Tauranga's Memorial Park. Photo: Supplied / Tauranga City Council
Four-year-old Nia Lohchab was described as an energetic young girl who was a fast runner for her age. Like many children, Nia could often be found jumping on the trampoline. She had not yet learnt to swim, but she enjoyed playing in water.
But just three days before her fifth birthday, her life was tragically cut short.
The pre-schooler drowned at Tauranga's Memorial Park in 2023.
The findings of a coronial inquriy into Nia's death are now able to be published.
Coroner Matthew Bates concluded Nia's cause of death was accidental drowning. Nia, who was autistic, climbed in the park's water fountain after running out of the sight of her grandfather who was supervising her and her younger sister.
But he said that with summer approaching, it was timely to remind caregivers to always be within reach of toddlers and young children, especially when they were playing outside or around water.
A life gone in minutes
On a Sunday morning, 21 May 2023, Nia, her sister, and their grandfather were dropped off at the park by the girls' father, Coroner Bates' report said.
The park was busy when they arrived at about 9am, full of families and people exercising and walking their dogs.
Just after 9:40am, Nia and her sister ran off in opposite directions. Nia ran to the water fountain, and her sister stayed at the playground, which is about 100 metres away.
Their grandfather went to retrieve Nia's sister first, which took him three to four minutes. Tragically, in that short time Nia was unsupervised, she would die.
CTTV footage shows Nia sitting on the fountain's ledge at 9:41am. She then entered the water bowl of the fountain, walking in first before lying down.
The Tauranga City Council (TCC) operates CCTV cameras in Memorial Park and the fountain is captured during part of a rotating camera cycle.
When the camera returned to the fountain at 9:44am, Nia was lying horizontally in the water bowl.
By the time the camera was back on Nia at 9:46am, she was motionless in the water. At the same time, Nia's grandfather could be seen walking past the fountain, unaware she was in it, before continuing to look for her around the rest of the park.
At 9:51am, a member of the public called emergency services and reported that a young child was lying face down in the fountain, possibly drowned.
Nia was not removed from the water at this time. The person who called later told police they knew something was wrong, but that "it did not seem real" and they did not know what to do.
Police arrived at the park at 9:53am and were directed by another member of the public to the fountain where they found Nia who was showing no signs of movement.
Police immediately removed Nia from the water and attempted CPR. Ambulance staff who arrived later also tried unsuccessfully to revive Nia, and she was pronounced dead at the scene.
Nia's grandfather saw police arrive and followed them until he his granddaughter on the ground being given CPR.
The coroner noted Nia's grandfather had arrived in New Zealand only a week earlier and was unlikely to have been familiar with the park. He did not speak English.
CCTV captured four members of the public near the fountain. The coroner determined at least three people were clearly aware Nia was face down in the water, before police arrived.
The coroner said bystanders should have removed Nia from the water. But he said even if they had, Nia likely still would have died.
He said Nia was first spotted 10 minutes after she was first captured on CCTV lying in the water.
"Police are satisfied that Nia's drowning was a tragic accident with no other person involved.
"Although I agree with that assessment, I am troubled by the fact that none of the members of the public who observed Nia face down and motionless in the water removed her from the fountain immediately.
"The members of the public did not know whether Nia had been lying face down in the water for a matter of seconds or a number of minutes.
"Minimising the period of immersion in water and commencing CPR as soon as possible are crucial steps for increasing the chances of survival."
Coroner Matthew Bates. Photo: RNZ / Jimmy Ellingham
The coroner's recommendations
According to the coroner's report, Tauranga City Council (TCC) advised there had been no reports of drowning or near misses at the Memorial Park Fountain in the 10 years prior to Nia's death. The council was aware that children would get into the fountain.
However after Nia's death in 2023, the Bay of Plenty Times reported that a toddler nearly drowned in the fountain.
The incident sparked a proposal to reduce the depth at the centre of the fountain by introducing a two-layer concrete ring. This was estimated, at the time, to cost $20,000 but the council decided not to proceed.
At the time of Nia's death, the coroner's report states the water towards the outer edge of the fountain bowl was about 5cm deep. The bowl sloped downwards towards the middle, reaching a depth of over 70cm.
Following Nia's death, the fountain was drained and an independent safety review was conducted.
The review made several recommendations to mitigate the risk of further public fountain drownings:
- Consider water safety as a primary design feature for new water builds.
- Where possible, do not install new water features close to play areas, unless it is a purpose-built water play feature.
- Incorporate warning signage to inform caregivers of risk.
- Keep water depth to a minimal level.
- Create a safe edge gradient with grip to enable a child to climb out.
- Consider zero depth where possible.
Following this review, several changes were made to improve the safety of the fountain, which Coroner Bates deemed acceptable.
"The fountain was fitted with an insert at the water surface, which spanned the water bowl and created a zero water depth by allowing water to flow through the insert.
"The aesthetics of the water feature were preserved whilst preventing/reducing the risk of further drownings by eliminating access to a body of water of any depth.
"TCC has also installed appropriate safety signage at some locations advising to keep out of water features. It is recognised that signage relies on a suitable response by an adult.
"Having considered the independent review and subsequent changes to artificial water features already implemented by TCC following Nia's death, I make no formal recommendations
directed at TCC."
Water Safety (WSNZ) also commented on the death in the coroner's report.
"WSNZ asks that I encourage other councils and organisations that manage water features to proactively look at the changes undertaken by TCC to see if they can also incorporate changes to their water features and improve water safety in their communities."
According to WSNZ, since records began in 1980, the only other drowning death of a child under five in a public fountain was in Whanganui in 1995.
However, between 2015 and 2024, there were 47 drowning deaths of children aged under five.
In 45 of those cases, adult supervision was deemed either inadequate or non-existent. Two dozen of the 47 drownings occurred in rivers, lakes, ponds, or other inland waters, and mostly involved the child wandering away from home or a large gathering near a body of water.
"WSNZ considers this suggests that adults can develop a false sense of security in some environments if the body of water is unseen or unthought of when at their own home or attending a gathering at a park.
"WSNZ recognises that in Nia's case, she and her sister became separated, and their grandfather could not be with both at the same time."
A warning to caregivers
Coroner Bates said that to reduce the chances of further deaths in similar circumstance, while he had no recommendations, it was necessary for him to make comments.
"I am mindful that we will soon enter the warmer summer months, meaning an increase in activities in and around water. It is therefore timely to reinforce water safety messaging.
"Contrary to popular misconceptions, a child slipping below the surface of the water can quickly drown, the drowning can occur without any calling out for help, or loud splashing, or any other overt action.
"When individuals drown, they can do so by quietly slipping under the water and if not observed in that very moment can drown before they are discovered.
"A child can slip below the surface in a matter of seconds and drown.
"This is why vigilant and constant observation of each individual child is required when they are near water."
He said as a minimum, toddlers and young children should always be within sight or sound range when playing or exploring.
He said caregivers should be aware of the environment children under their care are in, including any potential hazards.
He also advised having a plan in place for emergencies, including knowing how to perform basic first aid and CPR.
The coroner also relayed WSNZ advice for caregivers to have "contact supervision of all children until at least 8 years of age", in relation to activities in and around water.
"Supervision around water is only effective when it is accompanied by either direct physical contact with the child, holding the child, or holding their hand, or being so close that the moment the child comes into contact with the water, the child can be physically reached."
They said responsibility for a child needed to be expressly with one adult, and if the arrangement needs to be changed, supervision needs to be expressly handed over to another adult.
The water safety agency also reiterated that there must be constant visual supervision of the very young.
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