April 2012

Children with Burns

Your effort can save the children

Although medical treatment can help reduce symptoms, severe burns cause a great deal of pain and can lead to serious changes in your life or even death. Unfortunately, these terrible tragedies occur to children every day in Bolivia. It is clear that prevention is the best hope to reduce the numbers of so many young victims. What is the most important thing to remember and what means of prevention can we learn? Dr Romero, a burns specialist at Viedma Hospital, Cochabamba, and Yuji, a Japanese nurse volunteering there, give us some insight into these issues.

By: Shiho Koyama
Projects Abroad Volunteer
Osaka - Japan

Dr Romero checking burn child
Photo: Yuji Yamamoto

"Awareness and prevention must come first. The medical service is the tertiary stage of this process and the supply of the medical assistance has limitations. I hope that Bolivia will be a country which does not require any medical treatment for burns,” said Yuji. He has volunteered to work at Viedma Hospital and every day is faced with children with burns. Having had only a few cases of such tragedies during his seven years working in Japan, he wondered why it occurred so often and how these burns can be prevented. Dr Romero felt the same. When I interviewed him, he strongly mentioned the importance of prevention, “Injury prevention practices should be carried out more often.”

”Many children suffer from burns caused by accidents, punishment by parents, or lightning.”

It is certain that only medical professionals can provide medical aid to injured children. However, prevention is more important than treatment. Creating a culture where burn incidents do not happen is no mean feat. It is down to Bolivia to educate its people with the knowledge necessary to prevent these incidents. Raising awareness of burn incidents and prevention can be done in the home or workplace.

Although pediatric burn statistics in Bolivia are hard to find, it is a fact that, many children suffer from burns caused by accidents, punishment by parents, or lightning. Here in Cochabamba, every day, injured children aged 0 to 15 are admitted to Viedma Hospital. Since this hospital has a specialized ward for burns, the biggest one in Bolivia, the seriously burned children from other cities are also transported to the emergency department at Viedma Hospital. Unfortunately, all fifteen beds are normally occupied. From early morning, operations are performed on the children, averaging 1200 per year. It is appalling to learn that every year around 2400 children receive medical treatment in this department. However, figures are not just figures. This is how many children have been hovering between life and death. Needless to say, there is a bigger story behind the statistic.

Burn detail children face
Photo: Yuji Yamamoto

Behind each figure, there is grief. Burns cause a great deal of pain and may lead to serious changes in a victim´s life. It can permanently influence every aspect of their life including continued pain, a changed appearance, discrimination and the risk of other diseases. A young boy – moaning in agony – had third degree burns (the most serious level) on nearly 70 percent of his body due to the hot water which his parents put on him. It is generally said that burns covering more than 20 percent of a child’s body will threaten their life. Almost all of his body parts are wrapped in bandages and his face was a melted mass. “I am most concerned about how he feels about other people’s reactions to his face,” said Yuji, with a gloomy voice. Entering a silent ward, infants with bandaged legs were sleeping. Though their faces were peaceful, their burned genitals were covered in blisters and rashes. In addition, children under four have a higher risk of complications – such as infections – which is the major cause of death in burn victims.

“A young boy had third degree burns on nearly 70% of his body due to the hot water which is parents put on him. It generally said that burns covering more than 20% of a child’s body will threaten his life.”

A countryside girl, 14, who was struck by lightning on her way home, just stared fixedly. Unlike other cases, her body – even her chest – appeared to be badly charred rather than the blistered, red wounds I had seen earlier. These tragedies occurred with unusual causes, but by things you can easily imagine. Nearly 85% are injured by hot water, followed by fires and oils from cooking. Most cases are avoidable if you have enough knowledge. However, in almost all cases, including punishment by parents, burns are completely preventable by education.

Is it so hard to avoid burns? The answer is related to the fact that almost all accidents occur in rural areas, and the home is the most common setting. Unlike urban home designs, some rural houses have only one room. There is no distance between the kitchen and the beds, so if a fire starts, it easily spreads and burns everything. Also, living conditions in the countryside are different from those in the city. Since both parents work, children have to spend the day by themselves and children aged over nine also make a lunch. Almost all accidents occur when children cook and play with fire. However, Dr Romero insisted that the fundamental reason is not environmental factors. “It is the difference of just how much information people have. It is a lack of knowledge and education.” There are low literacy rates in rural areas and, in addition, people usually speak Quechua and Maia while the widespread information about burns is written in Spanish. These factors make it difficult for them to access accurate knowledge. “Truly, parents did not even know about burns until they came here with their burned children,” said an angry Dr Romero.

Dr Romero
Photo: Shiho Koyama

When asked how these conditons could be resolved, “Impossible,” answered Dr Romero “The origin of all aspects of this issue is poverty. We cannot solve it without a huge amount of money or without governmental commitment.” Having known the real situation through all of his activities, including his foundation – Mosi Ph’unchay – to develop burn education, these must be his true feelings. It is also his simple message to us; he just wants all of us to think of a solution.

So how can people access information when they cannot read and write? What action can we take at local level? As you may have realized, an effective way is through community and individuals. It seems obvious that community-based burn prevention programs should be carried out in rural areas. However, those who can organize this have not realized the importance of burn education. With a smile, Dr Romero finally reported the result of his ongoing activity “Telemaraton”, which connects injured children to people who support them. “Donations from both individuals and local companies reached $us 250,000. It was quite huge.” With all the effort people made, it raised his hopes that the number of burn injuries can be reduced because this donation proves that his sentiment is shared by numerous people. So, let us change your kindness into power to improve society. Gain accurate knowledge and then do what you can do at your level. Your actions will definitely save the children.

What You Need to Do How to Prevent Burns

  1. Place appliances such as a kettle on stable surfaces, out of reach of children and away from flammable substances.
  2. Teach children about fire safety and the hazards of fireworks.
  3. Keep a close watch on children while a kettle is heating up and you cook.
  4. Know about and practice fire escape routes at home, work, and school.

For Burns

  1. Run cool water over the burnt area and keep it submerged for 10 minutes.
  2. Prevent low body temperature.
  3. Remove any clothing that has smoldering materials, but do not remove burned clothing that is stuck to the skin.
  4. Get medical help if the person has a blister, or electrical and chemical burns.
  5. Do not rub ointment into the area of burns.
  6. Cover the burn with clean gauze.
  7. Do not give them water and food if the injured person might need an operation.
  8. Move the injured person to a safe place.

For major burns

  1. Use stop, drop, and roll
  2. Use thick material (e.g., blankets) to smother flames or water to douse flames.

Resource: Agua antes que nada Fundacion Mosi Ph’unchay

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