Citation

Van der Merwe AE, Steenkamp WC. Ann. Burns Fire Disasters 2012; 25(4): 188-191.

Affiliation

Tygerberg Burn Unit, Department of General Surgery, W.C. Steenkamp Department of Social Works, Tygerberg Hospital, University Stellenbosch, South Africa.

Copyright

(Copyright © 2012, Mediterranean Council for Burns and Fire Disasters)

DOI

unavailable

PMID

23766751

PMCID

PMC3664526

Abstract

Burns represent an important health and economic problem in Africa and in the developing countries. Prevention programs in the developing countries are still at an infant phase. It is well known that prevention includes surveillance with data analysis and reporting. With information campaigns, an effort can be made to use regulatory action, to educate the population and modify the environment. The aim of this paper is to identify the risk factors in communities in order to implement communitybased burn prevention strategies, not only on the African continent but also in other developing countries. Effective prevention programs are highlighted. Evidence regarding adequate safety legislation with policing seems to show immediate effects with multiparty involvement and statistical decrease of injury and death. Three examples are discussed where political commitment is mobilised to ensure regulatory action. Other programs are cost-effective and have long-lasting effects, but they take time. Cochrane database system reviews highlighted the problems when people were encouraged to change their lifestyle. NGOs play a definite role in developing countries, and in Bangladesh and Pakistan efforts are being made to curb acid-throwing violence.

Prevention programs that rely on educational strategies alone are not very effective, especially in the developing countries. It is difficult to educate people in matters concerning safety, and knowledge does not necessarily lead to a change in behaviour. Dinesh Mohan sets out clearly that a community comprises many different groups of people, e.g. some who are upset because they have recently suffered a personal tragedy, others taking medications or drugs that alter their behaviour and perceptual abilities, those under the influence of alcohol, and elderly people whose motor and cognitive functions are impaired. One could add those who are worn down by poverty and the daily struggle to make a living. Mohan holds that “we have a societal responsibility to design our products and environment so that people find it easy and convenient to behave in a safe manner. The systems must be such that they are safe not only for normal people but also for those individuals who might belong to any of the groups listed above. These kinds of designs, rules and regulations would reduce the probability of people hurting one another or themselves even when they make mistakes. Such systems are very often referred to as “forgiving systems”.

Prevention of burn injury is the key. In the developing countries effective prevention programs face barriers to their implementation. Adequate safety legislation and policing prove to be the best ways. Thoughtful interventions have reduced burn morbidity and mortality in high income countries. In low and middle income countries it is time to coax partners and governments to do the same.

Language: en

Vernacular Abstract

Les brûlures constituent un problème sanitaire important et économique en Afrique et dans les pays en développement. Les programmes de prévention dans les pays en développement sont encore à la phase initiale. Il est bien connu que la prévention comprend la surveillance associée à l’analyse des données et le reportage. Il faut réaliser des campagnes d’information et faire des efforts pour utiliser correctement les mesures réglementaires, éduquer la population et modifier l’environnement. Le but de cet article est d’identifier les facteurs de risque dans les communautés afin de mettre en oeuvre des stratégies communautaires de prévention des brûlures, non seulement dans le continent africain, mais aussi dans les autres pays en développement. Les programmes de prévention les plus efficaces sont mis en évidence. Les expériences passées indiquent que pour ce qui concerne les questions de législation dans le secteur de la sécurité adéquate il semble que l’intervention de la police produit des effets immédiats, avec une participation pluripartitaire et une réduction statistique dans le nombre des personnes lésées ou décédées. Trois exemples sont présentés où l’engagement politique est mobilisé pour garantir une action réglementaire. D’autres programmes sont rentables et ont des effets durables, mais ils prennent du temps. Le système des données de base Cochrane a mis en évidence les problèmes quand les gens ont été encouragés à modifier leur mode de vie. Les ONG jouent un rôle précis dans les pays en développement, et au Bangladesh et au Pakistan on fait de grands efforts pour freiner la violence de la pratique de lancer l’acide dans la rue. Les communautés sont composées de personnes communes de tous les groupes sociaux. Il doit exister un sens de responsabilité sociale afin de projeter des produits et des environnements qui permettent aux personnes communes de se comporter d’une manière sure. Ces systèmes sont définis “les systèmes qui pardonnent”.