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Dr Michael Linnan Technical Director, The Alliance for Safe Children [email_address] www.tasc-gcipf.org
The Hidden Epidemic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
It is different from drownings in wealthy countries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Low and middle income countries have none of that ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
It’s not pools, it’s not beaches, and there is no association with alcohol use – it’s just daily life
As an epidemic it will require a public health approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why cant we use the available data? ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],The Thai National Injury Survey
But drowning is not usually seen in the hospitals or reported there ,[object Object],[object Object],[object Object],[object Object]
The surveys to date 95,000 / 450,000 National, Manila separate Philippines  2004 100,010 / 319,500 Provincial, all counties Jiangxi 2005 29,400 / /104,000 National, 8 provinces Indonesia  2003 72,500 / 348,000 National, all provinces Cambodia 2007 100,100 / 370,000 National, Bangkok separate Thailand  2004 28,000 / 87,000 Beijing capital, all counties Beijing  2003 175,000 / 698,000 National, Dhaka separate Bangladesh  2003 27,000 / 128,000 National with 8 regions Vietnam  2001 (HH/residents) Scope of sample Country and date
What the surveys show
Drowning causes over half of all child deaths after infancy
Drowning kills more children  than tuberculosis
more than HIV
more than dengue
more than malaria
more than SARS or Avian Flu combined
more than tetanus, whooping cough and polio put together
Child drowning by season Matlab 1983 - 1995
The current toll of drowning in the region ,[object Object],[object Object],[object Object],[object Object],[object Object]
Keys to prevention ,[object Object],[object Object],[object Object],[object Object],[object Object]
Only about 2% of drownings result from  a stated recreational intent ,[object Object],[object Object],[object Object],[object Object],[object Object]
What strategies will be the most effective  given this picture? ,[object Object],[object Object],[object Object],[object Object]
What strategies will be the most effective? (cont’d) ,[object Object],[object Object],[object Object],[object Object]
What strategies will be the most effective? (cont’d) ,[object Object],[object Object],[object Object],[object Object]
What about providing life guards in recreational settings? ,[object Object],[object Object]
Does swimming ability prevent drowning? ,[object Object],[object Object],[object Object],[object Object]
Does swimming ability prevent drowning? ,[object Object],[object Object],[object Object],[object Object]
There is also a recent natural experiment  we have examined ,[object Object],[object Object],[object Object],[object Object]
3,750 households divided between 4 zones at varying distances from beach 16,240 household members as of morning of 26 December, 2004; 49.9% male. 50.1% female 52% urban, from Banda Aceh and 48% rural from Aceh Besar 2.7% infants, 28.5% 1-17 years, and 68.7% 18+ years Aceh, northern Sumatra Banda Aceh Aceh Besar Direction of waves coming ashore
Mortality rates in tsunami by age and distance to beach
Mortality rates in the tsunami by age and swimming ability
Swimming saves lives ,[object Object],[object Object],[object Object]
If this is their walk to school shouldn’t they know how to swim?
If this is how they go to the store, shouldn’t they know how to swim?
If this is their backyard,  shouldn’t they know how to swim?
If they play here, shouldn’t they know how to swim?
If they live on a boat shouldn’t they know how to swim?
Alone or together, shouldn’t they know how to swim?
We need your help ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Child drowning
Will you take up the oars? Lifesaving Aye!
Relative risk of child surviving the tsunami according to whether a parent or caretaker could swim

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Pulling on the same oars together - we can make a difference

  • 1. Dr Michael Linnan Technical Director, The Alliance for Safe Children [email_address] www.tasc-gcipf.org
  • 2.
  • 3.
  • 4.
  • 5. It’s not pools, it’s not beaches, and there is no association with alcohol use – it’s just daily life
  • 6.
  • 7.
  • 8.
  • 9.
  • 10. The surveys to date 95,000 / 450,000 National, Manila separate Philippines 2004 100,010 / 319,500 Provincial, all counties Jiangxi 2005 29,400 / /104,000 National, 8 provinces Indonesia 2003 72,500 / 348,000 National, all provinces Cambodia 2007 100,100 / 370,000 National, Bangkok separate Thailand 2004 28,000 / 87,000 Beijing capital, all counties Beijing 2003 175,000 / 698,000 National, Dhaka separate Bangladesh 2003 27,000 / 128,000 National with 8 regions Vietnam 2001 (HH/residents) Scope of sample Country and date
  • 12. Drowning causes over half of all child deaths after infancy
  • 13. Drowning kills more children than tuberculosis
  • 17. more than SARS or Avian Flu combined
  • 18. more than tetanus, whooping cough and polio put together
  • 19. Child drowning by season Matlab 1983 - 1995
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30. 3,750 households divided between 4 zones at varying distances from beach 16,240 household members as of morning of 26 December, 2004; 49.9% male. 50.1% female 52% urban, from Banda Aceh and 48% rural from Aceh Besar 2.7% infants, 28.5% 1-17 years, and 68.7% 18+ years Aceh, northern Sumatra Banda Aceh Aceh Besar Direction of waves coming ashore
  • 31. Mortality rates in tsunami by age and distance to beach
  • 32. Mortality rates in the tsunami by age and swimming ability
  • 33.
  • 34. If this is their walk to school shouldn’t they know how to swim?
  • 35. If this is how they go to the store, shouldn’t they know how to swim?
  • 36. If this is their backyard, shouldn’t they know how to swim?
  • 37. If they play here, shouldn’t they know how to swim?
  • 38. If they live on a boat shouldn’t they know how to swim?
  • 39. Alone or together, shouldn’t they know how to swim?
  • 40.
  • 42. Will you take up the oars? Lifesaving Aye!
  • 43. Relative risk of child surviving the tsunami according to whether a parent or caretaker could swim