A new ray of hope for burn survivors in Tanzania

Burn survivors ,Pendo James on the left and Sophia Fundikila on the right . Both successfuly got their reconstriuctive surgeries done at the Agha Khan hospital in Dar es Salaam. PHOTO|JOHN NAMKWAHE

What you need to know:

  • “For 20 years, I lived with the obnoxious stares from people because the scars on my face defined my being,” Pendo James shares in the interview.
  • A fire burn accident that happened at the age of one left Pendo’s future almost repressed. She narrates that when she was a year old, she was playing in the kitchen and unintentionally the burning wick stove fell down on the floor that caused fire and caught her. As a result of the accident, her right body part was severely burnt, especially her hand and face.

For 20 years, Pendo James lived in a shell of self-doubt and isolation. The 21-year-old burn survivor from Mwanza tells Your Health that she had never imagined a day where she wouldn’t have to walk the street without being stigmatised by society, neighbours, friends and relatives.

“For 20 years, I lived with the obnoxious stares from people because the scars on my face defined my being,” Pendo James shares in the interview.

A fire burn accident that happened at the age of one left Pendo’s future almost repressed. She narrates that when she was a year old, she was playing in the kitchen and unintentionally the burning wick stove fell down on the floor that caused fire and caught her. As a result of the accident, her right body part was severely burnt, especially her hand and face.

The same afternoon of the incident, she was taken to Bugando hospital in Mwanza for first aid and preliminary treatment to cure the wounds caused by the fire.

Pendo received the necessary treatment with instructions to visit the hospital for regular change of the dressing on the wound and monitoring. “I have been taking painkillers (Aceclofenac) since then. But the doctors at Bugando hospital couldn’t repair the deformities in my right hand and the scars on my face,” she says.

Pendo was diagnosed with third degree-burn complications that would necessitate a surgical and reconstructive procedure. Muhimbili National Hospital (MNH) plastic surgeon Dr Edwin Mrema noted that burns that affect only the superficial skin layers are known as superficial or first-degree burns. He explained that the burns appear red without blisters and pain, typically lasts around three days.

When the injury extends into some of the underlying skin layer, it is said to be a second-degree burn. “Blisters are frequently present and they are often very painful. Healing can require up to eight weeks and scarring may occur,” Dr Mrema explained.

“In a full-thickness or third-degree burn, the injury extends to all layers of the skin. Often, there is no pain and the burn area is stiff. Healing typically does not occur on its own,” Dr Mrema added.

The patient suffering from third-degree burn becomes at high risk of developing skin cancer due to damage of first and second layers attributed to fire burns. Dr Mrema noted that the first two layers are protective layers of the skin therefore once they are destroyed; the patient becomes exposed to numerous skin complications.

As for Pendo’s case, she was unable to stretch her right hand’s fingers as they were deformed in a way where she neither could a pen nor carry heavy materials.

Pendo’s right side of the face is half covered by her hair falling on the front. She still appeared shy to face the by-passers. She continues with her head down, “I have a faint memory of what had transpired the day of the accident. I still can recall bits and pieces of the incident because my mother had told me everything about how and what had happened.”

The only thing that Pendo seemed interested to talk about is her mother who has been her hero and a mentor. “I love my mother, she took good care of me and has always been there for me, on the good and bad days,” she tells.

Pendo admits that the hand and face deformities had affected her schooling schedules. She was unable to pen down notes and hence always felt obliged asking help from her fellow classmates to assist her with writing. “During the mid-term or final examinations at school, I used to get extra 30 minutes added to the normal time allotted for the test,” she recalls.

When her life took a complete u-turn

Last year, she was transferred to Sanitas Hospital in Dar es Salaam, but her family could not afford the treatment cost required for the rare plastic surgeries, that will cure her deformity on the hand and lessen the scars that had left her face worn-out.

“At least Sh4.5 million was required for the rare plastic surgeries at the hospital in Dar, but my family couldn’t afford the expenses,” Pendo re-emphasises.

Before she could completely lose hope, Pendo and her family came across a social media announcement about a reconstructive surgery screening camp, which was scheduled in October at the Aga Khan hospital in Dar es Salaam. “I saw the brochure post circulating on Facebook and WhatApp while I was back in Mwanza. With a new hope, I left for Dar es Salaam where my elder sister was there to receive me,” Pendo now speaks with confidence and head held high.

She continues, “The information on the brochure suggested that the screening and the surgical procedures were provided at no cost. I saw it as a huge opportunity to bring back the lost smile on my face,” she tells.

Pendo was one among the 241 candidates that were screened at the camp. She underwent a successful plastic surgery last December. Upon learning about why Pendo waited for 20 years to get the reconstructive procedure, she says, “My family couldn’t afford the treatment cost and therefore due to circumstances I was forced to wait for the aid. It has been a long journey but I am glad it is all over now.”

Dr Mrema admitted that economic factor, lack of awareness and shortage of medical personnel especially in rural areas accelerates to the increasing burden of fire burns-cases, just like Pendo’s.

“The rare plastic operations require a lot of money, this is why the majority of the victims can’t afford the expenses. They are obligated to wait for special programme or charity to come along. I personally commend the institutions that are willingly showing support to burn victims,” he said.

A mother who survived a third-degree burn

In a similar situation, Sophia Fundikila, 31, a resident of Iringa and mother of three children shares her story with Your Health about the unforgettable incident that almost left her with a disability due to severe wounds caused by fire burns.

She recalls that at the age of four, after a shower she went straight into the kitchen for warmth next to a wood stove due to Iringa’s chilly weather. In a blink of an eye, her clothes caught fire that resulted into severe burning of her right hand.

She was rescued and taken to Ipamba hospital in Mafinga for treatment. Since then, Sophia has had numerous difficulties to fully participate in domestic activities due to the fact that she was neither able to stretch her right hand properly nor lift heavy things such as a 10 litre water bucket.

In October last year, she heard about the specialists at Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) in Dar es Salaam were offering reconstructive plastic surgeries for women, therefore she visited the hospital in the hope of getting cured. Unfortunately, she was told to contribute the treatment cost of USD500 (Sh1.1 million), of which her family could not afford to pay.

“I was told that the surgeries were meant for children with deformities caused by fire burns and domestic violence only, hence adults were recommended to contribute at least USD500,” Sophia recalls.

She explains that it is against this backdrop, she started looking for donors. That’s when she came across a post on Facebook that mentioned about a free screening camp at the Aga Khan hospital in Dar es Salaam and the eligible survivors would receieve the reconstructive surgery at no cost.”

The success of the reconstructive surgery camp

In December last year, the specialists at Aga Khan Hospital in collaboration with the plastic surgeons from Muhimbili National Hospital (MNH) and experts from WomenForWomen organisation in United States (US) had performed the rare plastic surgeries on at least 37 women and children who had suffered from fire burns, domestic violence and deformation.

The programme worth USD60, 000 (Sh131, 400, 000) initially included patient selection based on 29th October, 2016 screening camp followed by patient pre-operative and anaesthesiology clinic screening and now surgery process and procedures for identified patients, post-operative consultation, care, dressing change, physiotherapy if needed at the Aga Khan hospital.

A total of 37 patients were selected ranging from age 1 – 65 years old. As almost all patients were victims of burns, most procedures included contracture releases of hands, elbows, axilla, feet, neck and lips with full thickness skin grafts, as well as nasal and ear reconstruction, mammoplasty and steroid injection.

After the surgeries, minor procedure patients were discharged on the same day of the surgery. Patients were discharged after one night of stay at the hospital while other patients had remained at the hospital for dressing change and daily monitoring for at least 10 – 12 days post-surgery.

All the 37 patients are continuing to receive post-operative consultation and dressing change at the post-operative clinic based schedule that was shared after surgeries.

WomenforWomen team leader Ms Azra Dallah noted that every year many women and children across the globe fall victim to injuries that leave them disfigured and at times disabled. She reiterated, “Injuries may be the result of domestic violence, accident, trauma, or war.”

She continued, “The injuries make women vulnerable to stigmatisation, isolation, and often violence. At times women are also neglected or abandoned by their families. Disfigurement and disability make it difficult for women to be productive and earn a living, pushing them into poverty and further away from access to quality affordable medical care.”

Pendo and Sophia lead normal lives

Pendo graduated with a Certificate in Accountancy at Belvedere Business and Technology College in Mwanza, last year. She is currently focusing on pursuing a Diploma course at the University of Dar es Salaam.

“I am very happy that the surgery was done successfully. I can now stretch my fingers but I can’t lift heavy substances at moment. I will surely be able to do so after I manage to recover fully from the wounds,” she noted.

Meanwhile, Sophia is serving as a teacher at Dar es Salaam Independent Primary School in Mikocheni. She usually visits Aga Khan hospital for dress change on her wounds.

“It took the doctors at least 45 minutes to complete the operation. I can now stretch my arm properly compared to previous years. I have a new build confidence now, and I am very happy to be able to participate fully in family affairs and community based programs,” she noted.