Bridging the Gap—Awareness, Legislation, and the Power of Data in Pakistan’s Burn Crisis

Abstract

The healthcare landscape in Pakistan is affected by a “triple threat”: a growing economic crisis, low literacy rate along with growing social media presence of unqualified healers and persistent political turmoil, which lead to frequent changes in policies thereby causing disruptions in smooth delivery of healthcare services. Burns injuries has emerged as a silent epidemic amidst these challenges. There is an estimated 1.3 to 1.5 million burn incidents annually. The mortality rates in specialized centers can vary depending on the region and the availability of resources, but can go up to as high as 26%.^1,2

The best and most cost-effective approach to burns injuries is by prevention. Developed nations have implemented safety protocols in the homes, industries and public places in such a way that the incidence of burns injuries have dramatically decreased. Prevention is of paramount importance in our country where a single patient presenting with severe burns can cost over 2 million - Far exceeding the annual income of an average family.  We should shift our focus to a more proactive approach in order to prevent these injures. It involves modifying the daily behaviors and environments of the most vulnerable: the 71% of victims, women & Children injured in their own homes.²

 Given the low literacy rate, we must move away from text-heavy pamphlets. Public awareness initiatives must be designed in a way that are able to connect with the people in their native languages and using visual story-telling. These programs empower families to reorganize high-risk areas, such as moving floor-level stoves and securing loose traditional clothing (e.g., the dupatta) that frequently act as accelerants.^3-5

The Role of Legislation: Beyond Advocacy to Enforcement

While education is vital, it is insufficient without the "teeth" of the law. Legislation is the most potent tool for population-level prevention. Currently, Pakistan's Building Code (Fire Safety Provisions) 2016 exists largely on paper. Robust enforcement is required to mandate:

1. Industrial & Residential Safety: Strict penalties for substandard electrical wiring and lack of fire exits in high-density urban dwellings.⁴


2. Product Regulation: Immediate bans on unsafe decanting of LPG and the sale of non-compliant gas cylinders in public transport and school vans, standardization for the electrical & kitchen gadgets.³


3. Installation of smoke detectors and availability of fire extinguishers in all residential buildings.

The Necessity of National Burn Registries

In order to adopt effective policies to prevent burn injuries, there must be some mechanism in place to document all the data in a centralized fashion. This enables us to identify the gaps in policies and implementation and timely address the gaps in a resource efficient manner.

A centralized burns registry can accurately map the geographical locations with active hotspots of burn injuries, moreover, it will also direct appropriate actions towards the specific types of burns injuries, thereby eliminating the environmental hazards. This data also identifies the gaps in policy making and can be instrumental in directing new policies in a timely manner to improve public safety. Precious resources can be allocated strategically to help prevention efforts using data from the burn registry, thereby, giving maximum results with limited resources.

Conclusion:

The prevention of burns injuries in Pakistan requires a multifaceted approach. Effective public awareness, appropriate legislation and effective implementation of laws to enforce public safety in the environment and equipment can guide our strategy to prevent these injuries that our economy can no longer afford. National Burns registry is an effective way to gauge the effectiveness of prevention programs and guide the efforts in appropriate direction.