Improving burn care in Tanzania
Treating burn injuries is complex and time consuming; often only the most dedicated healthcare staff chose to remain in this work. Issues common to low resource settings include the lack of trained multi disciplinary staff, limited prevention measures and little focus on, or funding for, burns. These issues prove intractable barriers to improving the quality of burn care globally.
The burn unit at Bugando Medical Centre (BMC), Mwanza, Tanzania is a plastic, burn and reconstruction unit that aims to be a centre of excellence in the region. Weill Cornell Medicine, New York, has a long standing and successful partnership with the Centre that includes clinical training and fellowships.
Through collaboration with Jim Gallagher, Director of the William Randolph Hearst Burn Centre, New York, Presbyterian Weill Cornell Medicine and Francis Tegete, Director of the Burn Unit, Bugando Medical Centre, and with the generous philanthropic support of Julia H. Merck and Hans P. Utsch, Interburns delivered a 4 day training programme for 38 burn staff from across Tanzania, and 2 staff from Uganda. The programme included:
Essential Burn Care (EBC). This course aims to engage and inspire doctors, nurses and therapists and give them the skills needed to treat patients with moderate sized burns, and safely manage the early stages of patients with more major injuries.
Basic Burn Care (BBC) focusses on first aid for burns and community prevention to support primary health care workers and community volunteers. The training was led by the Interburns regional team from Nepal which has much experience in developing and leading community burn prevention initiatives. Participation of a local community organisation from Tanzania, enhanced the workshop.
Surgical case studies. 25 doctors, surgeons and nurses attended to discuss and consider different aspects and challenges including how to prevent problems and prioritise. The burn team as a ‘caring’ team, not only clinical, was highlighted through cases involving potential end of life and palliative care decisions.
Burn rehabilitation. The aim of the day was to give in depth knowledge and skills in burn rehabilitation to a wider group of therapists. The team was led by Interburns rehabilitation lead Alberta Rockson (Ghana) supported by Mercy Agtuahene (Ghana) and Megan McCarthy (US). It is hoped that further training through Advanced Burn Care (Rehab) may be possible in future.
Nursing ward round. Interburns Nursing Lead, Dominique Potokar (France), and Ziphilly Sichinga (Malawi) accompanied nurses during their morning ward round. There were 4 burn patients as well as patients with major contractures, a child with a snake bite, and a late presentation with infection.
Review of the 2021 Delivery Assessment Tool (DAT). In November 2021, the burn team at Bugando Medical Centre ran a DAT focus group discussion to understand strengths and weaknesses of the burn unit and to prioritise areas for improvement. The mission was an opportunity to discuss findings and draft recommendations for quality improvement projects.
‘Burn injuries are one of the most devastating injuries and a global public crisis. We need to improve the quality of care of this neglected disease to reduce the high morbidity and mortality rate. We have a lack of medical personal as well as established burn units. Burns cause severe social and economic impacts. I am proud to host this global event. Please work with us to make BMC a centre of excellence in Tanzania and East Africa at large’. From the opening speech by Dr Masaga, Director of Bugando Medical Centre