Burns: The Forgotten Global Health Crisis

Nearly 4 million women fall victim to a severe burn from fire each year—the same number who are diagnosed with HIV/AIDS every year. (And like HIV/AIDS in the beginning, burn victims are often stigmatized and isolated.) More school-aged children die of fires each year than of tuberculosis or malaria. Almost all severe burns happen in developing countries where open fires for cooking, heating and lighting are commonplace. Without adequate medical care, burn victims are frequently disfigured, disabled and shunned; they often lose the ability to be productive citizens.

Burns can cause debilitating contractures which restrict crucial functions, like bending an arm or walking, and left untreated can leave one disabled forever. Interplast provides free surgery, for the world’s most impoverished people, and restores their ability to use their hands to eat, to use their legs to walk to school/work, or to use their arms again to care for their babies. And by doing so, it improves productivity and alleviates some of the economic burden on developing countries, one patient, one family at a time.

To learn more about the Forgotten Global Health Crisis of Burns, watch the video or download our factsheets below.

Renowned photographer Phil Borges directed this new short documentary on the problem of disabling burns in Zambia, where there is only one plastic surgeon, Interplast partner Dr. Goran Jovic. It tells the story of 7-year-old Mateo, the impact his disabling burns have on this family and how reconstructive surgery really can make a lifetime of difference.

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Factsheets

The Faces of Burns Burns Factsheet Burn Study

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How Burns Compare With Other Diseases

As the world’s attention and resources focus on three major diseases (malaria, tuberculosis and HIV/AIDS), Interplast has undertaken a study to see how the impact of severe burns compares. The findings are surprising: numbers like 3.8 million women fall victim to a severe burn from fire each year—the same number who are diagnosed with HIV or AIDS every year.(i)

Worldwide, 3.8 million women fall victim to a severe burn from fire each year—the same as the total number of those who are diagnosed with HIV or AIDS every year.

During its 40 years of working in developing countries, Interplast has helped those who survive burns—restoring their ability to walk or to use their hands through reconstructive surgery.

Most burn-related disability is due to permanent tightening or contracture of the skin as the burn wound heals, which occurs when there is no immediate access to adequate medical care. Such burn contractures can severely limit mobility and may damage the underlying nerves. For example, without adequate acute burn care, a burned foot may attach to the shin as the wound “heals” and the skin contracts, consequently eliminating the ability to walk. By releasing contractures, surgeons restore movement and function to the afflicted areas.

Over the decades, Interplast has witnessed the devastating consequences of burn-related injuries—but this study demonstrates that the grave need Interplast has seen in the field is also a health care crisis of global proportions.

Using World Health Organization’s (WHO) statistical databases to compare diseases, Interplast finds that:

•Just as many women worldwide suffer a severe burn from fire each year as are diagnosed with HIV or AIDS.(ii)
• More school-aged children die of fires each year than of tuberculosis or malaria.(iii)
• Three times as many Southeast Asians suffer a severe burn than contract HIV/AIDS(iv); and
• More girls in that region die of fires than die of tuberculosis, HIV/AIDS and malaria combined.(v)

The above statistics describe the scope of severe burns from fires, but do not adequately illustrate the impact a burn has on the survivor, who may be forced to live with the economic, physical and psychological scars of disfigurement and permanent disability. This impact is measured in terms of disability-adjusted life years (DALYs), which is a WHO calculation of the productive years lost due to the burden of having a certain disease or disability, like a disabling burn. With this measurement,

• Worldwide, school-aged girls lose almost as many productive years because of a disabling fire burn as from tuberculosis and malaria combined.(vi)
• African children lose six times more productive years from disabling fire burns than from war.(vii)
• Females in Southeast Asia lose more productive years from fire burns than from malaria and HIV/AIDS combined;(viii)
• School-aged girls in the same region lose 1.5 times more productive years from fire burns than malaria, HIV/AIDS and tuberculosis combined.(ix)
• And even in developing countries with high mortality rates due to rampant disease, girls still lose almost as many productive years due to fire burns as from tuberculosis and malaria combined.(x)

But the ability to show the complete scope and impact of severe burns remains limited; these global statistics do not account for burns caused by means other than fire. The only type of burn statistic currently gathered by the WHO is on burns caused by fires; yet, disabling burns also frequently occur because of electrocutions, hot cooking liquids and acids in cases of domestic violence—and those disproportionately impact women and those living in poverty, especially in developing countries. Therefore, the prevalence of burns and its impact on women and the poor is higher than the WHO data present. . In developing countries, it is speculated that fire burns represent only around 60 percent of all burns. While one cannot assume that ratio for burns worldwide, it is reasonable to conclude that the problem of burns may be significantly higher than presented here.

(i)Source: WHO’s Estimated annual incidence (‘000s) for selected causes: by sex, age and WHO subregion 2002.

(ii)Same as above.

(iii)Source: WHO’s GDB 2002: Deaths by age, sex and cause for the year 2002. Children 5-14 who die of fires each year: 34,180; of tuberculosis: 33,182; of malaria: 15,633

(iv)Source: WHO’s Estimated annual incidence (‘000s) for selected causes: by sex, age and WHO subregion 2002. The sum of HIV and AIDs in SEARO is 1,211,000; fire burns in SEARO: 3,641,000.

(v)Source: WHO’s GDB 2002: Deaths by age, sex and cause for the year 2002. Girls 5-14 who die of fires each year, 9700; of TB, 6337; of HIV/AIDS, 2105; of malaria, 352. Last three together: 8,794.

(vi)Source: WHO’s GBD 2002: DALYs by age, sex and cause for the year 2002, World. Girls 5-14 DALYs from fire, 1,373,826; from TB and malaria, 1,423,693.

(vii)Source: WHO’s GBD 2002: DALYs by age, sex and cause for the year 2002, AFRO. Children 0-14 DALYs from fire, 1,659,465; from war, 259,774. 259,744 x 6 = 1,558,464.

(viii)Source: WHO’s GBD 2002: DALYs by age, sex and cause for the year 2002, SEARO. Females DALYs from fire, 4,634,030; from HIV/AIDS , 3,031,666; from malaria, 1,288,938.

(ix)Source: WHO’s GBD 2002: DALYs by age, sex and cause for the year 2002, SEARO. Girls 5-14 DALYs from fire, 841,284; from tuberculosis, HIV/AIDS and malaria, 533,466.

(x)Source: WHO’s GBD 2002: DALYs by age, sex and cause for the year 2002,Developing Countries High Mortality. Girls 5-14 DALYs from fire, 1,186,752; from malaria, 544,525; from tuberculosis, 681,562; malaria and tuberculosis combined, 1,226,087.

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In the News

The Chronicle of Philanthropy: Surgeons Go Online for Help With Cases

The Washington Times: Burns a 'forgotten' crisis

NPR: Sri Lankan Burn Victims Build New Lives

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