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Burns are a serious health problem globally. Every year over 300000 people die from fires alone. Many more are killed by burns caused by hot liquids, electricity, and chemicals. In addition, millions of people are disabled and disfigured by severe burns. Survivors of burns often lead a life complicated not only by the physical consequences of the burns but also by stigma and discrimination related to the disability and disfigurement. The vast majority (over 95%) of these burns occur in low‐ and middle‐income countries. People of lower social economic status are at higher risk of burns. People who suffer severe burns and their families are also very often thrown into further poverty as a consequence.
This suffering is all the more tragic because it is so preventable. Rates of burn‐related death are much higher in low‐ and middle‐income countries (4.5 deaths/100000 per year) than in high‐income countries (1.0 death/100000 per year). This discrepancy is one of the largest for any injury mechanism.
In high‐income countries, much has been done to lower the rates of burns through prevention activities such as promotion of smoke detectors, lowering the temperature of hot water heaters, installation of sprinkler systems, and promotion of flame‐retardant children's sleepwear, among many others. For example, use of smoke detectors has been associated with a 61% reduction in the risk of death from residential house fires in the US.1 Multifaceted community burn‐prevention strategies decreased burn‐related hospital admissions of Norwegian children by 52%.2 Moreover, burn‐prevention strategies have been found to be cost‐effective. For example, each US dollar spent on smoke detectors has been shown to result in US$28 (€21; £14) in health‐related savings.3
These advances have been assisted by development of related surveillance systems, legislation, social marketing, and advocacy. Improved burn care has included better capabilities for resuscitation of burn victims, better care of burn wounds through techniques such as skin grafting, better control of infections, and improved rehabilitation. Such improved burn care has also lowered mortality, improved functional outcome, and diminished disfigurement. Further, burn survivor groups have provided needed emotional support, assisting survivors to lead full and meaningful lives. They have also been instrumental in advocacy for improvements in burn prevention and treatment.
Most of these advances in prevention, care, and recovery have been incompletely applied in low‐ and middle‐income countries. WHO and the International Society for Burn Injuries (ISBI) have developed a partnership to intensify international and national action. As a result, the First Consultation on the Prevention and Care of Burns was held at WHO headquarters in Geneva on 3–4 April 2007. Participants included representatives of the ISBI, the International Federation of Red Cross and Red Crescent Societies, Safekids Worldwide, WHO collaborating centers, NGOs, multiple local and national institutions, and several WHO departments.
Experts from 14 countries attended this meeting. These included burn care specialists, public health practitioners with expertise in burn prevention and surveillance, burn victims, advocates, and government officials. Participants included people who have developed innovative responses in both burn prevention and treatment in their own countries. For example, a program in Sri Lanka developed and promoted a safe kerosene (paraffin) lamp, which was less likely to start a fire if tipped over, a major source of burn injury in that country. A program in South Africa has been promoting education on burn prevention for the public and is working on standards for safer stoves. Likewise, efforts to improve care of burn victims in other low‐ and middle‐income countries have included adaptation of new skin grafting techniques to the local circumstances, resulting in better and faster recovery of burn victims.
The major part of the two‐day meeting was devoted to the development of A WHO Plan for Burn Prevention and Care. This strategy will be finalized over the coming months and will address ways to lower the huge burden of burns globally. This builds on previous WHO burn work, such as the Burn Fact Sheet, burn‐prevention material in TEACH‐VIP, surveillance guidelines that have included burns, Guidelines for Essential Trauma Care which includes sections on burn care, and the upcoming World Report on Child and Adolescent Injury and Violence Prevention which will include a chapter on burns. The WHO Plan will address the spectrum of injury control as applied to burns: (1) improving data sources and surveillance; (2) promoting burn‐prevention strategies, including increased use of known interventions, such as smoke detectors and setting of hot water heater temperatures in environments in which they would be effective, such as urban settings in middle‐income countries; (3) encouraging innovative pilot programs to address burn‐prevention priorities in areas where the risk factors have not been well addressed, such as in rural areas and low‐income countries; (4) strengthening burn care services, including both acute care services and longer‐term rehabilitation and recovery of burn victims.
The WHO Plan will augment the activities of many stakeholders worldwide and will catalyze burn prevention and care improvements, especially in low‐ and middle‐income countries. ISBI President Mehmet Haberal stated: “I am convinced that cooperation between the WHO and the ISBI will result in significant contributions to the field. I feel strongly that our mutual efforts will both diminish the frequency of burns and fire disasters around the world and facilitate application of existing treatment modalities to a broader population.”
It should be noted that similar previous WHO processes for violence prevention, traffic safety, and trauma care have significantly catalyzed efforts to increase attention to these problems globally.
For further information, please contact Charles Mock (email@example.com) or go to http://www.who.int/violence_injury_prevention/other_injury/burns/en/index.html where documents related to WHO burn activities can be found.