Burn injuries: A preventable cause of disabilities and loss of lives

A burn is an injury that happens when skin touches hot liquid, steam, certain chemicals or fire.

Sometimes, burns are minor and can be treated at home. Other times, burns are life threatening and need advanced medical therapy at hospital. Even in the developed centres with well-equipped medical centres and well skilled burn specialists, patients with severe burns are at times hard to manage and end up losing their lives.

According to World Health Organization (WHO), burns are a global public health problem, accounting for an estimated 180,000 deaths annually. The majority of these occur in low-and middle-income countries and almost two thirds occur in the WHO African and South-East Asia regions.

In many high-income countries, burn death rates have been decreasing, and the rate of child deaths from burns is currently over seven times higher in low-and middle-income countries than in high-income countries.

Children under five years of age in the WHO African Region have over two times the incidence of burn deaths than children under five years of age worldwide.

Non-fatal burns are also a leading cause of morbidity, including prolonged hospitalisation, disfigurement and disability, often with resulting stigma and rejection.

Contrary to other injury patterns, females have slightly higher rates of death from burns compared to males, according to World Health Organization statistics.

Along with adult women, children are particularly vulnerable to burns. Burns are the fifth most common cause of non-fatal childhood injuries. While a major risk is improper adult supervision, a considerable number of burn injuries in children result from child maltreatment.

According to Center for Disease Control (CDC), younger children are more likely to sustain injuries from scald burns that are caused by hot liquids or steam, while older children are more likely to sustain injuries from flame burns that are caused by direct contact with fire.

Burns occur mostly at home and workplaces. Children and women are usually burned in domestic kitchens, from equipment containing hot liquids or flames, or from explosions. Men are most likely to be burned in the workplace due to fire, scalds, chemicals and electrical burns.

People with mental disorders and disorders of seizures are at increased risk of getting burns. Hence, people with conditions such as epilepsy need maximum caution and should stay away from any possible cause of burns.

Other known risk factors for burns include; occupations that increase exposure to fire, overcrowding and lack of proper safety measures, alcohol abuse and smoking, easy access to chemicals used for assault (such as in acid violence attacks) use of paraffin as a fuel source for non-electric domestic appliances and inadequate safety measures for liquefied petroleum gas and electricity, and many others.

Common preventive measures usually under looked yet very easy and not costly to institute and can be very effective against most causes of burns in all settings include; supervision of young children at all times when they are in or around the kitchen and bathroom, keeping hot foods and drinks and all kitchen appliances out of reach of young children, taking care when serving or walking with hot drinks when young children are around and checking the temperature of the water before putting a young child in the bath.  Children and their caretakers at home should be educated about burns, possible causes and consequences.

Other measures include use of water thermostat heaters which limit temperatures of water in bathrooms and taps, fire alarm systems in the workplace and homes if one can afford. Ensuring strict control measures against inflammable substances such as petroleum, cooking gas at places or work as well as homes can limit burns due to such related explosions.

 Dr Ian Shyaka , Resident in Plastic surgery, Rwanda Military Hospital,