Preventing drowning in the Philippines
A drowning prevention pilot project in Dagupan City, Philippines focused on the construction of barriers and fences to prevent children falling in the water, increasing awareness and giving first aid training.
When Jonathan Guevarra was asked to prepare the groundwork for a drowning prevention project in Dagupan City, Philippines, he was most concerned about the way local communities would react to the project.
Drowning is the leading cause of death in children under 18 in the Philippines – a fact that Guevarra, Chair and Assistant Professor of the Department of Health Promotion and Education at the College of Public Health of the University of the Philippines, knows well.
Guevarra was unsure, whether local communities understood how serious the problem was, or that they would be prepared to support his proposals to prevent drowning in children.
To better understand the challenges ahead, Guevarra travelled the four hours north of Manila to Dagupan City, on the coast. To his relief, the community was ready to engage.
“The partnership between the stakeholders, between the Department of Health, the Local Government Unit, the City Health Office, the village leadership and WHO – was very instrumental in helping communities understand the need for such a project and to implement the proposed interventions,” noted Guevarra. In one site, a Community Drowning Prevention Committee was created, composed of subcommittees on health; infrastructure; and monitoring and evaluation. A community leader was assigned a number of village workers to assist in all phases of the project, including community surveys and presentations of the survey findings to the public.
Based on the findings, the Committee selected specific sites, which typically were rural villages completely surrounded by natural and manmade water hazards. The children most at risk for drowning are 1-4 year olds who are old enough to move around in their environments, and – due to very large family sizes averaging close to 10 – all too often cared for by a slightly older sibling, despite the omnipresent threat the water poses.
Dagupan City drowning prevention programme
The Dagupan City region has a long coastline and many lagoons and fishponds around which the local people make their living. The drowning prevention programme included the construction of porch barriers and backyard fences in homes built above or near water and the provision of playpens to physically prevent children falling into water. It also focused on rebuilding and covering wells. First aid training was provided to local officials, health workers and community volunteers so they could react better when children did fall into water.
The pilot project does not yet cover enough households to provide a measurable decline in drowning, however an awareness of drowning risks has clearly increased. Families are willing to have barriers constructed; and the barriers themselves appear to be holding up well. Equally important, people looking after children recognize that the barriers will not prevent all accidents: constant supervision remains necessary.
Based on these results, Jonathan would recommend other areas adopt the approach.
Increased action on violence and injuries prevention
Efforts to prevent drowning such as those WHO is supporting in the Philippines come at a time when ministers of health from 37 countries and areas across the WHO Western Pacific Region have formally recognized the need for increased action to prevent injuries .
“Violence and injuries account for 1.2 million deaths and have enormous non-fatal consequences in the WHO Western Pacific Region," said WHO Regional Director Dr Shin Young-soo. "Unless we take action now, the problem of violence and injuries will continue to increase." In late September 2012 WHO’s Regional Committee for the Western Pacific adopted its first resolution on injuries including violence-related injuries, calling for an enhanced regional response which will require multisectoral action and multiple interventions.
Violence and injuries are the main topic of Safety 2012 conference, hosted in New Zealand 1-4 October. A major theme of the conference is the need for leadership at the highest level to ensure that all relevant sectors—health, infrastructure, transport, police, city planning, education—play their respective roles effectively.