SINCE the mid-1980s, the Atlantic Ocean in Lagos has been surging ashore without warning at daytime or nighttime. During such occurrences, shanties erected by worshippers on the beaches or for hire to tourists were usually swept into the ocean. No records of human casualty have been available in the previous incidents until last weekend's in which 10 people were confirmed drowned while six or more are yet to be accounted for at the Kuramo Beach, eastward of Bar Beach, ocean surge.The government is worried. The residents are sad. Tourism will receive a knock. Medical experts look at drowning and what can be done.The Chairman, Nigeria Medical Association (NMA), Lagos Chapter, Dr. Francis Faduyile, in a telephone chat with The Guardian yesterday said: 'What happened is part of the poverty thing in Nigeria. The housing issue and Alma Ata Declaration of 1978 that housing is necessary, the health and total wellbeing of individuals are necessary for the overall development of any nation. The people drowned with those affected is because they do not have homes to lay at night except reclining on the beach at night and loafing around at dawn. For good health we have to make sure that citizens have adequate housing.'Faduyile said it is unfortunate that these people were swept away by ocean surge. He said the way to prevent future occurrence is for government to look at its housing policy to make housing adequate, accessible and affordable. 'These people were living under tents and most of them were there because they did not have better alternatives,' the NMA chairman said.He said the area should be evacuated and the government should find alternatives for people living in the area. 'Because of the deaths, they should clean up and decontaminate the area,' Faduyile said.The medical doctor said government should find a long-lasting solution to break the waves of the ocean. 'If you travel along the coast to Ghana you will see what other African countries have done and are doing to address the ocean surge. Our government should borrow a leaf from these proactive countries,' Faduyile said.The NMA Lagos chairman said most of the dead must have been because of drowning. Faduyile described drowning as the process of experiencing respiratory impairment from submersion/immersion in liquid.He said drowning is caused when the lungs are filled with water and oxygen cannot get into the blood due to long stay under water.'A lack of blood oxygen can cause brain damage and death. Water in the lungs, especially contaminated water, can damage the lungs,' Faduyile said.The medical doctor said people can drown in as little as water in a bathtub or swimming pools. 'Babies can drown in a sink or bathtub. Most preschooler drowning incidents occur in swimming pools. People who have seizure disorders are also at risk in the water. Drowning can happen quickly and silently,' he said.The NMA chairman said drowning precautions should include:' Fences around pools; supervising children near any body of water, including tubs;' Not swimming or boating when under the influence of alcohol or sedatives;' Wearing life jackets when boating; and' Learning cardiopulmonary resuscitation (CPR).CPR involves doing chest compressions and rescue breathing. CPR is performed on people who are not breathing or who have no heartbeat. It may be needed in cases of cardiac arrest, respiratory failure or accidents, such as drowning. It helps keep the blood circulating to the vital organs. In addition, it helps provide oxygen to the lungs. CPR guidelines are different for an adult, child and infant.According to the World Health Organisation (WHO), drowning is the third leading cause of unintentional injury death worldwide, accounting for seven per cent of all injury related deaths. The WHO, in 2004, estimated that 388,000 deaths of drowning occurred worldwide, excluding those due to natural disasters, with 96 per cent of these deaths occurring in low- and middle-income countries.Drowning itself is quick and silent, although it may be preceded by distress, which is more visible. A person drowning is unable to shout or call for help, or seek attention, as they cannot obtain enough air. The instinctive drowning response is the final set of autonomic reactions in the 20 to 60 seconds before sinking underwater, and to the untrained eye can look similar to calm safe behaviour. Lifeguards and other persons trained in water rescue learn to recognize drowning people by watching for these instinctive movements.Drowning occurs more frequently in males and the young. Surveys indicate that 10 per cent of children under five have experienced a situation with a high risk of drowning.The following definition was accepted by the World Congress on Drowning in 2002 and, subsequently, by the WHO in 2005:'Drowning is the process of experiencing respiratory impairment from submersion/immersion in liquid.'This definition does not imply fatality, or even the necessity for medical treatment after removal of the cause, nor that any fluid necessarily enters the lungs. The WHO further recommended: 'Drowning outcomes should be classified as: Death, morbidity, and no morbidity. There was also consensus that the terms wet, dry, active, passive, silent, and secondary drowning should no longer be used.'The National President of NMA, Dr. Osahon Enabulele, explained how drowning leads to death: 'If water enters the airways of a conscious victim, the victim will try to cough up the water or swallow it, thus inhaling more water involuntarily. Upon water entering the airways, both conscious and unconscious victims experience laryngospasm, that is the larynx or the vocal cords in the throat constrict and seal the air tube. This prevents water from entering the lungs. Because of this laryngospasm, water enters the stomach in the initial phase of drowning and very little water enters the lungs.'Unfortunately, this can interfere with air entering the lungs, too. In most victims, the laryngospasm relaxes some time after unconsciousness and water can enter the lungs causing a 'wet drowning'. However, about 10-15 per cent of victims maintain this seal until cardiac arrest. This is called 'dry drowning', as no water enters the lungs.'In forensic pathology, water in the lungs indicates that the victim was still alive at the point of submersion. Absence of water in the lungs may be either a dry drowning or indicates a death before submersion.'A study published in Nigerian Postgraduate Medical Journal and titled: 'Drowning in the Niger Delta region of Nigeria: An autopsy study of 85 cases,' concluded: 'Death from drowning is a common but preventable public health problem in the Niger Delta region of Nigeria, since most of the victims drowned accidentally mainly due to lifestyle and psychosocial problem.'Dr. Seleye-Fubara Daye, Dr. Etebu Ebitimitula Nicholas, and Dr. Ijomone Esse of the Department of Anatomical Pathology, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, studied the frequency distribution of gender, age, cause and circumstances of drowning in the Niger Delta, using autopsy.The autopsies were performed and reported by the authors covering January 1, 1998 to December 31, 2009, after being served with the coroner's inquest forms by the police. Bio-data and other variables were the age, sex, the environment in which the bodies were recovered and the pattern of death of the victims. The photographs used were taken by police at autopsy.A total of 85 drowned persons were studied during the period under review. The youngest was a year-old male and the oldest was a 76-year-old male. Males were 63 (74.1 per cent) and females 22 (25.9 per cent), giving a male to female ratio of 2.9:1. The highest frequency of death occurred in the age group 50-59 years 21 (24.7 per cent). Most of the bodies 48 (56.5 per cent) drowned in the river, accidental drowning was the most common circumstances of death, 68 (80.0 per cent) and asphyxial death was the most common pattern of death, 72 (84.7 per cent).
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