Burn injuries are among the most frequently occurring injury types for pediatric patients in most developing countries. The injury, the treatment, and the rehabilitation process following a burn affect children not only physiologically, but psychologically as well. Children often demonstrate poor prognoses due to scarring, contractures, joint and tissue deformities, and functional limitations. The physical and emotional scars make their lives more difficult. In addition, the long and painful scar treatment required for these patients comes with significant financial burden for parents and society.

In the US, burn treatment is expensive and aggressive. The early care often consists of a combination of wound management, nutritional support, pain management, acute surgical management, and rehabilitation. As a result of early intervention, deformities are often prevented. However, in most developing countries this aggressive, team approach to the problem is the rare exception. Often, children and women that suffer burns experience prolonged wound healing, little to no dietary or pain intervention, and extended hospitalization. The burned tissue heals slowly resulting in profound scar formation.

Rehabilitation and surgery are often never experienced and the victim of the burn is released with early deformities. Over the subsequent months, the deformities worsen. There is no champion for the problem as there are often limited funds available. As is the case in the US, the clinicians capable of managing this problem seek opportunities elsewhere to support their personal and familial needs.

With the lack of a patient champion and structured intervention during the acute stage, the child or woman burned suffers further from an outpatient healthcare structure that is unfamiliar with the case and often unable to manage the incredible deformity. There are very few medical workers focusing on any aspect of burn management as the patient population often reflects the poorest of the poor. There is often no psychological support for the victim or family and any chance of “normality” is gone.

Consider the following statistics:*

• Just as many women worldwide suffer a severe burn from fire each year as are diagnosed with HIV/AIDS.
• More school-aged children die of fires each year than of tuberculosis or malaria.
• Three times as many Southeast Asians suffer a severe burn from fire than contract HIV/AIDS.

The statistics referenced above represent burns resulting from FIRE alone. The World Health Organization currently does not track burns by other means nor burns specific to the pediatric population. However, for developing countries, the accepted burn incidence is 0.005% of the general population per year. That means that in any given community, one person for every 200 people will get burned per year. That adds up to 5,000 people burned per million in a given year. Ten percent of the overall incidence will demand some medical service and resources.

Sixty percent of all burn patients are older than 15 years (considered adults) and the remaining 40% are under 15 years of age (considered children).

*Statistics provided by World Health Organization statistical database-Interplast Study Fall 2007

The focus of the rehabilitation program is to provide high quality, clinically effective services that include (but are not limited to) compression garments, custom splints, and Uvex masks. This program provides access to supplies and equipment necessary to support the different treatment modalities. The use of the IWCBF database provides telemedicine education and assures quantitative outcomes. Digital photography substantiates the clinical outcomes.

The use of burn compression garments and splints can dramatically reduce the severity of scarring and improve long-term outcomes. The use of garments, masks, and splints is the standard of care in the US. Unfortunately, this low-tech, high-yield intervention is too expensive for impoverished families in developing countries. In the US, custom compression garments cost more than 100 US dollars each, splints are 125 US dollars, and a custom mask costs 1000 US dollars. The families helped by IWCBF earn in many cases less than a few dollars per day. The IWCBF has successfully provided these custom items for 3-5 dollars each. This simple intervention considerably improves aesthetics and functional use of the burned tissue.

In more than 90% of the cases, this method of care prevents the need for surgical reconstruction. There are few if any such programs available in developing countries. Providing this low technology, with the three medical rehabilitative components combined, offers a cost-effective approach that requires minimal staffing and limited low cost technological equipment.