There should be a system in place. Ideally, the state at all levels should provide adequate funding not only to the Kirtipur Hospital but also to many other hospitals to deal with these accidents
Now that we are in the summer, almost no day passes without news related to fires that are savaging rural and semi-urban local communities alike. While it is essential to talk about the massive effects of these natural disasters induced by high temperature and drought, it is also paramount not to forget the other types of fires that mostly happen during the winter.
I am talking about fires caused by gas cookstoves and gas cylinders, tragedies that every single year are causing high numbers of casualties and injuries. I was reminded of these incidents while visiting the Kirtipur Hospital, which is considered the premier health facility for treating burn accidents, and is run through a very interesting partnership between PHECT Nepal (Public Health Concern Trust) and Kirtipur Municipality.
There I met with Dinasha Dahanayake, an American Fulbright-Fogarty Fellow who since August 2023 has been working and researching on ways to prevent burn injuries. In a presentation of her work, which was carried out with a team of colleagues from the Kirtipur Hospital, Dinasha, a medical student at Oakland University William Beaumont School of Medicine located north of Detroit, shared the findings of the research conducted from January to April this year.
The team had interviewed 623 households throughout the nation, covering nine districts, representing both the Tarai, Hills and the Mountains. In addition, different areas of the Kathmandu Valley were identified.
Dinasha explained that every single year approximately 56,000 people (and this is an underestimation) suffer burn injuries, many of which are caused by unsafe practices, especially related to the use of gas cookstoves or other LNG-powered cylinders that are used for heating purposes.
I could see firsthand the suffering and pain thanks to Dr. Kiran Nakarmi, Head of the Department of Burns, Plastic and Reconstructive Surgery at Kirtipur Hospital.
The most important message that Dinasha had to offer during the presentation was that a very high number of burn injuries are totally preventable if only there was more awareness among the general public.
During the survey, they made sure also to include an awareness component, distributing papers with key tips to avoid in house fire-related incidents.
The research also revealed that a vast majority of the people interviewed had no first aid training knowledge nor any insights on what to do when someone at home incurs a burn injury. In these cases, it is essential to immerse the wound, I was told by Dinasha, in cool running water for at least 20 to 30 minutes within the first three hours of the injury. Therefore, it is essential to dismiss the myth of aloe vera or the use of toothpaste as first remedies because they further exacerbate the problem.
Dinasha will soon be back to her medical studies in the USA but will return to Nepal because she would like to focus not only on prevention but also on policy regulations. Without better and stronger policies, especially binding legislations, more casualties, more sufferings will happen.
The industry representing the manufacturers and producers of LNG cookstoves and more general LNG cylinders could do a much better job. Apparently, according to Dinasha, there is potential for some technological "twists", some safety arrangements that could make these gas bottles safer. More information could be attached to the cylinders when being sold. The dealers of these products together with the retailers on the streets could also play a much better role at helping create awareness. House owners who rent out rooms or apartments in their properties obviously would have a keen interest in ensuring that their tenants do follow all the safety precautions while cooking or while sleeping.
One of the findings of the survey was that a very high number of people sleep very close to the gas bottle used for heating. This is an issue of inequality and vulnerability because only poor households, those who live in small houses in informal settlements and slum areas, spend their lives in very confined and limited spaces. Also people living in rural and remote areas are the victims simply because whatever health facilities are available in the rural areas are not equipped to deal with burn injuries.
The Kirtipur Hospital is doing what it can to alleviate the sufferings. Last August the hospital established a Burn Fund to support those patients and their families who cannot afford the already subsidised costs of the treatment. Dr. Chandra Kanta Bhandari, the member of the Federal Parliament who last year had to be airlifted to India after being injured in a cooking gas cylinder explosion, an incident where his own mother lost her life, is one of the key persons behind the Fund. Together with him, there are the comedy duo Madan Krishna Shrestha and Hari Bansha Acharya who have also generously contributed to the Fund.
It is a great thing that there is such a mechanism, but if you reflect on it, why is there the need for such a fund? Ideally but also in practice, a nation like Nepal should not be in need of forcing a local hospital to establish a mechanism to help the victims of burn incidents. There should be a system in place, shouldn't there? Ideally, the state at all levels should provide adequate funding not only to the Kirtipur Hospital but also to many other hospitals, especially outside the valley, to deal with these accidents.
Higher standards and provisions should be imposed on the gas cylinder manufacturers, and more preventive awareness should be created. Here also newspapers, radio and TV programmes and podcasts could play a big role.
A dedicated Fullbright Scholar has worked with many well-meaning and dedicated medical professionals like Dr. Nakarmi and other responsible citizens to garner essential data, but we are only at the beginning.
It is going to be a long journey and it is going to be hard work, but Nepal must do whatever it takes to prevent more pain caused by burn injuries.
