Out of Africa: Nursing Care of the Burn Patient in Zambia

Abstract

In March 2005, The American Burn Association (ABA) become a sponsor of Health Volunteers Overseas (HVO). This sponsorship allows HVO to offer burn care programs (patient care, education, prevention and advocacy) to developing countries through expert burn care providers. In the summer of 2005, a medical director and a nurse manager of a Burn Treatment Center (BTC) of a tertiary care hospital spent 28 days in Zambia. The purpose of their visit was to: (1) teach Advanced Burn Life Support Course (ABLS), (2) provide individual instruction/training sessions on burn care with the nursing and medical staff, (3) participate in surgical and reconstructive care in a theater setting, (4) meet with non-government service organizations to advocate financial support and prevention efforts for the burn unit, (5) be available for consultation as experts in burn care, and (6) identify possibilities for future relationships/partnerships in Zambia. During the time period of our visit, we shared burn care knowledge and skills with medical and nursing staff. The ABLS course was attended by 50 staff and was the first of its kind to be taught in Zambia. The course was an overwhelming success. Our assessment of the nursing unit or “burns ward” identified the following issues: inadequate medical and surgical supplies, lack of technology, competition of resources, delay in burn care resulting in 1:5 mortality rate, and lack of prevention efforts. The care of the burn patient was family focused with supplies and nourishments provided solely by the family. Due to limited resources for the family, dressing supplies and food was often inadequate. The majority of the patients observed were pediatric victims under the age of 3 with injuries sustained around cooking or heating fires. It was reported that the country is currently experiencing a 75% nursing shortage and that the nursing staff is dying from AIDS at a rate of 30%. The annual salary for the nurse, “sister” is $2,500. The nurse to patient ratio is 70–80 patients to 1–2 nurses. Warm water is not available for dressing change and infection control policies are not present.