoons, mangrove swamps, ponds, rivers and lakes in and around it. Now imagine the dangers of living in houses in Bangladesh without having the appropriate fences or barriers around most of these water bodies. The reality that stems from this situation is that since 2005, up to 18,000 children drown every year in Bangladesh, which equates to around one death every 32 minutes1 . The World Health Organization (WHO) estimates that the drowning epidemic claims more than 60,000 children under the age of five and more than 360,000 people globally.
Most people, however, are unaware of the severity of this problem as most of these deaths are reported by the press. Figures compiled by child rights organization Bangladesh Shishu Adhikar Forum (BSAF) showed that 352 children were reported to have drowned in 2016, 423 in 2015, 165 in 2014, 132 in 2013 and 125 in 2012.

Over the past two decades, efforts to eradicate infectious diseases in children have yielded commendable results with under-five and infant mortality declining by 65% and 56% respectively between 2004 and 2014 . However, this drowning epidemic has taken precedence with 43% of deaths for these children – more than measles, cholera, diarrhea and pneumonia combined.

Over the past two decades, efforts to eradicate infectious diseases in children have yielded commendable results with under-five and infant mortality declining by 65% and 56% respectively between 2004 and 20142. However, this drowning epidemic has taken precedence with 43% of deaths for these children – more than measles, cholera, diarrhea and pneumonia combined.
In Bangladesh, especially along the rural plains of the nation, one deep pond, sometimes more, sit next to houses and are frequently used for fishing, bathing, swimming, cleaning household items and etc. With little or no protective barriers to prevent them, children often wander into these ponds or lakes unsupervised between 9am and 2pm as their parents are busy working and finishing chores. 43% of these incidents occur in ponds, and 80% occur within 20 meters of the children’s homes. Children aged between 1 and 5 spend most of their day playing around the house as they haven’t started school yet. “That’s why these children have high risk of exposure to water bodies because they’re playing right there,” says Dr. Adnan Hyder, Director of the International Injury Research Unit of Johns Hopkins Bloomberg School of Public Health.
Now, despite being labeled as the leading killer of children from as far back as 2005, little had been done until 2015 to address this crisis. In 2015, the education ministry issued a circular which called for swimming to be taught in all educational institutions; however, this has yet to make a dent in the number of deaths due to a lack of training/swimming facilities available in most educational institutions.
The Bangladeshi government and CIPRB set up an International Drowning Research Centre (IDRC), which has made mandatory swimming lessons part of its plan to stop this epidemic. One of their more successful projects has been the SwimSafe initiative which is backed by Unicef. SwimSafe employs community-based instructors to teach children how to swim and rescue others. Since its inception in 2006, the program has trained more than 200,000 children which has led to a drastic decline in drowning death rates for children.

Photographs From Pulitzercenter.org

According to the Guardian, during harrowing interviews with the parents of children who had drowned, it was found that while people acknowledge the problem, many parents felt powerless to take action as some simply put it down to “God’s will”. A lot of these lives could be saved every year if these people can be encouraged to put aside superstitions that view the deaths as some spiritual intervention and to eradicate the culture that views this type of death as inevitable.
To counter this issue, CIPRB, the Royal National Lifeboat Institution (RNLI) and the George Institute for Global Health, in Sydney, launched a £2.5m project in 2016 seeking to challenge these traditional ideas and spread their nationwide drowning-prevention strategy. This four-year Bhasa project, which means “rise up” in Bengali, is a household survey of 400,000 people, aimed at providing a detailed picture of drowning deaths, to identify where the worst problems are and where the most effort is needed. The survey is based in Barisal, an area which the CIPRB believes to be the worst place in the world for child drownings. Local interviews conducted for the Bhasa survey found that in 97% of the drownings in the Barisal region, no one in the area had cardiopulmonary resuscitation training.

Photographs From Pulitzercenter.org

Another program to fight this ongoing situation was initiated by Bloomberg Philanthropies. Their Drowning Prevention Program began in 2012 and currently focuses in two countries – Bangladesh and the Philippines. In 2014, they announced a $10 million commitment to prevent drowning deaths. Recently, in May 2, 2017, Michael R. Bloomberg, WHO Global Ambassador for Non-communicable Diseases and founder of Bloomberg Philanthropies, announced a commitment of $25 million to expand their drowning prevention program. Details on this expanded program will be released soon.
“We need an approach that uses reliable data to demonstrate how we can address these risks. Examining what strategies work will serve as a model to prevent drowning on a global scale,” said Dr. Adnan Hyder, Director of the International Injury Research Unit of Johns Hopkins Bloomberg School of Public Health, which is leading the study.

In May 2, 2017, Michael R. Bloomberg, WHO Global Ambassador for Non-communicable Diseases and founder of Bloomberg Philanthropies, announced a commitment of $25 million to expand their drowning prevention program.

The first phase of the drowning prevention program, piloted in 2012, tested the effectiveness of playpens and community daycare as prevention measures in Bangladesh. The second phase of Bloomberg Philanthropies’ program expanded on the use of daycare and support survival swimming in Viet Nam as well as continue to support community-based daycares in Bangladesh.
The initial funding for drowning prevention program also included support for the WHO report Preventing Drowning: An Implementation Guide. The report outlines the severity of drowning as a global predicament and presents effective drowning prevention strategies to be taken by national and local governments. Key prevention policies include:
• Providing safe places for pre-school children
• Installing barriers controlling access to water
• Teaching school-age children swimming and water skills
• Building resilience and managing flood risks
• Training bystanders in safe rescue and resuscitation
• Set and enforce safe boating, shipping and ferry regulations.
Bloomberg Philanthropies is partnering with the World Health Organization and Johns Hopkins Bloomberg School of Public Health to identify scalable solutions to help prevent drowning deaths, and to build strong networks between public health officials and advocates who may participate in future efforts. Bloomberg Philanthropies is also supporting the World Health Organization to publish an evidence-based global report on drowning prevention later this year and to provide expert guidance on effective strategies to battle this global killer.
Dr. Etienne Krug, Director of WHO’s Department for the Management of NCDs, Disability, Violence and Injury Prevention had this to say, “It is unacceptable that hundreds of thousands of people drown each year. We have the means to prevent the enormous loss of life associated with drowning. It is time to implement the knowledge we have about what works.”

1 Centre for Injury Prevention, Health Development and Research, Bangladesh (CIPRB)
2 The Bangladesh Demographic and Health Survey 2014

PHOTOGRAPHS FROM PULITZERCENTER.ORG

SOURCES: THE GUARDIAN
BLOOMBERG PHILANTHROPIES

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