Of the all government hospitals in the country, only the DMCH has a burn unit.

"The burn and reconstructive surgery unit's coming into full operations is a significant accomplishment," retired British Plastic Surgeon Ronald William Hills told The Daily Star yesterday. "At the same time, much remain to be accomplished yet, as every year some 1.5 million people receive burn injuries in the country and the medical manpower is too little here to serve them properly," he observed.

Hills is now visiting Bangladesh as a member of the British plastic surgery team 'Healing the Children'. He said people deserve better treatment. And the government, physicians and people must understand the necessity of upgrading the unit to an institute for the sake of proper treatment of the huge number of burn patients.

Echoing the British surgeon, DMCH Burn and Plastic Surgery Unit Project Director Dr Samanta Lal Sen said most of the burn victims get inadequate treatment at hospitals and clinics not equipped to treat such patients, often causing permanent physical deformities.

He said if the unit is turned into a post-graduate institute, it could train doctors in burn treatment and plastic surgery, and thereby increase the number of burn specialists in the country.

REAL LIFE CASES
A victim of a dowry dispute, Sufia, a mother of two, of Dinnathpar village under Lohagara in Narail district, was admitted to the DMCH in October 2004. Several months ago, her husband and in-laws doused her with kerosene and then set fire to her, burning her severely.

Her neighbours took her to Narail Health Complex. After being shifted from hospital to hospital for several months, she was finally sent to the DMCH, where the doctors had to amputate all the fingers of her left hand and two of the right, as they were beyond cure.

During a visit to the DMCH last week, The Daily Star saw how Sufia's skin had shrunk and her legs and hands become stiff as a result of not getting proper treatment in time.

Another patient, a four-year-old orphan named Anamika hailing from Kishoreganj, whose cheek and hands had been burnt at the age of only three months, was found struggling with her twisted fingers. Reconstruction of the girl's fingers will require plastic surgery, which is very costly. But if she had received proper medical care immediately, her fingers would be fine, burn specialists said.

People who do not get proper treatment within the first few days of getting burnt may lose normal functioning of their injured hands, legs or necks. Skin grafting is needed if the wound remains raw for two weeks. Often the limbs would become rigid if proper treatment is delayed, said Professor AZM Salek, head of the DMCH burn unit.

"Most of our local medical centres don't have proper provisions for skin grafting. Even our burn unit can't do it properly for lack of manpower. Moreover, lots of people with burn injuries come to the DMCH after six or seven months of the incidents. By that time the damages have gone beyond any scope of cure," he added.

The situation can be changed if the DMCH burn unit is turned into a burn treatment and plastic surgery institute, said Dr Samanta Sen. It would be a prudent thing to do, since the unit already has two six-storey buildings that could be used by the institute, he said.

"As the institute would generate manpower it would be able to work round the clock. The burn unit is now providing full service to the patients only until noon," he said, adding setting up burn units in every medical college and hospital across the country is an imperative.

There is a severe seat crisis in the DMCH burn unit, which has only 50 beds now and expects to get 50 more beds soon, the authorities said.

On top of that, other hospitals send their patients with burn injuries to this unit, aggravating the crisis, said Samantalal.

"Patients with burn injuries are admitted to the casualty ward first instead of the burn unit, since there is a scarcity of seats. This has resulted in an onrush of burn patients at the casualty ward, creating sufferings for other patients, as they are not getting seats here," said a nurse at the DMCH casualty ward.

Dr Sen said patients with burn injuries take much time to heal and they also need much care and attention. "So a patient has to occupy a seat for a long time. But the scarcity of seat sometimes forces us to release them before they are cured, which we should not have done."

"But we always visit the burn victims in the casualty ward and try our best to treat them," he said adding that actually they have nothing to do with the onrush of patients as the seats and the budget are already limited.

"Though the burn unit will have 100 beds by June, we think it should have 500 at least. It will require 50 medical officers and at least 100 Class-Four employees in the unit, which is now operating with only 12 doctors treating 70-80 patients a day," said Samanta Sen.

"We are in more pressure during the winter, when the number of accidents increases, since people warm themselves by sitting beside fires and use hot water for different purposes," he went on.

The number of burn injuries from electric shocks is also very high, which take place mostly in slum areas, he added.

Sen also recommended a countrywide awareness-raising programme to reduce the number of burn injuries.