One On One

Q & A – Burns Week Sr Moelo Emily Mokhele

Everyday thousands of people, including men, women and children are treated of burn wounds. Burns are among some of the most devastating injuries as they leave behind, both physical and mental scars. To help improve people’s safety, South Africa observes the National Burns Awareness Week at the beginning of May every year to educate communities about burns, fire and safety measures to prevent danger. The Weekly’s Martin Makoni spoke Sister Moelo Emily Mokhele, Professional Nurse: Burns Unit at the Pelonomi Tertiary Hospital about some of the major causes for burns, the most vulnerable groups and how to prevent danger. Makoni also asked Mokhele how bad the situation is in the Free State and why her institution is considered one of the best burns treatment centres in the country. Excerpts:

What does the National Burns Awareness Week seek to achieve and how important is it?

As you are aware, we are heading towards winter and that is usually the period when most burn related accidents occur as people try to keep warm. We know that in winter, people are using electricity quite a lot, as well as candles and all sorts of fires to keep warm. So, the National Burns Awareness Week is aimed at ensuring that people are aware of the dangers of using some of these methods to keep warm. We want people to be more careful when handling electricity, inflammable substances as well as open fires. It is therefore very important for us to go out and educate people on these issues. We will be having a major roadshow at the Lemo Mall on May 17.

What would you say are some of the main causes of burns from the injuries that you treat in your unit?

When people use candles, they don’t always secure them on candle-stands. Quite often, they just put them on a piece of plank, and that is very dangerous because it can fall at any time and cause a fire in the house. We also have a challenge with teenage mothers. Most of them still want to have fun and take very little care or don’t know how to prevent danger for their young children. It would seem it’s too early for them to be mothers. They usually leave their children alone in the house, unattended and go out partying. That is very dangerous because if anything goes wrong in the house, those children don’t know what to do, if they are awake. We also have a problem of people coming home drunk and trying warm up their food or cooking and then falling asleep in the process.

Cases of teenage mothers leaving their children unattended is quite dangerous, is this becoming a regular occurrence, from your experience?

The situation is actually so bad that most of the children brought in with burns, are brought by their grandmothers. And when you ask the grandmother where the mother of the child is, she will tell you she doesn’t know where the mother is. The grandparents are usually too old to take care of their grandchildren alone. Their eyesight is poor, the hearing is diminishing and the energy as well. In most cases, when something is burning, it may take time for them to realise that. Even if the child is crying, they may not hear that the child is crying. That is one of the reasons why we have severe burns from these little kids and the young mothers too.

What would you say are some of the main types of burns that you are treating?

We have different types of burns that we are treating here, including burns from hot water, electricity, open fire and chemicals, like acid burns. Cases of hot water burns are usually as a result of children jumping into a hot water bath or pulling a kettle with hot water from a table. Men also suffer hot water burns during fights with their partners and vice-versa. Chemical burns usually happen in the mines or factories because there maybe gases that can easily explode into flames when there is a certain chemical reaction and just a naked flame. We treat a lot of zama zamas (illegal miners) here. There are some inflatable gases underground and some of them, especially the new ones, are not aware and may light a cigarette while underground, resulting in these fires. Open fires usually occur in the informal settlements. As you are aware, there is no electricity in most of those communities and they are using candles and paraffin and they don’t really supervise their family at all times. You may find that the mother and the father are both working and have to leave the little ones with other little ones at certain times.

How safe are teenagers given that most teenage mothers leave their little children when going out to party?

There is a problem lately, of teenagers committing suicide. Some are drinking paraffin and then burn themselves in a bid take their own lives. For others, its superstitious beliefs. We once had a patient here saying at church they had been told to drink paraffin. After that, he had a running tummy. It so happened that at one point, this person stood in front of a heater to keep warm, but because he had paraffin in his system and had diarrhoea, he caught fire and actually burnt from the inside. He burnt from inside out. This happened here last year. There was nothing else coming from that patient except paraffin. When you walked into the ward, you would not smell anything else, but paraffin. And unfortunately, the person couldn’t make it.

The Pelonomi Tertiary Hospital is popular treating burns in the country, who do you cater for in the Burns Unit?

We cater for the whole of the Free State. We are the only burns unit in the province, so you can imagine how big our area of coverage is. We also take patients from other parts of the country as well as patients from Lesotho. We are not a very big unit. We only have 23 beds but we always make sure that we give our patients the best treatment possible.

What makes the Pelonomi Tertiary Hospital Burns Unit unique in terms of the treatment you give?

I think our biggest strength is teamwork. We are a very close team and we always meet to discuss each and every patient we receive so that we all know what to do. Also, we don’t just treat our patients with the different medications available. We have what I would call a holistic approach to treating our patients. The pain we feel and the healing come from the brain. If your mind is not in one place when we are trying to treat you, you may not respond well to treatment. So, we want you to relax your mind when we are treating you. If it’s music that makes your mind relax, we play you your favourite music when cleaning and dressing your wounds because we want to be relaxed. We do everything to ensure you are at peace, mentally when we treat you. It’s been working for us. I have been working in this unit for the past 27 years and I have seen miracles in this place. We have successfully treated patients who had literally been written off by other major health facilities in the country.

But doesn’t it also affect you as medical staff when treat some of these severe burns?

It does and it can be quite traumatic. But we get a lot of support. We all undergo counselling to ensure that we are in the right frame of mind to work. I struggled when I first joined the unit, but with time, I realised this was the best place for me. If you try to put me anywhere else outside the burns unit, I will resign. I have a deep understanding of my work and I would like to help people here. Most of us are so attached to this place that we even come and check on our patients even when we are on leave. We tend to miss them at times.

What sort of advice would you give to people so they don’t endanger their lives?

People should not put heaters under the table because, naturally, when you feel warm, you relax, when you relax, you fall asleep and when you fall asleep, you may kick the heater and a fire can easily start. A whole family can burn when this happens. When you come home drunk, don’t try to cook or warm food. Eat the food cold if you are really hungry. Never use the stove when you are drunk because you will fall asleep the moment you start feeling warm. Don’t smoke in the house, particularly when drunk because we have had cases of people setting a whole house on fire after a cigarette fell on something when they fell asleep. The carbon monoxide coming from the cigarette, if inhaled excessively, can put one into a deep sleep and you won’t hear or feel anything when the house starts burning. You may suffer smoke inhalation which has to the treated urgently because it affects your lungs. Children should never be left unattended in the house whether there is an open fire or not. Our children are very intelligent but they don’t know the dangers that come with some of their actions. Avoid using table cloths when you have toddlers because they will pull them when they want to reach for something, and that could be boiling water. When bathing your, you must pour cold water first and then hot water while you monitor the temperature.