Tanzania

Burn care at Haydom, Tanzania

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

Burn injuries are still one of theĀ 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 HospitalĀ 
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.

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.