Monday, 6 February 2012

2 year old oil burn victim

Talking of Nanna Jean losing her sister to a burn brought back me my experience here in the Philippines with little Tiffany last year.

(I know blogs are supposed to be short to hold your interest, but this is a long story.  I hope you'll stick with me.)

Moments after our Xcell meeting ended one Saturday, I sat down in my office to start my work when I received a call.  I could barely hear what was being said because there was just noise and panic.  Two year old Tiffany (who had just been at our meeting with her grandma) had been in an accident and a pan of deep frying oil had fallen and poured over her back. 

Grandma had gone with friends to visit a lady who sold fish balls for a living.  There are no health and safety regulations here for people selling food by the roadside, and the wok of deep frying oil stood precariously less than a foot from the ground.  As the friends chatted and ate their freshly fried fish balls, Tiffany tripped and pulled the whole pan over her back, chest, arm, and neck.  It was a miracle that she was still alive and that the oil hadn't touched her face.

Here in the Philippines  it is said that toothpaste and ketchup are remedies for burns, so the neighbours had subjected poor Tiffany to bottles of ketchup and tubes of toothpaste prior to calling me.  As they removed her clothes, her skin was stripped from her body too. That was when they called for my help (as I am their only friend with a car).

As I approached the area of the accident, shocked neighbours crowded the streets and watched as panicked friends were running carrying Tiffany by her hands and feet not knowing what to do, but trying desperately to avoid anything touching the burns.  I didn't know what to do either!!  But when I don't know what to do, I always find that the best thing is to pray.  Knowing what happened to Nanna Jean's sister, I knew that a miracle was the first thing we needed. Tiffany stopped screaming and a calm seemed to come over her.

I asked my son Nathanael to drive us to the hospital but hen I suddenly remembered Val.  Val is an English/Australian nurse who specialized in the treatment of burns and had worked in the best British and Australian burns units.  She now works as a volunteer here in the Philippines, helping arrange for teams of volunteers to conduct cleft palate operations for the indigent.  When I called her, she told me not to go to the hospital but to go straight to her and she'd be ready for us.  So we did a u-turn  and headed straight to Val's.

Within 30 minutes she had Tiffany's burn completely dressed with the best honey dressings that money can buy that 'just happened' to arrive from Australia days before.  Though Tiffany was clearly in pain, her wound was well protected.

Val explained to me that it was good that I had brought Tiffany to her because the nearest burns unit was over 4 hours drive away and the local hospitals do not have any trained staff to deal with burns.  However, she cautioned us that due to severity of the burn (that covered more than 20% of her body) Tiffany may need to go to hospital for re-hydration and anti-biotics. But she warned me that the dressing must remain on for 10 days and must not get wet under any circumstances.

Tiffany's fever rose and we had no choice but to have her confined in a local hospital.  I told the staff that we had been given strict instructions for the dressing not to be removed.  Which they agreed.  I left Tiffany at the hospital with her dad (as her mum was working away).  Less than an hour later I received a call from a very stressed dad.  Just as I had feared, the moment I left the hospital, the new surgeon on duty insisted that Tiffany's dressing be removed, and she was convulsing.  Of course, I do understand that a doctor would like to see the extent of the child's wounds if that child was being confined, but surely they would make sure that they could give at least as good a protective dressing as the one they removed??  But no!!!

When I called Val, she was so upset.  Aside from the waste of the expensive dressings (of which she only had 1 more piece), she knew that they had put Tiffany's life in danger by exposing her wound.

When I returned to the hospital I wanted to cry when I saw her.  I could not believe the flimsy excuse of dressing that they had put on to protect her from infection, and she had been put on the general ward with children with all kinds of sicknesses and diseases.  Even the attending Pediatrician asked who had left this child in such a state, and immediately had her put in isolation (which had another patient in but it was considerably better than the general ward).  

I have learned over the years, that it doesn't help to get angry.  It only antagonizes people and nothing improves.  So Val and I asked nicely if she could come and re-dress Tiffany's wounds (which was strictly against hospital policy for non-staff to be involved with the patients for obvious reasons).  However when I showed the chief surgeon the state of the 'new dressing', he had to admit that the child was severely at risk of catching infection, and (as the skin controls the body temperature) there was little hope of her temperature stabling.  It took hours of convincing then one kind surgeon offered to change the dressing under Val's supervision in order to satisfy the hospital's requirements and our request was granted (incidentally both surgeons had witnessed Val's skill and success in treating burns, so they knew that Tiffany was in safe hands).

It is normal practice in local hospitals (where there are no burns specialists) to clean severe burns every day and scrape the burn (with absolutely no sedation even for small children).  The purpose I'm sure is to keep the wound clean, but in actual fact, every time a dressing is removed, it removes the skin and hinders the healing process.  Tiffany would have been subject to having her wound washed (with local tap water) and scraped daily.  Thank God for surgeons who had compassion and spared her that!!  

I picked up Val to take her to the hospital.  She was equipped with scrub suit, baby bath, purified water, sterilized  equipment, dressings, anti-histamine meds (to at least dull the pain) and even a table on which to place her equipment.

True to his word, the doctor came and the procedure started.  It was hard for me to endure the screams of hysteria as poor Tiffany had to bathe in soapy water so that the flimsy dressing would fall off with minimal pain and damage.

I will never know how on earth the doctors would be able to endure the kicks and screams daily as they would normally bathe their patients wounds without purified soapy water and no pain relief at all, scraping away at the sores!!  Thank God that this was the last that Tiffany would have to endure for at least 10 more days!!

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