Interburns:delivering real change to people across the world

BAPRAS member Tom Potokar, Consultant Plastic Surgeon at the Welsh Centre for Burns and Plastic Surgery is also Director of Interburns. Here he outlines how the organisation is delivering real change to people across the world, and why BAPRAS has been supporting its work.

You may have heard of Interburns – BAPRAS has supported our work a number of times over the years – and if not, hopefully you’ll see here that our essential work is leading to step changes in burn care and prevention around the world. We are a global organisation based in the UK that works to improve burn care in resource poor environments through education, training, research, advocacy and prevention.

We have developed a comprehensive, integrated approach to quality improvement in burn care, developing consensus international standards and subsequently an innovative and comprehensive system for assessment of services based on capacity, delivery of care and outcomes. All our education and training materials are developed from scratch by our international network and are specifically for resource poor environments and are therefore contextualised and highly relevant.

We work directly with doctors, nurses, therapists and other practitioners in the field as well as providing strategic advice at government and international level (through WHO, national burn organisations and others). As an example of our work, since July 2013, we have been running a large-scale, multi-year comprehensive quality improvement project in Nepal and Bangladesh funded by the UK Department for International Development.

The project involves working with 14 different burn services (including seven of the main government and NGO hospitals in Nepal), delivering training, assessment, research and capacity-building in partnership with the Nepal Burns Society and several partners in Bangladesh. Work to date includes the training of over 475 people in Essential Burn Care, the development and delivery of a five-day Advanced Burn Care module in Rehabilitation to physiotherapists and occupational therapists, a community survey into burns in rural Nepal, and the ongoing assessment of the seven project services to measure the impact of this training and additional support.

All aspects of this programme – the training courses, monitoring and evaluation tools and other resources – have been developed from the framework of the operational standards specifically for the context of Low and middle Income Countries and have also been adapted and evolved over the course of this pilot project to increase their relevance and effectiveness in Nepal and Bangladesh specifically. 

Based on the success of this programme, DfID have now funded a second follow-up project under their new Aid Direct fund, which will enable us to continue to deliver assessment and support to key services while developing and delivering further Advanced Burn Care modules in Nursing, Acute Surgery, Reconstructive Surgery and Prevention, as well as a Basic Burn Care course focused on first aid and prevention at the community and primary health care levels. Both projects have been accompanied by extensive advocacy work, which has led directly to the Nepali government National Health Training Centre (NHTC) funding the delivery of Essential Burn Care training in rural Nepal, and a commitment by the Bangladeshi government to develop a new purpose-built 500-bed burn and Plastic Surgery hospital in Dhaka. 

Combined, these two projects will enable us to develop a full suite of training, monitoring and evaluation and research tools designed specifically to improve burn care and prevention in the LMIC context. Due to these two significant grants from the UK government, we have been able to commit to a long-term programme of quality improvement over six years working with a large number of hospitals and clinicians from across Nepal. We are currently in the process of submitting a number of academic articles about these programmes, explaining the findings and impact of our work and how we have tried to address the many barriers to implementation in this context.

Thanks to funds from BAPRAS as well as the Royal College of Surgeons of Edinburgh and the Welsh Government through Wales for Africa, we are now working on a similar programme in Ghana and also with the Ethiopian Federal Ministry of Health to develop and implement a national strategy for burn care and prevention. Partners include the Pan African Burns Society as well as national burns societies and other NGOs.

This is a long term commitment aimed at sustainably transforming burn care and prevention and improvement, which is going to take years rather than months, but building a solid foundation and creating an expanded workforce of trained professionals is a critical stage, and we are seeing dramatic results.

If you’d like to know more or wish to get involved, please get in touch. http://interburns.org/