Burn care at Haydom Lutheran Hospital.

Lack of capacity in surgical burn care in sub-Saharan Africa

Burn injuries are still one of the most common and devastating global health problems. The vast majority of burns occur in low- and middle-income countries, particularly in sub-Saharan Africa. Good quality burn care is essential to reduce mortality and disability from burn injury. However, the capacity to systematically provide burn care remains limited in these countries. Also, research on surgical burn care in resource limited settings is only scarcely available. For example, little is known about surgical outcomes in sub-Saharan Africa.

Efforts are needed to have a better understanding of limitation in access and safety of surgical burn care in LMICs. In response to this, Haydom Lutheran Hospital (HLH, Tanzania), in collaboration with Global Surgery Amsterdam, developed a research project to evaluate the access, safety and outcomes of surgical burn care. In August 2017 the project kicked-off with a research project on two main topics: acute burn wound treatments and contracture release surgery. This is the first research project in a sub-Saharan Africa, evaluating on the long-term outcomes of acute burn wound management and contracture release surgery.

Burn research project, Haydom Lutheran Hospital

HLH is a referral and teaching hospital, remotely set in the rural Manyara district. HLH is a private organisation, supported by the national government of Tanzania. The hospital provides all-round services for a catchment area of 2 million people. HLH is the only hospital in the Manyara district providing surgical treatment for acute burn wounds and contractures.

Efforts are needed to have a better understanding of limitation in access and safety of surgical burn care in LMICs

Acute burn wounds

The study on acute burn wounds provides insights into the short and long-term benefits of acute burn care, involving excision and skin grafting. Data on treatment, quality of life and functionality of all patients visiting HLH are recorded for a follow-up period of one year. Next to this, this study also evaluates access to burn care in terms of timeliness, affordability, surgical capacity and safety. During the first year of the study, 66 patients with acute burn injury were admitted to the hospital. 23 patients received surgical treatment of which 19 patients received at least one skin graft procedure.

Contracture release surgery

Patients that undergo contracture release surgery are studies over a period for one year. Patients are included during a short-term reconstructive surgical missions. The surgery is provided plastic surgical specialists from Doctors of the World. After two missions, 34 patients were included and contracture release surgery was performed in 84 joints.