Drowning – fast, silent, and largely preventable

Drowning is almost silent. A drowning person cannot call out, because breathing takes priority over speech, and they cannot wave, because their arms are pressing down on the water instinctively trying to lift their mouth clear.

• Head low in the water, mouth at water level, or head tilted back with mouth open.
• Eyes glassy and unfocused, or closed.
• Upright in the water with no kicking, appearing to climb an invisible ladder.
• Hair over the eyes and not being brushed away.
• Quiet. Children playing are noisy — a child who has gone quiet in water needs checking immediately.

1. 1Supervise actively — within arm's reach for young children, watching the water rather than a phone. Designate one adult as the watcher and swap explicitly.
2. 2Fence pools on all four sides with a self-closing, self-latching gate. Fencing is the intervention with the strongest evidence, and a fence that separates the pool from the HOUSE works better than one only around the property.
3. 3Empty buckets, basins and paddling pools straight after use, and store them upside down.
4. 4Cover or fence rainwater tanks, drums and open water on the property.
5. 5Teach children to swim — but never treat swimming ability as a substitute for supervision.
6. 6Use a properly fitted life jacket on boats and around open water. Inflatable toys and armbands are not safety devices.
7. 7No alcohol around water. It is involved in a large share of adult and teenage drownings.
8. 8Swim where there are lifeguards, and between the flags.

• Rip currents pull outwards, not under. Do not swim against one — swim parallel to the beach until free, then in. Float and signal if you cannot.
• Rivers and dams hide cold layers, sudden depth changes, currents and submerged objects. Cold water shock causes involuntary gasping and can drown a strong swimmer within a minute.
• Never dive into water of unknown depth. Spinal injuries from diving are permanent and common.
• Water levels rise fast in a South African summer thunderstorm, including in rivers where it is not raining locally.
• Never drive through moving floodwater. It takes very little to lift a vehicle.

1. 1Do not jump in unless you are trained. Would-be rescuers drown regularly, often alongside the person they went for.
2. 2Reach or throw: extend a pole, branch or towel, or throw something that floats.
3. 3Call for help and for lifeguards.
4. 4Once out, if they are unresponsive and not breathing normally, start CPR — with rescue breaths if you are willing, because drowning is an oxygen problem.
5. 5Get them medical attention even if they seem fine afterwards. Breathing difficulty, persistent coughing, chest pain, extreme tiredness or confusion in the hours after a near-drowning needs assessment.

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