Introduction
The five (5) years Hospital Admission data (Health Informatics Center, Ministry of Health, 2013) shows that accidents which include drowning had been consistently listed as one of 10 principal causes of morbidity and mortality in Ministry of Health Hospitals and in 2012 it had shifted to sixth principal causes of death compared to seventh in year 2008. As other type of injuries, drowning is associated with tremendous public health burden. The non-fatal drowning incidents and immersion related injuries results in negative impact on the physiological, social and also economics aspect of the victims and the families. Thus a stakeholder meeting was organised to identify, gather and obtain information pertaining to drowning in the country. This will help in understanding the issues and mapping the way forward in drowning prevention in the country.
Methodology
This research studied a defined organisation based on a bounded system of organisation. A stakeholder meeting was held in October 2013 participated by 23 institutions from identified 50 organisations. Information and data for this study has been collected from the various sources on drowning events including government and non-governmental organization in Malaysia. The agencies that has been involved in providing the data to this study is Department of Statistics Malaysia, Ministry of Health Malaysia, Malaysia Maritime Enforcement Agency (MMEA), Fire and Rescue Department Malaysia and Civil Defence Department. The non-governmental organization which provided data was the Life Saving Society Malaysia (LSSM). The data was also derived from news report in local newspapers and also Internet search where the keyword ‘drowning’ was used.
Results
There are many agencies involved in drowning prevention both from the government and private sectors. Inline with it, there are many sources of drowning data collected by different agencies. An average of 296 deaths per year (Mean=296.4, SD=34.5) of children aged 0-19 years occur due to drowning in Malaysia. The average of drowning death rate is 2.92 per 100,000 children. The percentage of drowning death among children aged 0-19 years is about 47% from total all-age of drowning incidents for the past 10 year period (2002-2011). The average ratio of drowning (male to female) was 4:1 and children aged 5-11 years were the most at risk. As for drowning morbidity, the average is about 2.10 per year and showed a higher number in children aged 1-4 years. This also deserves due attention as drowning morbidity would create a tremendous public health burden. Most locations of all-age drowning reported occurred in rivers and sea/beaches and most drowning cases took place in Kelantan, Johor, Selangor, Sabah and Terengganu.
Discussion
The discussion centered along data collection on drowning, need for a lead agency on drowning and proposals to run intervention programs to address drowning in the country. There were some suggestions blowing out from the discussion session:
i. Small survey to be carried out on drowning in Kelantan or Terengganu during monsoon season by stakeholders.
ii. To produce a yearly drowning incident report
iii. To implement a colour coding flags (like being implemented in foreign beaches)
iv. Increase number of Baywatch Tower (by Civil Defence Department)
v. Need to increase parent’s awareness and knowledge on drowning issues and prevention
vi. Focus prevention strategies at vital areas – sea and river
vii. Conduct key stakeholders meeting which includes Royal Malaysia Police (PDRM) – to ensure their contribution and cooperation especially on data collection for drowning incidents.
viii. SafeKids Malaysia UPM to take a lead in carrying out major intervention studies on drowning prevention among children in Malaysia.
Conclusion
The stakeholder meeting concluded with three recommendations:
i. To pilot a community based drowning intervention program in Kelantan, which has high drowning cases by Safe Kids Malaysia UPM with the help of Ministry of Health Malaysia.
ii. To re-suggest the establishment of a national database on drowning registry.
iii. To established a National Water Safety Council to coordinate water safety and drowning prevention in Malaysia.