The danger that lies beneath…

By Dr Eddy Bajrovic*

Water can be fun. It can also be dangerous.
Girt by a sometimes-savage sea, Australians know this better than most. Or we should.
Every summer we flock to beaches, pools, lakes, dams and rivers to enjoy the water. Yet the coming months are also the peak season for drowning and we’re sure to hear of more tragedies as summer rolls on.
A total of 266 people drowned in Australia in the 12 months to July this year. Another dozen overseas visitors on average die by drowning each year – most commonly at our beaches (33%), ocean or harbour locations (31%), or inland waterways (19%) – based on figures from the Australia’s Royal Life Saving Society
We don’t know how many Aussies drown while travelling overseas each year because, surprisingly, the Department of Foreign Affairs and Trade doesn’t identify the causes of death for Australian travellers. However, from media reports alone, we know that a percentage of the 1215 Australians who died while travelling overseas in 2013-14 were victims of drowning. 

Young men the most likely drowning victims

With summer almost upon us, the World Health Organisation’s first ‘Global report on drowning: preventing a leading killer’ is a timely reminder of the dangers of drowning. Among its key findings, the new report found that:
- Every hour of every day, 40 people die from drowning (372,000 on average worldwide each year).
- Drowning is the third leading cause of unintentional injury death, accounting for 7% of all injury-related deaths. It is the most common cause of death in kids aged 5–14 in our region (the Western Pacific) where 1 in every 5 of those 372,000 annual global fatalities occurs.
- Over half of all drowning victims are under 25.
- Worldwide, twice as many males die from drowning as females. (In Australia, the percentage of male deaths is even higher at 80%.)
There are many ways to drown at home or on holidays.
As Kidsafe warns, babies can drown in just 5 centimetres of water in a bucket, swimmers get caught in a rip or tidal current, or get their foot or arm trapped by rocks or other submerged obstacles, while ferry or boat passengers can fall overboard. People have even been known to fall asleep on an inflatable mattress and be carried out to sea! 

Young not learning swimming, water safety skills

Two disturbing trends related to drowning deaths emerged in Australia last year.
The first was the lack of swimming skills among primary school students, and the second was a significant increase in the number of drowning deaths involving teens and young adults aged 15-24. There were 40 last year compared with 28 the year before.
Yet, as the WHO report points out, many of these drowning tragedies and other non-fatal serious injuries sustained in recreational waters could have easily been prevented. At home or away, the rules for staying safe in the water are these:
Don’t drink and dive – With your fine motor skills impaired by alcohol (or drugs, for that matter) it’s easy to slip on pool surrounds or rocks, hit your head and fall into the water. It takes only a few minutes for an unconscious person to drown. If your mates are in the same state, they may not notice you’re missing until it’s too late.
Ask an expert – Look for patrolled beaches or pools, swim in the sign-posted area (between the flags in Australia) and follow the direction of lifeguards. They are the experts when it comes to the local waters and if it’s safe to swim – or not – at any given time. It’s NEVER safe to swim at night – especially alone.
Always check first – Check the depth of the water before diving or jumping in. Murky lakes, creeks or rivers can hold hidden dangers like submerged trees that may not have been there last time you took the plunge. 
Wear a lifejacket – On any vessel (even a kayak or canoe) wear a lifejacket. They’re life savers if you fall out in deep water and you’re hit by another craft. The same goes if you are returning from a night out by water taxi. Falling into the water in the dark after consuming alcohol could make for a sobering experience at best. But, without a lifejacket, getting dunked could spell a deadly end to your night out.

Parents must be ever vigilant

Parents of toddlers and young children need to be extra vigilant around water – especially while holidaying in a developing country. The important lessons are:
Teach kids to swim early – Just how early kids should start lessons is open to debate. Authorities like AustSwimsuggest water familiarisation at 6-12 months and development of basic swimming skills from 2 years and upward. 
But, don’t look away – Your toddler may be able to swim to your outstretched arms during swimming lessons, but they are just as likely to panic if they fall in and no-one is around to rescue them. Watch them when they’re in or around water – always.
Think ‘safety’ – Are there lifeguards? Are there enough of them given the number of swimmers? If not, you or another responsible adult need to be ‘on duty’ too. Most children who drown were being supervised by a watcher who was distracted “just for a moment…”
Real ‘floaties’, not toys – Children should always be wearing personal flotation devices that meet national standards rather than air-filled or foam toys. And, these life-saving devices should be properly fitted and be on the child at all times while they are in the water AND around it. A significant number of young children who drown or have near misses were not supposed to be in the water but simply wandered away from a picnic or fell off rocks or a wharf.

Other dangers below (and above) the surface

Parents should also take special note of:
Water cleanliness – Pool or ocean water is for swimming in, not swallowing. Crowded pools with lukewarm water and littlies (especially those in nappies) are a few of the factors that lead to water-borne infections. This is borne out by studies that show that swimmers who place their heads under water tend to have more gastrointestinal illnesses than those who don’t, while waders have fewer illnesses than swimmers. The US’ CDC rates the top causes of disease from untreated recreational water as Shigella, Norovirus, E. coli, Cryptosporidium, Avian schistosomes, Giardia, Leptospira, Algal bloom (freshwater and marine blooms), Plesiomonas, and Campylobacter. 
Hidden dangers – ‘Look but don’t touch’ is the message for kids and adults alike in tropical waters. Coral wounds and jellyfish stings are almost always painful and sometimes deadly. So too the sting from a stone fish. Either could also mean expensive evacuation for treatment if it’s not available at your location. In addition, tropical fresh water lakes, rivers and other waterways may contain small snails that transmit a parasite that causes schistosomiasis. (Fortunately, these parasites aren’t found in chlorinated pool water or seawater.)
Dangerous temptations – Young people on holidays are often tempted to try parasailing, diving and jet skiing – some for the first time. The down side is that the instruction and supervision can be poor in some countries, with little or no supporting medical services nearby if needed. When speed and altitude are involved, the risk of a serious injury is high. Remember, insurance will almost certainly NOT cover accidents involving these water sports unless you pay extra to be covered.

*Dr Bajrovic is the Medical director of Travelvax Australia.