Two things could prevent fatal drownings. Why is New Zealand not doing them?

OPINION:

This summer has been a year of drowning tragedies. Each one a ripple that affects a wider whānau, each loss an intergenerational injury as grandparents mourn mokopuna and adults grieve the loss of their partners and friends. Witnesses and rescuers too, are left with disturbing memories and lingering questions. These losses damage a community, especially when the deaths have come so fast as they have this summer of 2022/23.

I’m not writing as the medical director of a rescue agency, a rescue helicopter doctor, or as an emergency medicine doctor. I’m not speaking on behalf of any agency, but as a father and husband. New Zealand lost 91 people to drowning in 2022, the most in a decade, and is on track to set more horrible records this summer. In a single two-day stretch this week, five lives were lost in three separate incidents. This is tragic, unnecessary, and preventable.

I want to share with you some ideas for what could work much better than what we’ve been doing. Ideas that have worked elsewhere, and could work here.

Emergency services were called to Piha Beach just after 6 pm on Saturday when two people got into trouble in the water. Photo / Hayden Woodward

The first step, and the one we’ve avoided for a long time, is requiring (and enforcing!) lifejackets to be worn while on board boats. We currently have a mix of very weak regional and local rules about lifejackets. They are far too lax and too variable, being required for children, or only when underway, or only on the skipper’s suggestion, or only on small boats, or only while crossing bars and other dangerous patches of water.

These laws or rules or recommendations are variously unknown, ignored, or unenforced.

We can do better.

Northland emergency doctor Gary Payinda says there are proven ways to reduce drowning fatalities - NZ just needs to enforce them. Photo / Supplied

Lifejackets are now comfortable (little more than a band of fabric worn around your neck), tiny, light, inexpensive, and automatically inflatable upon falling into the water. Yet every week I’m reading stories about kids, adults, or older people being found in the water without a lifejacket. We need to enforce the number one rule that will prevent fatal drownings in New Zealand.

Lifejackets are proven lifesavers. Most rescue swimmers will drily note that they’ve never pulled people wearing lifejackets from the water dead. Lifejackets save lives. But only if you are already wearing one.

Lifejackets turn a 60-second fatal drowning into a 60-minute float until rescued.

Your chances of survival when you unexpectedly end up in the water (and it’s almost always sudden and unexpected) are not as great as you might think. As a rule, we underestimate the risk and overestimate our abilities. Clothing, shoes, the sudden 30-second involuntary gasping reflex of cold shock in frigid water, and exhaustion can kill people much more quickly than most might assume. Males especially underestimate the risk, and end up accounting for 80 per cent of all fatal drownings.

Self-inflating lifejackets could literally save dozens of lives this year if we were to pass a law this summer. Places that have passed and enforced strict lifejacket laws, like Victoria and Ireland, have seen deaths promptly plummet.

New Zealand politicians: require them for boating and rockfishing/shorefishing, and drowning deaths in your district would markedly drop. Dozens of human lives would be saved this year, and every year thereafter. I cannot believe we don’t yet do this. We should.

The second step is to publicly post signs with the 10-year fatal drowning tally at every one of our most dangerous beaches, lakes and river sites. As the tourism operators groan, hear me out.

Whangārei Heads School students practising floating with an arm raised in a lifejacket as part of the WaterSafe Programme. Photo / Supplied

I have treated many dozens of non-fatal drowning patients in the emergency department in my 20 years as an emergency doctor and in drowning prevention. The one consistent message I hear from patients or their family members is that they had no idea that a place as beautiful as Kai Iwi Lakes or Piha Beach could be so deadly. They may know “Rips are Dangerous”, but they did not know that people actually died on this very patch of beach they were entering for a quick cool-down dip.

If I was tasked with stopping fatal drownings in New Zealand, every location that had a fatal drowning would be marked with a sign within 200 metres showing a black X and the number of people that had died there in the past decade, as a reminder to all that the risks are not just of a dangerous “Rip”, but of actual death.

Instead, we allow those deaths to become invisible within a couple of hours, clean, seemingly safe, and back to normal, thereby ensuring that these very spots will take more lives.

Some people have no idea that a place as beautiful as Piha Beach can be so deadly Photo / Alex Burton

Rescuers and local governments already know all the drowning-fatality black spots: it’s time we started sharing this information with the public. I heap much praise on the occasional brave coroner who insists that a location of multiple and frequent fatal drownings gets a sign saying “Dangerous”.

It’s time we go much further and admit what really happened, that someone lost their life here. Or in many cases, that multiple people over multiple years lost their loved ones to fatal drowning at *this very spot*. Only then can we say we honour their loss, and are serious about preventing more tragedies.

There are a half-dozen other highly-effective steps that we should immediately take to eliminate this problem – drowning – that a hundred years ago used to be called the “New Zealand Disease” because it was so common. It is still too common. Our drowning death rates are some of the worst in the OECD, even among countries with dangerous coastlines and outdoor cultures like ours. The steps I’ve outlined above are just the first two steps we should take…if we are serious about not losing more of our families and loved ones to drowning.

Dr Gary Payinda is an emergency medicine specialist working in Northland and Auckland.