Imran came running when his mother called him in for lunch and tripped over a pot of hot water on the stove, badly burning his stomach and thighs. Liviness was standing by the fireplace after her bath when her dress caught fire, burning both her legs. Miracle’s mother was serving him roasted potatoes from the stove when the brick supporting the stove gave way toppling the pot with hot potatoes all over him. Florah was chasing a dog when she fell over a frying pan with hot cooking oil, suffering second degree burns on her back and hands.
These stories are all too common in developing countries like Malawi that lack the necessary infrastructure to reduce the incidence and severity of burns. Most burn accidents occur in domestic settings, where open fires and ground-level stoves are used for cooking and heating. Children under five are especially vulnerable.
Burns are among the most devastating of all injuries. Burn injuries when not treated immediately can lead to significant life-long disability, even death. Without timely medical attention, including skin grafting, reconstructive surgery and physical therapy, burn victims who survive end up with permanent disabilities from scar contractures – the body’s immediate reaction to close up the wound and heal. The scars tighten and thicken skin in the process, impairing mobility and often damaging muscles and nerves as well. This results in fingers fused together, legs and arms bent permanently, chins pinned to chest and other such contractures, rendering the victim disabled and dependent on others for life.
That will not be happening to Imran, Liviness, Miracle or Florah. Even though their burns were quite severe, they were brought to the burn unit at Kamuzu Central Hospital and received excellent medical care for their burn injuries. They are well on their way to a full recovery.
Kamuzu Central Hospital (KCH) in Lilongwe, Malawi serves a population of approximately 5 million. It is the only hospital in the central region of Malawi providing tertiary (specialized) care, with a referral base of seven district general hospitals. Currently, over 75% of all burn patients at the hospital are children under 5.
The hospital’s burn unit was established in 2008 as part of the University of North Carolina Malawi Surgical Initiative, with partners including the North Carolina Jaycee Burn Center and Chris Hani Baragwanath Hospital, to reduce burn mortality rates in the region.
In June 2014, a dedicated operating theater within the burn unit was opened making it possible for burn victims – both children and adults – to receive timely and appropriate surgery and not have to wait for the hospital’s over-booked general operating room to be available. This fully-functional operating room, funded by Johnson & Johnson, is adequately staffed and equipped to enable life-saving surgery every day of the week.
“With a dedicated operating room, patients can be operated on sooner, recover sooner, and get back home sooner,” says UNC trauma surgeon Dr. Anthony Charles, who has been involved with the Malawi Surgical Initiative since 2008. “An operating room within a burn unit is not standard even in hospitals in the United States. Now KCH has the real opportunity to improve burn mortality rates in the region and provide the very best burn care treatment to its patients.”
The average hospital stay for a burn patient is around 4 weeks. Johnson & Johnson also supports the unit’s nutrition program, a key element in the healing process. “Because of the poverty in Malawi many of the children are malnourished to begin with,” adds Dr. Charles. “The burn takes a lot of calories. Supplementing their diet with eggs and milk is essential and makes a big difference in speeding recovery.”
The KCH burn unit and operating theater is staffed by surgical and anesthesia nurses and clinical officers who received specialized training in burn treatment at the Johnson & Johnson Burn Treatment Centre at Chris Hani Baragwanath Hospital in Soweto, South Africa. Their training is part of the Malawi Surgical Initiative, a residency program at KCH supported by the Malawian Ministry of Health that brings together professionals from the University of North Carolina and other institutions to improve surgical training and increase the number of surgeons in Malawi.