A home without fire risk for the poor
 

Manjari Peiris in conversation with Dr. Wijaya Godakumbura, Consultant Surgeon and President of the Safe Bottle Lamp Foundation.

Accidental kerosene burns are a common type of home accident in Sri Lanka. About 1.5 million homes in our country do not have electricity and the people who live in them very often use home-made lamps to light the stove, to light up the living area or for reading. These lamps are unsafe. Even in houses with electricity, they are being used in kitchens to set the firewood alight and also when there are power failures. About one third of all domestic burn accidents in Sri Lanka is caused by them.

The misery caused by unsafe bottle lamps:

Many bottle lamp victims get severely disfigured. Some cannot close their mouths as the lips are gone. Some have lost all 10 fingers and a few are blind. Young women cannot find a husband afterwards. Wives burnt in household accidents are sometimes driven away form their homes. They become social outcasts and they are a burden to the family, society and the state. Therefore, campaigns to prevent them are a crying need.

The global state on injury prevention:

The International Society for Burn Injuries states, "The majority of burns can be prevented, but there are very few prevention campaigns". The same applies to all other injuries too; this is what the WHO states: "Most nations do not place injury prevention high in the list of priorities, and it is difficult to impress upon them the need for programmes of injury prevention". Due to that attitude, concerned citizens have to fill the void.

This is the story of one such person and his campaign here in Sri Lanka, now is its thirteenth year. It has received much kudos nationally and internationally, and we feel that all those who can help him and his team should readily do so to maximize their output.

The person who took up this challenge is Dr. Wjaya Godakumbura, a former consultant surgeon of the National Hospital, who has immense experience in treating severe burn injuries caused by unsafe lamps. He has realized that it happens due to poverty and ignorance. Bottle lamp burns are also a women's issue as most victims are females, and nearly a third are children.

Prevention of bottle lamp burn injuries:

In countries like Malawi and Mozambique, only 10% of houses have electricity. We are much better off as 68% of our houses have this commodity, but that is certainly not good enough. Due to various reasons, this figure will not reach a healthy 90% even in 20 years. When one uses unsafe kerosene lamps, a single moment of inattention is enough to cause a serious burn injury and therefore, there is a great need for safe kerosene lamps for many years.

Unsafe bottle lamps:

Dr. Godakumbura discovered that the flashpoint of spilt kerosene was lower than many people believed and the danger is far higher. He found that when kerosene soaks into clothing the material acts like a wick turning the victim into a blazing torch that may take 10 to 125 minutes to extinguish. He understood that people knew little or nothing of how to aid the sufferer and limit the extent of the injuries. Once the burns affect more than 60% of the body, the outcome is usually fatal.

After treating the burn victims, Dr. Godakumbura had asked them to bring in their lamps and understood the real cause of it. These lamps generally referred to as 'bottle lamps' were ordinary household bottles or fused bulbs with a small in sheet resting on top and a metal tube for the wick.

When the bottle tipped and rolled, the fuel and the wick-carrier that holds the flame - fell out, often starting a fire. A child reaching out for a book or a mere bump against a table could extinguish a life. Sometimes, it is a cat that causes the catastrophe.

At the start of his campaign, Dr. Godakumbura invited the public to design a safe and cheap lamp. Many people had put forward ideas, but the designs were complex and rather costly make. "In the end I decided that the best design would be on a simple Marmite bottle - small and squat with two flat sides equipped with a safe metal screw cap to hold the wick. In this manner the bottle was more stable. Also the fuel does not spill even if the bottle overturns. It cannot roll either and would not break even if it dropped".

With approval for the lamp he designed from the Sri Lanka Medical Association, the College of Surgeons, the National Committee for Prevention of Injuries, the International Society for Burn Injuries and the WHO, Dr. Godakumbura launched a campaign to make and distribute thousands of safe.

Lamps, while starting media publicity campaign to educate the public on safety and first aid for burns. He also sought funds to sell the lamps below cost as the bottle lamp users are the poorest in the country, and for promotional activities.

"Only a few offered to help in this task whereas all the attention was focused towards disease prevention. The exact statistics on deaths and injuries through accidental burns are not available. Every week about three die from bottle lamp burns while hundreds are horribly disfigured. It's a pity that their lives are ruined by a preventable accident" Dr. Godakumbura explained.

According to him and his colleagues, the number of patients brought to their hospitals with lamp burn injuries is decreasing with the distribution of safe lamps. While a million people are now safe from lamp burns, there is another five million in homes without electricity who remain at risk. They too need protection!

"The lamps are sold in thick paper cartons with valuable information printed on them. We educate the public as to how to put out the flames if a burn occurs. We also warn them not to pour kerosene into burning lamps and advise parents not to allow children to handle kerosene lamps. It is essential to pour cold water on the patient for about 25 minutes after the flames are extinguished to prevent the heat from the burnt flesh making the injuries worse," Dr. Godakumbura explained.

Burn injuries from bottle lamps have been there for nearly a century. According to a WHO publication, it was only in 1965 that some prevention campaign was started. Unfortunately is was not successful. For the next 27 years, there were no further effective attempts towards prevention of these injuries until Dr. Godakumbura started his campaign. That was in 1992, and since then it has been on a sound footing, with much acclaim but less than adequate support.

Initially, the Canadian High Commission and Dr. Arthur C. Clarke made donations to the project when it was in its infancy. It was the US$ 50,000 grant that the Rolex Watch Company gave him when he won a Rolex Award in 1998 that enabled him to establish an office and have his own staff. Later, several organizations like the President's Fund, the Ministry of Health, and the Lindbergh Foundation in the US and the Commercial Bank donated money to make this project a success. To date, safe lamps have been distributed among 275,000 homes.

Acclaim for the project:

The President, Dr. Arthur C. Clarke, Dr. Kan Tun (WHO Representative to Sri Lanka) and former Canadian High Commissioner have praised the attempt in this regard. Besides the Rolex Award for Enterprise, Dr. Godakumbura received a Presidential Award, a Sarvodaya Award, and honours from the Reader's Digest and the Lindbergh Foundation of USA, for finding a simple solution to a devastating problem.

Several international magazines like 'Science and Nature', 'National Geographic', 'Science', 'Asia Week' and 'Readers Digest' featured his project CNN telecast a short documentary on it and VOA (Voice of America) broadcast an interview with him. The International Society for Burn Injuries appointed him to its Prevention Committee and the organizers of seven international burn congresses held in India, Taiwan, Turkey, France, USA, Libya, Australia and Japan invited him to make presentations on his project, which he accomplished.

An appeal from the project:

"Those who use bottle lamps are the poorest in the country. They have been using their unsafe lamps costing a mere Rupees 3/- for many years and they are unaware that they could maim and kill. So it is difficult to sell our lamps that cost more despite the use of recycled glass to make them.

Therefore we have to sell them below cost, and also have an assertive and costly promotional campaign. Both these activities cost a lost of money, and we expect the unstinting support of state and private sector organizations.

We are very grateful to those who supported us in the past, and they could be pleased that their contributions have prevented a great deal of misery. By replacing 17% of the 3 million unsafe lamps in use with our safe lamps, we have prevented thousands of burns and dozens of deaths while saving millions of rupees to our government. We would have achieved much more, had there been better support".

The International Society for Burn Injuries has agreed to produce a handbook on the prevention and treatment of kerosene injuries. This will be submitted as a "best practice" manual for the World Health Organization. The Safe Bottle Lamp Foundation, which was established to promote the use of safe lamps is now located at the National Hospital of Sri Lanka, Colombo.

Phone 2674847 - email [email protected]. The website www.rolexawards.com has an article on the project under journal, and then under latest publication. The title is "Surgeon of the lamp".