Annals of the M.B.C. - vol. 1° - n° 1 - September 1987

EDUCATION FOR PREVENTION OF BURNS IN THE NEGEV DISTRICT OF ISRAEL

Rosenberg Lior, Mahler Dan

The Department of Plastic Surgery & Burns, S0roka University Hospital, the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

SUMMARY. A detailed epidemiological surv,-y of more than 800 hospitalized burn victims every year at the Soroka University Hospital defined small children and their parents as the highest risk group, with home accidents the most common cause. The differences between the Bedouin (the Arab, desert nomads) and the Jewish population resulted in establishing and implementing two different preventive projects for these two communities.
Generally, the campaign's goal is to increase awareness of the damage caused by home accidents and burns and to teach prevention and first-aid skills. In the Jewish sector, instructiona. group meetings led by trained plastic surgeons have been organized by the Center For Research and Development of Advanced Services in Plaitic Surgery.
Teachers, parents and pupils from kindergartens to secondary schools as well as groups within the community take part in the project. A comprehensive audio-visual program has been prepared to suit various socio-economic and age groups.
In the Bedouin sector, the survey found that the highest population at risk is children up to age of 10 and their mothers (80% of the burn population). These target groups may be approached "en bloc" only at the kindergarten, schools and Kupat Holim clinics (which have become the meeting place for the Bedouin women).
Due to the specific problem of changing deep-rooted behavioral patterns of the conservative Bedouin society we decided to start the project with the young children and reach through thcm the adults. We train Bedouin teachers (one in every kindergarten and school) to carry out this campaign within their schools and communities.
The preliminary evaluation protocol assesses understanding and memory. The long-term evaluation will be based on a five-year epidemiological study.

The young state of Israel had to dedicate most of its childhood period to existential solutions, thus relatively neglecting some fields of education, among them education for Preventive Medicine. Apart from this, the melting pot of the cultural, ethnical and social origin of the new-coming immigrants, together with versatile persistent local population, gave rise to major difficulties in education, including education for Preventive Medicine. The difficulties -,onfronting easy and quick nation-wide education are as follows:

VERSATILE, PERSISTENT, NEW IMMIGRATION
NOMAD POPULATION
POLYMORPHIC LANGUAGES
MIXTURE OF CONTROVERSIAL RELIGIONS
"ESTABLISHED" FOLKLORISTIC MEDICINE

Recently the Faculty of Health Sciences in this Institute has dedicated efforts and facilities to expand the spectrum of Preventive Medicine, especially in the area of Burns.
During the last 20 years, our Center has treated some 5834 Burn patients, of whom 85% had thermal burns. 75% of these thermal burns were Domestic Burns, while all others were only 25%. For us, planning the Educational Protocol, it is obvious and clear: most of the effort should be cledicated to this part of the population which lives and works at home - namely children and women.
Analysis: the age groups in this 5834 burn series presents a clear and significant age distribution:

WRONG
BURN
CORRECT

The first slide presents wrong handling with the cause of burn, presented by real photography or acting, the second slide demons~rates the consequence (the burn damage itselo and the third slide teaches the correct handling with the cause of burn. We have found that theoretical presentalon makes no move towards change or improvemeat unless the child or even the adult learns, by visualizing, what is the damage of the burn, and how awful its consequences could be.
Education of the Settled population is much easier than that of the Nomads. Here in the Negev district nomads still live in tents, far beyond reach and communication. This Target Group can be reached only in three ways: through Day Clinics, through their Leaders (Sheiks) or through special educational framework. The Ben-Gurion University team is specially arranged for transportation in desert areas, thus reaching and treating even small familial locations. Yet, regular education cannot be undertaken in such circumstances. The solution was found by teaching the teachers of these nomads the issue of Prevention of Burns, and these teachers transfer this knowledge to their pupils, in their own community, in their own language.
This presented program has been installed only recently, and years will be needed - ten at least - until we are able to evaluate its results, according to the statistics of Burn Cases of the future. Hopefully, for the benefit of mankind, the numbers will reduce.

RÉSUMÉ. Un examen épidémiologiqu.- détaillé sur plus de 800 brûlès hospitalisés chaque année à lHôpital Universitaire de Soroka a relevé que ce sont les enfants en bas âge et le ars parents qui constituent le groupe le plus touché car ce sont les accidents à la maisod qui en sont la cause principale. Les différences entr.- la population nomade et la population sédentaire rendent nécessaires l'établissement et l'organisation de deux différents projets de préventior, pour ces deux communautés.
Généralement le but de la campagne est d'inculquer une certaine peur des accidents à la maison et des brûlures, et d'enseigner un système de prévention et de soins de premier secours. Dans le secteur sédentaire, les chirurgiens spécialisés dans la reconstitution plastique ont formé des groupes d'instruction sous la tutelle du Centre pour la recherche et le développement des services avancés en matière de chirurgie plastique. Les enseignants, les parents et les élèves des écoles maternelles et secondaires, aussi bien que tous les autres groupes de la communauté ont pris part au projet. Un programme audiovisuel compréhensible a été préparé et adapté aux différents groupes de la communauté qui ont pris part au projet. Un programme audiovi;uel compréhensible a été préparé et adapté aux différents groupes socio-économiques et en fonction de leur âge.
Dans la zone nomade l'examen a mis en évidence que la population à plus haut risque englobe les enfants de moins de 10 ans et leurs mères (80% des brûlés). On ne peut atteindre ces groupes en bloc que dans les écoles maternelles et les écoles en général et les cliniques.  Nous avons fait démarrer notre projet au niveau des jeunes enfants pour atteindre, à travers eux, leurs parents. Nous instruisons des enseignants locaux (un dans chaque école) à diffùs(~r cette campagne dans les écoles et dans les communautés en se servant du programme audio-visual du centre.
Le protocole préliminaire se base sur la compréhension et la mémoire. L'évaluation à long terme se basera sui une étude épidémiologique de cinq ans.