Priceless Picture...

Children enjoying a rare treat in their rural village, a child safety lesson in water, burn and road safety. Each child in this school was able to be provided with a copy of "Luka's Safety Adventure" and a small pack of crayons! It is absolutely priceless to see a child hold a crayon for the first time and see the expression on his/face when they figure out how to color!

Drama Skits Prove Effective, as Patients Line Up for Clinic

November and December were incredibly exciting to see Prevention efforts switch into full gear. An Nkhoma-based Drama Group did an outstanding job playing out the role of a family who neglected to watch their young child around a fire and go through the steps of visiting an herbalist doctor and finally reaching a Malawian doctor to get the proper treatment the child needed. The group was hugely entertaining and reached over 2000 rural Malawians surrounding the Nkhoma area.
In reward we witnessed numerous persons with burn contractures and epileptics who saught out treatment for their seizures to avoid a potential burn injury.
This program is extremely important to teach kids and parents about the dangers of fire and what do in case of an emergency. With a donation of $125 you can provide a rural village with this vital information!

Who Said Elephants Are Extinct in Nkhoma!

As early as 30 years ago there were reports of wild elephants roaming the valleys in surrounding the Nkhoma Hospital. They have since all been poached for meat and their tusks but last week Prevention Leader, Sam Thompson found a rare toddler elephant in the villages while teaching! I simply could not resist posting his adorable picture!

Burn Survivor Pays It Forward

Pictured is one of my favorite programs offered at Nkhoma. Loyce stands and reads a burn prevention safety book in Chichewa to mothers and children staying at the Nkhoma Hospital. Loyce isn't a teacher, she's a burn survivor who lived through a 4th degree burn of her scalp when she fell into a cooking fire by her home while having a seizure. She spent 370 days in the hospital in 2006 and lives to tell her story of survival in the wards at Nkhoma Hospital.
Loyce visits the hospital once a month to provide the invaluable prevention education, and also stops by the pharmacy to pick up her epilepsy meds that are offered free of charge by ABR to prevent her any further injury by fire.

Visiting ReSurge Team Tackles Disability in Nkhoma

Last week, Africa Burn Relief and Nkhoma Hosptial were most fortunate to partner with ReSurge International (formally Interplast) to help patients with disabilities, including burn contractures and cleft lips a new outlook on life.
With the help of Dr. Scott Corlew and Susan Smith, NP, 5 patients were provided services that are not otherwise offered in the rural site of Nkhoma. Besides surgery, assistance with continued education was offered in 2 hospital sites and most appreciated by Malawian clinician and nurses who rarely recieve the specialized expertise and teaching they were able to provide.
During their stay, ReSurge team members benefited from witnessing our newly launched prevention program and dramas. Teaching children and parents in the rural setting about preventing burns is simply a unique, amazing, and rewarding experience.
I most welcome ReSurge team members to return to our site to continue much needed reconstruction services with us and our partner, Nkhoma Hospital. Hope to see you soon!

Burn Prevention Program Escalates!

December brings a busy month for Africa Burn Relief! While many people in the US are winding down for the holiday season we have kicked things up notch here in Nkhoma. With the help of friend and volunteer Sam Thompson, our burn prevention efforts have escalated to reach 6 rural villages and 4 schools. Sam is working with an amazing local drama group who work rurally to give health care messages to the neediest of Malawians.
Sam is concentrating his efforts on the education of parents and young children in an attempt to decrease the number of preventable burn injuries. The simple teaching concept of STOP-DROP-AND-ROLL, is a well known technique to put out a flame amongst our youngsters in the US. But here in Malawi this has never been heard of our taught by teachers.
Pictured a child proudly demonstrates his new learned skill of stop drop and roll, and some of the many children that Sam has reached with his prevention teachings and children's coloring book, Luka's Safety Adventure!

The Way It Is...

This is a picture of a patient’s grandmother laundering the dressings that were removed from her grandson. Because of hospital wide shortages of quality dressings, family members must wash their outer dressings daily to be reused the next day. This certainly is not practicing sterile technique or even clean technique by any means, certainly not acceptable by US standards, but there is simply no other alternative. If they don’t wash the dressings they have, the child will go without the dressings. The boy was burned over 23% of his body. At first the family did not divulge how the accident occurred, they told us he was pushed into a fire by a friend. Days later it was revealed that he fell into a fire while practicing a traditional dance. Likely they hid this from us as some Malawians view traditional dancing as voodoo or possibly associated with unchristian-like teachings. This is of course irrelevant to his treatment, and tomorrow he will leave a healed 12 year old boy after 3 skin graft operations.

DeSales University 5k Walk/Race to Benefit Africa Burn Relief

The DeSales University PA Program Student Society will host it's second annual 5k Walk/Race to help raise funds for our program serving burn victims in rural Malawi, Africa.
Please consider joining us for an amazing Autumn day to support a great cause. I will be flying in from Malawi to support this event and raise awareness of the Africa Burn Relief Program in Pennsylvania communities.

Place: DeSales University; 2755 Station Ave, Center Valley, PA 18034
Time: Start 9am-registration, until about 12noon
Date: October 16th, Saturday
Price: 10$ Students/ 15$ non-students
Details: You can register and pay the day of the event at 9am. (cash/check)
A silent auction will accompany the race featuring handmade Malawian and Zimbabwean artworks. Credit card, check or cash accepted for the silent auction portion. Short presentation to follow.
For pre-registration details, please email me at africaburnrelief@gmail.com.

I deeply thank the DeSales University PA Program Society for organizing and supporting this event.

In the Headlines...

September 3, 2010
A central Malawi newspaper, The Nation, reads; "Mother Recounts the Ordeal of Losing 2 Sons and Youngest Daughter" in what appeared to be a suicide ritual. The mother of the three ages 31, 27, and 16 perished after throwing themselves into a blazing fire outside of the parents home. Another child who initially survived, was taken to a Blantyre Hospital but later died of severe burns.
"The deaths followed three days and nights of continuous prayer to exorcise their parents of alleged witchcraft. One of the children undressed their 52 yr old mother and then attempted to throw her also in the fire, but she managed to escape. She and her husband fled the home running to neighbors for help. They returned just when the children were throwing themselves onto the fire, back first, hands clenching a Bible each. The tragic drama lasted for 5 hours." The mother stated, 'it hurts to recall the picture of my children jumping to their deaths. The loss of Annie, my youngest daughter, is the most painful out of the three because I know she was pushed. She was never part of the ritual.'

A Farewell and a Blister...

It has been only 6 weeks since we admitted Tim and baby Victor. After 3 surgeries each, the brothers who won the hearts of everyone on the ward, will return to their far away village with their parents and go-go(grandmother). I can hardly believe it is time to let them go. I must admit, I was in shock when Victor survived in the early days after his burn, particularly with all odds against him when we discovered he was also suffering from malaria. He will have challenging days ahead of him, but luckily his parents are incredibly supportive and I believe they will make every effort to return for the physical therapy he requires.
Tim has done remarkably well. He has a contagious smile. Many of the kids fear when they see me, because they know their dressing will be changed, but Tim was always calm, polite and we could always get a smile out of him (quite abnormal for my patients!).
They both came to my mind when I reached into the oven for a pan without a proper oven mit the other day (yes, stupid!). This of course burned my hand and hurt like all heck. Nothing would stop the pain unless I had it in ice cold water. It hurt for hours, and eventually a less than one centimeter blister appeared. We've all done this...but that night I could not imagine the scene for this family when their only 2 sons suffered burns over 20% of their little bodies. The pain had to be absolutely unbearable for the hours it took for them to arrive to the hospital. I am so happy the family somehow made it to our hospital. If they would have landed at the hospital closest to them they would have been in a ward that does not provide wound care or specialized surgery. I think the family realizes this, they thanked me endlessly every day I visited and many times over on their farewell day.
If you are a donor, you should be proud, helping to build this program gave this family their kids back today.

Shipment Arrives

It was a year ago when I first started packing up my garage at my Phoenix home, preparaing for this year long stay in Malawi. There, boxes upon boxes on various assorted medical supplies had been donated and filled half of my 18x12 ft garage! Containers literally went to the ceiling. It was a large task and took a team of weekend warrior volunteers to sort through, but in the end 30 large boxes were stuffed with valuable supplies. At that time we had no idea that plans were underway for the hospital to build a burn ward and that these supplies would stock the shelves of a future constructed burn ward. I am looking forward to itemizing and seeing these shelves filled, hopefully this November. It is my hope that many of these items will last the unit for 9-12 months. An estimate to make donors most proud for putting their utmost effort in donating and displacing me in my own garage!
Donated supplies from the US are very important to our program. The quality of these supplies are by far greater than those I can purchase in Malawi. If you are a medical professional or product rep interested in supply donation please contact me at my private email africaburnrelief@gmail for an itemized list and warehouse address where items can be sent.

Prevention is the Best Treatment

60% of all patients we treat in Nkhoma are less than age 6. This disturbing figure calls for strategies to help prevent these burn injuries. Africa Burn Relief is working to target these children and their parents to help give them the education tools they need to think twice when kids are nearby when cooking or near heating fires. Fortunately, with the help of child psychologist, Dr. Rimmer and illustrator, Allyson Rimmer we have brought a culture appropriate and Chichewa translated children's prevention book to rural Nkhoma, Malawi. Luka's Safety Adventure is a coloring book that teaches Malawian children how to stay safe around environmental factors which they are most vulnerable to; fires, road accidents, and drownings.
Pictured is 6 yr old Tim with his book. As he is on bedrest after a recent surgery, he will need all the entertainment we can find to keep him in bed!

ABR Seeks Directed Donor for Youngest At-Risk Burn Patient

Baby Victor, featured earlier in my blog, was severely burned at the young at of 4 weeks old. He is progressing in his healing process, which is miraculous to say the least. He has made it through some very difficult weeks. I have confidence that with one more surgery he will make it to proper wound healing.
The obstacle then becomes his function. Now at just 7 weeks old there is no way to tell if he will ever be able to walk correctly after such a devastating injury. It will take a year of intensive therapy, if not longer, to determine what function each of his disfigured feet and ankles he will have. Will his new grafted skin be able to stretch as he rapidly as he grows in infancy?
What he needs is the best chance possible to prevent him from a severe disablity. We are fortunate to have one Physical Therapy assistant at our hospital who can help rehabilitate young Victor over his critical year of recovery.
Although we never ask for a directed donor for a specific patient, baby Victor is the exception. He is the youngest and most severe burn in a infant ever treated in Nkhoma. He is highly at risk of severe handicap. I am seeking an interested donor to consider funding his transport to and from the hospital (30 minute minibus drive) twice a month for PT sessions. As a rule, ABR does not fund transport, but if an interested donor would agree to fund this piece of his critical rehab we would be most grateful. The cost of this transport, plus his PT sessions would cost about $25 per month.
If you have an interest in this story, please email me directly at africaburnrelief.gmail.com.

Updated: Aug, 24
Many thanks to the Orlowsky-Ferhat family for graciously meeting our request to fund Victor's burn rehabilitation for an entire year!

Saying Goodbye to Dr's de jonge Vink's!

Today marks a sad day for Nkhoma Hospital, as well as for me personally. Dr. Naomi Vink, who has been a friend and colleague for four years here at Nkhoma, will depart Malawi to move on to new opportunities to Portugal with her husband, Erik. Both Naomi and Erik have made incredible strides for Nkhoma Hospital in their respective departments. Naomi has fostered the burn program and looked after the burn patients in my absence. For this I will be forever grateful. She always had a special way of handling the very youngest burn patients, who are the most difficult to treat, seeing the pain they must endure until they progress to healing. It was always a happy moment to see a picture sent to the US when she appeared in the picture with a smiling healed child! Dr. Vink later progressed to settle in the obstetrics and gynecology unit, where her extreme dedication has led to saving the lives of multiple new mothers and infants. Maternal mortality rates are amongst the highest in the world in Malawi, and Dr. Vink passionately tried to overturn these figures during her 4-year stay.
Equally as impactful, Dr. Erik has been instrumental in helping to shape the Public Health Department. Many new programs for safe motherhood and malaria prevention were initiated during his stay. The most visible change for Nkhoma Erik has made is starting an IT department. When I first arrived 4 years ago there was no chance of having the internet in Nkhoma. You had to travel 1.5 hrs on a dirt road, dodging cows and goats, to find access! Moreover, the first ever computerized data base is now functioning on each unit to assist with patient data and patient bills, which will progress to higher advances over the years to come, all because of Erik and his IT team.
Words cannot express the loss we will all feel on their departure. I know they will again return to see their work flourish over the years to come. Goodluck on your new adventures in Portugal, and we hope to visit one day!

Nkhoma Burn Ward Construction Quickly Progressing

Nkhoma Hospital will recieve its' first ever burn ward equipped with 8 beds, tub and shower rooms, dressing room and supply closet this November. This is a tremendous step in improving the overall burn care for burn victims. ABR is extremely grateful to Nkhoma Hospital and the Bosrand Malawi Work Team for making such a state-of-the-art unit possible in rural Malawi.
It is our desire and hope to find proper funding in the future to make this unit a center for burn reconstruction for central Malawi. To date no such facility exists. Currently our program does reach the immediate area surrounding the mission hospital to provide the reconstruction surgeries that burn patients need. Most of these patients are young children and without intervention would lead a disabled life. Additionally, a much larger population exists in the capital city and several surrounding district hospitals where patients have no place to turn to for specialized surgery.
In order to extend our services to a larger geographical area we will require partner organizations as collaborators and committed donors to assist with the needed funds to turn this into a reality.
The typical reconstruction surgery in our Malawi facility costs astonishingly only 20$ and total hospitalization cost of $125! Compare this with US pricing at $12,000 and $30-40k total stay.

Saving Baby Victor

Baby Victor, at the early age of 4 weeks, was being carried by his 6 year old brother, Tim, when he accidentally dropped his infant brother into a fire they were trying to stay warm by. Trying to save him from the flames, Tim and Victor both endured 3rd degree burns. Pictured is Baby Victor's wrapped legs and blistered feet. He has a long journey to recovery. He will require skin grafts, splinting, therapy, and proper nutrition. He will battle malaria, fevers, and infections during his foreseen 3 month stay. The boys parents will never be able to afford these hospital costs on 1$ per day salary.
These horrific stories are all too common in Malawi and moreover completely preventable. Because parents are often working outside the household or caring for the home, young siblings are often left to care for even younger siblings. It is not uncommon to see a 3 or 4 year old carrying an infant strapped to their backs while making long treks to gather water, firewood or food.
Very luckily, both boys, despite all odds against them, will have a good chance of healing due to ABR donors helping to supply exactly what they need. They will have clean dressings for their wounds, soap to be cleansed with, and trained staff who know how surgically care for their wounds.
It will take only $125 to pay for his hosptial costs and essentially save his life. ABR donor money will pay for his care and ensure he receives every chance for survival. Without this funding assistance, families of burn victims often flee the hospital in the middle of the night, fearing the fact they cannot pay for their child's care, ignorant that their child's life is at stake.

PA Student Serves as Role Model for Future Student Volunteers

DeSales University Physician Assisant student, Tracy Gould, serves as ABR's very first student accepted by the our program in Malawi. Tracy was able to stay for 3 weeks with her primary goal of jump starting burn prevention teaching to pre-schoolers in our immediate village, primary school and local orphanage. She was able to reach 120 children during her visit and additionally taught nursing students about burn contractures and how they can be prevented.
Her experience was diversified, observing burn surgeries, wound care and rounding with the local hospital team. Here she witnessed massive numbers of children stricken with malaria and measles, an experience she will never or fortunately see in the States. One of her most eye opening experiences was staying in a village hut with a local Malawian family, observing and experiencing first hand what it is like to live in the developing world. One man's words stuck with her when he stated, "make sure you come back soon. Malawi cannot stand on it's own and we need your help".
Tracy has served as an ideal role model for future student volunteers and students. PA Students interested in volunteering with the program can write a letter of interest to Jenn Wall-Dean, PA-C at africaburnrelief@gmail.com.

Staring Into the Face of Epilepsy and Burns

Ethelo is a young married woman. Six months ago, while cooking over a fire she had a seizure and fell face first into the flames. In Malawi, those with epilepsy are regarded as cursed, and because of this unfortunate cultural belief, no one would remove Ethelo from the fire, fearing her condition could be contagious. She arrived to our hospital seeking help for her scars. To avoid embarrassment, she wears a cloth wrapped around her entire head and stares down at her feet to watch her footing. She presents with a neck contracture, forcing her head to the left and eyelid contractures exposing her mucosa, painfully to the air. When asked how often she was having seizures at home, she replied 'everyday'. She denied that she was taking any medication and didn't seem to understand that it needed to be taken daily to avoid her convulsions. Near 25% of all patients we treat in Nkhoma have an associated seizure disorder that leads to their burn injury.
Ethelo is scheduled for the first of many reconstructive surgeries this week. We can improve some her scars functionally, but she will never appear the same. The scars will always be evident. Most heart wrenching is that her injury was completely preventable. With education regarding epilepsy, medication compliance and safety teaching around open fires we can prevent these horrific injuries.
Africa Burn Relief aims to enforce these prevention strategies and additionally help cover the costs of anti-convulsants. These medications, only about 5$/month per patient, are unaffordable to the common Malawian living in the villages.
If you are interested in aiding this project, consider a donation of $60 to fund medications for an entire year for an epileptic.

Rediscovering Ellen

Ellen was the very first patient I ever encountered at the Nkhoma Hospital. Clinicians did not know what do about her difficult and desperate case. I found her in the corner of a small room, with labored breathing, skeletal appearance, flies swarming her, and fear of having her gangrene wounds touched. Her problem was far gone, and I feared that she would not be able to survive her condition in such a late stage. It was evident that she needed both of her feet amputated to have any chance of surviving. We did perform the amputations and gradually started showing improvement. She was discharged, healed, but without the large portion of her feet. Her grandmother(gog-go)took her in and carried her on her back for the next 4 years until an American teacher heard of this child in the village.
With the help of an Nkhoma nurse, Marelise, and the teacher Ellen was donated prosthetic feet that have enabled her to begin walking again! Now that she is has her feet and she is no longer embarrassed of her disability she is now looking forward to attending the local primary school here in Nkhoma. She is a petite, beautiful girl with a contagious smile. An amazing success story and amazing this has all occurred since I have been here, unbelievable really!
In this picture she stands next to her caring Go-Go. When I asked the grandmother if she remembered me she said...'Jennifer!' I couldn't believe she remembered my name after all these years!

Why Burns Occur in Malawi...

Many people ask me, 'why are these burns happening so frequently in Malawi?' The sad truth is that it is a harsh consequence of living in poverty. According to the World Health Organization, 95% of all burn injuries occur in low income countries. Many Malawians live as farmers, making less than $1 per day. The majority of the population live in mud huts with grass roofs that were originally made over 100 years ago, passed down from generation to generation. To this day only 2% of the population has access to electricity. Families consequently heat and cook by open flame fires. Children will often hover around their mothers, clothes easily catching flames, or small children may be attended to my other children not old enough to have this responsibility. 63% of all burn victims we treat here are less than 6 years old.

Unfortunately, when these burns occur there is rarely a clinician who knows how to treat these injuries. Hence, the need and purpose of our program; to teach local providers on how to care for these patients, giving victims the best chance of survival and quality of life.

Reflecting on Month One

The first four weeks of work have been wonderful here in Nkhoma. As the burn program here is now entering it's 5th year of existence, local staff are taking the lead in caring for the burn victims needs on multiple levels. I am absolutely impressed on how the patient attendant (tech) staff have been performing the wound care for the burns. As always, the operation team has been top notch, the donated equipment is impeccably maintained, and I am well pleased concerning our operative outcomes for patients.
We have had our first Malawian Committee meeting, where staff nurses and clinicians are enthusiastic to be leaders and advocates for the burn program.
Continuing our good fortune, we are incredibly excited and thankful that a Dutch group has graciously donated funds for a newly constructed burn unit will be completed in the next 5 months!
A big thank you is deserved for the Malawi Mission Work Team and the Bosrand Malawi Work Team for making it possible for our patients to have a suitable, modern unit to be housed during their lengthy admissions.