Hope with a new face

TWENTY-ONE years ago, history was made in Kilpauk Medical College Hospital when a 50-bedded ward was opened to exclusively handle burns victims. It was the largest single Comprehensive Burn Care Unit in the State, the second largest (now), and a step towards revolutionising burns care for the poor and the underprivileged.

Today the ward, with over 2,000 patients a year, has come a long way.

The concept evolved under the supervision of plastic surgeon K. Mathangi Ramakrishnan, who headed the department till 1992. It was under her that the department excelled in providing better treatment facilities for poor and underprivileged burns victims. The problem was approached from a social standpoint due to the stigma attached to it, and to rehabilitate the victims.

This accomplishment has earned Dr. Mathangi the Padma Shri this year. Even after her retirement, she has continued her crusade as the Director of the Intensive Paediatric Burns Unit of Kanchi Kamakoti CHILDS Trust Hospital.

While forays have been made in the fields of reconstructive, plastic and cosmetic surgery through various procedures involving skin grafting, the burns care is still critically important due to its impact on the social lives of patients, Dr. Mathangi says.

After passing out of the Madras Medical College in 1957, she did general surgery in UK and subsequently qualified for MCh (plastic surgery) in 1967. She obtained a Ph.D in plastic surgery from the Madras University in 1979 and was the first to obtain a DSc from the Dr. MGR Medical University (1992) for her work on Nutritional Management in Burns.

``Deformity itself is unfortunate. Even more so if it is caused by burns. The survivors live on to tell the tale of pain and struggle towards a grotesque and sometimes, crippling end. The treatment requires a multi-speciality approach as also the social aspect of rehabilitation,'' adds Dr. Mathangi.

Though the number of victims crippled by burns was huge, there is no registry to ascertain their number in the country. Representations, she said, has been made to the Union Government to set up a National Registry for burn victims and carry out necessary amendments to accommodate them in a Schedule.

``Still a grey area, a lot of preambles have to be set for treatment of burn victims. Constructive efforts should come from the Government and research organisations,'' she says, adding that the socio-economic impact of such accidents in a large country like ours is immense.

While many facilities were required, some were necessary immediately. Occupational therapy centres to evaluate the extent of normal activity capable by the victim after the treatment, could be set up on a regional basis. This would help in their rehabilitation.

It was, however, disheartening that there was not much support from the medical fraternity as burns cases were chronic and their treatment time and manpower consuming.

``It is difficult to enthuse youngsters to come into the field because it might not be very financially rewarding,'' Dr. Mathangi adds.

The best treatment, however, lies in prevention. As in the U.S. and U.K., various agencies should take responsibility to sensitise and educate the population towards prevention of fire accidents.

Such efforts were in the nascent stage in India with the National Academy of Burns doing their bit. But Dr. Mathangi feels that a policy shift and an active contribution by the Government and research organisations is required to chart out a proper strategy to deal with fire victims.

By Saptarshi Bhattacharya

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