“Pinokkio Story” by Joost Bierens

Thursday, 22.09.2022

Reading time 5 mins

It must have been in the middle of the the previous century, that the postman delivered a package at my door that, once opened, appeared to contain a grey ring-binder with the Dutch title “Pinokkio Beademings - Oefenpopje“ (Pinokkio Breathing – Mannikin) on it. Inside the binder were some 40 pages, each neatly arranged in a plastic insert cover. The pages contained colored or black and white photos and pencil-drawn technical pictures. A copy of my first international drowning publication was inserted in the first insert cover. A short note was attached with the remark that I might find the content interesting. The sender, unknown to me, hoped that the production of the device might save many children from drowning. He hoped that I could bring this idea to life.

In the absence of any information, I needed some focus and study to understand what this mystery book meant. Then I realized that this was a teaching aid for learning mouth-to-mouth ventilation. The photos showed a very simple puppet made from house-hold material such a bleach-bottle, a garden hose, a flexible pitcher and the spout of a whipped cream syringe.

One photo showed a line of 9 teaching aids, pictured with different and all-inclusive colored faces of girls and boys. A view pencil-drawn sketches showed the sizes and volumes of the different parts and how to connect them. Several pictures depicted a ball mechanism that apparently had the function to block the airway when the head was not well extended.

I found it heart-warming to receive this simultaneously uncommon and clearly passion-driven information. But what to do with it? At that time, I was in my last year as resident in anesthesiology and about to start a second specialization in emergency medicine. During my medical study, I had been working as a professional lifeguard during my university holidays and had continued my interest in drowning related issues once I started my specialization. Due to several interviews, presentations at conferences, and research publications, some people knew that I had an interest in the resuscitation of drowning, which in the Netherlands has an ages-long tradition to emphasize the importance of ventilation. I concluded for myself that I was a clinician and researcher, no marketing-expert or product developer.

During the years to come, the grey ring-binder sometimes passed through my mind because the basic idea, how to learn ventilation with an absurdly simple device, seemed brilliant. In spite of several removals, including one in which I had to thin out my over 2000-book library, the ring-binder followed me. I sometimes mentioned the idea to resuscitation committee members and even to CEO’s of resuscitation equipment industries to create awareness but gradually the Pinokkio puppet disappeared from my head.

Until more than 25 years later, when SLRG director Reto Abaecherli and I had a conversation, that if I remember well was most of all about climate change and sustainable lifeguarding, about simple resuscitation manikins made by locally available material. I briefly mentioned the Pinokkio story. A few months later, Reto informed that he was planning a concept-changing project regarding Do-It-Yourself manikins, in which I was very honored to be asked to participate. It felt as if I had the opportunity to pay a tribute to the man who sent me the construction manual of the Pinokkio puppet. It felt as though, somehow, the inspiration of the inventor of Pinokkio has remained floating under the clouds and is now inspiring a great project group.

But who was the inventor? On the cover of the binder his name was written: André van der Sluis. In the many years that I possessed his idea on paper, I had time to learn more about him. He seemed to be among the two most significant persons who had obtained the national political support that swimming lessons were a formal part of the physical education of Dutch children. It was largely his work that over 95% of Dutch children under the age of ten are able to swim, even at this moment.

In my memory, the idea of Pinokkio was transferred to me because André had died or was about to die. Once the DIY project wanted to include this story in a webinar, I preferred to check my memory. To my surprise, André is still alive, and I was able to talk by phone with him about the adventures of Pinokkio. He was too weak to tell his story to a wider audience and allowed me to tell this story on his behalf. He had always believed that next to swimming, all children also need to learn how to resuscitate another child in case of drowning. That was the reason why he developed Pinokkio.

Joost Bierens MD, PhD, MCPM (1954) is a retired clinician who had been specialized in anesthesiology and emergency medicine.


Between 2000 and 2009 he was the first professor in the Netherlands nominated with an academic chair in emergency medicine at the VU University Medical Centre in Amsterdam. At this moment, he has a part-time appointment as visiting professor and thesis coordinator for the European Master Disaster Medicine at the Research Group Emergency and Disaster Medicine of the Vrije Universiteit Brussel (Belgium).

In the 70-th of the previous century, he worked as a professional lifeguard at Netherland’s most southern beaches during student’s holidays.

Since then, he has had a lifetime commitment as researcher and activist in field of drowning and other aquatic emergencies. This resulted in a large number of publications and invited presentations at conferences. In 2002 he coordinated the first ever World Congress on Drowning. He volunteers for several national and international organizations related drowning prevention.

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