A Plan to End Childhood Drowning
Developed and written by: Rebecca Wear Robinson
(www.rebeccawearrobinson.com)
September 2011
One child drowns every minute.
Drowning is the leading cause of death for children ages 1-4 globally.
Drowning is entirely preventable - so why aren’t we preventing it?
Current situation:
• Lack of awareness - most people don’t even know it’s a problem.
• Many of the programs which have been developed to combat drowning are fearbased or focus on avoiding the water - they have not been effective in changing
behavior and may have exacerbated the problem.
• Children are viewed as an unthinking enemy incapable of self-control or of
understanding danger and altering their behavior appropriately.
• Programs aimed at educating children generally target older, school-age children, yet
the age group with the highest risk factor (ages 1-4) is virtually ignored.
• Most programs focus on swimming, which is only one component of water safety.
• Organizations committed to preventing drowning are frequently in competition with
each other and are competing for scarce resources. Duplication of effort is rife and
sharing of successful programs is not done effectively.
• Global financial and human resources have not been harnessed.
• Research and rigorous cost-benefit analysis of programs is still in it’s infancy.
Statistics are not packaged compellingly to attract funding and high-level commitment to
change.
• The issue of drowning is not marketed effectively.
The result?
One child drowns every minute.
The solution:
We need a global strategy and local solutions. In this paper, I will lay out a global
strategy for ending childhood drowning in three parts: targeting young children; raising
awareness; and effectively harnessing economic arguments to gain funding and
government commitment. I will also address the elements of successful local solutions
that can be adopted in every community.
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Creating a Global Strategy
Targeting young children
Why target young children? First and foremost, young children (ages 1-4) are at the
highest risk of drowning globally. Drowning is the leading cause of death for children
ages 1-4, yet very few programs exist for young children. The standard message of
‘watch your children at all times’ and ‘use barricades to keep your children away from
the water’ is directed at the parents of young children. These messages are insufficient
and unrealistic. Yes, pools should be fenced, but a fence can be just another
interesting challenge for a determined and adventurous toddler. And as a mother I can
tell you that it is physically impossible, and probably psychologically damaging, to keep
your child in your sight 100% of the time. The goal is, eventually, to create selfsufficient and independent adults. As part of this growth process, children of all ages
constantly push for independence, test their limits, and sometimes forget their limits.
The message our children need to have is that there is a reason the pool is fenced or
that they shouldn’t wander out of sight, or, most importantly, that they shouldn’t go near
water without an adult - and we’re missing that crucial step.
Think about it. We teach our children to navigate any number of potentially lethal
situations in their lives. We teach them to cross the street safely - we don’t ban cars or
fence off every street. We teach them that the stove or fire is hot and we teach them
not to touch and to ‘stop, drop, and roll’ - we haven’t stopped cooking and we still roast
marshmallows over the campfire. We set reasonable limits, we explain the limits, and
we reinforce those limits positively, repetitively, and age-appropriately for years until
finally, the day when our child will consistently, with no direction, stop and look both
ways before they cross the street, or they can actually prepare their own meal on the
stove.
Children know when limits don’t make sense. Our children received mixed messages
about water every single day. A child’s first exposure to water is one of joy - the first
bath. Undoubtedly soothing given the association with the very peaceful 9 months they
spent floating in utero. We encourage our infants to enjoy their bath through toys, facial
cues, our tone of voice. When our children become mobile we add to the fun - more
bath toys, trips to the pool, water parks, water guns, water balloons, sprinklers, and the
beach. Even without the props, watch any child near a puddle or the ocean and they
will gravitate to splash and cavort - interacting with water positively is a natural instinct.
Children see that water is critical to our survival - we bathe, drink, cook, and clean with
water. Water is used in rituals in all religions. In every part of the world water is part of
our normal existence, whether in streams, lakes, oceans, pools, drainage ditches,
reservoirs, wells, watering troughs, fountains, open fire hydrants, or simply rain. And
yet then we turn around and send messages of doom and gloom to parents about how
their child is going to DIE if they go near water, we don’t teach our children how to
navigate the water safely, and we don’t teach parents how to correctly supervise their
children around water. We show them in a myriad of ways that water is soothing,
invigorating, necessary to our existence, and basically a lot of fun, and then we say ‘but
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don’t go near water’ without providing any explanation or framework on how to interact
with water safely. And we wonder why they get into trouble and drown.
Children are also very open to change and to learning new things, unlike many adults.
It is ludicrous to ignore the group most at risk and yet most open to learning how to act
appropriately, respectfully, and safely around water. Children are naturally curious and
open to new experiences, especially when those experiences are presented positively we need to leverage that in our favor.
Fear doesn’t change behavior permanently. In fact, I will argue strenuously that the
plethora of fear-based programs surrounding water have had the opposite effect than
was intended. I think it has lessened people’s respect for the water and made them
more likely to engage in risky behavior around water. I also believe that bombarding
parents with fear-based messages about a substance that is so constantly present in
our lives leaves parents with a sense of helplessness which then results in their not
addressing the issue of water safety at all. The psychological concept of ‘learned
helplessness’. I’m willing to bet that far more parents spend their time worrying about
their child’s school being bombed by terrorists, dying of H1N1, or of their child being
abducted on the way to school than they do their child drowning. And so, one child
drowns every minute. Drowning is a dramatically greater danger, but since we haven’t
given people the tools to navigate water safely, the danger seems so overwhelming that
parents focus on ‘manageable’ dangers - introduce terrorist lock-down procedures, use
antibacterial soap, drive your child to school so they can’t get picked up by a stranger.
Our brains will not let us live in a state of constant terror. If we are only getting
negative, fear-based messages about something so integral to our existence, our brains
can only cope by shutting it down and minimizing the danger. ‘That couldn’t happen to
me’ or ‘I always watch my child’ or ‘we don’t have a pool’ or simply ‘I’m going to figure
out how to keep my child from being abducted’ - avoidance. Remember, water covers
70% of the earth’s surface - it’s everywhere - and it takes only 2 minutes for a child to
drown in under 2 inches of water. You can’t get more omnipresent than that.
In addition to fear-based programs, many programs start too late. It is most common to
see programs targeted at school-age children - at exactly the age when the risk of
drowning starts to drop. This is not to discredit all those excellent programs, in fact I’m
guessing there is a correlation between the decrease in drowning rates starting at age 5
and the increase in effective programs starting at age 5. The vast majority of programs
that I have seen also focus on teaching swimming - not water safety. Swimming is a
skill. Water safety is an attitude that shapes behavior. Swimming is a critical
component of being water safe, but it’s only one component - and for very young
children, swimming is not even a physically viable option. There are programs that
teach infants to roll over and float, though not without controversy. There are parent
and tot classes designed to introduce children gradually and positively to the water. As
a mother I am a strong proponent of gently introducing a child to water, from infancy,
and gradually teaching them their limits, but I can tell you that it is the rare child who has
the physical coordination and endurance to truly ‘swim’ until they are at least 5, and it is
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several years beyond that where swimming skills are developed to the point where the
child is truly competent out of their depth for any length of time.
One child drowns every minute. It’s an epidemic, but if we are going to end childhood
drowning permanently, we need to begin by teaching young children how to relate to the
water safely - with respect and joy - in a way that becomes internalized and
permanently changes their behavior.
So how do we go about changing behavior?
We have plenty of research to show where children drown at different ages, where the
greatest risk occurs, and which demographic groups are at the greatest risk - which
gives us a great framework for intervention. In the U.S., and many other high-income
countries, children under one drown predominantly in bathtubs. Children ages 1-5
drown mostly in pools. Open water for children ages 6-12 and with teenagers alcohol
use is the greatest contributing factor in drowning deaths. A lapse in, or lack of,
supervision is a contributing factor in drowning rates of 1-4 year olds in virtually every
country. Minorities and indigenous people generally have higher drowning rates. And
the list goes on across cultures and geographic locations - we have data on tourists,
recreational boating, commercial fishing, natural disasters and more. We know how to
keep people safe, but we need to communicate that knowledge more effectively. The
‘how’ must be translated into an 18-year plan for teaching children water safety (birth
through the teenage years). It sounds like an overwhelming proposition, but with a nod
to the common wisdom of how to eat an elephant (one bite at a time), let’s lay out a
plan.
Our primary goal is lasting, internalized behavioral change. If we have accomplished
this, by the time a child is an adult they will act more safely their entire life, and, more
importantly, pass on that knowledge instinctively to their child which will then create a
permanently safer population. I believe that if we achieve internalized behavioral
change with this generation of children, drowning rates will drop permanently as a
result. As Chip and Dan Heath point out in their excellent book ‘Switch’, “the more
instinctive a behavior becomes, the less self-control it requires and the more
sustainable it becomes”. When cars were invented I’m guessing there were some
fatalities before ‘look both ways before you cross the street’ and traffic lights were
invented - but they are an excellent example of how instinctive behavior can be
developed, and reinforced through visual prompting. Do you even think before you
fasten your seatbelt now? It has become a habit in one generation and even if you
absent-mindedly forget you have that annoying ‘ding‘ to remind you. We can use the
same concepts in teaching water safety. Internalized behavior becomes a habit with
external cues as a reminder.
We need to start with the most basic of rules, ‘always have an adult with you when you
go near water’ and then layer on the skills needed to navigate water safely throughout a
lifetime - positively, repetitively, and age-appropriately. (That basic rule becomes
‘always swim with a buddy’.) The program is material for another paper, and requires
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some significant input from aquatics professionals, early childhood education specialists
and public safety experts, but I would stress that the program needs to set clear
behavioral goals and script the critical moves necessary at each step. It must use the
KISS philosophy - Keep It Simple, Stupid. We don’t need to shock and awe the public
with our combined brilliance and theory, we need them to change their behavior, so let’s
give them a simple, positive roadmap.
Let me give some examples of key concepts and how they could be supported by
reasonable, easily achievable action that becomes habit.
“Always have an adult/buddy with you when you go near water”. This is probably the
biggest immediate hurdle because in the first generation we need to teach the adults as
well as the children. In future generations adults will do this instinctively. For children
this should be a basic rule like ‘hold my hand when you cross the street’. The corollary
for adults is ‘always watch your children near water’. It is also important to tell children
that if they do go near water and someone gets in trouble to tell an adult. Young
children may focus on not getting in trouble - this is a time to say ‘I’ll never get mad at
you if you ask me for help because someone is in trouble.’
“Know your water.” Teach about the different places you find water and how water
looks and acts differently in different places. A bucket is different from an ocean.
Obvious to an adult, not so obvious to a 2-year old.
“Look before you leap.” Never enter water unless you know the water. Talk about how
a stream is different during a dry summer than after a torrential rain storm. Hidden
drains in calm retention ponds exert deadly suction. Don’t dive into water unless you
know it’s deep enough. And of course, don’t jump in, period, for the non-swimmer. And
that means making it very clear when they are a swimmer ability-wise which is generally
vastly different from the confidence level and perceived ability-level of the average 3year old who will insist, “I can swim!”. It may not harm your 4-year old to tell them they
bend it like Beckham, but telling them they swim like a fish or Michael Phelps gives
them a deadly false confidence.
A full program will require sifting through the accumulated knowledge and result in
simple, directive instructions that are consistently and accurately interpreted. Potential
instructions are laid out in the ‘local solutions’ section of this paper. The instructions
must be rigorously and comprehensively tested to ensure the correct outcome is
achieved, but it is imperative that the program not just be another list of don’ts. Tell
children (and adults) what they can do RIGHT, don’t keep telling them what not to do or
their subconscious will continue to drift over to the undesired action and continue to
repeat that undesired action until it becomes the habit. We need to understand human
nature and work with it, not against it. Notice that each statement above instructs
positive action. It tells people what to do. Nothing extra for the mind to process, easy to
follow, and again, positive direction. The statements are simple - the minute you add all
of the reasons for the statement in one sentence you’ve lost 99% of your audience. Get
their attention first, let the rule embed itself in their consciousness and then layer on the
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finer points using a range of media and reinforcing messages. It is also crucial that
specialists in communication and early childhood education be involved. Too many
programs are developed by aquatics professionals with well-meaning efforts that they
understand but do not result in engagement, understanding, and the desired behavioral
change by children. Aquatics and public safety professionals need to develop the
message - communications and early childhood education professionals need to
interpret the message appropriately for the target audience.
There is a tendency to give too much information. We face a serious challenge in
distilling vast knowledge into manageable chunks. Research shows that most people
can’t remember more than 3 pieces of information at a time. This is not to imply that we
can, or should, ‘dumb down’ water safety, but it does mean we need to be realistic
about the messages. I favor the phrase: Teach. Watch. Protect.© Each word can
have a whole lesson plan behind it, but the basic message of simple words is evocative.
Teach. Teach your child water safety. Teach your child to swim. Teach your child how
to behave around water. Watch. Watch your child whenever they are near water.
Watch the water. Protect. Protect your child. Learn CPR. Protect your child with a
proper life vest. Fence your pool. Cover your well.
Teach. Watch. Protect.©
The best place to start on the messaging? Find the programs that are working - don’t
recreate the wheel - survey the industry and see who is getting results in their program.
“Keep Your Guard Up” in Broward County, Florida is getting measurable results and
changed behavior in terms of parents watching their children, not leaving it to the
lifeguard. Kim Burgess can tell you more about the success they’ve had in dropping
Broward County from #1 in drownings in Florida (which is #1 in the U.S.) to not even
being in the top ten. There are other excellent programs, we need to identify them and
replicate the ones that are working. I’ll talk more about some of these programs when I
address ‘local solutions’.
And let’s not forget the JOY!!! As anyone who is involved with the water will tell you
there is a passion and a joy related to the water that is quite possibly the most powerful
weapon in our arsenal. Look at programs that have effectively changed behavior and
you’ll see that they share a common strategy - they are pragmatic and they do not deny
basic human emotions or needs. They do not rely on abstinence as a strategy. The
most successful AIDS program are not the ‘don’t have sex’ programs, they are the ‘use
a condom when you have sex’ programs. Ditto with the success of needle-exchange
programs instead of ‘don’t do drugs‘ for cutting transmission of HIV. MADD (Mothers
Against Drunk Drivers) doesn’t tell people not to drink, they tell people not to drink and
drive. Abstinence as a policy against activities which are inherent in human nature or
are the source of joy, fun, relaxation or other positive emotions don’t work. Selfrighteousness is not an effective strategy. Changing people’s behavior around water
must follow the same strategy - balance the fun with safety - not chastising behavior
that most people don’t actually know is dangerous. Show people what to do pragmatically and positively - and they are more likely to change their behavior.
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Effectively delivering the message is key to success. Children learn from stories. They
also respond well to visual cues which prompt the correct behavior. Look at the
success of Sesame Street in the States which has taught several generations of
children the alphabet, numbers, and how to treat others, be empathetic, and be a good
friend. Sesame Street effectively uses characters to embody different personalities and
behaviors that all children recognize in themselves and others, while having some
characters doing the right thing and being positively recognized, or being helped to
adjust their behavior. Not many children want to be Oscar the Grouch, but they sure
recognize that they (or their parents) act grouchy some of the time and it helps them
navigate those difficult emotions to arrive at acceptable behavior. We must educate
and entertain children at their level, not with dumb-downed adult content. I defer to the
iconic Mr. Rogers, an expert on early child education, for the best explanation.
http://www.youtube.com/watch?v=yXEuEUQIP3Q&feature=player_embedded
I believe we need one global symbol of water safety that is targeted specifically at
children under age 10, beginning at age 1. My brilliant colleagues created Jabari™, an
adorable lion cub, to be this symbol. Lions are at the top of the food chain, the king of
the jungle, are a source of fascination, and are widely recognized by children
everywhere. Jabari™ is the Swahili word for ‘brave’ and while all children want to be
brave and do the right thing, most are honest enough to recognize their own
personalities in Jabari’s™ band of friends - timid, rascal, risk-taker, rule-follower,
distracted, sporty, and twirly-girly. Three positive adult role models are added to the mix
to teach and correct behavior - a father, a teacher, and a lifeguard. The characters and
concept were developed in the tradition of Sesame Street and Smokey Bear - tried and
true, and effective. If we can engage children and the children become attached to a
character, they will emulate that character’s behavior. Young children have rich and
active imaginations - they don’t pretend to be a Super Hero or a Princess - they ARE a
Super Hero or a Princess. Adults forget that particular intensity of childhood, but if we
remember and exploit that natural and endearing developmental trait to teach children
how to be safe, we can positively shape their behavior permanently.
The full rationale and theory that went into developing Jabari™ is laid out in a paper
available at: http://www.scribd.com/doc/57445907/Why-Jabari . In short, Jabari™ was
developed to appeal to children across cultural and geographic boundaries - to be a
global symbol. Many characters exist related to water safety, and there are many
excellent programs which effectively use those characters, however, there is no one
global face associated with water safety. If you teach a child about the dangers in his
own neighborhood, he is still not water safe out of his environment. Knowing about the
local lake and swimming pool does not prepare a child for the ocean. We live in an
increasingly mobile society and water presents different challenges and dangers no
matter where you go. A lake is not a lake, a river is not a river, and sometimes a pool is
not even a pool. Having one face on the ‘there are rip tides at this beach’ sign, at the
arrivals hall in the airport, at the hotel pool, in the bathtub, at the back door leading to a
pool or other water source, the consistent face acts as a positive visual reminder to
children (and adults) about how to safely navigate that particular water and provides an
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instantly recognizable focus point for key safety messages. This also holds true for
populations that may never travel further than 5 miles from their home. Children are
children the world over and all children respond well to stories and can adjust their
behavior if they have consistent, positive visual cues to remind them of the correct
behavior.
I envision Jabari™ embedded into children’s television programs or on 30-second public
service announcements between the popular programs giving positive tips on how to be
safe. Jabari™ puppet shows in local villages. Jabari™ video games. Jabari™ games
on smart phones. Jabari™ programs at preschools, day care centers and reading
hours - led by lifeguards, firefighters, teachers, surfers, competitive swimmers,
community leaders - all those wonderful role models we have but are not utilizing. We
live in an unprecedented era of communication - we need to harness that power.
We need to harness market forces as well. A Jabari ™bath toy may remind a parent
not to leave the bathroom while children are in the tub. Jabari™ on a beach towel or
swimsuit reminds children to keep their adult in sight. A Jabari™ sticker on the door
heading out to the pool or open water may remind a child ‘I can’t go near water without
my mom/dad’. Jabari™ stuffed animals. Jabari™ life vests. Keep the character in front
of children and they will develop a frequent, positive association with that character and,
most importantly, for the lessons the character is teaching them.
The goal is market saturation with positive messages teaching water safety, but let me
be very clear that this is not a profit-driven motivation. The concept falls under the
category of ‘social entrepreneur’, or addressing a social issue with a for-profit solution.
My rationale was covered more fully in my lecture at the University of Chicago about
being a social entrepreneur, http://www.scribd.com/doc/56073063/Why-Be-A-SocialEntrepreneur#source:facebook. The model, by definition, harnesses market forces to
create positive social change. Revenue is created which is then directed back to
funding solutions, but it uses proven market-driven psychological motivation to drive the
revenue stream. The model makes the intellectual property of Jabari and friends
available at a low cost to be integrated into programs.
If you study human motivation, and Daniel Pink’s “Drive” is an excellent summary, it is
clear that empowerment, intrinsic motivation, and positive messaging are key to lasting
results. Ending childhood drowning requires permanent, internalized behavioral change
and that occurs most easily and most effectively if people relate positively to the desired
change. Subsidizing programs and products for at-risk children and low-income
populations makes sense both economically and motivationally because it empowers
people to make positive change in their lives which will keep their children alive. Low
cost, not no cost, because humans don’t value what they don’t pay for. Low cost not
high cost because the goal is to positively reach all children and teach them water
safety - not to make safety a perk of socio-economic status or high-income countries. A
good example would mean directing a portion of profits from Jabari™ programs into
subsidizing Jabari™ programs in low-income areas, water survival classes, the creche
program in Bangladesh, and programs that teach swimming to at-risk youth such as
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‘Make A Splash’. Direct aid makes sense in situations where death is imminent and
there is no way of changing a situation, but it does not empower the recipient.
Empowerment is key. Again, people do not value what they do not pay for. Unless
someone is at the very base of Maslow’s pyramid of needs they will perceive that they
have a choice and even a modest financial contribution will ensure that the person has
skin in the game - they have made a conscious decision that water survival classes
have value and they will be more likely to follow-up and take full advantage of the
classes. Think of programs like Heifer International which are effective because they
empower their clients and require them to take responsibility for their success, and then
to share their success within their community. Jabari ™ must empower people to take
positive, proactive action if it is to be successful.
Economically having one character makes sense as well - economies of scale in terms
of public health campaigns. There seems to be an increasing acknowledgement in the
academic and aquatics communities that we need consistent messaging - adapted for
cultural and geographic differences. If there is another character which can accomplish
this more effectively than Jabari™ - show me the research and I will be your best and
most vocal advocate, provided that the message is delivered from one consistent
voice/character to make the message truly effective. Which brings us to.....
Raising Awareness
One child drowns every minute. I developed that statement, and before you all start
arguing about where I got my numbers, let me explain how and why, because it leads
nicely to the fact that we need to market drowning effectively.
The WHO estimates that roughly 376,000 people and 409,000 people drowned in two
recent years, which works out to one person in a bit under a minute and a half but more
than a minute and a quarter. The WHO also states that the numbers are under-stated
due to inaccurate reporting, inability to capture all drowning deaths, and mis-reporting of
drowning deaths related to cataclysms, transportation accidents, assaults, and suicides.
The International Life Saving Federation estimates that 1.2 million people drown every
year, half of whom are children (which works out to a child every 55 seconds or so).
Most sources agree that around 80%-97% of drowning occurs in low- and middleincome countries and pretty much everyone agrees that because the definition of
‘drowning’ is not clear, and because many countries simply don’t accurately capture
data on childhood deaths, the numbers under-state the problem. In the U.S., drowning
is the second leading cause of accidental death for children but the numbers are fairly
low, around 3,400 children per year - less than 10 children a day, or a ratio to the
general population that is incredibly consistent across high-income countries.
No matter how you look at the statistics in the previous paragraph, the initial reaction is
probably confusion and frustration if you are an academic, and if you are not a stats
geek like me I’m pretty sure you stopped reading after the first line. Statistics may be
able to shift high-level political and academic policies and research, but they do
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absolutely nothing to shift public opinion unless you market them correctly and make
them personal.
The minute I utter the phrase ‘second leading blah, blah, blah’ or ‘X hundred thousand
children’ I have lost the average person who will think ‘well, that won’t happen to me’.
The numbers are too big, they are too abstract, and they aren’t personal. So, I looked
at the statistics and applied marketing principles to them. One child drowns every
minute and 23 seconds is also too wordy and pedantic, especially since other statistics
point to one child every 55 seconds.
One child drowns every minute.
The statement gets an immediate reaction every time I use it. It’s short, it’s powerful,
it’s evocative. We are talking about children dying. We have the dubious honor of
working to eliminate the number one killer of children ages 1-4. Protecting children is a
primal response and we need to channel that raw emotion towards positive change. It’s
not that people want their children to drown, it’s that they don’t know how to prevent it.
We need to tell people clearly it’s an issue AND tell them what to do. As the Heath
brothers stated, we need to make change a matter of identity rather than consequence.
“I protect children” is a powerful statement that will resonate with most of the world’s
population. Imagine giving a speech to the United Nations to encourage them to
recognize childhood drowning as a global epidemic under the Millenium Development
Goal 4. You have a screen with pictures of 30 smiling children behind you. At the end
of your 20 minute speech you black out 20 of those pictures and say ‘since I started
speaking that many children drowned. You can change that. You can protect children.’
Powerful. Impactful. Meaningful.
Yes, technically it’s one child every minute and 18 seconds, or every 55 seconds, or,
well, actually the numbers are under-stated but we can’t capture the data accurately
because of these highly technical reasons. And the lack of accurate data needs to be,
and is being, addressed. But I’m not using the statement (which is actually accurate
given the compilation of sources, or at least as accurate as all the other statistics out
there) to convince academics and aquatics professionals - they KNOW that drowning is
a problem. I want to reach parents, and children, and grandparents, and everyone else
on earth who is not in the drowning prevention business and jolt them into awareness
that it can happen to them. And yet it’s factual - it’s not hysterical - it’s a simple but
powerful statement of fact. If that statement is followed up with a positive checklist of
things parents can do to make their child water safe - an empowering and simple
prescription - then I believe we’ll start seeing real change in attitudes and behaviors.
Once we have people’s attention, I propose that we begin a global campaign that
dovetails nicely with One child drowns every minute. “Make the Minute Matter”©.
Talk about what you can do in a minute - hug your child, make a cup of tea, start the
rice cooking, check your messages, pay some bills, schedule an appointment. All
benign parts of life. Then switch to an informative checklist of how to make that minute
matter permanently and positively - enroll your child in swimming lessons; find a water
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survival class near you; check your pool gate lock; check to make sure the house door
is secure; empty the buckets behind the house; buy a cover for the well; drain the
ornamental fish pond; check the life vests are in the boat.
The key to any campaign being successful is full cooperation among the organizations
dedicated to saving children and ending drowning. A great example is the campaign to
end tomb-stoning in the UK - the result of a number of organizations putting their
personal agendas to the side and focusing on stopping teenagers (and adults) from
jumping off cliffs. Steve Wills is the person to contact on how that program came into
being. I am not suggesting that any one organization become the most important
organization. I am not suggesting that any one organization’s carefully developed
programs be scrapped. What I am suggesting is that there be more cooperation and
sharing of intellectual resources among the thousands of dedicated and effective
organizations addressing the diverse needs of our global population and the many ways
which water impacts our life. Following up from the World Conference on Drowning
Prevention in Vietnam in May, which attracted over 400 people from 52 countries, the
International Life Saving Federation is working towards this aim. So, without their
knowledge or approval I’m going to nominate the organizers, and especially Justin
Scarr, to establish the water equivalent of the United Nations. The culture of an
organization is set by it’s leader. The leaders of all the major organizations working on
drowning prevention must agree to work together proactively and collaboratively on the
development of a global strategy. There is too much time spent defending turf and ‘the
one right way’ to end drowning, not to mention a fairly closed group of experts working
on the issue. Drowning is an incredibly complex issue and there is room for everyone at
the table, but egos must be checked at the door. I would suggest an annual meeting of
the leaders of key organizations and an effective way of keeping in touch electronically
and disseminating information - an e-mail distribution list, an interactive web-site, a
LinkedIn group - the method is not important, but the current closed system of insider
information and inter-discipline competition has not been effective and must be reexamined.
Once we have agreement on the message, we need to package the message
effectively. I am not a creative. I’m stymied when confronted with a box of crayons and
a blank piece of paper, but at least I know my limits. We need a global campaign of the
quality and visual appeal of Apple, Coca-Cola or McDonald’s. Positive, consistent, with
strong emotional pull and an eye on the bottom line - with our bottom line being No
More Children Drown. The truly brilliant and creative types who reside in the large
advertising and public relations firms can change behavior in positive, joyous ways, and
they routinely do pro bono work for great causes. We must find one of the best firms,
ideally headed by someone who ‘gets’ water and children, give them the facts and the
program, then give them full creative license to develop a campaign that changes how
the whole world relates to water. Let them know we want a positive, game-changing
campaign that will roll out in one country and then spread to every country, in every
language. Aside from the industry award potential it is the opportunity for a firm to have
their work showcased globally, positively, in a way that saves children. It is possible to
11
leverage the fact that we are fighting the leading cause of death for young children
positively to get things done. After all, who doesn’t care about children?
The plan must incorporate effective use of all media channels, including social media.
The esteemed New England Journal of Medicine recently published a study on
Integrating Social Media into Disaster-Preparedness Plans.
http://www.linkedin.com/news?viewArticle=&articleID=663441332&gid=3972058&type=
member&item=63860787&articleURL=http%3A%2F%2Fhealthpolicyandreform%2Enej
m%2Eorg%2F%3Fp%3D14975%26query%3DTOC&urlhash=7FcK&trk=group_most_po
pular-0-bshrttl&goback=%2Egsm_3972058_1_*2_*2_*2_lna_PENDING_*2%2Egmp_3972058%
2Egde_3972058_member_64499669 .
Another great source of the widespread, and increasing, influence of social media can
be found at: <a href="http://www.searchenginejournal.com/the-growth-of-social-mediaan-infographic/32788/"><img src="http://www.searchenginejournal.com/wpcontent/uploads/2011/09/social-media-black.jpeg" alt="The Growth of Social Media:
An Infographic" border="0" /></a><br />Source: <a
href="http://www.searchenginejournal.com/the-growth-of-social-media-aninfographic/32788/">The Growth of Social Media: An Infographic</a> .
The most staggering statistic in the second article? If Facebook were a country, it
would be the 3rd largest country on Earth. Those who doubt the latent and still underestimated power of social media to influence behavior need look no further than Egypt,
Tunisia, and the Arab Spring Facebook revolutions. Information is out there whether we
like it or not - we have a responsibility to make sure it is the right information that
supports the script we have created. A great example of a grass-roots effort is the
movement to establish International Water Safety Day, which is intended to be similar to
Earth Day. http://internationalwatersafetyday.org/ With full and everlasting credit to
Shaun Anderson and Jayson Jackson of www.diversityinaquatics.com who came up
with the idea, I’d still like for it to become just ‘Water Day’ - broader, more positive, more
encompassing, and less of a mouthful - especially when translated to other languages.
We can also harness the internet in other ways to reach more people. As an example,
www.uswim.com is an iPhone app out of Australia that allows parents to teach infant
and toddler basic beginning swimming in their backyard or local pool. An amazing idea
for people who want to supplement traditional lessons or have no access to, or money
for, regular lessons. Innovative thinking on an old problem.
Once we have the organizations in line, we also need to attract a stable of high-profile
spokespeople. The purpose is not only to raise awareness across a range of media,
but also to provide positive role models for older children. Children are most influenced
by female role models from birth to age 5. Male role models are most important for
children ages 6-12. Teenagers are actually not supposed to listen to their parents, they
are most influenced by peers. First and foremost I believe we need to use our best
resources - the amazing people who already understand the issue - lifeguards, Olympic
athletes, surfers, Special Forces military. As I keep explaining to all these amazing
12
people who I work with every day, “You have a serious cool quotient, kids will listen to
you, we need to leverage that.” Our in-house heroes can make it cool to be safe, if we
organize them with consistent messages, identify those who are media-friendly for talk
shows, interviews and events, and then organize regular exposure.
Looking again at campaigns which have successfully raised awareness and raised
funding, we need to attract a stable of high-profile celebrities and ‘names’ to rival the
AIDS advocates. AIDS was able to attract actors and the fashion crowd early on
because those populations were disproportionately devastated by the disease. The
‘good’ thing about drowning is that so many people are affected - directly or indirectly.
The actors, athletes, musical artists and public figures are out there - we just need to
mobilize them and give them the message. How fortunate that the new Princess of
Monaco, Charlene Wittstock, was also an Olympic swimmer for South Africa and has
dedicated the last 15 years for raising awareness about water. And what if we could get
Catherine, the charming new Duchess of Cambridge? Cullen Jones. Hawaii’s famed
Watermen. Tribal leaders in cultures which are entwined with water (such as Maori and
other Pacific Islanders). Religious leaders. Jack Johnson. Kelly Slater. Lovie Smith
(Chicago Bear’s coach - his son almost drowned when he was 2). Not to mention all
the professional athletes who have saved children from drowning. Stathis Avramidis aquatics academic AND Mr. Greece. Navy SEALs and the Special Forces guys in other
countries. Michael Phelps. Aaron Peirsol (also a voice for clean water). Ryan Lochte currently being aggressively courted for his ‘cool’ quotient. Even Christine Lagarde, the
new managing director of the International Monetary Fund, who was a member of the
synchronized-swimming team that won the French national championship in 1973 and
was also an able lifeguard and swim instructor, not to mention a mom. Granted, she’s a
bit busy right now, but she certainly has the ear of every Finance Minister in the world
and would understand a solid economic approach to the issue. The list goes on - we
just need to be creative in how we build our stable. We need to make keeping children
safe in the water ‘the’ cause to support, have popular actors model the correct behavior
in television shows (done with great success by MADD), on YouTube, and even when
they are photographed in the tabloid magazines, and people will begin to emulate their
behavior. Does the Jolie-Pitt brood know how to swim? Do they wear life jackets on
boats? They certainly appear in every tabloid magazine in the States every single week
and Ms. Jolie is a UNICEF ambassador. These are the people that the public listens
too, and if they are all saying one child drowns every minute, people will start to
listen.
I believe we also need to think laterally and creatively in terms of establishing strategic
alliances. I asked the question at the Vietnam conference about why we talked about
‘drowning prevention’ instead of the more positive ‘water safety’ and was told that the
research had shown that people assumed water safety meant safe water - as in clean
and drinkable. Important research that can be used to shape communication strategies.
and also strategic alliances. My theory is that in low-income countries children are at
substantially higher risk for drowning because the water is not clean and drinkable.
Mothers, and children, spend a significant part of their day hauling water. Check out
www.water.org, an organization started by Matt Damon and Gary White, for one group
13
that we should approach with our common cause - safe water. They estimate the time
commitment of hauling water at 200 million hours per day. This exposes young children
to water hazards or leaves them under-supervised. If dirty, unsafe water increases
drowning risks we need to be working more with the clean water people. The
outstanding program in Bangladesh identified when young children were drowning
(between 10am-2pm) and conducted a study which determined that they drowned
because mothers were busy preparing meals. Rather than preach or criticize, they
introduced creches. Children are now properly supervised when mothers need to be
doing other work, and the children even learn basic skills like washing hands which will
reduce other illnesses. A great example of creative and lateral thinking to change the
outcome although I’d like the program even better if they taught the children about water
safety while they are at the creche. Early-childhood education initiatives is another
good potential strategic alliance. Another cause to partner with - reducing childhood
obesity. In the States, our First Lady, Michelle Obama, has made reducing childhood
obesity her cause. Swimming is an excellent form of exercise and studies have shown
that swimming also increases physical coordination, increases IQ and increases life
expectancy. Pediatricians and emergency room doctors in all countries should be on
board as well - for both the health benefits and the injury prevention standpoints.
One question. How often does a child drown? If you answered ‘one child drowns
every minute’ then I just proved the powering of marketing because it was embedded
eight times in this paper. Subversive but effective.
By now I’m sure you are thinking I am completely out of touch with the economic
realities of the day and wondering how all this will be funded. On the contrary, the
entire strategy laid out previously is key to address the problem with cost-effective
solutions along with attracting significant funding for programs that are effective, so let’s
look at:
Effectively Harnessing the Economic Arguments to Gain Funding and
Government Commitment
The United States government debt has just been downgraded for the first time. The
European Union is struggling to contain the economic crisis within it’s membership.
China is searching for safe havens for their cash surplus. The Middle East is in turmoil
with civilian uprisings. The majority of the world’s population is focused only on basic
existence. Economies around the world are scrambling to assess what the ripple-effect
will be and how to navigate the first truly global financial crisis.
Given the current economic environment it is not enough to just have a good cause. It
is not enough that the cause is the number one killer of children ages 1-4. We don’t
have the resources to just ‘feel good‘. Compelling economic arguments must be made
that preventing drowning is actually cost-effective and will reduce costs permanently.
Effective economic arguments require the following components: accurate statistics; a
full understanding of the full economic costs of drowning; a cost-effective, proven plan
14
for ending drowning; and a plan for effectively marketing the issue to attract funding and
public support.
First and foremost, having accurate statistics to lay out the full scope of the issue is key.
As I demonstrated above, the lack of consistency and clarity in the current statistics is
not only confusing, but denigrates our argument that drowning is a global epidemic. If
we can say that ‘X children drown every year’ and that it is, proven, the number one
killer of children ages 1-4, we have traction. If we can’t even agree on the numbers,
then the better organized causes will grab the headlines, the attention, and the funding.
It was clear from the conference in Vietnam that developing accurate statistics has
become a priority, so I will focus here more on how we ‘sell’ those statistics, although I
will plead that statistics are not gathered just for the sake of statistics and academic
research, but with a view towards supporting economic arguments for addressing the
issue pragmatically and effectively. The statistics must tell a compelling story and
provide a baseline for measuring the effectiveness of programs.
In gathering statistics, counting ‘just’ the numbers of children who drown is not sufficient
- we must make it personal. We must overcome the widespread belief that ‘it happens
to other people, or in other countries.’ It is not only individual governments, or
overseeing bodies such as the WHO, the UN or UNICEF that are funding solutions and
directing resources. We are competing with all of the other urgent causes and the
private funding they attract - malaria, AIDS, maternal health, vaccinations, civil wars,
crushing poverty, inadequate education, and the list goes on to an overwhelming
degree. We are also competing for people’s attention. Politicians, policy wonks,
philanthropists, and the general public are people too. People support what they
perceive to be important to them. If you have breast cancer, you support breast cancer.
If your child is autistic, you support autism-related causes. AIDS activists have been
more successful than most in raising awareness beyond those who perceive
themselves to be most at risk. They have made it a social cause that is ‘cool’ to
embrace and put some marketing creativity behind it (The Gap RED campaign is a
good example of marketing effectively, although admittedly it’s easier to be cool if Bono
is your front man.) We must create an understanding that drowning affects everyone that it is a one or two-degree of separation issue rather than an ‘it happens to other
people’ issue in order to hasten a lasting, global, behavioral change towards water. We
need to find the donors and politicians who believe that, “I’m the kind of person who
cares about children. I’m the kind of person who keeps children safe.” and help them to
understand that in order to accomplish that they need to work towards ending childhood
drowning.
Enough of the soft approach though, let’s look at the numbers and examine how to
capture and present the full economic cost of drowning, assuming we have accurately
captured the true death and injury tolls. New Zealand estimates the annual social cost
of drowning to be NZ $402 million a year (http://www.watersafety.org.nz/research/ ),
based on the 2008 value of a statistical life of NZ $3.35 million. I believe that if we take
the ILSF’s number of 1.2 million people a year that works out to US $3.35 trillion dollars
a year at today’s exchange rate. US $3.35 trillion is equal to the GDP of Germany, the
15
world’s 4th largest economy (excluding the EU as one entity). I have found hard
numbers, like those that New Zealand have developed, are hard to find, but it is a start.
It gives us a template for how to present the issue with relevant comparisons effectively
and economically. Clearly in my example the value of a statistical life would be vastly
different across countries, and since an estimated 80%-97% of drowning victims come
from low- and middle-income countries, US $3.35 trillion is a great overstatement, but I
use the grossly over-simplified calculation as an example. The first step is to identify
the number of people that drown, by country or continent, calculate the social cost of
drowning, and then put that number in a context that makes the number real. Compare
it to GDP, military, health care or education expenditures to demonstrate the magnitude
of the issue - make the comparison relevant to the organization or country in question.
For instance, if I were approaching the Gates Foundation I’d position the cost-benefit
analysis relevant to the cost of malaria treatment or another public health concerns that
the Foundation supports.
In the U.S. and many other high-income countries, for every child that drowns, four
children almost drown. I read one estimate that in the U.S. each near-drowning injury
that results in brain-damage costs US $4.5 million dollars. In the U.S. alone, using the
roughly 3,400 children who drown times the additional four children who almost drown
times the $4.5 million per child we are talking about an additional added cost in social
costs, lost work time, medical costs and care costs of $61.2 billion a year. Which
means we are losing more money in the U.S. on 13,600 children over their lifetime (and
the same number almost drown every year) than we are spending on educating on
educating 74.3 million children annually.
(http://www.childstats.gov/americaschildren/tables.asp ) ($54.5 billion in federal funding
was spent on education in the U.S. in 2007 - this excludes substantial state and local
funding.)
There are enormous caveats with my back-of-the-envelope estimates that I just went
through, not to mention the comparisons. I certainly wouldn’t go trying to impress
anyone with just those numbers because you could drive a truck through the logic, they
are for example purposes only. The point is, drowning is expensive and we need to
communicate that effectively. We need accurate economic analysis by country and
continent - calculations of the social cost of one person, multiplied by the number of
people who drown. One source of drowning rates per capita, which appears to have
been drawn from WHO data is available at:
http://www.nationmaster.com/graph/mor_dro_percap-mortality-drowning-per-capita .
Interesting the number of Eastern European countries ranking so high up the list.
Relevant comparisons are also key - it helps people comprehend the magnitude of what
becomes ‘funny money’. We need to find the comparisons that tell a story. Comparing
the cost of drowning to the cost of keeping a child healthy and educated to become an
economically productive member of society is powerful. We talk about providing
children with the basics, but if children are dead they don’t need education, food,
vaccinations or health care. We need to show how much money is wasted on children
drowning that could be diverted to creating positive economic investments - a healthy
and educated future workforce.
16
Highlighting and comparing to health care costs is especially effective because near
drowning accidents directly impact a country’s health care costs. With the exception of
the U.S., most high-income countries have some form of state-funded medical systems.
(The U.S. does have Medicaid and Medicare, which cover the poor and the elderly.
They operate efficiently and cost substantially less than private sector medical care).
The fact that most countries pay for their citizen’s medical costs provides a strong
motivation to contain long-term costs (care from near-drowning accidents) and to free
up money to pay for other medical care. Prevention is cheaper than the treatment. It
should also be emphasized that when a child almost drowns, in addition to the medical
expenses, there is lost work time from one or both parents and potentially of the child
when they reach working age, which further decreases a country’s economic
productivity. Health economists and statisticians need to sit down with the marketing
people to create a compelling argument for addressing the issue of childhood drowning.
There are many cost-effective ways that governments and organizations can become
involved in reducing drowning. It is crucial that we use existing research that identifies
where drowning is most likely to occur demographically and geographically to put
targeted programs and policies into place. In the U.S., programs tend to focus on
swimming pool safety. Although this is the place where children ages 1-5 are most
likely to drown, it overlooks the fact that children under 1 drown primarily in bathtubs
and older children in open water. Focus the educational efforts where the immediate
danger is. Teach parents at the hospital when their child is born about the dangers of
bathtub drowning. When children are school-age, programs should focus on open
water safety. Pushing only for pool safety is a narrow and dangerous strategy in highincome countries and absolutely ludicrous in low-income countries.
Duplication of effort without sharing information is also rife. I have come across a
number of outstanding programs in the last four years, but it is rare to see the most
effective programs rolled out in other geographic areas. It is far more common that
great programs are developed from scratch in every location. There must be greater
coordination of effort to identify the best programs, test the programs under a rigorous
cost-benefit analysis, and then look to expanding the programs where possible,
adapting for cultural or geographic differences where necessary. Drowning prevention
lends itself beautifully to economies of scale since water is everywhere.
Not only are we in the enviable position of working to save children, a cause few would
dispute, but the primary solution to the problem is inexpensive and can be
accomplished in one generational cycle. Unlike diseases which require a significant
investment in R&D for vaccines and treatment and have rarely been eradicated, the key
to ending drowning is internalized behavioral change, which requires an anthropological
assessment of how people react to the water with interventions (through education and
example) that enable them to change their behavior, permanently. There are a number
of examples of how this approach has been effective, for very little capital investment.
Dr. Dave Jenkins and SurfAid International (http://www.surfaidinternational.org/ ) are
using these concept of anthropologically developed internalized behavioral change
17
mechanisms to address public health concerns in a number of countries. Other
successful programs have been identified and are being promoted through
organizations such as Ashoka, the Omidyar Network, the Skoll Foundation and others.
Education is key. Education is not glamorous. Education is not sexy like the latest
technology and does not attract exciting venture capital funding looking for a short-term
bonanza like the next Google. Education is a patient slog, as any good teacher or
parent will tell you, but education also yields long-lasting results, providing you are
educating on the right subjects. It’s a curious business model, but if we attack drowning
effectively, we’ll be out of business in one generational cycle. Behavioral change will be
internalized and passed on from parent to child and drowning rates will drop
permanently. It’s not glamorous, but it’s effective. This approach takes great courage.
Few organizations have the goal of going out of business because they are no longer
needed, yet that courage is needed. What would you rather say? “I helped to eradicate
the leading cause of death of young children in one generation” or “I worked for an
organization that has been working to end childhood drowning for over 100 years now
(though sadly not much has changed)”. Have the courage to be a visionary, to push for
lasting change, and to put yourself out of business.
The current emphasis in the drowning prevention field is on teaching swimming. I
believe the emphasis needs to shift to teaching water safety, which I addressed
previously. First and foremost, swimming is not water safety, it is a component of water
safety. Even the best swimmer can drown in a rip tide or if they are caught in a storm
drain - they needed to understand water sufficiently not to go into those dangers in the
first place. So many aquatics professionals focus on the ‘best practice’ of one-on-one
swimming lessons over a fairly lengthy period of time and many won’t tolerate any other
solution. I agree, it is absolutely the best way to teach swimming, but just teaching
swimming will not ending drowning, and in terms of a pragmatic solution, reality intrudes
once again. First and foremost, the majority of the population does not view drowning
as a real danger so unless you raise awareness, you’ve already substantially cut the
number of parents who will commit the time and money for swimming lessons - it’s
viewed as a luxury, not a life skill at best, and an elitist sport at worst. Second,
individual lessons are expensive and the number of facilities to reach all children is not
sufficient. Few countries have the physical resources to teach swimming to all children
and even fewer of the geographic areas where the most ‘at risk’ children live (minorities,
indigenous populations and children at the lower end of the socio-economic scale).
There are simply not enough pools. Countries like New Zealand and Vietnam are
successfully using portable pools at to teach children at school. I’ve heard complaints in
the U.S. that the cement lobby is opposed to using portable pools and has effectively
limited their use. We need to convince them that if we increase awareness and the
need for swimming, the demand for permanent pools will increase as well. Perhaps
market forces will create a market for swimming facilities to rival the interest in soccer
(football) and baseball if we stop working at cross-purposes and focus on getting kids in
the water. Third, swimming lessons is truly a luxury in areas where food, clothing,
shelter and education are more pressing concerns. Water survival classes are a very
cost-effective method of teaching people to survive if they fall in the water. It is a
18
manageable, cost-effective, economically viable, and realistic alternative to suddenly
pushing for full-scale swimming lessons for an entire population which is expensive and
has no contextual rationale - people need to want to learn something that takes such a
time commitment.
Good programs in water survival exist and can be easily replicated. Canada has
identified the need to teach basic water survival to their new immigrant population.
Their Lifesaving Society offers the excellent ‘Swim to Survive’ program
(http://www.lifesaving.org/training_programs.php?page=199 ). A couple of Navy SEALS
in the U.S. have developed a not-for-profit that teaches survival skills.
(http://site.watersurvivalinc.org/ ). These programs can teach basic water survival skills
in 3-8 hours to children as young as 6. I’d like to push for these basic survival skills
program to be rolled out in every country, and in countries where the military is
respected, not feared or corrupt, why not use that existing resource to teach? Military is
a substantial sunk cost. In the U.S., the SEALS need to perform community work in
order to be promoted - why not have teaching water survival to children be part of their
job? The fledgling ‘Swim with the SEALS’ program in the States has had great results kids are thrilled to learn from the cool guys. It doesn’t have to just be the elite forces,
although from a public-relations standpoint, why not? Ready made role models/heroes
with an enormous amount of expensive training invested in them giving back to our
children. It’s a public-relations slam-dunk. From a government viewpoint you have a
fixed cost (military personnel) with minimal additional costs (using local pools or
portable pools), to address an expensive public health/safety issue. It also keeps your
military forces positively engaged when they aren’t fighting - perhaps positive
psychological benefits for the soldiers would also result. The programs need to be
tested and assessed from a cost-benefit standpoint before they roll out
nationally/globally, but I believe it’s the type of creative thinking with an economic focus
which will start making a difference.
Expanding our thinking on how to get more children in the water safely also has a
potentially lasting impact in a number of areas. If more children are positively
introduced to the water it is possible that a greater number will begin to view swimming
as a desirable sport and form of exercise. Childhood obesity is on the rise and
swimming is one of the best exercises. Again, more and more studies show that
children who swim are smarter ( http://news.smh.com.au/breaking-news-national/doesswimming-make-you-smarter-20101102-17bgh.html ), better coordinated (Citation:
Sigmundsson, H. and B. Hopkins. 2010. Baby swimming: exploring the effects of early
intervention on subsequent motor abilities, Child: Care Health and Development. 36:3,
428-430. DOI: 10.1111/j.1365-2214.2009), live longer (
http://www.active.com/swimming/Articles/Swimmers_live_longer__study_says.htm ) and
do better in school. Emphasizing the need to relate to the water safely and positively
may also encourage more parents and children to expand their skills. Again, supply
and demand principles suggest that a greater demand for swimming will push for a
greater number of swimming pools - a boon to pool manufacturers and the aquatics
industry who regularly compete with other, more mainstream, sports. The aquatics
19
industry must stop fighting. There is no one right answer. If water is 70% of the earth’s
surface and is present in all of our lives that’s a lot of market share to take advantage of.
Lastly, we must leverage economies of scale. One size does not fit all when it comes to
educating people about water safety. Cultural and geographic demographics must be
understood and respected for programs to be effectively communicated. However the
messages are communicated, the messages must be consistent globally if we are truly
aiming to keep the world’s children safe for future generations. Again, I support the
concept of one global face of safety and rigorously tested and proven consistent
messages, but adapted to local markets.
Local Solutions
Water is as diverse as our population and demands diverse solutions. The pools in
Southern California are not the wells and water tanks of Central Australia. Lake
Michigan is not Lake Victoria. The Mississippi is not the Amazon. And Bangladesh is
certainly not Kansas. Geography, culture, literacy levels, language, socio-economic
status, religious beliefs and gender roles must all be assessed in order for messages
about water safety to be effectively communicated.
Although the message needs to be communicated using different methods to be
effective, I stand firmly by my belief that the underlying message and the approach must
be consistent across cultures and continents. Dr Linda Quan, Elizabeth Bennett and Dr.
Kevin Moran presented eight key messages that had been identified by the International
Task Force of the International Life Saving Federation. Do a mental checklist of the
water hazards in your community and country and I believe you’ll find that these
messages are applicable no matter where you live.
The key messages for ‘Care of Self’ are:
1. Learn swimming and water survival skills
2. Always swim with others
3. Obey all safety signs and warning flags
4. Never go in the water after drinking alcohol
5. Know how and when to use a life jacket
6. Swim in areas with lifeguards
7. Know the weather and water conditions before getting into the water
8. Always enter shallow and unknown water feet first
For ‘Care of Others’ the key messages are:
1. Help and encourage others, especially children, to learn swimming and water safety
survival skills
2. Swim in areas with lifeguards
3. Set water safety rules
4. Always provide close and constant attention to children you are supervising in and
around water
5. Know how and when to use a life jacket, especially with children and weak swimmers
20
6. Learn first aid and CPR
7. Learn safe ways of rescuing others without putting yourself in danger
8. Obey all safety signs and warning flags
These messages give us an excellent framework for creating programs that are
effective. I am still very concerned that this actually works out to 16 messages with 134
words - significantly more than the three items that most people can remember. Any
effective campaign must be layered. Start with attention-grabbing and memorable
directions, such as Teach. Watch. Protect.© Each of the sixteen messages above fits
nicely beneath these three words. First we have to get people’s attention and give them
simple prompts to remember, then we can fill in with the details. The messages must
be marketed effectively - not in purely academic theory or public health shaking of
fingers, but in a way that the lay-person will listen to, understand, and change their
behavior.
Effective communication is critical and the least expensive component of any program’s
success but is the most overlooked. Too often the experts who develop the programs
understand what they are trying to accomplish and they forget that their target audience
simply doesn’t have the background or knowledge. If you spend $1 on communication
for every $100 in program costs your effectiveness will go up exponentially. Technology
(including text messaging) and social media provide even more bang for the buck to
reach a staggering number of people very inexpensively. I will stress that professional
communication is needed, this is not the job for someone who has not had training in
communications, graphics and art. Nike swoosh. Golden arches. Apple. Need I say
more?
Dr. Rose Jones and her team at Dallas Children’s Hospital have done extensive work
on how to communicate basic water safety to their culturally diverse community and
argue persuasively for different messages for different populations. Mark Haimona with
Te Ripo works directly with the Maori population in New Zealand to teach water safety.
An excellent example because the Maori can tap into their deep cultural roots in the
water which is a different framework than the background of a non-indigenous New
Zealander. The Netherlands have made it a national priority, with the monarchy leading
the way, while still addressing their reasonably diverse population,
http://www.youtube.com/user/Nationaalplatformzw#p%2Fa%2Fu%2F0%2FaSJS3X2Wb
aI . The Sri Lanka Women’s Swimming project tackles the modesty issues that can
keep women from learning to swim. http://www.icanswimcanyou.com/ Surf Life Saving
Australia sends volunteers to the Australian interior to educate children who never see
the ocean about water safety. http://www.sls.com.au/what-we-do/community-education/
And the list goes on.
Local programs share an anthropological component that is the basis for their success.
Understand how the local population thinks and works. Understand what methods of
communication are effective - from puppet shows to YouTube to mobilizing mothers or
tribal chiefs. Find the local leaders (and these may not be the people technically in
charge) and engage them to push for change. Give them the script and the concept
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and let them tell you how to best reach people. I have a wonderful anecdote that
demonstrates the effectiveness of this approach. To cut arms dealing in a region, the
idea was planted with the tribal chiefs that some men in the tribe were bringing shame
on the tribe with their activities. The chiefs went to the mothers of the arms dealers.
The mothers went after their errant sons. And the level of arms dealing dropped. All
because someone took the time to understand how power and communication really
worked in that culture. Understand local cultures and work within them, don’t impose
outside beliefs on them.
There are amazing programs around the world, but several things must be addressed.
First, measurement that the programs are effective. Part of measurement is testing that
the actual words used to convey the ideas in the above messages are clearly
understood by the targeted population, correctly interpreted, and elicit the correct action.
Some words where I can see potential interpretation concerns in the key messages
above include ‘lifeguard‘, ‘safety signs’ ‘warning flags’. Does the population know what
a ‘lifeguard’ is? Can they identify a lifeguard? Do they know what uniform they wear?
What about ‘safety signs’? What signs should they expect in different locations? What
do the signs look like? Where would they be posted? Are they text or pictures? What
language is used? What is the grade-level standard for the language used? Are the
most basic signs related to water safety consistent across countries and globally? Are
the signs effective or are they a laundry list of ‘don’ts’ that provide legal defense such as
the signs at hotel pools in the States and at unguarded beaches the world over that
everyone ignores? Same questions for ‘warning flags’. Do people recognize what they
look like? Do they know where to look? What do they mean? Are they used judiciously
or are they a ‘cry wolf’ always giving a higher perception of danger which will eventually
be discounted? Are basic signs and warning flags consistent globally? Again, the
academics and experts can set the message, but we must use experts in
communication to develop the signs/symbols and test them on the general population.
We can’t assume that people know what we mean. Communication is only effective if
it’s understood.
Effective and consistent communication must saturate the market. Newspapers, news
programs, children’s programming, embedding correct behavior in television programs
and movies, Facebook, Twitter, town hall conversations, children’s books, school
meetings, government policy debates, positive role models. Let’s make it cool to be
clued in on the importance of water safety.
Sharing information about what programs do work is necessary for consistency, costcontainment, economies of scale, and effectiveness. There are some great programs
out there operating on a shoe-string and a prayer, and others created with enormous
expense and paid staffing. Regardless of the provenance, we need to figure out what is
working and duplicate those efforts. As the Heath brothers say, “Focus on the bright
spots”. I discussed the use of social media earlier for communicating information, but
social media is also an ideal mechanism for sharing information about successful
programs and also asking ‘what did you do about ....?‘ to tweak almost, but not quite,
successful programs. People who work on drowning prevention tend to do it because
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it’s more than a job, it’s a passion, either to help, because we love the water and want
others to enjoy the water as well, or a combination of the two. The hard part can be
accepting that your particular program is not working, or that another program might be
more effective, but if our ultimate goal is saving kids, I think we all need to leave our
preconceived ideas at the door.
And finally....
The thoughts and observations contained in this paper are entirely my own, I stand
ready to be challenged or corrected, and I’d appreciate your input. You can contact me
at rebecca@rebeccawearrobinson.com. The ideas in this paper are the culmination of
four years of full-time study on the issue of childhood drowning, independent of any
organization. I have hired experts in marketing, communications, systems and design
to help me with my work, who have helped me to clarify my thinking and to
communicate it effectively. I was also fortunate enough to have a business partner for
the first part of the journey who developed Jabari™ and provided an excellent counterpoint to my weaknesses, as well as a being a good friend.
I have not received any funding or recompense for my work or for highlighting the work
of organizations or individuals, therefore any bias represented is also entirely my own.
In developing my theories and this plan, I have drawn on my professional history in
consulting on human resources and process restructuring, coupled with my academic
training. My first master’s degree is from the Kellogg School of Management at
Northwestern University in international management, marketing, and economics. My
second master’s is in Organizational and Social Psychology from the London School of
Economics where I focused on group dynamics, motivation, and gender issues. I am
also a voracious reader and observer of human nature, a global citizen, and have
completed ten years of intense field work in child development in the course of my
other, incredibly rewarding, full-time job, mom.
In addition to pushing for a global strategy and local solutions to end childhood
drowning, I work to raise awareness on the issue and push for change every day. I blog
weekly at www.rebeccawearrobinson.com. I tweet at RebeccaSaveKids and
JabariWater and am on Facebook at Rebecca Wear Robinson and Jabari of the Water.
I am also active in LinkedIn. My web-sites are: www.rebeccawearrobinson.com and
www.jabariofthewater.com. I speak on the issue whenever and wherever possible and
will continue to cultivate the media and the power of social media until real change
occurs. I look forward to working with you.
My goal, in my lifetime: No More Children Drown.
Copyright 2011 RWR Consultants, Inc.
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