At least 57,000 people in China perished by accidental drowning during 2004 according to the Ministry of Health, but the World Health Organisation says the actual number of fatalities could have been as high as 112,000, and ranks drowning as the number one cause of death among under-15s on the mainland.

The problem was discussed during a two-day conference in November which yielded “wide acknowledgement” of the need for improved quality and dissemination of data, according to a concluding statement issued in late January.

Discrepancies between the WHO and government estimates stem from different methods of counting. The Ministry of Health bases its figures on certified deaths at sentinel sites, but the WHO points out that such sites cover only 10% of the population, mainly across Central and Eastern China.

“To register the cause of all deaths in a country as large as China would be unfeasible,” according to Jon Passmore, an official with WHO in Beijing. He confirms that the higher WHO figure includes an estimate for the uncounted population, which government sources do not capture.

Ministry of Health statistics do however suggest that drowning is more serious in rural areas. Approximately 44% of all child deaths in urban areas are the result of drowning, but the figure rises to 58% in rural areas.

“Drowning occurs in virtually any accumulation of water, but particularly in rivers and ponds and also notably in floods and boating,” says Joan Ozanne-Smith of Monash University Accident Research Centre in Melbourne, the principal sponsor of the November conference.

A recent UNICEF-sponsored study in Beijing revealed that only 20% of 3-17 year olds could swim.

Ozanne-Smith points out that “A hundred years ago the mortality from drowning in Australia was similar to that of China today,” but hopes that the 2008 Olympics will catalyse change. “The 1956 Olympics in Melbourne, Australia, led to a surge in interest in children learning to swim and an increase in safe places to swim, and the subsequent reduction in drowning was dramatic,” she points out.

Other ways to reduce fatalities, she adds, include covering wells in rural areas, improved care for young children, training life-guards, and regulating boat and ferry safety.

Monash University is a WHO Collaborating Centre for Violence, Injuries and Disabilities. Joan Ozanne-Smith is also part of a joint WHO-UNICEF group that is planning a world strategy and global report on child and adolescent injury.

In 2005, UNICEF began a Child Injury Prevention pilot project in Pinggu and Haidian Districts of Beijing, in collaboration with the Working Committee for Women and Children. Drowning prevention is one part of this programme, which emphasises ‘four safes’—safe community, safe home, safe school and safe kindergarten. The project, says UNICEF, has led to citizen calls for improved street lighting, warning sings for uncovered manholes, and the establishment of river patrols in Pinggu. Future plans for drowning prevention include training parents and caretakers in supervision skills for pre-school children and encouraging children to swim as part of a life skills scheme.

Report by Matt Perrement, February 6, 2006