Away We Go

On the brink of embarking on something that I've wanted to do for so long, I'm more apprehensive than anything else. There is so much to do.

My name is Indranil and I'm one of the Plastic Surgery residents at Brigham and Women's Hospital in Boston. One of the core reasons for which I entered into a Plastic Surgery residency was to be able to aid patients internationally. I knew before of Operation Smile and their history of significant international outreach- it's a non-profit company that treats cleft lip/palate around the world. But my interest has always been in burns, and India needs all the help that it can get. Thankfully, due to the tremendous generosity of both Operation Smile and Cents of Relief in sponsoring this Burn Surgery mission to Mumbai, I'll have a chance to do my part.

India is the only country in the world in which burns are classified as one of the top fifteen causes of death. This is a staggering finding considering many burn injuries and fatalities may go unreported when occurring in a rural setting and, thus, significantly underestimates the incidence of burn injuries. Therefore, burn care is of great concern now in India. This is especially true given underdeveloped trauma care, which magnifies the morbidity and mortality associated with burn injury. The lack of pre-hospital care, inadequate emergency transport systems, and low rates of Advanced Trauma Life Support (ATLS) training amongst surgeons are all contributing factors. In some states, such as Punjab and Haryana, burns are even reported to be within the top five most common causes of death.

Multiple factors account for India’s high rate of burn incidence and morbidity. Firstly, cooking, particularly in rural areas, is still performed over open-kerosene burners leading to an increased number of accidental burns, which overwhelmingly occur in the pediatric and the female population. Dowry deaths, which constitute women being burned for disputes over dowry, and bride burning, in which a wife is burned for suspected infidelity or other transgressions against the marriage, still account for a number of cases of burn-induced mortality. Although the Indian Government has taken legal steps towards outlawing these procedures, which can loosely be traced to cultural and religious origins, the number of these deaths may still be on the rise and the issue of exchange of dowries in marriage remains an issue remains to be effectively addressed. These aforementioned factors only add to both the number and extent of accidental and traumatic burn injuries.

This is the first time a major mission focusing on burns in India is being undertaken by Operation Smile. Being the first, it will be simple. The plans call for approximately fifty operations over the course of one week, screening of one-hundred patients, and an education day in which physicians of both India and America can share their ideas on ways by which to improve care. While there, research will be conducted on why patients don't immediately present following burn injury and ways to improve proposals for burn intervention. I'll be blogging everyday along the way.

I'm apprehensive, but excited. The first step really is the hardest. Thanks to everyone who has made this possible. Thanks most of all to my wife, who reminds me always what is most important.