The Tribune

As part of a National Rehabilitation Awareness Week series Sasha Daneah Anderson looks at the physical and mental traumas caused by burns.

By Sasha Daneah Anderson

A FEW years ago, while working as a professional massage therapist, I became friendly with a fellow employee who felt comfortable sharing with me her personal experience with burns.

Sarah (not her real name) was in high school when she received severe burns to parts of the right side of her body. The scars were visible on the right side of her face, neck, shoulder, arm, chest, and stomach. Sarah explained to me how this had left her traumatised and being a high school student did not make it any easier as teasing was inevitable.

Although Sarah was able to cover most of her scars with clothes, there was no way to cover her face. As a result, she suffered from low self-esteem, anxiety and depression.

Depending on our perception, our skin is one of the main components that determine how we are evaluated by society. Therefore, a major burn is possibly the most traumatic injury a person can endure. Not only does it have the potential to cause excruciating pain, it can also have a big impact physically, spiritually, psychologically and emotionally.

In a world where people are heavily judged based on their appearance, no wonder Sarah and those like her have difficulty adjusting to their physical scars. Unfortunately, physical scars often result in emotional scars and without proper treatment and guidance, burn survivors will not fully grasp the concept of “beauty is only skin deep”.

In Sarah’s case, she was fortunate enough to be surrounded by a positive support system which told her she was beautiful every day. This support system also introduced her to the wonders of cocoa butter. It wasn’t easy: nonetheless, Sarah was able to face her school-mates and the world every day with her survivor’s burn scar on her face and live. Eventually, with daily use of cocoa butter, Sarah’s burn mark diminished. For others suffering from a major burn, the cocoa butter remedy isn’t that simple. More severe cases will call for the Rehabilitation team.

Rehabilitation of burned clients is a complex process that is considered to not be a direct progression where clients are subject to one type of treatment. Burned survivors move through a series of treatments with the ultimate goal of enhanced function. At times, the treatment required for one form of injury or client may not be beneficial for another.

It is essential for all members of the Rehabilitation team to communicate effectively in order for clients to have a successful treatment.

Further, the ultimate goal of treatment of burn survivors is to preserve function. However, scar formation may hinder this, whether by damaging the joints the scar is on or causing cosmetic and psychological distress. Despite the hindrance of scars, other forms of treatment include:

• Positioning

This helps prevent contracture (a condition that leads to deformity of joints), oedema and skin breakdown and assists with later mobilisation of the joint.

Splints – this is used to provide ideal positioning for protection. Use of splinting is customised to the patient in an effort to prevent contractures from forming or to correct deformity.

• Therapeutic exercise

Though positioning and splinting are important, they must be balanced with motion. This is where physical therapy comes in. Active and passive range of motion of all joints and skin surfaces are vital.

• Scar management

When burn wounds heal, abnormally large scars can form. To manage scars, clients can be assisted by a physician to determine which scar management procedure is best for them.

• Pain management

Pain with burn care and rehabilitation is a severe problem. In those with open wounds, it is clear where the pain is coming from. With those with closed wounds, the reasons may not be so apparent.

Finally, burn survivors are immediately faced with a severe change in their personal sense of identity and wellbeing. A bad haircut in today’s society can be a source of embarrassment with its emphasis on youth and beauty; those with visible burns suffer worse. Like Sarah, many burn survivors cannot bring themselves to look in the mirror for months.

Psychological problems following a burning incident are common and it’s important for burn survivors to know that rehabilitation can help. Though active rehabilitation may be prolonged, with the right people involved and consistency the majority of clients will do well. Treatment begins with reassurance and education for both clients and families.

• Sasha Daneah Anderson is a rehabilitation counsellor born and raised in Nassau. Educated at St Anne’s Anglican High School and College of the Bahamas, she graduated from Emporia State University, Kansas, with a Master of Science degree in Rehabilitation Counselling. She can be contacted at sander12@g.emporia.edu