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For Burn Study Printable Version 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 as the total number of those 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 almost 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 and muscles. 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 every 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 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. Burns are the forgotten global health crisis and deserve the focus of the world community. Like tuberculosis, malaria and HIV/AIDS, disabling burns affect huge swaths of the earth’s population, especially women, school-aged children and those living in poverty who do not have access to care. And like those major diseases, burns can be largely prevented and burn victims can be treated—but only with additional attention and resources. Thankfully, millions of lives have been improved or saved because of the world’s attention on tuberculosis, malaria and HIV/AIDS. Isn’t it time to take notice and makes burns a global health priority too? Please help Interplast spread the word about the burns crisis. i WHO’s Estimated annual incidence (‘000s) for selected causes: by sex, age and WHO subregion 2002. ii Same as above. iii 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 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 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 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 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 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 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 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.
For 39 years, Interplast has provided free reconstructive surgery for those with a variety of birth defects and injuries, including disabling burns. It has restored the ability to walk or to use their hands for thousands of burn victims through reconstructive surgery. 
The economic impact of lost productivity due to fire-burn injuries is $5.7 billion annually in the 16 developing countries in which Interplast works. That is more than Nicaragua's GDP and nearly that of Mali's.(i) This fall, Interplast conducted a study that demonstrated that the devastating consequences of the burns Interplast sees in the field are also a forgotten global health crisis. Consider the following: • Just as many women worldwide suffer a severe burn from fire each year as are diagnosed with HIV/AIDS; “Burns constitute a major public health problem, especially in low- and middle-income countries where over 95 percent of all burn deaths occur,” said Dr. Etienne Krug, director of the World Health Organization’s department of violence and injury prevention and disability. “However, deaths are only part of the problem; for every person who dies as a result of their burns, many more are left with lifelong disabilities and disfigurements.”(iii) Over the decades, Interplast has seen how ruinous and debilitating burns are for the victims and their families. They cause children to stop going to school because they cannot use their hands to write. Mothers cannot pick up their babies because they can no longer bend their arms and fathers lose their jobs because they can no longer walk, plunging a poor family deeper into poverty. The human suffering from burns is immense and Interplast works diligently to restore function and hope. But what does this mean in economic terms, in lost productivity? What is the financial impact of burn injuries globally? Interplast recently examined the economic impact of fire-burn injuries and calculated that the worldwide economic impact of lost productivity due to fire-burn injuries is $80.2 billion a year. It is $5.7 billion annually in just the 16 developing countries in which Interplast works.(iv) That is more than the GDP (gross domestic product) of all of Nicaragua and nearly the GDP of Mali.  Compounding these staggering figures is the fact that the burden of burn injury falls predominantly on the world’s poor; more than 95 percent of fire-related burns occur in low- and middle-income countries. “Not only are burn deaths and injuries more common in people of lower socioeconomic status but, among those who suffer severe burns, it is the most economically vulnerable who are the more likely to be thrown into further poverty as a consequence,” states WHO’s March 2008 report on burn prevention and care.(v) Millions of poor around the world have no access to basic medical care, let alone the reconstructive surgery they need to lead normal, productive lives. Burn survivors are often forced to live with the economic, physical and psychological scars of disfigurement and permanent disability. WHO measures the impact of these kinds of physical limitations in terms of disability-adjusted life years (DALYs); these are calculations of the normal, economically productive years lost due to the burden of having a certain disease or disability, like a disabling burn. Interplast took these WHO figures and multiplied them by the average annual individual income by country to illustrate the economic impact of burn injuries.(vi) Here are a few examples: • In India, where the annual average income is $820, the cost in lost productivity due to severe burns is more than $4 billion a year; “These numbers provide an additional dimension to the burn work Interplast does, beyond the physical and psychological,” said Susan W. Hayes, Interplast president & CEO. “We restore function and movement. We reduce physical limitations. We return people to work. In doing so, Interplast relieves some of the economic burden on developing countries, one patient at a time.” i These numbers only include the economic cost due to lost ii WHO’s Estimated Annual Incidence (‘000s) for Selected Causes, 2002. iii “A WHO Plan for Burn Prevention and Care,” World Health Organization, Geneva, Switzerland, March 2008. iv See (i) v “A WHO Plan for Burn Prevention and Care,” World Health Organization, Geneva, Switzerland, March 2008. vi To calculate income per year, Interplast used each country’s GNI/capita (gross national income divided by the country’s population) to give a rough estimate of the average income per citizen.
 Photo by : Phil Borges Interplast on National Public Radio 
Interplast Grand Rounds in the Chronicle of Philanthropy
Interplast's burn study in
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