Burn Management In Resource Limited Setting: Lessons From Zambia

Burn Management In Resource Limited Setting: Lessons From Zambia

Peter Bauti Daka, Halwiindi Trevor, Dayson Kumwenda, Holly Harris
St Francis mission hospital Katete Zambia, Katete, Zambia; Oxford university NHS Trust, Zambia

Introduction: Burn injuries, caused by thermal, chemical, electrical, or radiation exposure, represent a significant global health burden. Between 2009 and 2019, an estimated 9 million burn cases and 111,000 burn-related deaths were reported globally. Notably, over 90% of these deaths occurred in low- and middle-income countries (LMICs), where burns remain a leading cause of disabilityadjusted life years (DALYs), contributing to long-term disability, disfigurement, social stigma, and marginalization.

Case Description: A 45-year-old Zambian woman sustained 7% superficial partial-thickness burns to the left gluteal region, back, and lateral thigh after falling into a fire during an epileptic episode. Initial management included povidone-iodine wash, followed by honey and papaya dressings. Within four days, necrotic tissue had softened, granulation tissue developed, and surgical grafting for the TBSA was done.

Discussion: Burn management in resource-limited settings poses significant challenges, including delayed presentation, high infection risk, and limited access to standard topical antimicrobial agents. In many LMICs, patients cannot afford conventional treatments, contributing to increased morbidity and mortality. This case underscores the utility of cost-effective, locally available alternatives such as papaya and honey. Both have demonstrated antimicrobial and wound-healing properties. In our experience, their use helps to reduce the need for surgical debridement, anesthetics time, and blood transfusion, while promoting healthy granulation tissue. Learning Points Papaya and honey are affordable, widely available in tropical regions, and offer effective alternatives to conventional burn care in LMICs. Their application may improve outcomes and provide effective treatments whilst patients are transferred to specialist regional burn units.

Keywords: Burns ,management, Resource Limited