INCIDENCE, MANAGEMENT AND PREVENTION OF BURNS IN LIBYA

Taguri S.

University of Garyounis, Faculty of Medicine, Benghazi, Libya

SUMMARY. There are two Burn Centres in Libya, serving a total of about 3 million people. An analysis is made of the incidence of burn injuries at one of these Centres, in Benghazi, which has 30 beds. The incidence is higher (70%) in females and children. About 70% of the bum injuries are minor ones occurring in the home. Minor bums are dealt with in the outpatients clinic. Moderate and severe bums are first treated in the bum shock room, before transfer to the burn ward. Prevention is very important. Audiovisual aids are most effective. A common research programme among the Mediterranean countries could help to make the authorities more aware of the problem and suggest appropriate legislation.

We have two Burn Centres in the country, one in Tripoli, the capital city, and one in Benghazi, the second city; eacli of these centres serves about 1.5 million people.
Our Centre in Benghazi has 30 beds, of which eight are designed for intensive care for patients with serious burn injuries.

Comparing the number of beds (30) to the number of population served by this unit (1.5 million), it is quite obvious that the incidence of burns is very high. Our statistical studies show that the incidence is higher in females and children (about 70%) than in adult males (about 30%). About 70% of these bum injuries are of the minor type, taking place at home, either due to hot liquids or fire injuries; females spend a long time in the kitchen for cooking and daily activities, usually accompanied by their young children, and are more at risk than adult males.

The other 30% of cases are patients admitted with moderate and severe bum injuries; these include:

1. Females and children with domestic burns involving large body surface area due to hot liquids
2. Females and children burnt by fire due to accidental gas leak, or the presence of flammable materials at home, or sustaining electrical thermal injuries
3. Males exposed to the same situations as above, or those attempting to rescue females and children
4. Males working in electricity service
5. Road traffic accidents
6. Industrial bums
7. People committing suicide
8. Children burned due to unsafe children toys, and fireworks in festivals.

Minor burns are dealt with in the outpatient clinic. Moderate and severe burns are admitted first to the burn shock room, where the patients stay for some time till their condition permits their transfer to the burn ward, and their treatment is continued, whether conservative or surgical. Early surgical treatment is performed, whenever indicated.

As we all know, prevention is the most important factor in dealing with the problem of burns, and one should consider carefully all aetiological aspects in the hope of identifying some features which, if considered in a prevention programme, will contribute to its success.

From our study of all cases admitted to our Burn Centre in Benghazi, we have identified some factors which we think are responsible for the high incidence of bums:

1. Although fire has been known and used by mankind since time immemorial, many people are unaware of its risks and hazards
2. The habit of spending a long time every day in the kitchen puts females and children at more risk
3. The increased use of dresses, especially among females, made of highly flammable textiles, and the increased use of furniture and house fittings made of highly flammable products
4. Negligence and insufficient care when using gas cookers, heaters, etc.
5. Negligence of safety precautions in factories, among people working in electricity departments, and in electrical fittings in homes
6. Unsafety of some types of children's toys, and fireworks
7. High-speed driving and lack of road safety measures
8. Selling to the public of highly flammable materials like petrol and other products without safety restrictions.

To give an idea, our admissions for 1987 were 650 cases. 36 died because of high percentage burns and complications and some ended with permanent disfigurements and disabilities in spite of effective treatment and multistage surgery. 1 have already planned certain measures in the hope of reducing the incidence; these are:

1. The use of all means of communications to explain to people the risks and hazards and how to protect themselves. The most effective means are audiovisual aids, and the MBC has already provided us with films and videotapes, which 1 found very effective.
2. Certain factors have to be explained to the authorities in the country for the approval of legislation and regulations which will protect the people, restrict the use of materials made of highly flammable products, and enforce certain safety measures in places where people may be at risk. 1 feel that we should combine our etTorts in protecting human beings against this bum insult. By studying aetiological factors for bum incidence in each of the Mediterranean countries, we may reach some common ends and as a Club we can suggest certain regulations and legislation which will protect our people for the consideration of the ofticial authorities in our countries.

RÉSUMÉ. Il y a deux Centres de Brûlés en Libye, qui servent plus de 3 millions de personnes. Une analyse de la fréquence des brûlures a été exécutée chez un de ces Centres, à Benghazi, doté de 30 lits. La fréquence est plus haute (70%) chez les femelles et les enfants. Environ 70% des brûlures sont mineures et se produisent à la maison.
Les brûlures mineures sont traitées en ambulatoire. Les patients avec des brûlures modérées et sévères sont traités d'abord dans la salle pour la thérapie du choc, et après dans le service des brûlés.
La prévention est de la plus grande importance, et pour cela, les supports audio-visuels sont très efficaces. Un programme commun de recherches entre les pays du Méditerranée pourrait sensibiliser les autorités au problème et suggérer des mesures législatives opportunes.