The Centre has been working in partnership with Interburns as part of the NIHR Global Health Research Group to deliver Advanced Burn Care training in low and middle income countries (LMIC’s). The training was funded by the National Institute for Health (NIHR) and the UK Department for International Development (DFiD).
This March, the training took place in Ethiopia’s capital, Addis Ababa. As part of a structured approach to capacity building and quality improvement in burn care, the Advanced Burn Care (ABC) programme is one of three key levels of training developed: basic, intermediate, and advanced.
The ABC training in Addis Ababa was a specialised ABC Surgery module. This level is aimed primarily at surgeons, both general and plastic, and covers key areas in burn care from treatment
in the first 24 hours since injury, to reconstructive surgery and through to post-injury. The training is developed to encourage participants to think critically and adopt multiple and flexible perspectives to treatment with limited resources. A secondary aim of the training is to immerse participants in knowledge share and to expose them to an environment rich with experience in the management of burn injuries in resource poor settings.
To ensure contextualisation and relevance and to build a truly global community of practitioners, faculty and participants came from a wide variety of countries in Africa and beyond. This enhanced the learning experience and exchange of ideas from different environments across the world.
The 5-day training was structured to cover key topics in burn care and to promote hands-on learning.
After an opening speech from Professor Tom Potokar and introductions, the training kicked off with a discussion on early surgery and the barriers faced in low resource settings. An interactive quiz was used to help open up debate around fluid use in burn injuries.
Day 2 included topics like inhalation injury, complex care, extensive burn management, critical care, and sepsis. A key message delivered on this day was the need for a paradigm shift to place pain management at the forefront of burn care in LMIC’s. The four phases of pain were discussed in detail as were the repercussions on the mental wellbeing of burn care patients when there was poor pain management. Participants were then divided into groups to discuss hypothetical pain management for simulated case studies.
“It has been a very good experience. Informative, interactive, and one that stimulates thinking.” – Participant from the ABC training.
The focus for day 3 was on palliative care and the fact it is often overlooked in low resource settings.
The focus then moved to quality improvement and the participants were encouraged to think critically about developing an effective burn service. A team-building exercise including marshmallows highlighted the need for effective communication, leadership roles, and a cohesive team in achieving a successful outcome.
On day 4 the faculty went into more depth with the participants regarding electrical injuries. Next, the discussion focused on reconstructive surgery, and people shared their experience and knowledge. Day 4 ended with the challenging topic of mass casualties. Participants were split into role-playing groups of victims and doctors dealing with likely stressful situations.
On the final day of the training, the onus was on consolidating everything that had been learned over the last few days. The training ended with a conversation with a burn survivor to give the participants a key perspective to finish on.
The faculty involved in the training came from within the region of Ethiopia and further afield including South Africa, Nigeria, Ghana, India, Nepal, Bangladesh, and the UK.
This was also true of the participants who had travelled from within Ethiopia as well as Malawi, Nigeria, Zambia, Afghanistan, Sudan, and Rwanda. This helped to give a truly global perspective of burn injury and burn care.
The course was considered very useful. In the course feedback participants indicated feeling more confident in all aspects of better burn care, a great result of a successful week!
“The overall experience was very good. The training was interactive and practical… the trainers came from different parts of the world where there are different challenges. The training will improve burn care at my facility” – participant from the ABC training