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08 May 2025 | Story André Damons | Photo Supplied
Nosicelo Madushana
Nosicelo Madushana, a third-year medical student at the UFS, was four years old when she sustained third-degree burn wounds on 70% of her body.

With winter fast approaching, healthcare professionals in the Free State are gearing up for an increase in burn injuries during these cold months. Many of these injuries are preventable, and doctors and medical staff believe educating communities about common preventive practices can help keep them safe.

Dr Hilge du Preez, Paediatric Surgeon from the University of the Free State (UFS), says they observe an increase in burn injuries, which can be devastating, causing serious bodily harm, long-term disability, and even death, during the winter months.

“As healthcare professionals, we do all we can to help burn injury patients recover and regain their health and activity. However, as with many other conditions, the best treatment for a burn injury is prevention. Thermal burns are the most common type of burn we see. These are caused by contact with hot substances or fluids, such as flames or boiling water. Children and adults sustain burn injuries in different ways.

“While children can suffer burns from flames, they are more likely to burn themselves by spilling hot liquids or food. We also see cases where children accidentally fall into a tub of hot water that is being prepared for a bath,” says Dr Du Preez.

According to Dr Du Preez, when cooking, it is safer to have pot and pan handles turned inward, rather than outward where children can reach them. Kettle cords and tablecloths should be tucked in and kept out of reach to prevent children from pulling them and spilling hot substances.

 

A turning point

Nosicelo Madushana, a third-year medical student at the UFS, was four years old when she sustained third degree burn wounds on 70% of her body after a large pot of boiling water, fell on her. However, she would only later really understand the impact of this accident on her life.

 “It wasn’t until I was in Grade 3 that I began to understand that I was perceived as different. During an Eskom educational session on the dangers of electricity, the presenter used the analogy of turning into a "chicken roast" when tampering with electric circuits. In that moment, a number of my peers turned, pointed, and laughed, likening me to the example given.

“That experience marked a turning point in my self-awareness and emotional resilience. It shaped me profoundly. I became emotionally guarded, not violent, but verbally defensive. I often felt I had to exist in survival mode rather than being allowed to simply be myself,” Nosicelo recalls.

As a result of these experiences, she explains, she developed a deep-seated need to constantly prove that she belonged in every space she entered. She wanted to ensure that any opportunity or recognition she received was based solely on merit and not influenced by perceptions of her physical appearance or sympathy for her circumstances. It became an unhealthy cycle of overcompensation and striving to validate her presence.

This is demonstrated in her academic achievements as she first did a Bachelor of Sciences in Medical Bioscience degree, followed by a postgraduate diploma in Augment and Virtual Reality (Comp Science) (both at University of the Western Cape). She followed this up with an Honours degree in Anatomical Pathology at Sefako Makgathu Health Sciences University.

 

Apply correct first aid treatment immediately

Dr Du Preez says they also recommend that children should never be left unsupervised around hot substances, whether food or fire. When running a bath for a child, add cold water to the tub first, then hot water to reach the desired temperature. This is safer because, if a child falls into the tub, they will only encounter cold water rather than hot, which could prevent a severe, potentially life-threatening injury.

Adults, on the other hand, explains Dr Du Preez, typically sustain severe burns due to flames, which may result from house fires or accidents involving fire. Paraffin stoves are responsible for a significant number of house fires in South Africa, and healthcare professionals strongly advise against their use.

In the era of load-shedding, people need to be mindful of safe practices when using candles, says Dr Du Preez. Candles should never be left unattended and should always be placed in a container that covers the flame. This helps prevent the risk of a candle setting a room on fire if it falls over.

“If someone suffers a burn injury, correct first aid treatment should be applied immediately. Remove any clothing and jewellery from the affected area, and ensure any burning debris is removed. Cool the burn by running it under lukewarm tap water for 10-15 minutes. Cover the wound with a clean, damp cloth and seek medical attention. Do not apply “home remedies” such as toothpaste, raw egg, or shoe polish, as these can impair healing and increase the risk of infection and scarring.

“In the event of a fire, remember to ‘stop, drop, and roll’ to extinguish any flames. Remove burning clothes and debris, cover the person with a clean towel, and seek urgent medical care.”

 

Being burned victim is her normal

Nosicelo, whose passion lies in research and the fight against cancer, being a burn victim is her normal. She has no memory or photographic evidence of herself without burns. “What I dislike the most is the empathetic gaze, the unsolicited pity, the assumption that I am a victim in constant need of help. I am not a tragic story. I am a woman who is brave, resilient, beautiful, and forging her own path.

“My life is not defined by the incident, but by the choices I make and the legacy I intend to leave. I am a three-time graduate, and I will not stop until I attain the prestigious FCPath(SA) qualification (the Fellowship of the College of Pathologists of South Africa, a recognised postgraduate qualification in pathology for medical practitioners in South Africa.) My journey is one of strength, not sorrow. I am committed to being a part of the global effort to eliminate this disease. Until that day comes, I dedicate myself to being a voice for cancer education, prevention, and early detection, empowering individuals with knowledge that can save lives.”

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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