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Country terribly short of burn care centres

40 plastic surgeons available against a demand for 400

Shaheen Mollah
When the first six hours of suffering burns is called the golden time for survival and wound healing, 12 years is indeed a long time to see a doctor. But this was what happened to Hafiza Begum who was burnt only 40 days after her birth. Why this much delay?
After the fire, the infant had been taken to the local health complex in Natore where graduate doctors are a scarcity never mind a burn specialist. So, little by little, her body contorted as she grew up to a 12-year-old today.
Her poor family managed to
afford a visit to Dhaka Medical College Hospital, which has the capital's lone burn unit, only a few days ago, by when the damage was already done.
1 lafiza's is not an isolated case. Such a fate befalls thousands of others around the country, which is awfully short of burn care centres as well as burn specialists. So, for around 50,000 people who suffer burns annually in Bangladesh and need hospital admission, the 100-bed burn unit at DMCH and 24-bed burn unit at Chittagong Medical College Hospital are the only hope.
"Only one burn unit in the capital can never be enough to treat a huge of number of patients," said DMCH burn specialist Prof Samanta Lal Sen. "instead, we need a full-fledged burn institute, not just for treating patients but for producing new burn specialists and plastic surgeons so that they can be dispatched to the district hospitals outside Dhaka," he said.
"This is because the first six hours into suffering burns is called the golden hours for saving lives and
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wound healing. Treatment is a must within a maximum of 24 hours," he added." But the victims in the distant parts from Dhaka are not taken to this burn unit within six hours, and in many cases 24 hours, because of travel duration or lack of awareness."
"On average, 60 percent of the severe burn victims whom we cannot treat within 24 hours die. This occurs due to acute blood scarcity in vital organs like brain, kidney and liver following injuries,'1 said Dr Tanvir Hossain, another burn specialist at DMCH.
"To cut this death rate, we need more burn units in hospitals outside Dhaka. And for that, the country should have over 400 plastic surgeons instead of nearly 40 that we now have," he said.
The country sees only two new plastic surgeons annually, he said. And that is where lies the need for a burn institute, which would produce at least 20 plastic surgeons a year, he added.
"In a sharp contrast, Hong Kong has 600 plastic surgeons where seven million people live, while we have only 40 here in Bangladesh with a population of 160 million."
Gurrently, seven doctors,
a physiotherapist, an operation theatre technician and a biochemist are all that the DMCH burn unit has, said DrTanvir. "Can you imagine they deal with 33,000 patients a year?"
Prof Samanta said there was not a single nurse right now. "Untrained volunteers are doing the job of nurses, sometimes causing deterioration of the patients' condition.
"Several hundred patients are lying on the burn unit floor since 500 patients are admitted to the 100-bed unit. This is a sight people usually want to spare themselves."
The physician said, "Moreover, the burn unit has been run as a project since its inception in 2003. There is no permanent staff. The authorities have to apply to the directorate of health every three months for funds to pay the staff.
"Had it been an institute, there would have been no worry over funding. In addition, a full-fledged burn institute would have been staffed with psychotherapists, nurses, physiotherapists and lab assistants, because they sometimes have a greater role to play than doctors."