In the U.S., drowning is a scientifically rare event, although a much too common tragedy. Because of the low rate of incident, it is difficult to evaluate programmatic efforts. In some low and middle income countries (LMIC), however, the drowning rates are 10 to 100 times that of the U.S. In these settings, evaluation of programmatic efforts is possible. This session will present how much the U.S. can learn from the proven efforts in LMIC and how successful programs may be adapted to work in the U.S.