INCIDENCE, MANAGEMENT AND PREVENTION OF BURNS IN LIBYA

Taguri S.

University of Garyounis, 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 bum 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 burn injuries are minor ones occurring in the home. Minor burns are dealt with in the outpatient 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 our country, one in Tripoli, the capital city, and one in Benghazi, the second city. Each of these centres serves about 1.5 million people.
Our Centre in Benghazi has 30 beds, of which 8 are for intensive care of patients with serious bum injuries.

Comparing the number of beds (30) to the population served by this unit (1.5 million), it is quite obvious that the incidence of bums 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 burn injuries are of the minor type, occurring at home because of hot liquids or fire injuries; women spend a lot of time in the kitchen cooking and engaged in their daily activities, usually accompanied by their younger children, and they 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 due to hot liquids, affecting an extensive body surface area.
2. Females and children burnt by fire due to accidental gas leaks, or the presence of flammable materials at home, or sustaining electrical thermal injuries.
3. Males exposed to a similar situation as above or attempting to rescue females and children.
4. Males working in electricity services.
5. Road traffic accidents.
6. Industrial bums.
7. People attempting suicide.
8. Children burnt due to unsafe toys, and fireworks in festivals.

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

As we all know, prevention is the most important aspect of bums problems; all aetiological aspects must be carefully considered in the hope of finding some factors which if considered in a prevention programme will guarantee the success of the programme.
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, a considerable percentage of people are unaware of its risks and hazards.
2. The habit of spending a long time daily in the kitchen puts females and children at higher risk.
3. The increased use, particularly by females, of clothes made of highly flammable textiles, and the increased use of furniture and house fittings made of highly flammable products.
4. Negligence and inadequate 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 the home.
6. Unsafeness of some types of 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, we admitted 650 cases in 1987; 36 of these died because of high percentage BSA and complications. Some of them, despite effective treatment and multistage surgery, had permanent disfigurements and disabilities. 1 have already planned certain measures with the aim of reducing the incidence:

1. The use of all available means of communications to explain to people the risks and hazards and how to protect themselves. The most effective means are audiovisual aids. The MBC has already provided us with films and videotapes, which I have found very effective.
2. Certain factors have to be explained to the authorities in the various countries for the approval of legislation and norms which will protect the population, restrict the use of materials made of highly flammable products, and enforce certain safety measures in places where people may be at risk.

I feel that we should combine our efforts in protecting human beings against burns. If we study the causation of bums in each individual Mediterranean country, we may be able to identify some common factors and as a Club we can submit suggestions for rules and legislation, which we think will protect our people, for the approval of the official authorities in our various countries.

RÉSUMÉ. Il y a deux Centres des Brûlés en Libye, qui servent plus de 3 millions de personnes. Une analyse de la fréquence des brûlures a été exécutée chez un de des 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 traitées 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.