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Survival beyond Surgery
Acid burns have a devastating effect on the skin and the injuries incurred are brutal and require long and complicated medical treatment. Early excision and skin grafting of deep burns offer important benefits to survivors by improving the function of the body area damaged, whilst also reducing the course of long-term treatment.
Speaking after performing surgery on Lucky, Dr Ron Hiles explains, “This happened 12 days ago, and we’ve learnt that by treating a lot of these cases that there are very considerable benefits from operating early. If we wait there is a greater chance of long term disability and disfigurement and particularly in terms of the eyelids, which we have been operating on. For instance if nothing had been done today, or if surgery had been delayed, or never happened as is what use to happen (everybody used to have to fight for very limited facilities for plastic and reconstructive surgery), then she would have had eyelids which were contracted, exposed her eyes and all the problems which would have arisen from that”.
The operational team at the Acid Survivors Foundation (ASF) Bangladesh Medical Unit provides acid survivors with the very best plastic surgery available in Bangladesh. However, the medical surgery is just the start of the long journey ahead for these survivors: “When they go back it is not the end, only the beginning of their suffering”, explains Dr Imtiaz, Medical Officer at the ASF-Bangladesh (2005 – 2009). “When surgery is done everyone thinks it’s all done forever, we have made changes in their life. But it is not the end. It is the beginning because they have to relocate themselves into society, and society is not accepting of them. They might lose their job, their social value as a person, as a disfigured person he can not express his views over there. This is the social context. If the disability from the burns injury is so bad they may not be able to do work, and so economically they become a burden to his family. When you loose your economic sovereignty you will not be able to control your family – this happens everywhere in the world”.
The foundations in Bangladesh, Pakistan, Uganda & Cambodia, all have adopted a holistic approach to supporting survivors. By approaching the problem holistically and by looking at all the angels which are relevant – be it political, legal, commercial, social – have, as a result, enhanced the foundations into eminent, successful projects. This approach entails that not only the medical needs of survivors are met, but also psychological counseling (to survivors and their family, if needed) is provided, and the adopting of social reintegration projects for the survivor to achieve economic independence, develop long-term life perspectives, and to recover their self-confidence and respect from the family, peers and community, are also made available.
Dr Ron Hiles comments that “the secret of success, and it has been a very successful project, has been this holistic approach. It is something that I think has not happened very much before in medical circles, and I think it is a model which could be followed for other limited categories of patients, particularly in trauma.”
Although plastic surgery is essential in most cases, surgery alone can not help survivors overcome their trauma. As Dr Imtiaz observed, “Once I was walking with Saira, she works her and has half her face burnt. I was walking on this road with her and a hundred of girls were walking by – they are the garment workers of Bangladesh. And what I noticed was them whispering. Saira was walking with her eyes down, so shy, and these girls were all thinking that she was a bad person, was not a good person. It is this kind of negative thing which gets into people.
As a surgeon I can do nothing for this. Actually that is the hardest. And we have to stop surgery at some point, and they need to accept their situation.”
Posted on August 21st 2009 by Test Member in Blog
