The rains force the children indoors. The children who spent their entire day and sometimes a significant part of the evening outdoors wandering, collecting water, gathering firewood and sticks, ‘stoning’ mango, plum and other fruit trees for food, and otherwise foraging in the ‘bush’ find themselves having to spend more time closer to home or worse, at home. It also means getting closer to the fire and being home when the piping hot food comes off the fire. Yes, here the cultural norm is cooking over an open flame. The stove is three rocks and a pot is placed over it. Some houses have a hut they cook in but it is still open flame cooking. The children who get burned often do from either reaching into the pot still on the flame or from the piping hot food spilling on to them. The story often gets lost in translation but the result is still the same – children with first and second degree burns covered in gentian violet. Yes, that mainstay of wound care in many an impoverished and resource limited setting, gentian violet. While gentian violet has some great antibacterial, antifungal, and antihelmintic properties, there are better (and less messy) things that can be used. But here, if it is skin related then it calls for some purple haze and for burns and blisters, it is a whole lot of Hendrix. We had wounds that have healed long before we were able to wash off all that dye off the skin.
We currently have at least four children aged 1 through 6 that we are treating for burns. Thankfully all have been manageable within our scope and ability, meaning none of them worse than a second degree. And all are slowly healing with the help of frequent dressing changes, silver sulfadiazine, and the occasional application of Surgilube.
Before starting treatment. The burn is covered in gentian violet and black/purple eschar, so it is hard to tell the extent of the burn.