The Greathouse family met Father Carl Carlozzi on the evening of April 24. It was the night their two toddler sons, Dylan and Steven, drowned in their unfenced swimming pool in Maryvale.
Carlozzi, a gray-haired man with a calming demeanor and kind smile, gets called in to help survivors deal with unspeakable tragedy. He's the Phoenix Fire Department chaplain.
When firefighters and Carlozzi arrived at the Greathouses' home on West Verde Lane, CPR was being done by neighbors, but neither boy was breathing or responding. The boys were taken to different hospitals, and Carlozzi waited with the boys' mother for word, even though they both knew what that word would be.
"She kept saying, I think he's dead.' What could I say? Because it was obvious that he was," Carlozzi says.
The boys were the third and fourth drowning casualties in Phoenix this year.
Carlozzi was there to help pick up the pieces, something he does far too often. By year's end there would be 12 tiny corpses in Phoenix and 19 in the Valley.
"Usually I ride with the family to the hospital and they're saying things like, I murdered my baby, I murdered my baby.' It's probably the most intense pain that I see anyone experience."
The double-drowning incident rocked the evening news. What was so shocking about it was not that someone did something wrong and children died; nothing was done "wrong." The boys were thought to be in bed, napping. Instead, they were floating in the backyard pool.
Carlozzi says that, most of the time, a child drowning isn't about clear negligence. "Even if you do everything right, you can still get distracted -- five minutes later, the paramedics are at your house doing CPR on your 3-year-old. It could happen to any one of us. People ask, Why me?' but the only answer I can give is: Why not you?'"
The leading cause of death in children under the age of 5 in Arizona is drowning. In fact, Arizona has led the nation in childhood drownings every year for as long as records have been kept -- since 1970.
Virtually every local television station and newspaper of any standing, as well as a veritable who's who of Arizona businesses from the Salt River Project to Circle K, has adopted or mounted community-wide efforts to prevent childhood drownings beginning in 1980.
Entering its third decade, the civic crusade to curb this litany of mortality in Arizona is America's longest-running public health campaign according to the Atlanta-based Centers for Disease Control (CDC), which maintains federal records on drownings as well as a host of other public health issues.
And yet the unprecedented length of the alliance among media, community leaders and corporate benefactors to save young lives in Arizona is an unremitting failure. The level of good intentions has been exceeded only by the degree of ongoing tragedy.
A yearlong investigation by New Times reveals a startling list of problems.
After 32 years of recordkeeping, community leaders have made almost no use of the data available. In fact, there is little agreement or knowledge of why kids continue to drown in Arizona. From the beginning, for example, parents have been admonished to be vigilant when their children are around water, a worthy enough message on the surface -- inspiring campaigns such as Water Watchers. Yet the vast majority of incidents do not occur during backyard barbecues or while children are playing in the pool. In more than 70 percent of childhood drownings, the victims were believed to be somewhere inside the home, even asleep in their bedrooms.
With no clear grasp of why kids are drowning, community leaders have opted for solutions they cannot explain with no track record of effectiveness. The first media personality to raise the alarm of pool safety, television broadcaster Dave Munsey, chose coloring books to popularize his message in 1980. Today, he candidly admits the coloring books simply popped into his head without any particular research into their applicability and certainly without any follow-up data to support their continued use. More than 22 years later, the state's largest water utility still passes out its own coloring books as part of its public relations campaign on pool safety. The coloring book puts the prevention issue in the hands of the child instead of the parents.
Because no methodical research has ever been conducted, community leaders have relied upon good intentions and common sense, a formula that has sustained disaster. For example, the state's largest daily newspaper, the Arizona Republic, teamed with the state's most popular television station, KPNX-TV Channel 12, both properties of Gannett, to coordinate Target Zero, their pool safety outreach. This combination of public relations and civic journalism ended on Labor Day weekend, the "common-sense" ending of the swimming season. But, as already mentioned, drownings are not tied to recreation, per se. Toddlers wander out of their homes and into pools year-round. This year's record of fatalities shows eight of 12 drowning deaths were in the nine "off-season" months.
Far from the world of coloring books and summer swim parties, the single largest of several critical factors is the lack of adequate pool fencing. In the more than three decades that records have been kept, there has not been a single piece of statehouse legislation passed or a single municipal ordinance approved to insist that fences be erected around all pools. Period. Instead, weak local directives "grandfather" thousands of pools into compliance even though they lack any fence whatsoever because the pools were already in place when guidelines were enacted.
In the decades-long partnership between business leaders and the state's media on childhood drownings, not a single organization has ever done the sort of demographic analysis routinely done by these same organizations to make decisions about content or market share.
Had anyone in the private sector sought such an analysis, they would have been confronted by a government morass of conflicting data between city, state and regional files -- records so compromised that the CDC flags numbers during certain periods as anomalies that cannot be confirmed. In 1999, for example, four different agencies have four different numbers on how many children actually drowned in the Valley of the Sun.
Despite such obstacles, there are clear lessons in the dusty filing cabinets.
The New Times investigation of relevant paperwork revealed that the vast majority of all childhood drownings appear to occur in three west-side zip codes, a relatively compact piece of geography generally known as the Maryvale area. Because of spotty recordkeeping, conclusions are educated deductions, but the Phoenix Fire Department's spokesman, Bob Khan, confirms that his records also show that 85 percent of childhood drownings occur in this neighborhood.
And what does a researcher find within these three zip codes?
According to city records, there are just over 1,700 pools in greater Maryvale; only 10 percent are secured by a fence. More than 1,500 of these particular pools have no fence. With more than 125,000 pools in the Valley, fewer than 2 percent of those pools account for 85 percent of the childhood fatalities.
The major difference between Maryvale and other, newer suburbs is the number of unfenced pools. With a mix of rentals and low-cost housing, the working poor of Maryvale's neighborhoods often lack the money to erect fencing.
The link between pool fencing and the income level in Maryvale has never been made in any story in the 32 years the press and community leaders have addressed the issue of childhood drowning in Arizona. Instead, the airwaves and print media have spent decades preaching parental vigilance when children are around water.
While adult supervision is clearly critical during the swim season, it is just as clear that parental vigilance is the wrong message; the records are unambiguous: The overwhelming majority of childhood fatalities occur in the off-season when the kids are thought to be nowhere near the pool; the overwhelming majority of childhood fatalities occur where unfenced swimming pools are the norm.
The consequences of not doing the research necessary to understand the problem only underscores the tragedy: In 2002, one small step in the overall media blitz was taken by Fulton Homes. The developer teamed with radio station KSLX to install pool fences, seemingly a step in the right direction. But only 12 fences were erected. Of those, only one was in Maryvale.
The rate of pool-related injuries in the Valley has remained "relatively unchanged," according to an internal study conducted by Dr. Tim Flood for the Arizona Department of Health Services and published to no fanfare or media coverage this past June.
Within weeks of ADHS' sobering assessment, Gannett media properties in Phoenix were nonetheless declaring victory in the battle against childhood drownings.
On September 3, 2002, the first day after Labor Day weekend, the Arizona Republic announced on the front page that summer drownings had been cut in half. The story ran under the public relations/civic journalism logo: Target Zero, One Drowning Is Too Many.
"If we had a part in raising education and helping stop drownings, you can't ask for much more than that for a successful campaign," says Gene D'Adamo, the Republic's vice president of community relations.
Announcing a 50 percent reduction was wildly premature and misleading, according to numerous sources interviewed for this article.
The very weekend after the self-congratulatory press coverage, the pool fatalities resumed, with two deaths and one near-drowning.
In 2002, the number of childhood fatalities in Phoenix is down 20 percent from 2001, from 15 to 12, but the drop is hardly significant in terms of the long-term record. In 12 of the 32 years that statistics have been kept, the number of drownings has dropped. But they always rise again.
There is no evidence to suggest that Target Zero had any impact on this year's numbers. In fact, the evidence suggests just the opposite. New Times commissioned a poll in the general area of Maryvale, and specifically in the three zip codes where 85 percent of all childhood drownings occur historically. Only 6 percent of those contacted could link Target Zero's motto -- Block, Watch, Lock and Learn -- to water safety. Only 4 percent of those contacted could correctly identify Target Zero with water safety. And only 3 percent of those contacted remembered one of the Salt River Project's giveaways, like a can cozy emblazoned with the Target Zero pool-safety message.
By contrast, more than 50 percent of those contacted by pollsters from Behavior Research recalled the message of safety from the fire department, a message firefighters from Phoenix and Glendale delivered door-to-door in greater Maryvale.
The good intentions of the press are not simply misguided, ignoring the role of fences and the data on how toddlers die year-round, but also virtually unknown in the neighborhood primarily afflicted with this tragedy. Community activists and firefighters, whose efforts are indeed remembered by Maryvale residents, are several steps ahead of the media. They acknowledge there is a problem in Maryvale, and it is reflected in their march door to door. But their primary message of adult vigilance ignores the economic reality of more than 1,500 unfenced pools in greater Maryvale.
Before the question can even be asked, Assistant Fire Chief Bob Khan barks out the answer: "It's 85033." Khan, a broad man with a thick shock of black hair, cornflower blue eyes, and the quintessential fireman's mustache, has been working on drowning prevention and awareness for 20 years. He is the face seen on the evening news for 20 years -- every time a child dies, or there is a water safety segment on the evening news. He has seen it all, watched the trends, and keeps an annual tally.
"I take each one personally," says Khan, his hands clenching around a plastic water bottle.
According to Khan, 85033 has long been the worst problem. Phoenix zip code 85033, and its neighbors 85031 and 85035, makes up a low-income area pocketed with more than 1,700 pools, only about 10 percent of which have any kind of barrier.
"I will go on the record. Do poor kids drown? Yes. Unfortunately, the numbers support that. Is it one area? Yes, it's 85033," says Khan.
The statistics published by the Arizona Department of Health Services show that the numbers have not significantly gone down since 1990, and the Phoenix Fire Department's statistics show that the highest concentrations are centered in one tiny area of only a few dozen blocks.
But the statistics so far have not paid attention to any socioeconomic factors, neighborhood commonalities, or any other in-depth research keys. Without these kinds of recordkeeping procedures, it has taken a long time to get even the scant correlations that are just beginning to be drawn. Without adequate tracking and research, the problem can barely be defined, much less solved.
There is clearly a crack in the system, and more than 100 kids per year -- the number of incidents the fire department responds to annually -- are falling through it.
At the center of the "crack" is the "C Shift." The C Shift works at Station 25 on 63rd Avenue and Indian School, in the heart of 85033. They get more drowning calls than any other shift in the nation.
Branden Leon, a firefighter and paramedic who's worked the C Shift for a year, is on duty tonight. He serves up a plate of chicken enchiladas for the station's dinner. When asked about children drowning, his impish smile drops and his hand pauses with a spoonful of tomatillo rice halfway from the pan to his plate. "Man, I've already been on six."
Leon rescued his first near-drowning victim when he was still in training to be a firefighter. "It was my apartment complex. We were barbecuing when I heard my wife scream. I turned around, and there was a kid floating in the pool."
The child's mother pulled the boy out, and was crying, trying to get him to breathe. Leon ran over, pushed everyone out of the way, and started doing CPR and rescue breathing on the 3-year-old child. "I just remember yelling at everyone, Get out of the way!'"
After a few minutes of CPR, the child began to wake up, and vomited in Leon's mouth.
"I didn't think I could handle that, but I had to. I just thought, Hey, it's ice cream, it's my favorite kind of ice cream.' And I just kept going." His efforts were successful. The boy survived and seemed to be fine. He wrote Leon a card the next day. "It said, Thanks for saving my life -- good luck with your training. Love Nathan.'" But that first look at a drowning took a toll on Leon.
"When I went into the bathroom after that to clean up, I looked at my face in the mirror -- covered in vomit -- and I just cried."
Dan Donohue, a veteran firefighter on Engine 725, is clearly sick of drowning calls. "It's all about responsibility. You have to be humble and say, Yes, it can happen to me.'" Though he says that supervision is the number one thing to work on, he also echoes the need for additional barriers. "Barriers give the parents time when the supervision lapses. Without barriers, forget it. Your kid is dead."
When asked why the people in Maryvale aren't getting the message about drownings, several more theories pop up from various firefighters.
Jeff Olson usually works neighboring Station 26, but is subbing in tonight at Station 25. He grew up in the Maryvale neighborhood, and even bought his parents' house years later. He blames the problem on many issues surrounding economics. "When people moved out here in the '60s, this was the nice place to live -- this was the best. Everyone had decent money, and they put in pools. That's why there are so many out here." But, according to Olson, when newer, nicer neighborhoods got built up around Maryvale, the homes fell into disrepair and the property values went down.
"Now you have people who could never before afford a home with a pool getting into these houses and they don't know how dangerous it is," says Olson.
Other low-income areas in the Valley never had the stock of pools that were part of Maryvale's original middle-class status.
The pools built in that era were almost never equipped with pool fences. If they were, when the neighborhood slid, so did the condition of the fence. Over the next 20 years, the pools in Maryvale were largely ignored as single-family homes gave way to rentals and multi-family living arrangements.
People often tell Donohue that drowning-prevention efforts are too graphic. But he says, "If people want to see graphic, they can come down here and I will show them what I have to do to these kids."
"Here, let me show you," he says, as he goes into another room, returning with a box of medical equipment, and assembling the pieces. He puts a long tube into a syringe about four inches in circumference and says, "This gets stuck down your baby's throat and into its stomach." Then, a small metal piece gets forced into the mouth of the child, to open an airway. "I stick this down their throat and pull out this," he says, and he demonstrates how he gets the trachea clear.
He holds up the tube with the syringe. "We suck the water out with the syringe." He holds up the syringe and pantomimes jamming the tube down an infant's esophagus, and draws imaginary water out of the tube with the enormous syringe. His eyes focus on a baby that isn't even on the Formica table. He is looking at a memory of every child he has done this to, mostly to no avail. He runs his hand through his thick, reddish-brown hair, pausing for a minute before continuing to work on his "patient."
He pulls out a bright blue plastic case that holds a wide-bore needle the thickness of a pencil lead. "This gets stuck into your baby's bone. And we pour drugs in through that." All of these steps are to get a heartbeat and start the child breathing again. But it is not always good news when those things happen. He stops, and says, "Now think about the neurological state your baby's got to be in to accept all of this. They're dead. They're just looking for the light."
According to Donohue, in most cases, by the time they get to these steps, it is too late. "You can usually pump enough drugs into these kids to get their heart started. And then you're the hero -- everyone loves you."
But things sometimes change when the parent has to deal with the real-life ramifications of their now-brain-damaged baby. "The next week, they hate you, because look at what you saved."
A member of the Station 25 crew brings out a navy blue canvas gym bag. It reads: "Pediatrics." Inside are several color-coded nylon zipper bags.
Donohue pulls out the yellow bag, on which is written "2-3 year olds" in black marker. He picks it up gingerly, as if it is painful to hold. "This is the one you don't want to get. This is the drowning bag." He opens the bag and shows the contents: pre-measured drug dosages, tiny intubation tubes, and other items that should never be that small.
The sheer volume of drowning calls is taking its toll on the C Shift. The friendly, helpful firefighters turn into a frustrated, angry lot the longer they talk about this subject.
"We need to get pissed on TV when they ask us about it. Everyone thinks that since we're firemen, we should be nice all of the time, but we've got to start saying, Hey, watch your kids or they're going to die,'" says Leon.
Donohue claims that people often look for a guarantee, a fail-safe that will ensure their child's safety. But he says the only way to guarantee that your child will not drown in a swimming pool is to eliminate the pool altogether. "Fill your pool with dirt. That's really the only way to get a guarantee."
Anyone looking to rent or buy a home with a pool without the money to install a fence gets no sympathy from Donohue. "They should just get a different house. Rent a different apartment. Otherwise, there's going to be a tragedy."
Maryvale is a neighborhood of west Phoenix that is generally considered to span from Camelback to Osborn roads, between 49th and 70th avenues. Named for the wife of developer John F. Long, Maryvale was one of the most prestigious areas to live on the west side in the '50s and '60s. Since then, it has slipped into a low-income area as better-heeled residents sought more modern homes in newer suburbs.
One of Phoenix's at-risk neighborhoods, Maryvale looks more unkempt than anything else. Its houses are well-built, sit on spacious lots, and generally have three or four bedrooms. But the veneer is gone. Now, most lawns are sun-scorched, and weeding, pruning, painting and other cosmetic work tends to be a few years, if not a few decades, behind.
Maryvale is a far cry from what most people envision when they think of "low-income" areas. It is not the run-down, makeshift dwellings from old south Phoenix, nor is it the government-subsidized housing projects on the Durango curve. It is, or was, a very well-apportioned neighborhood with pleasantly winding streets and several grassy and park areas. It was never intended to be a low-income area.
It is now a neighborhood on the verge. More than 70 percent of families make less than $35,000 a year. Most residents are young families. Only a third of residents have high school diplomas. And a third of residents in 85033 rent their homes.
The firefighters, and a new community coalition called the Water Safety Task Force, have been blanketing the area with grassroots efforts. They have given out CPR tapes, taught classes in the area, and literally brought water safety information door-to-door in Maryvale.
The root of the problem in Maryvale specifically is a chronic problem of economics. "When you have a family that is lower income, they're going to take the house they can get into financially, regardless of the state of the pool. And they're not going to be able to afford to get the pool up to code," states Khan.
Media coverage, no matter how diligent, is not enough, in and of itself, to close the gap in Maryvale.
"Providing education alone isn't going to solve the simple issue of economics," admits Khan.
All drowning-prevention programs across the country say emphatically that back-up plans are needed to supervision to really ensure the best possible safety plan. No one parent or caregiver can guarantee that they will never lose focus. The CDC states in its most recent report that 70 percent of drowning deaths in Maricopa County could have been prevented through fencing in combination with adequate gates and latches.
The Arizona Department of Health Services confirms CDC's findings. According to internal studies by ADHS' Tim Flood, the majority of problems throughout the year focused upon the lack of pool fences and inadequate latches on fences already in place.
The CDC's recommendations for layers of protection include a pool barrier, access to pool area secured with high locks, alarms on doors, water survival training for the child, and the caregiver having knowledge of CPR. These five layers ensure that when the inevitable lapse happens, you can come as close as possible to having a fail-safe plan. All five things have to fail before the child will drown.
Unfortunately, these "layers of protection" cost money, something that is harder to come by in Maryvale than in other areas with similar numbers of pools.
A personal friend's loss of a family member to drowning prompted Dave Munsey's Emmy Award-winning Watch Your Kids Around Water campaign. Munsey started the campaign in 1980, and he kept it going, despite changing ownership of the station. Munsey states, "Every time we changed ownership, I would have to re-sell the campaign."
Since the new owners were often from other states, they were not aware of the severity of the problem here and just how important the coverage was. "I would tell them in December that I needed money for drowning coloring books, and they'd look at me like I was crazy. Then around July, they'd get it and jump on board." According to Munsey, the most supportive so far has been Fox, the current network affiliate. "They got it right away and they have given me as much support as they can, and gotten the advertising department to recruit sponsors."
Munsey's efforts are known and lauded by every person connected to the drowning effort because his is the face constantly there from the beginning, sweating in the sun, handing out coloring books at every water safety event in town.
The Watch Your Kids Around Water campaign, though, has been a rocky road that oftentimes is a one-man, uphill battle. "I go anywhere, I do anything. If three people show up, and they want to know about water safety, I will give them the speech," Munsey says. There have been many times when there were only a handful of people.
Munsey says that he has always kept his message the same. "I end every broadcast with Remember to watch your kids around water.' Pool fences are important, and so are alarms and all of that. We do pieces about that, too, but the simple fact is that if you watch them every minute, they won't drown."
Munsey's effort was supplemented by Steve Jensen, a former TV news anchor who had begun work as a fire department media liaison. Jensen teamed with Forrest Richardson, an advertising executive with Richardson or Richardson Agency, and Chuck Alvey, then an anchor for local Phoenix Channel 5. They came up with a campaign called Just a Few Seconds. The campaign was based on Jensen's observation that the phrase they heard repeatedly from families was: "I only looked away for a few seconds."
The three-man team played on their contacts within the media, and corralled everyone from anchor people to printers and billboard makers to support and promote the Just a Few Seconds campaign. Its message was clear, concise, and hit the mark on a large scale. It told people to watch their kids constantly.
And it worked -- temporarily.
In 1989, 35 children drowned in Arizona.
In 1990, the number was 17. The number had dropped by almost half.
But in 1991, the number jumped back up to 26, an increase of nine children dying within one year. And it rose a little every year. The per capita rate of children drowning remained steady, scarcely changing at all.
Media efforts were constant, too, combining the public relations campaign with news segments.
Coverage of a drowning was similar on most networks. The anchor usually introduced the story, and the reporter on the scene showed the house, detailing the circumstances. Sometimes, the cameraman got there early enough to show the firefighters working on the child. On those occasions, viewers watched the gurney carrying the lifeless body, its arm loping off the side, dangling like a soaked Raggedy Ann doll.
When watching a decade of footage in rapid succession, the only clues as to which year it is are Munsey's hairstyle and Khan's mustache.
The firefighters turned repeatedly to the media, but by the '90s the press had begun to respond differently. Each outlet began to diversify the campaign, each trying to come up with the new, magic slogan that would cut the numbers again.
After 1990, and over the next 10 years, new campaigns cropped up at almost every television network, radio station and newspaper. There was Water Watchers 12, Enough Is Enough, One Is Too Many, Two Seconds Is Too Long. Over the next few years, the campaigns piled up almost as fast as the dead kids -- and the one thing that each new campaign had in common was a branded, promotional tie-in to the sponsor or network.
The message began to shift and diversify. This resulted in a myriad of messages with the veneer of civic journalism -- not inherently wrong, but less effective than the original, unified effort.
"None of the messages were bad," states Richardson. "It's just that anyone who knows anything about marketing or advertising can tell you that the reason successful products or campaigns work is because they have a consistent message. We lost that."
According to Richardson, the Federal Communications Commission was extremely interested in the late '80s and early '90s in seeing public service announcements (PSAs) on broadcast media. When cable television became king, Richardson says that the FCC was "less impressed" with PSA efforts and stations began to use promotional tie-in spots produced by corporate sponsors instead of traditional PSAs, which had been free of ulterior motive.
Richardson thinks that the shift in the FCC's emphasis was what changed public service announcements forever. "The new thought process of the FCC was what spawned the movement toward proprietary messages.' Now, a network can fill its quota with a spot [paid for] by a for-profit company, and that's just not going to be as effective."
He cites the Partnership for a Drug Free America ads from the early '90s. The ads made the words "This is your brain on drugs" a household phrase. Everyone all over the nation heard and knew these ads. This was the type of PSA that was popular before the shift. Now, the PSAs tend to be branded with a corporate message, and each television and radio station has its own version.
The problems that arise when a PSA is looked at as a money-making tool instead of merely a pro bono piece of airtime is that if a station wants to make money on its PSAs, it needs to sell each issue to a sponsor. This means that, in order to make a profit on the PSAs for drownings, each station has to have its own message that it can sell to advertisers -- which means diluted messages and constantly rotating tag lines to create new opportunities to sell the "paid for by" line.
SRP paid to be mentioned as a corporate sponsor of Target Zero. Its logo appeared in the morning newspaper's ads, and its name was mentioned on Channel 12's spots.
Channel 11, the government access channel, created new, non-promotional PSAs and no one ran them. They were free of charge, but they could not be sold to sponsors, so they only aired on public access.
According to Richardson, the crucial impact is the loss of the unified effort.
"When we started Just a Few Seconds, we had a kickoff luncheon, and every media outlet, possible sponsor and fire department was there. They all signed off on it. But could you get all of those people together in a room today to work on the same project? I don't think so."
Every time a new campaign is planned, many factors that have little or nothing to do with the drowning-prevention effort come into play. For example, if one TV station sponsors a campaign, other stations are less likely to sponsor it. And a recent pool fence giveaway sponsored by Fulton Homes met with opposition from the firefighters because the developer was non-union.
The division and the conflicts have an effect.
According to numbers from the CDC, the mean average of Arizona children drowning from 1990 to 2000 was 25 kids per year. Though better than the previous decade's average of 30, it was a far cry from the drop in numbers that the initial campaign received.
As broadcasters and newspapers tried to coax money out of what was initially proposed as a public service effort, community organizers were left with little to do but go along with the numerous campaigns and hope to sustain the results.
A campaign called Enough Is Enough came out in 2001, sponsored by the Fire Fighters Union local, Phoenix Children's Hospital, Channel 3, Domino's Pizza, La-Z-Boy, and Lowe's hardware. The campaign took a bit of a tougher attitude, stating, "Enough is enough -- take responsibility for your children." But the ads drew complaints because they were very graphic, and a year later, the campaign was shelved.
The Arizona Republic did a canon of stories on drowning incidents, prevention and water safety in 2001.
For the first time, the Maryvale issue was addressed. A single article in the series noted in passing: "There was a cluster of nine drownings in a 13-square-mile area of west Phoenix." The article also stated obliquely that the rate of children drowning in that 13-square-mile area was higher than in a comparably sized block of the East Valley. Maryvale itself was never mentioned by name. Maryvale's unfenced pools were never mentioned. Maryvale's historic role in drowning statistics was not mentioned.
This June, the Republic started a campaign called Target Zero. The campaign was sponsored by Channel 12, azcentral.com, SRP, Univision and La Voz. Target Zero fliers were posted on Arizona Republic stands all over town, and the paper ran full- and half-page ads for the campaign regularly.
Maryvale was identified for the first time in 2002, in the Arizona Republic in a sidebar that accompanied the principal story, in a bullet within the sidebar.
The article, which credited the Target Zero campaign for the drop in drowning, had a sidebar naming a "coalition of city officials, police, firefighters, hospitals, school officials and community leaders" had focused on the Maryvale problem because "there has been a disproportionate number of drownings."
Once again, the issue of pool fences was never mentioned, nor was Maryvale's historic role cited.
According to Jeannine L'Ecuyer, the fire department coordinator of the recently formed Water Safety Task Force, a community coalition did a great deal of on-the-ground work in Maryvale. In addition to this effort, they also put on several events in Maryvale at malls and parks to get out a CPR video, water safety information, and address people on a more personal level. L'Ecuyer says, "We got them face to face and said, Please do us a favor and watch your kids.'"
The coalition did not focus on fences.
The task force had materials in English and Spanish, and went to where the problem was the worst -- canvassing a neighborhood in Maryvale the day after a 2-year-old boy drowned. "We wanted to use that fresh reminder of how easy it is, and how close it is," says L'Ecuyer.
When asked if this year's effort worked, L'Ecuyer laughs. "That's the $60,000 question, isn't it? We won't really know that for a few years. But we think sustained attention is the answer, so we try to hit people from all sides."
Fulton Homes currently sponsors Dave Munsey's Watch Your Kids Around Water campaign on Fox, and also funds KTAR-AM's Two Seconds Is Too Long campaign. Fulton Homes is a Tempe-based homebuilder that builds mostly east of the 101, and in new areas such as Litchfield Park and areas of Peoria. The economic focus of the developer has never been Maryvale.
Douglas Fulton, president of Fulton Homes Sales Corporation, recently sponsored two programs to give away fences. One was called Fence Watch, which urged neighbors to rat out badly kept pools to KSLX-FM, which then referred the information to the fire department, which inspected the pool. The most needy pool each week was given a free pool fence. Fulton built a total of 12 fences. Only one fence was in Maryvale.
Fulton Homes tried to target Maryvale through Spanish radio, and also gave away 750 sets of free swimming lessons at the YMCA. "We realized that there were so many more drownings there and that maybe putting out Spanish ads would help," says Fulton. But there is no YMCA in Maryvale. The closest one to 85033 is more than 40 blocks away.
Leslie's Pool Supplies, which carries many water-safety products, also had a fence giveaway program. It teamed up with the firefighters to provide fences for people who wrote letters explaining their need. This campaign was called Help Us Save Them. A spokesman for the fire department was unable to locate their records, but thought approximately 15 of the 18 fences were built in Maryvale.
Assuming that Fulton Homes, Leslie Pools and the firefighters erected approximately 16 pools in the target area last year, it would take 100 years at the current rate to provide Maryvale with the margin of safety the CDC recommends.
Salt River Project is also in on the effort. It has been sponsoring drowning prevention efforts since it started in the Valley. It also sponsored Target Zero. Jennifer Martyn of SRP says that SRP has been involved in water safety for 100 years. Martyn says that SRP's involvement has always been closely tied to the fire department. "People trust things more when they're getting it from the fire department. We also sponsor several other campaigns, but we've always worked with the firefighters."
SRP's involvement has been one of both cash and trade, the only sponsor that has consistently asked the fire department what was needed and provided the cash to purchase it. It has paid for printing in English and Spanish, reproduction of more than 15,000 CPR videotapes (also in both languages), creation of other items such as can coolers, and has also given time to water safety events all over the Valley. But Martyn confirmed that no specific research had been done, that SRP generally asks the fire department what to do and does it. The good intentions are there, and could possibly be used more effectively if there were a specific understanding of the Maryvale problem.
Even when targeting the area, sometimes the message gets lost. Ironically, the Just a Few Seconds message itself was part of the problem in Maryvale. Since 22 percent of drowning victims and 59 percent of 85033 residents are Hispanic, it was necessary to translate materials into Spanish. But when they translated the Just a Few Seconds message into Spanish, they met with an unexpected problem. John Harrington of the Arizona Drowning Prevention Coalition says, "In English, that means to people, Oh, it only takes a few seconds for my child to drown.' But in Spanish, it translates as, Oh, I have a few seconds that I can step away.'" An Arizona Department of Health Services study also points out that the rough translation of the message in Spanish was, "You have enough time."
The Arizona Drowning Prevention Coalition, one of the most vigorous of all citizen-led groups in the drowning prevention since its beginning in 1989, recently enlisted the help of Sarah Fleury of BJ Communications. The mother of a near-drowning victim herself, Fleury is trying to get other advertising agencies on board. "BJ Communications is a PR firm; we're really not equipped to handle something of this magnitude by ourselves, but it would be a potentially award-winning campaign, and I hope someone sees that potential and agrees to help."
The idea is to get an independent message, free of a sponsorship tie-in. "The dilemma of media or other corporate sponsorship is that the message is stuck with an ulterior motive," says Khan. "Any sponsor obviously has their own reasons for backing a campaign, which usually has as much to do with PR as with saving kids."
But the ideology with the fire department is to take what's offered, because it needs all of the help it can get.
"It's like getting a free lunch. You aren't going to complain about it. Even if it's not your favorite dish," explains Khan.
In the playground at Hacienda de Los Angeles, the bright plastic slides and swings are rock still, not even the wind having the energy to make them play again.
Marisa Martinez is the assistant director of nursing at Hacienda de Los Angeles, which specializes in long-term, permanent care for children with little brain function. She has been there for 10 years, and has seen more children dying from near-drowning incidents than anyone should. Near-drowning victims who live are brain-damaged children left to grow up on life support, with machines functioning for every system in their body.
The ADHS says that, in 9 percent of incidents, the child survives with some neurological impairment. The CDC reports that, of 398 children admitted to a major children's hospital in Arizona from July of 1982 to July of 1989 for near-drowning, 74 (19 percent) died, and 36 (9 percent) were discharged as neurologically impaired. When this happens, they usually grow up alone at a facility like Hacienda de Los Angeles. They live for 20 years sometimes, or more.
Martinez says that, in most cases, parents will choose to take their child off of life support within the first few years. "The average is to live one or two years. But it depends on how aggressive the parent is. Some put in DNRs [do-not-resuscitate orders], and will allow them to pass away -- but it's difficult." Martinez says that, for many parents, the reality of their child's condition is too much to handle. "At first, they come every day, then it slows down. They call a lot after that, and then little by little we don't see them so much anymore."
Tara Axsom is one child who moved over into permanent care. But Tara isn't a child anymore. Tara is 18 years old. She turned 18 here at Hacienda, just as she turned every birthday since her second. She has been a patient here since she was 15 months old, when she fell into the family swimming pool. No one knows for sure how long she was under, but after three minutes, parts of the brain begin to die. Like all near-drowning impairment cases, the chief problem comes from a condition called hypoxia, a condition resulting from the brain being deprived of oxygen. Even a minute of this can cause irreversible brain damage. Three minutes or more causes complete incapacitation. Like Tara.
But not all of Tara's brain died. There is very clearly a little girl still behind her lopsided smile who looks at the people around her, recognizes her nurses, and sometimes looks like she is about to pipe up and say "hello." Her head is swollen and her face has flattened, but her big, gray eyes remain bright, open and constantly looking around. She cannot speak, but can sometimes blink or move her cheek in response to a question.
"We treat her like anybody else because you never know what she can hear. She might get everything but just be unable to communicate back.
"Tara's eyes are fine. But her brain doesn't really know what to do with the pictures it sees. It can't understand them or process them. Maybe she sees shadows, highlights, we don't know," says Martinez.
Tara's daily routine is about the same since she was very young. She has a tube attached to her mouth because, though she can breathe on her own, she cannot keep back the amount of secretions and saliva from her throat and mouth and could easily choke on them if this tube were not suctioning it out on a 24-hour basis. She is fed through a tube in her arm because she cannot swallow.
Her mother refuses to let the nurses cut her long, thick, wavy hair, and the nurses take turns braiding or styling it. Today, it is put into a series of trendy ponytails on top of her head, secured with pink rubber bands to match her bright pink outfit. Soft curls frame her porcelain face and twirl down her pink cheeks. Tara is beautiful, even when you look down at the rest of her.
Her muscles have atrophied to such an extent that they are pulling upward. Her feet and legs have curled up and the bones have followed, leaving almost hooklike limbs. Her hands hold folded white towels because the muscles want to pull the finger bones and nails right through her pink palms. A towel is also placed between her knees so that the force of the leg muscle pulling them toward each other does not damage what is left of her knee cartilage. Tara has developed severe scoliosis from being confined to a chair or bed for so long. Her entire body now fits into the seat of her wheelchair.
Martinez does not know how long Tara will live. "Her family has been great. They really care so much about her, even now. She could stay with us for a long time, but it's hard to tell."
Martinez says that people don't realize how much damage can be done and how soon. "People know that it just takes a few seconds, but they don't know that it only takes three minutes to lose the child, whether they live or not. Just three minutes."
In the city of Phoenix, it is fairly standard procedure to bring a house up to code before it is sold, but it is not mandatory. According to B.A. Waitman, a Phoenix real estate agent, the items that usually come up for review are major appliances, roofs, termite inspection, and other similar repairs, which might put new residents at risk. But inspectors do not even look at the state of the pool or fencing.
"Maryvale pools were built prior to the fencing and barrier codes being adopted. There are no laws governing sellers or landlords regarding this issue," she states.
Sharon Marksbury, the Greathouse boys' great-great-aunt, has seen this tragedy three times in her family already. A fire department employee for 25 years, Marksbury has seen a niece's 2-year-old, and now her grandniece's two boys, drown. "I used to say it can't happen to me. . . . There's nothing you can do to tell people what it's like -- it's like trying to give children your knowledge."
She remembers the boys' funeral, where the brothers were buried together, arms around each other, wearing baseball caps.
"The landlord didn't want to do anything to fix the pool, even though she knew there were kids there. And they [the Greathouse family] can't afford to put in a fence." After the boys drowned, Marksbury says that the landlord filled in the pool.
According to Waitman, the cost of replastering a pool is about $2,500, and various fencing companies have quoted $1,000 to $2,000 to install an adequate barrier, depending on what type of fence is built. This cost could be figured into a home loan for $20 to $50 extra per month on the mortgage, depending on how much repair work needed to be done. The buyer or seller, depending on the sale agreement, could foot the cost of the repair for a minimal increase in a monthly mortgage payment, or minimal cost to the seller than could be incorporated into the price.
FHA loans also allow for some types of home repair to be figured into the mortgage agreement, but the pool isn't on the FHA's inspection list. According to mortgage broker Sandy Coates, FHA loans allow for the incorporation of small amounts such as pool repair at the request of the buyer.
"As long as the improvement is written in the original offer and is done before closing, it would be allowed," says Coates. "FHA is particularly anxious to include anything that would improve the safety of the house, both with the repair to the pool and putting in a fence."
According to Waitman, landlords will usually offer a waiver to the tenant and leave the decision of whether to put in a fence up to them. "Again, 99 percent of the landlords don't care and will not pay the expense to fence the pool or provide door alarms or other barriers," says Waitman.
If the City of Phoenix wanted to tackle this problem in the Maryvale zip code, it would to have to find a way to enact ordinances with a bit more teeth than what is currently in place.
Mayor Skip Rimsza's office declined to comment on the viability of more stringent pool codes, instead referring queries to the Phoenix Fire Department. A caller placed on hold by Rimsza's office listened to a public service announcement about water safety.
Beyond the city governments, there is also the possibility of state-mandated legislation requiring universal codes for pools. This would usurp the cities' individual rights to opt out of fencing ordinances, like in the case of the city of Gilbert. In Gilbert, if there are no children in the house at the time the pool is built, no fence is required. The state does not require that one be put in when the house sells.
But the idea of mandating state controls on parental responsibility isn't the quick-fix it first appears to be. Representative Bill Brotherton of District 20, which encompasses the majority of the Maryvale area, isn't so sure that it would be well-received, or even successful. "I don't purport to be an expert, but if the Phoenix Fire Department felt it would solve the problem, it seems they would have brought that to the city council," says Brotherton. Brotherton is more supportive of local controls than statewide legislation on issues such as this.
"What is necessary in Maryvale isn't really going to be the same in Pinetop or other smaller communities. A one-size-fits-all situation is not going to be an effective one," claims Brotherton.
He compares state legislation on pool fencing and codes to the state stepping into roles best left to families. "How far do we want government to go into this quasi-parental role? Where do you draw the line? Kids run into the street and get hit by cars, so do we start mandating front fences so that kids can't get access?"
Brotherton suggests that the cities themselves look at taking out the grandfather clauses preventing the older homes from being up to code. "But again, you've got people in these neighborhoods who can't afford it. If it's a law, what are they going to do?"
The "less government" argument infuriates former state senator Kathi Foster: "Pardon me, but that's crap. If all parents were decent parents, fine. But it's like with bicycle helmets. You can't ask that kids pay the price for their parents' not doing their job. We have to do everything we can."A major part of the problem with the formulation of a solution is a lack of standardized recordkeeping over the years. The trends in drowning and near-drowning incidents are hard to trace with often incomplete and sporadic tracking that changes tabulation methods every few years. Tim Flood's study includes a disclaimer stating that "there are a number of significant data gaps. Many of these are inherent in a system that lacks adequate funding and personnel to give proper attention to the task."
The CDC statistics do not track incidents, only deaths, and ADHS statistics (which come from the hospitals, not the fire departments) only track drowning and near-drowning, not submersion incidents, while the Phoenix Fire Department tracks all submersions and incidents, including the ones that do not end up at hospitals. Even between the fire departments and the ADHS, the numbers are often very different. None of the statistics figure in how many children are taken off life support or die of complication years after a near-drowning. The various city fire departments each keep fairly similar records now, but this has only been the case since 1999, and they are still different from the statistics of both CDC and ADHS, the agencies that analyze the data. The CDC statistics come out a year or two after the fact, so when trying to trace what has worked and what hasn't, it is almost impossible to say for certain where the numbers came from, and how many children are truly being affected.
Despite the chaotic records, there is precedent for successful public health campaigns in Arizona.
Cathy Bischoff, the director for the Office of Tobacco Education and Prevention Program, is a woman with a similar mission -- quite a daunting one. Her agency is responsible for implementing a multifaceted program to prevent young people from taking up smoking and to implement cessation programs for teens, adult and other smokers.
In 1994, a cigarette tax was passed that led to the creation of the Tobacco Education and Prevention Program in 1996.
"We looked at what the tobacco companies were doing to target people and we followed that example," says Bischoff. TEPP created a program that addressed not only the marketing aspects of the problem, but also the community involvement necessary to really get to the problem where it lived. "We built a comprehensive model to both bring the rate down and increase awareness."
The two major elements that the TEPP program has that the drowning effort does not -- the factors that have led to its success -- are adequate funding, and detailed research on targets, demographics, with programs tailored to each sliver of the problem.
In six years, TEPP and Bischoff achieved a 24 percent drop in their target demographic.
The very idea of questioning the assumptions behind America's longest-running public health campaign proved unsettling to several of the key players.
The spokesman for Gannett, Gene D'Adamo, vice president of community relations for the Arizona Republic, did not make himself available for an interview.
KSLX instructed its public relations agency not to release critical data regarding the station's role in pool safety.
And much of the information that was released only underscored the need for better recordkeeping.
The head of Fulton Homes, Douglas Fulton, had no idea where the pool fences his company sponsored were built. Leslie Pools, the other company that sponsored the construction of fences, likewise had no idea where its barriers were erected. They said to contact the firefighters for that information. The firefighters claimed they were pretty sure that nearly all 15 or 16 -- they couldn't recall the exact count -- of Leslie's fences were erected in Maryvale. But the firefighters could only trace five fences built by the pool company, and only two of the five were in Maryvale.
Data wasn't the only issue.
No one wanted to discuss finances on the record. And yet money was the keystone to this civic campaign.
None of the promotions undertaken by the media, for example, were launched until a financial sponsor was located.
One source intimately involved with the production of the television spots on pool drowning observed, anonymously, "Even Dave Munsey is sponsored. They don't do anything without money, that's just the fact."
Paying cash for sponsorship identification isn't inherently wrong, but the issues in Maryvale involve a commitment of community resources, and therefore the allocation of limited funds is not a small question.
The 1,500-plus pools in Maryvale would need approximately $3 million to fence. Furthermore, they would need an ordinance or a statute to address the issue of their "grandfathered" status. It's all about money.
"If you passed a law, it would be an unfunded mandate," observed the Phoenix Fire Department's Khan. "We are laying people off, and [without funding] it's just going to be a feel-good piece of legislation. Where does the money come from? We don't have the resources to get out and inspect hazardous buildings that are dangerous to the community as a whole, much less to inspect homes that are a risk to a single family."
Are the firefighters prepared to lead the political fight in front of city councils, or at the statehouse, the way they've led so many other civic campaigns?
The question gives Khan pause.
"You'll have people who are opposed and lobbying against it because there is a cost involved," observes Kahn. "We lose a classroom of children a year in a Valley that has two million people. That probably isn't enough to get somebody that involved in it."
Khan's difficult conclusion has certainly proven true in the past, but what of the future?
"We don't have the juice or resources to do something like that," concludes Kahn.
In reality, there are few organizations in all of Arizona with the juice of the firefighters. Firefighters led the fight to change the Phoenix city council elections to district votes and have been a potent political force ever since. One of their leaders is a special assistant to Governor Jane Hull, and no serious candidate for public office tosses their hat into the ring without considering the role of the firefighters union.
The president of the United Phoenix Fire Fighters Association, Billy Shields, says they would back an effort to address the unfenced pools in Maryvale.
"We'd absolutely be behind that," says Shields. "I wasn't aware of the grandfather clauses, but that would definitely help. Pool fences are proven to work. Even if it makes people angry, we should do what we can to get them in everywhere."
Two Seconds Is Too Long. Just a Few Seconds, Target Zero, and Enough Is Enough. Pick the slogan of choice, but with so many messages coming from so many places, the effort just blends into a cacophony of background noise.
One producer involved in a variety of television campaigns could no longer recall a single, specific promotion: "All I remember is seeing sponsor logos over wavy water."
As Bob Khan states, "We need to look at ourselves, look at parenting skills, and constantly remind people what the stakes are." The stakes are that, unless something truly effective is implemented, the Valley will continue to lose around 20 kids per year.
The state is entering the third decade of this effort, and hasn't made any significant progress toward reducing numbers for more than a year or two at a time.
"We are judged as a society by how we protect those who cannot protect themselves," says Khan. "And we're failing."
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