Kevin Patterson is a physician and novelist whose books include Consumption and News from the Red Desert. He practises on Vancouver Island and on the west coast of Hudson Bay.

Steve Beerman is a clinical professor with the Department of Family Practice, Faculty of Medicine at the University of British Columbia, and co-chair of the Canadian Drowning Prevention Coalition.

The wealthy regard access to waterfront as a privilege they pay for – and pay through the nose, they grumble-brag to one another – be it Muskoka lake frontage, Marine Drive homes in Vancouver or suburban pools anywhere. It is easy to understand why they do. Summer afternoons next to shimmering waterscapes form memories that go to the heart of what it means to be blessed, surrounded by beauty.

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Alongside that is an understanding that water, like wealth itself, can be a menace. Attentive parents watch nervously over their children as they fish and swim and water-ski and sail. Tragedies will occur regularly anyway, and they know it. Last month, a 23-month-old girl wandered away from a daycare in Mission, B.C., and was found drowned in a neighbourhood pool. Also in May, a three-year-old was playing with other children beside Tulabi Falls in Manitoba’s Nopiming Provincial Park and wandered away; he was later found drowned. And over the May long weekend, a mother in Tofino on Vancouver Island to celebrate her daughter’s wedding went surfing and died off Long Beach. Guests had been gathered and facilities had been booked; the mother’s own nature having been what it was, the wedding went ahead anyway a few hours later. It might be worth it to try to imagine the shocked grief attending that ceremony, if only to grasp the larger point about the complexity of what water represents to Canadians, the wealthy and the exuberant.

For poor people, water is a threat of an entirely different character: Worldwide, drowning is one of the leading causes of death for children between the ages of 1 and 18 years. The world’s highest rates of drowning are in Angola, Haiti and Equatorial Guinea. In Bangladesh, in 2008, an average of 46 children drowned each day.

In much of the developing world, river and coastal transportation remain the principle daily means of moving people and goods, and so communities exist along the water for pragmatic as well as historical and aesthetic reasons. Poor people all over the world generally spend their lives along and upon the water. The poverty of these communities is such that Western infrastructures of life guards and fencing and readily available PFDs (personal flotation device) and swimming lessons is often absent – just as medical resources for the care for tuberculosis, HIV, malaria or for traumatic injury is often less than what we might see in the West. But the response to TB, HIV and malaria has included the Global Fund, Bill Gates’s fortune and United Nations ambassadors drawn from the glitterati. The drowning death toll, however, astonishes most people when they learn of it. No one seems to have heard of it, and nothing much has been done by those with means to address it.

In the Canadian North and in Canadian Indigenous communities, most of these realities apply as well. Every community in Nunavut except Baker Lake is on saltwater and none of them have road or rail access. All the boreal forest reserves – which are the majority of the reserves in Canada – are on rivers or lakes. And among Indigenous Canadians, drowning is between 11 and 22 times as common as it as among non-Indigenous Canadians.

The poor drown at these rates for some of the same reasons that poverty accelerates all pathologies, whether infections, trauma or mental illness. Crowding and large families play a role, as children are sometimes supervised near ponds and lakes by their own non-adult siblings. (In 2016, half of drownings among Canadian children 14 or younger occurred without adult supervision.) The poverty of the built environment as well as the use of intoxicants, which featured in about half of the drownings of people between 15 and 34 years of age, also play a role. The poor die, in the water as elsewhere, because of the demographics of poverty – that is, mostly because they are poor.

The boreal forest is the largest on the planet and Canada’s portion of it is the most arresting part of the country. In Nopiming Provincial Park, where that three-year-old boy died on May 12, the Oiseau River wanders in a chain of lakes and channels from Tulabi Lake, up to Eagle Lake and into Snowshoe Lake, which straddles the Ontario border. Canoeists thrill at the clarity of the water and at the extent and untouched nature of the spruce and pine forest. It was on a lake such as this that the painter Tom Thomson drowned, in Algonquin Provincial Park in 1917. In the years before his death on Canoe Lake, he depicted the boreal forest and its rivers and lakes with a reverence that had not been seen before. In Northern Lake and West Wind and Spring Ice, the foreboding beauty of the cold and white-capped water is expressed with a power that has made these some of the defining images of our national consciousness – and presaged his own death in that strong water.

Any of us who has swam and canoed in the Oiseau River chain and elsewhere in the boreal forest, and anyone who has looked at Thomson’s paintings, has felt the power and the danger of these waters. Their power is part of their beauty, despite the danger they pose. In the big picture, it is better that we do not remain safely at home in front of our TVs experiencing that beauty only through David Attenborough and Planet Earth documentaries. But in the more immediate picture, for anyone who has lost someone to the water, it is incomprehensible that the magnitude of that danger is not more widely understood.