The region of South Asia has the biggest burden of injury related deaths in the world. Throughout the region, over 90,000 people drown every year (1).  In India alone, one person drowns every 8 minutes!  Studies by the United Nation’s World Health Organization have shown that most of the South Asian countries have higher drowning death rates than the world average as illustrated in the table below (2).  On average, the drowning death rate in South Asia is 6 times higher than that in the U.S. and the western European countries.

Drowning by the numbers (2):

Country	Rate (per 100,000 population)	Total Annual Drowning Deaths
Worldwide	6.14	381,640
USA	1.31	3,812
India	6.57	68,914
Nepal	7.18	1,767
Bangladesh	5.78	8,319
Bhutan	6.16	135
Sri Lanka	4.72	892

Higher Death Rates in the South

While India, as a whole, has an average drowning death rate of 6.57, areas in the south see substantially higher rates.  Mangalore, a coastal city in the state of Karnataka has an average drowning death rate of 13.55, over double the national average (3).Rural villages of Bangladesh see even higher rates.  Children ages 1-4 drowned at a rate of 156.4 per 100,000 children in some areas with the highest rate (289.7/100,000) being seen in one year-olds (4).

Why Do So Many South Asians Drown?

Such high drowning death rates are primarily due to the torrential monsoon rains the region sees every summer.  The rains fill ditches and cause rivers and lakes to swell throughout the country, creating hazards for locals, particularly young children.  Villagers are often too preoccupied with their work to adequately supervise their children’s play.  When a child is pulled from the water, most villagers lack any knowledge of proper resuscitation techniques.  They often resort to “spinning,” an ineffective method of resuscitation where the child is held by the ankles and spun around in an effort to expel the water from their lungs (5).  The lack of sufficient education in drowning prevention and resuscitation has resulted in thousands of unnecessary deaths.

How Can This Be Prevented?

Researchers teaming up with local villagers have come up with a number of intervention ideas to help prevent drownings in the future.  Some of the ideas proposed include putting bells on children, teaching swimming skills, and educating communities in drowning prevention and resuscitation skills (5). Following these research results, Project: Swim International is operating projects in India (Swim India) and Nepal (Swim Nepal) that focus on educating locals, primarily school children, in drowning prevention and resuscitation skills.  In the future, Project: Swim International hopes to be able to provide swimming lessons to children as well.  Keeping its mission statement in mind, Project: Swim International will strive to develop effective drowning prevention programs, in accordance with the most current research findings.

References

1. World Health Organization. Global burden of disease and risk factors. Geneva: WHO, 2002

2. World Health Organization. Global burden of disease and risk factors. Geneva: WHO, 2004

3. Mahabalesh, Shetty. Deaths in Mangalore, a coastal city of Karnataka. Medico-Legal Update. 2005; 5(2): 39-42

4. Rahman, A. et al. Drowning - a major but neglected child health problem in rural Bangladesh: implications for low income countries. International Journal of Injury Control and Safety Promotion. 2006; 13(2) 101-105

5. Hyder, A.A. et al. Death from drowning: defining a new challenge for child survival in Bangladesh. International Journal of Injury Control and Safety Promotion. 2003; 10(4): 205-210