Institute for Social and Health Studies (ISHS)

Injury Prevention

Burns

It has been estimated that South Africa's burn fatality rate is approximately four times higher than in the industrialised world. Using a sample of mortuaries across South Africa, it was found that on average 4.4% of all deaths where due to burns, ranging from 2.3% in the Germiston area to 7.1% in East London. Over 80% of fatal burn injuries are said to occur in informal settlements. In a study undertaken in Gauteng, it was found that burns were six times more common in informal settlements than in formal residential areas, where burns accounted for the smallest proportion of all household injuries. Incident rates tend to be elevated in informal settlements because of the reliance on fossil fuels (paraffin, wood, coal) for heating and cooking. With the close proximity of the stove or fire to the ground, the possibility of an adult or a child stumbling into it or upsetting the cooking pots is very great. This risk increases when children play in cooking area, the implements are unstable, and the surfaces are uneven as is frequently the case. In addition, the use of candles for lighting is a major source of house fires. 

Mortuary data suggest that males and females are approximately equally at risk, that victims are predominantly black (reflecting the social inequality in the uneven pattern of access to electricity), and that the highest proportion of deaths due to burns is in the 0-14 year age group. The risk for burn injury also increases in older age groups (from 55 years).The greatest risk periods are in winter and during the night, at 19h00 and around midnight. Most burns occur in the home.

The Medical Research Council has estimated that more than two thirds of burns in South Africa are due to dangerous or inappropriate energy sources. Continued reliance on fossil fuels is primarily associated with the lack of access to electricity. Electrification would therefore greatly decrease the number of burn injuries. This needs to be undertaken together with other housing improvements to reduce the likelihood of secondary risks like electrical fires and electrocution in an inadequate environment. Educational campaigns to reduce burn injuries have proven ineffective even in industrialised societies. Most of the reduction is due to technological advancement and improved medical care, suggesting that electrification may be the most effective form of burn injury control. As interim measures before electrification and housing improvement, a safety audit of all fossil-fuelled cooking, heating and lighting devices should be done in order to design and promote the use of inexpensive alternatives to improve safety (e.g., stable bases to support paraffin lights, wick stoves instead of open fires).

Note: This information was obtained from the Medical Research Council's Health Consulting Office and the UNISA Institute for Social and Health Sciences. Readers interested in more information should contact these organisations.