HYDERABAD, April 30: The burns ward in the Civil Hospital Hyderabad lacks room, an intensive care unit and state-of-the-art equipment, increasing infection prevalence rate among patients to 15 to 20 per cent, which is too high according to experts. The ward, which caters to patients who come not only from Hyderabad but also from other districts as far as Badin and Tharparkar, has to turn away those with 60 per cent burns and send them to Karachi because it has no ICU, mandatory for a burns ward, to keep serious patients.

The ward’s building has 19 rooms and can admit 18 to 20 patients but contrary to protocols, two patients each along with their attendants are admitted to a room, exposing them to greater risk of infection.

The risk increases because of intrusion of patients’ attendants into the rooms at all times of the day. Doctors and staff have no control over them. “Since we don’t have required nursing staff to take care of patients on our own attendants remain unsatisfied and insist on staying with their patients against doctor’s advice,” said a doctor at the burns ward.

“ICU is essential for burns patients because resuscitation is needed in cases in which victims have inhaled smoke during burning or self-immolation,” said Dr. Tahir at the burns ward.

He appears to be single-handedly managing the ward along with plastic surgeon, Prof Razaq Memon. “We are delivering the best we can in given circumstances although we can do much better if system improves,” he said.

He said that serious burns patients require grafting, in which an affected part of skin is peeled off, or they need flap surgery in which entire piece of mass is extracted from an unaffected part to cover the wound.

“The most important thing during and after a surgery is management of patients under controlled environment that restricts exposure to infection but it is entirely non-existent here. This makes management of burn victims very difficult for us as it is too harmful for them,” said Dr. Tahir. He explained: “When we take decision to go for grafting or flap surgery the wound’s appearance becomes pale. It develops pus due to infection, making the skin uneven”.

He said that in developed countries four to five per cent of infection rate is inevitable and in developing countries it is 8 to 10 per cents. “But we are dealing with an infection prevalence rate of 15 to 20 per cent which is alarming,” he pointed out.

It multiplies problems for patients, lengthens their stay and adds to more burden on their purse well that of the hospital’s.

Doctors believe a deep wound requires 10 days to get ready for surgery and recommend a seven day post-surgery stay. But in most cases, a patient has to stay in the hospital for around 27 to 30 days, putting extra burden on hospital and management of other emergency cases difficult.

On an average, 15 per cent of adult victims and 10 per cent of children are admitted and around a dozen or so come from the hospital’s outpatient department, which lacks trained staff to take care of burn victims.

Officially speaking, the existing burns ward has not been approved so far.

According to procedure, the hospital management will have to submit a separate schedule of new establishment (SNE) to the department concerned to get approval for setting up a new ward or section, which will then be released funds and posts.

Successive medical superintendents have not paid any attention to get the SNE approved for the burns ward to set it up officially and equip it with required paraphernalia.

Out of the 19 rooms of the ward, four the hospital management has vacated four to set up an operation theatre. Among others, sitting MS Dr Ghulam Mustafa Abbasi has also reservations over the new OT and he has conveyed it to Sindh health minister.

He said that old burns ward building needed to be demolished to make room for establishing an ICU for the burn ward.