Frontline, Volume 16 - Issue 17, Aug 14 - 27, 1999
Inside the burns ward
PARVATHI MENON
The more than 40 beds in the female burns ward of the
Victoria Government Hospital are always occupied. There is a
typical occupancy profile in this ward. The women who come here
are mostly young, married, from lower middle-class or poor
economic backgrounds. Most of them are victims of the most
vicious forms of marital violence. It is here that we get a
searing picture of the horror and violence of a death by burning.
The wards are as busy as a railway platform, and indeed as
unclean. Patients' relatives, policemen, harried doctors
and overworked nurses walk freely in and out of the ward. There
seems little chance of keeping out the infection that can prove
deadly to a severely burnt victim fighting for her life. "In
the late 1970s, when my association with this ward first started,
four or five burns cases a week was considered very high,"
recalls Dr. Gurumurthy, Head of Department of Plastic Surgery and
Burns. "Today we have six to seven patients coming
in every day."
"Will these marks go? Will I get better,"
whimpers Shabrin Begam, 20, a second-year PUC student, her
bloated and peeling face wincing under the effort of speaking.
She has just given a clear statement, in the presence of the
doctor and the investigating officer, of the circumstances which
led to her husband setting her on fire. She has suffered 90 per
cent burns and, although she does not know it, there is little
chance that she will live more than a couple of days.
"I'm hurting, help me," implores Lalitha to a passing
nurse, a few beds away. She holds out her arms from which hang
strips of burnt skin. Lalitha says she set herself on fire out of
"despair", but declines to give the reasons for it.
In yet another bed lies Selvi, 18, her upper torso and face
charred. Her husband, who is no more than a boy himself, hangs
uncertainly around, his attention more on the police than on his
dying wife. "What, changed her statement
again?" sniggers the portly investigating officer, preparing
to take her declaration, the third since she was admitted.
"First she says it was an accident, then that she was forced
to do it to herself, and now that her mother-in-law did it to
her. Why don't these people make up their minds?" he
grumbles as he enters the ward again. Selvi worked in an
agarbathi factory; her husband, Anwar, is a construction worker.
"There is a high mortality rate in our burns ward,"
explains Dr. Gurumurthy. "While other hospitals can treat
cases that have up to 50 per cent burns, all cases above 80 per
cent are sent to us." Good nursing is critical to the
survival and recovery of a burns patient with over 50 per cent
burns. "All patients with burns up to 50 per cent should
survive, and above that some should survive. Nurses must monitor
burns cases 24 hours a day. Ideally there should be one nurse per
bed," he says. At the Victoria Hospital, there are just
three doctors with five house-surgeons to assist them, and only
three nurses for an eight-hour shift.
There have been many changes for the better in recent times in
the quality of treatment, nursing care and cleanliness in the
Victoria Hospital burns ward. The credit for this goes partly to
Vimochana, which initiated a campaign in September 1997 to draw
attention to the general state of the burns wards. There were
complaints of negligence and rampant corruption, while the
general levels of cleanliness were very poor. Following
Vimochana's campaign, which included a hunger strike in front of
the hospital in April 1998, there were also demands, in both
Houses of the Legislature, for an inquiry into the state of the
wards. Not only did this result in a dramatic improvement in
conditions within the wards but an entirely new burns ward was
constructed on an other floor at a cost of Rs.18 lakhs. The cost
of air-conditioning the new unit has been underwritten by
Infosys, the Bangalore-based software company.
Vimochana also got permission to have two volunteers posted in
the wards. They keep detailed registers on individual cases,
counsel victims and families on legal procedures, talk to victims
and try to elicit their real stories, monitor under what sections
the police book cases, and act as friends to traumatised victims
and families.