​What kinds of symptoms do patients experience before receiving treatment?

Burn scar contractures occur when acute burns are left untreated. Scar tissue forms and tightens the skin, restricting function and mobility and causing pain. In severe cases, patients can lose total mobility in affected limbs.

​What is the impact on patients’ lives of living with these conditions?

Children are often the victims of accidents when fire breaks out or when they play near an open flame. Children with restricted mobility due to burn scars and contractures lose their independence. Children with impairments and disabilities caused by a lack of mobility have restricted access to education and are less able to socialize with peers in their community. Burn survivors are often stigmatized and shunned due to the cosmetic impact of their injuries.

What cultural or regional factors affect the treatment of these conditions?

Burn-related injuries are common in countries like Tanzania, where most people cook with small charcoal or kerosene stoves or over open fires. Burn scar contractures occur when burns are left untreated due to a shortage of skilled physicians and the prohibitive cost of treatment. When an accident occurs, the unexpected medical bills are not only an obstacle to treatment, but can also limit a family’s ability to cover other expenses, such as school fees for other children, food for the family, or other healthcare needs. The average cost of a single contracture release/skin graft surgery is over $1,000. Up to 67% of the population lives on less than $1.25 a day. With most patients requiring multiple surgeries, and burns primarily affecting the poor, families are simply unable to afford treatment for their children

What does the treatment process look like?

Patients can present directly to CCBRT for treatment, but they are often referred from other facilities that are not equipped to provide the level of care required. Patients are evaluated before being scheduled for surgery. After surgery, which takes on average 75 minutes, there are a series of post-operative followup checks. CCBRT’s highly-trained surgeons and medical teams are equipped to perform burn scar contracture release surgeries, skin grafts, and skin flap surgeries. The average length of hospital stay for a patient is 15 days. To facilitate maximum comfort for patients who are often very young, parents/caregivers are permitted to stay in the ward with them. 30-50% of patients are referred for physiotherapy in CCBRT's Physical Rehabilitation Department following surgical care.

What is the impact of this treatment on the patient’s life?

CCBRT’s burn program dramatically changes the lives of the children who receive mobility-restoring surgery. The impact of this surgery also reverberates throughout the entire family. By improving mobility through contracture release, children are granted their independence and the opportunity to access education and integrate with their peers. The economic burden upon the family is greatly reduced. Relieved of the responsibilities of caring for a child with a debilitating impairment, and unburdened by the cost of medical care, parents are able to seek employment and are better able to afford food, healthcare, and education for the wider family.

What potential side effects or risks come with this treatment?

The main risk, as with any major surgery, is post-operative infection. CCBRT is committed to quality and safety in its hospital and makes every effort to mitigate the risks of post-operative infections.

How accessible is treatment in the area? What is the typical journey like for a patient to receive care?

Tanzania faces a severe shortage of skilled healthcare workers nationwide. The need for surgical care in Tanzania is staggering. With a population of over 49 million people, Tanzania has only five physicians for every 100,000 citizens. The country has 73 practicing surgeons who are listed in the College of Surgeons of East, Central, and Southern Africa’s database of members. There is also limited capacity to train additional surgeons—only 51 general surgeons have graduated from Tanzania’s medical schools in the past ten years, and about a dozen of them practice some reconstructive surgical techniques. CCBRT is one of a few facilities equipped to provide quality reconstructive surgical care in Tanzania. Patients are often referred to CCBRT for treatment from other facilities unable to perform the necessary surgery. Patients traveling from rural areas will often have to take multiple buses to reach the facility in Dar es Salaam. The journey to the hospital can be very expensive for families living in poverty.

What are the alternatives to this treatment?

If a patient does not receive surgery, he or she will live with a permanent disability. There is no alternative therapy that will have the same impact as specialized reconstructive surgery. Burn injuries disproportionately affect people living in poverty, as they are most likely to cook over open flames and live in overcrowded conditions, and they are unable to access urgent care in the event of an acute burn injury.