Towards a paediatric burns rehabilitation centre

1. Towards a paediatric burns rehabilitation centre Dr Roux Martinez

2. The Burn Survivor • Acute / Hospital Phase • Excellent medical, physio, OT & dietary management • Good alternative medical support • Insufficient time on psychological support • No reintegration skills taught • No schooling for prolonged periods • Late / Ongoing Rehab Phase • Most lost to follow-up • No reintegration skills taught • Uninformed & unaccepting public • No financial support / disability grants • No school reintegration or ongoing support • No vocational training • No place to go

3. Successful outcomes The burn survivor must be able to manage the reaction of others in all situations - J. Partridge • Physical rehab - realistic expectations • Psychological rehab - child & family • Social reintegration - effective skills • Quality social support - family, professionals, public • Education & employment aspects - vocational training

4. A rehab unit should provide • Physical rehab • Medical, OT, physio, dietary, etc • Psychological rehab • Place to discuss fears, anger, anxieties • Support groups (parent & children) • Positive burn survivor role models • Cognitive therapy • Psychotherapy • Social reintegration skills for child & family • Appropriate to culture and age • Education & vocational training • Fun & enjoyment

5. A rehab unit should • Have a core of highly trained professionals • Have a holistic and multi-disciplinary approach • Respect patient confidentiality & never exploit the pt • Be strongly research orientated • Be integrated with government & private healthcare systems • Be integrated with relevant NGO networks • Be financially sound & accountable • Be sustainable • Be accessible to all child burn survivors • Be an advocate for burns survivors • Promote public awareness & education

6. A phased approach • Phase 1 • Develop operational experience & validate methodologies • Phase 2 • Build a strong professional core and community network • Phase 3 • An autonomous centre of excellence in burns rehabilitation

7. A phased approach - Phase 1 • Rented venue • Volunteer professionals • Develop assessment criteria for services & volunteers • Carefully selected small patient pool • Support for parents • Prevention & awareness • Provide transport & meals Day programme - patients rotate through stations • AM: Physio, dietician, OT, psychologist, surgeon • Lunch • PM: Free play, touch therapy, music therapy, colour therapy, life skills training, socialisation, pastoral care for various faiths.

8. A phased approach - Phase 2 • Core of permanent employees assisted by part-time professional volunteers • Patient monitoring & follow-up • Develop plans for a dedicated facility • Start to train lay community based volunteers • Start satellites in community • School reentry programmes & assisted vocational training • Expanded day programme (more activities on more days) • Tertiarystudent involvement

9. A phased approach - Phase 3 • A dedicated burns rehabilitation facility • Core professional staff assisted by professional volunteers • In-patient & outpatient programmes • Research programmes & outcome studies • Satellite clinics at community centres • Dedicated lay community volunteer pool • School bridging programmes • Vocational training placements • Scholarships for learners • Own patient transport facility • Student rotation & visiting fellowships