3 BURNS Ashley

South Africa has a high rate of childhood burns, with as many as 1300 deaths every year, many of which are thought to be preventable. South African investigations have described child burn circumstances of occurrence; perspectives on the aetiology and prevention of childhood burns; and descriptions of a number of prevention interventions. These reports have emphasised the vulnerability of especially infants and toddlers, with the highest incidence among very young black boys. Congested homes, paraffin appliances, family stress and general impoverishment are reported to contribute to childhood burn injuries. This Chapter reviews these contributors and the environmental, legislative and educational preventative strategies and activities reported to have had some success internationally, if not in South Africa, in the prevention of burns. The improvement of home design and layout, installation of electricity, control of hazardous domestic equipment and provision of safe appliances, are all high priority or effective burn prevention strategies. In addition, the formulation of South African legislation to enable these infrastructural improvements, such as policies or standards for both hot water cylinder temperature control and paraffin appliances, is strongly supported. Educational interventions that target children, caregivers and policy makers, potentially consolidate the efficacy of burn prevention. Posttraumatic, psycho-social interventions are important in the South African setting and this Chapter reports on the emerging local and international practices. These include burn camps, support groups, school reintegration, counselling, and expressive arts. However, there remains a scarcity of information on which rehabilitative and preventative interventions work in South Africa, with few scientific evaluations of local interventions. keywords: burn injury, epidemiology, prevention, rehabilitation INTRODUCTION This Chapter provides an overview of South African burn injury prevention research. It provides a synopsis of the most recent research in the sector, and supplements an earlier review that documented burn injury prevention research and interventions 1 To whom correspondence may be addressed: Ashley van Niekerk, Medical Research Council-University of South Africa Safety & Peace Promotion Research Unit, P.O. Box 19070, Tygerberg, 7505, South Africa. Email: [email protected].