Mumbai: In 2018, there were 83 deaths every day in India, on average, due to drowning--an unseen public health disaster--according to a report on Accidental Deaths & Suicides in India (ADSI), released in 2020. Still, in a country with unguarded lakes, ponds and rivers, especially in rural areas, there is no government policy for preventing drowning, such as barriers around water-bodies, safety lessons to children in schools, and safe boating laws.

There were 30,187 deaths in 2018, which experts said is an underestimation, as many drowning deaths go unreported.

In 2018, drowning (7%) was the third major cause of all accidental deaths reported in India, after traffic accidents (43%) and sudden deaths (11%), according to the report released by the National Crime Records Bureau.

The most common cause of drowning was accidental fall into a water body (66% of deaths) which resulted in 19,939 deaths, and capsizing of boats (less than 1% percent) which led to 258 deaths. One-third of drowning deaths (9,990) were due to unspecified causes.

About 360,000 people died from drowning across the world in 2015, making it the third leading cause of unintentional injury-related deaths in the world, the World Health Organization (WHO) reported in January 2018.

Drowning deaths underestimated

About 62,000 drowning deaths were estimated in 2017, according to a December 2019 Lancet report on estimates of ‘healthy life’ lost in India. This was nearly twice of all (30,279) drowning deaths reported in ADSI 2017. The rate of years of life lost (YLL) by drowning were highest in the central states of Madhya Pradesh (MP) and Chhattisgarh, and the northeastern state of Assam, accounting for 11% of all drowning deaths, the Lancet report said.

“Thirty-thousand drowning deaths a year is [a] highly underreported figure,” said Rear Admiral (Ret) Purushottam Dutt Sharma, founder and president of the Rashtriya Life Saving Society (India), a non-governmental organisation that provides educational programmes in operational safety, first aid and resuscitation. The figure could be over 100,000, including those which are unreported and those registered as accidents, as drowning is rampant across the coastline and river-side settlements, he estimated.

When a bus or a truck falls into a river, it is called an accident and not drowning. At times, drowning due to a boat capsizing is categorised under accidental deaths, Sharma said, on the reasons for the underestimation of drowning deaths.

“Nearly 70% of the country lives in villages and small towns having water bodies like ponds, lakes, rivers and reservoirs, most of which are unprotected, unguarded and unsupervised, leading to drowning incidents,” he said, adding that people are unaware of life-saving skills essential to save people from drowning.

Drowning also happens to be an easy way for murdering people,” Sharma said. He said that police are reluctant to register drowning cases as they are difficult to solve, especially in rural areas. Even in urban areas, only cases covered by the media are reported, he added.

Policy, awareness and training to prevent drowning

“Lifesaving is an important concept,” but our country has taken a long time to realise this, said Sharma. “We do not have a central policy or authority to form policy on drowning prevention and safety.”

The need of the hour is to have national or state-level comprehensive guidelines for preventive measures, Jaseena Naduveetil, a Doha-based family medicine practitioner who studied drowning in school children in Kerala’s Malabar region, told IndiaSpend.

The WHO recommends six policy interventions to prevent drowning: Install barriers controlling access to water, provide safe places (such as a day-care centre) with capable childcare away from water for preschool children, teach school-age children swimming and water safety skills, train bystanders in safe rescue and resuscitation, set and enforce safe boating, shipping and ferry regulations, build resilience and manage flood risks and other hazards locally and nationally.

Supervision (which could be done by self-help groups or increasing the time that government childcare centres are open) has been shown to reduce child drowning, said Jagnoor Jagnoor, head, injury division, WHO Collaborating Centre for Injury Prevention and Trauma Care at The George Institute for Global Health, India. She cited the example of a survival swimming programme that taught six- to 10-year-olds over 12 sessions at local ponds that reduced child drowning.

“Of late, there is a thrust towards ‘road safety’ but little attention is given to drowning prevention,” Sharma said. “The only way is to create a huge bank of life savers across the country so that no matter where an accident or drowning incident takes place, somebody in the vicinity knows what to do.” The government should set up ‘life-saving institutes’ in every state to impart training on how lives can be saved in cases of drowning, he suggested.

There should be more public awareness using mass and social media and more government resources for awareness programmes, protective and security devices, said Naduveetil.

30% of all drowning deaths were in Maharashtra, MP

Madhya Pradesh reported the most (4,542 or 15%) drowning deaths in 2018, followed by Maharashtra (4,516 or 15%), Karnataka (2,486 or 8%), Tamil Nadu (1,785 or 6%) and Gujarat (1,670 or 5.5%). These states accounted for nearly half of all drowning deaths in India.

Drowning was also reported as a means for death by suicide, with 6,579 deaths (5% of all suicide deaths) in 2018. Maharashtra had the most (1,287), followed by Karnataka (866) and Tamil Nadu (632).

More men die of drowning

Men accounted for 78% of all drowning deaths in India. The world over, men are at a higher risk of drowning, with twice the mortality rate of women, because of a higher exposure to water and riskier behaviour such as swimming alone, drinking alcohol before swimming alone and boating, according to the WHO. Men are also more likely to be hospitalised than women for non-fatal drowning.

Of the 30,187 deaths in India in 2018, 52% (15,686 deaths) were of people aged 18 to 45 years. Children below 14 years accounted for 3,968 or 13% of drowning deaths. Drowning is the third leading cause of death worldwide for children aged 5-14 years.

“Most children, in rural areas, where every household owns a pond, are at risk due to [the] lack of supervision, mostly when mothers are busy in household chores,” said Jagnoor. She said that medical malpractices such as ‘spinning the child’ to induce vomiting after drowning, instead of cardiopulmonary resuscitation, also puts children in danger. “Most deaths happen within 20 metres of the child’s home,” Jagnoor said.

(Mallapur is a senior policy analyst with IndiaSpend.)

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