Drowning is the second leading cause of childhood injury-related deaths worldwide and the most common cause of injury-related deaths among children under 5 years old. In Bangladesh, drowning has previously been identified as the leading cause of death among children aged 1 to 17. Efforts to reduce childhood drowning in Bangladesh have so far largely neglected the Rohingya refugee camps in Cox’s Bazar district.
We investigated fatal drowning cases that occurred in the camps between January 2019 and December 2020, to explore the factors associated with drowning incidents and identify potential interventions. After learning of a fatal drowning, our field team visited key informants of the incident and conducted interviews with them. In total, twenty child drowning fatalities were recorded during the investigation period. The findings revealed that most drowning fatalities in the camps are associated with males, the rainy monsoon season, daylight hours, inadequate supervision, and occur in ponds. Fatal drowning incidents among children under 5 usually occurred as they fell into nearby unprotected water whilst caregivers were occupied with household duties. For school age children, fatal drowning incidents commonly occurred whilst playing or bathing in a water body without adult supervision and engaging in risky behaviours, primarily on breaks from or days without school or madrasa. COVID-19 related restrictions may have influenced an increase of drowning incidents among older children in 2020.
A drowning prevention programme specifically suited to the refugee camps is needed. Measures for children under 5 should focus on installing barriers to restrict access to water bodies and establishing community crèches to increase supervision. Interventions for older children should focus on teaching them basic swimming, water safety and safe rescue skills. These measures could be complemented by training bystanders in safe rescue and resuscitation, strengthening public awareness of drowning and highlighting the vulnerability of children. Despite certain limitations, this study succeeds in providing an insight into drowning risks in the camps and reveals opportunities for future research.