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January 20, 2005
Rebuilding lives
Burn victims not only have to struggle with a changed appearance, they also have to deal with how others perceive them, writes Faiza Ilyas
Hundreds of people are injured in accidents or burned in fires each year with many suffering from severe disfigurement. These burn victims not only have physical scars, but deep emotional ones, too. However, they can lead constructive lives if they have access to advanced medical treatment and proper rehabilitation.
In our society, a majority of the burn victims suffer in silence. The reason being the scarcity of modern burns units in the country and the high cost of its treatment. They have no hope but to put up with the insensitive attitude of people around them and spend the rest of their life in isolation.
Feeling the plight of burn victims, especially children, the NGO Healthcare and Social Welfare
Association (Haswa) was formed some years ago and it started a programme in collaboration with the Houston-based House of Charity. Under the programme, children suffering from severe physical deformities are sent abroad and treated at the Shriners Hospital in Texas.
Recently, Haswa invited Dr W. Geoff Williams, a plastic and reconstructive surgeon at the University of Texas, Galveston, to Karachi to speak on cleft lip and palate surgery and reconstruction of a burned face. The lecture was attended by doctors, students and burn victims.
Describing the face as the most important part of the body to communicate with the world, Dr Williams said it’s function was more than just a means to eat, see and smell. The burn victims not only had to struggle with the perception of their changed appearance, they also had to deal with how other people perceived them. They suffered both functional and emotional trauma which could be alleviated through reconstructive surgery.
Dr Williams explained the different types of surgery techniques. He termed flap tissue technique better than the skin grafting technique. “The facial muscles are used to a lot of stretching and the skin transplanted through skin grafting becomes darker, wrinkled and harder over time. If lips become deformed they are the most difficult part on the face to deal with.”
Skin grafts, he said, were good for lighter skin with thin pigmentation. He also showed the results obtained with the help of tissue expander and said that a surgeon should not leave any vertical scars in the middle of the neck as this part of the body was the most stretchable. He added, “Plan your surgery well. Talk with the patient about what changes he wants and what bothers him the most. But do not give him false expectations. The priority should be to make the vital organs functional.”
He also emphasized the need for emotional support for the patient from family, friends and society and said that they could play a vital role in building confidence and self-esteem in the patient.
Dr Mazhar Nizam of Patel Hospital, who has been selected for a fellowship at the University of Texas under the Haswa-House of Charity programme, said that one of the major complications involved in the surgery of the face was that the skin type differed from one part to another part of the face. For instance, the skin close to the eyes was different from the one on the cheeks. Reconstructive surgery, he said, was just the beginning of the whole process of rehabilitation.
Dr Nizam said, “Pakistan has few functional burn units and the majority are not properly working. The treatment is also very expensive. What the government needs to do is to initiate public-private ventures to fill up this void.”
About prevention, he said, that an awareness campaign was needed to make the public, especially women, aware of how to avoid common hazards at home.
For instance, stoves should not be placed on the ground, women should avoid wearing a loosely wrapped dupatta in the kitchen, they should not light a match stick if they smell gas, should not pour kerosene oil in a burning stove and always use a torch instead of a candle while pouring petrol in a generator or near a sewerage line or water tank where dangerous gases can accumulate.
Sharing his emotional trauma, Syed Atif Bashir, a burn victim, said it hurt when people look at him and then turn away in fear. Bashir has gone through multiple surgeries which have cost him over Rs400,000, so far. He was burned by some miscreants two years ago. This incident shattered him and his family as they were preparing for his marriage. Life is not what it used to be for him, but small significant improvements in physical appearance through surgeries have made him strong enough to be able to play a constructive part in society.
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