India launches major programme to treat burn injuries

A committee of cabinet ministers in India has approved a fully fledged national programme for the prevention and management of burn injuries.

The government set up the programme as a pilot project in 2011 after years of lobbying by the National Academy of Burns India. The campaign was spearheaded by J L Gupta, the former head of the department of plastic surgery, burns, and maxillofacial surgery at Safdarjang Hospital in New Delhi. The national programme will be implemented over the remaining period of the government’s 12th five year plan (2012-17).

The academy has estimated that around seven million people receive burn injuries every year in India. Of these, around 700 000 need hospitalisation, 250 000 are left disabled, and 150 000 die. “A large number of these patients are poor and cannot afford treatment,” said Lalit Makhija, a member of the national advisory and monitoring committee that outlined the programme.

Makhija, who is head of the department of burns and plastic surgery at Dr Ram Manohar Lohia Hospital in New Delhi, told the BMJ that the current infrastructure in India was inadequate for treating patients with burns. “Our estimates suggest that there are just 800-1000 beds dedicated to burns patients in the country,” said Makhija. He said that major causes of burn injuries in India included kitchen fires and electrocution, adding, “Illiteracy and poverty also add to the problem.”

Under the pilot project one medical college in each of Assam, Haryana, and Himachal Pradesh was equipped with a burns care unit. Similar units were also established in at least two district hospitals in each of these states.

Makhija said that a lack of data on burns patients and injuries was a major problem. “One of the goals of the programme is to establish a national level registry for burn injuries. The registry allows collection of data about burn injuries and patients down to the level of primary health centres,” he said.

Gupta said that 67 colleges would be equipped with modern burns units, each with an intensive care unit for treating serious injuries. In addition, he said that there would be provisions for a high protein diet and rehabilitation for burns patients. “A well equipped operation theatre will be added in each medical college to facilitate surgery and skin banking,” he added.

The national programme aims to create mass awareness about the prevention and management of burn injuries. This will include electronic media, campaigns, school education programmes, books in regional languages, and exhibitions.

Gupta said that training would be an important element of the national programme. “The focus will be on hands-on training of general surgeons, technicians, and paramedical staff,” he said.

Gupta welcomed the cabinet’s move but expressed disappointment over the time taken for approval. “We have only three years to complete the project. Had this been approved two years back, we would have had more time to achieve our targets,” he said.