Blum Lauren S, Khan Rasheda, Hyder Adnan A, Shahanaj Sabina, El Arifeen Shams, Baqui Abdullah
Public Health Science Division, International Center for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh.
Soc Sci Med. 2009 May;68(9):1720-7. doi: 10.1016/j.socscimed.2009.01.020. Epub 2009 Mar 11.
While reductions in infectious disease have resulted in impressive declines in child mortality in Bangladesh, drowning is becoming proportionately more important as a major cause of death, accounting for at least 19% of deaths of children between 1 and 4 years of age in trend analysis since 2000. Little is known about indigenous beliefs and behaviors associated with drowning, which may be critical to preventing child-related drowning deaths. Qualitative research was carried out over 13 months in Matlab, Bangladesh to describe the indigenous explanatory model of drowning and to identify behavioral factors increasing the risk for drowning deaths. Methods included cognitive mapping procedures as well as open-ended interviews with families who had lost a child or experienced a near-death due to drowning and families with at least one child under 5 years living near a body of water. Along with diarrhea, fever, and pneumonia, drowning is perceived as a leading cause of child death. Causal explanations are primarily associated with "evil spirits" believed to entice young children to water or bewitch mothers so that they forget about the child. Another primary interpretation relates to a water goddess known to prey on small children. When a young child is discovered in water, parents refrain from rescuing the child due to a belief that if a parent touches a drowning child, the child will die. After the child is removed from the water, traditional practices that have no known benefit are employed. The research identified locally constructed beliefs and practices such as refraining from touching the child that may increase the incidence of drowning deaths. Future efforts are required to address these beliefs and assess the feasibility, cultural acceptability and effectiveness of strategies designed to prevent drowning.
虽然传染病的减少使孟加拉国儿童死亡率显著下降，但溺水正日益成为一个重要的主要死因，在2000年以来的趋势分析中，溺水至少占1至4岁儿童死亡人数的19%。对于与溺水相关的本土信仰和行为知之甚少，而这些信仰和行为对于预防儿童溺水死亡可能至关重要。在孟加拉国的马特莱进行了为期13个月的定性研究，以描述溺水的本土解释模型，并确定增加溺水死亡风险的行为因素。方法包括认知绘图程序，以及对因溺水失去孩子或经历过溺水濒死的家庭，和家中至少有一名5岁以下儿童且居住在水体附近的家庭进行开放式访谈。除腹泻、发烧和肺炎外，溺水被视为儿童死亡的主要原因之一。因果解释主要与“恶鬼”有关，人们认为恶鬼会引诱幼儿靠近水源或蛊惑母亲，使她们忘记照看孩子。另一种主要解释与一位以捕食幼儿著称的水神有关。当发现幼儿在水中时，父母因相信如果父母触碰溺水的孩子，孩子就会死去而不敢施救。孩子从水中捞出后，人们会采用一些并无已知益处的传统做法。该研究发现了一些当地形成的信仰和做法，比如不触碰孩子，这可能会增加溺水死亡的发生率。未来需要努力解决这些信仰问题，并评估旨在预防溺水的策略的可行性、文化可接受性和有效性。
