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 arent we preventing it?

Current situation:
Lack of awareness - most people dont even know its a problem. Many of the programs which have been developed to combat drowning are fear-based 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 its 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 self-sufficient 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 shouldnt wander out of sight, or, most importantly, that they shouldnt go near water without an adult - and were 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 dont 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 havent 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 dont make sense. Our children received mixed messages about water every single day. A childs 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
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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 dont teach our children how to navigate the water safely, and we dont 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 dont 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 doesnt 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 peoples 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. Im willing to bet that far more parents spend their time worrying about their childs 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 havent 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 cant 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 couldnt happen to me or I always watch my child or we dont have a pool or simply Im going to figure out how to keep my child from being abducted - avoidance. Remember, water covers 70% of the earths surface - its everywhere - and it takes only 2 minutes for a child to drown in under 2 inches of water. You cant 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 Im 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
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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 its 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 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. Its 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), lets 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 Im guessing there were some fatalities before
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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 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 dont need to shock and awe the public with our combined brilliance and theory, we need them to change their behavior, so lets 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 Ill 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. Dont dive into water unless you know its deep enough. And of course, dont 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.
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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 donts. Tell children (and adults) what they can do RIGHT, dont 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 youve lost 99% of your audience. Get their attention first, let the rule embed itself in their consciousness and then layer on the 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 cant 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 - dont 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 theyve 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. Ill talk more about some of these programs when I address local solutions. And lets 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 youll 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 dont have sex programs, they are the use a condom when you have sex programs. Ditto with the success of needle-exchange programs instead of dont do drugs for cutting transmission of HIV. MADD (Mothers Against Drunk Drivers) doesnt 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 dont work. Selfrighteousness is not an effective strategy. Changing peoples behavior around water must follow the same strategy - balance the fun with safety - not chastising behavior that most people dont actually know is dangerous. Show people what to do - pragmatically and positively - and they are more likely to change their behavior. 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 Jabaris 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
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true, and effective. If we can engage children and the children become attached to a character, they will emulate that characters behavior. Young children have rich and active imaginations - they dont 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. If you would like to read it, just e-mail me at rebecca@rebeccawearrobinson.com . 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 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 childrens 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 cant 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 Pinks 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 dont value what they dont 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 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 Maslows 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.....
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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 dont 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 Im 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 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 wont happen to me. The numbers are too big, they are too abstract, and they arent 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. Its short, its powerful, its 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. Its not that people want their children to drown, its that they dont know how to prevent it. We
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need to tell people clearly its 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 worlds population. Imagine giving a speech to the United Nations to encourage them to recognize childhood drowning as a global epidemic under the Millennium 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 its one child every minute and 18 seconds, or every 55 seconds, or, well, actually the numbers are under-stated but we cant capture the data accurately because of these highly technical reasons. And the lack of accurate data needs to be, and is being, addressed. But Im 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 its factual - its not hysterical - its 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 well start seeing real change in attitudes and behaviors. Once we have peoples 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 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 organizations 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
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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 Im 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 its 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. Im 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 McDonalds. 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 leverage the fact that we are fighting the leading cause of death for young children positively to get things done. After all, who doesnt 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&articl eURL=http%3A%2F%2Fhealthpolicyandreform%2Enejm%2Eorg%2F%3Fp %3D14975%26query%3DTOC&urlhash=7FcK&trk=group_most_popular-0-bshrttl&goback=

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%2Egsm_3972058_1_*2_*2_*2_lna_PENDING_*2%2Egmp_3972058%2Egde_397205 8_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, Id 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 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
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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. Hawaiis 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 Bears 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, shes 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 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
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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 Id 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 Im 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 lets 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 its membership. China is searching for safe havens for their cash surplus. The Middle East is in turmoil with civilian uprisings. The majority of the worlds 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 dont 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 for ending drowning; and a plan for effectively marketing the issue to attract funding and public support.
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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 cant 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 peoples 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 its 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, Im the kind of person who cares about children. Im 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, lets 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 ILSFs number of 1.2 million people a year that works out to US $3.35 trillion dollars a year at todays exchange rate. US $3.35 trillion is equal to the GDP of Germany, the
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worlds 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 Id 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 wouldnt 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 dont need education, food,
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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. Highlighting and comparing to health care costs is especially effective because near drowning accidents directly impact a countrys 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 citizens 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 countrys 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 high-income 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
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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 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. Its a curious business model, but if we attack drowning effectively, well 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. Its not glamorous, but its 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 wont 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, youve already substantially cut the number of parents who will commit the time and money for swimming lessons - its 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
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successfully using portable pools at to teach children at school. Ive 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 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. Id 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 doesnt 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. Its 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 arent 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 its 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
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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 industry must stop fighting. There is no one right answer. If water is 70% of the earths surface and is present in all of our lives thats 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 worlds 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 youll 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
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4. 5. 6. 7. 8.

Never go in the water after drinking alcohol Know how and when to use a life jacket Swim in areas with lifeguards Know the weather and water conditions before getting into the water Always enter shallow and unknown water feet first

For Care of Others the key messages are: 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 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 1. 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 peoples 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 programs 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 doesnt 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 Childrens 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
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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%2FaSJS3X2WbaI . The Sri Lanka Womens 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 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, dont 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 donts 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
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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 cant assume that people know what we mean. Communication is only effective if its understood. Effective and consistent communication must saturate the market. Newspapers, news programs, childrens programming, embedding correct behavior in television programs and movies, Facebook, Twitter, town hall conversations, childrens books, school meetings, government policy debates, positive role models. Lets 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 its more than a job, its 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 Id 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 counter-point 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 masters degree is from the Kellogg School of Management at
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Northwestern University in international management, marketing, and economics. My second masters 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. For permission to reprint or reference any elements of this article, please contact the author directly: rebecca@rebeccawearrobinson.com

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