What causes burns in LMICs?

In LMICs, the main burn causes are: open cooking fires (particularly in women cooking with solid fuels — scalding and flame burns); kerosene stoves and lamps (explosion and spillage); electricity (electrocution and arcing — from unsafe wiring); industrial and workplace accidents; and hot liquids (scalding — the most common cause of non-fatal burns in children). Fire safety and cleaner cooking fuels simultaneously prevent burns and respiratory disease.

What is the correct first aid for burns?

Cool the burn immediately with running cool water (15-20 minutes). This reduces burn depth and pain intensity. Do NOT: use ice or iced water (causes tissue damage); apply butter, toothpaste or household remedies (infection risk); break blisters (infection risk). Cover with clean cling film or a non-stick dressing. Seek medical attention for any burn larger than a palm, any burn on face/hands/genitals/joints, or any burn with blistering or deeper injury.

How are severe burns treated?

Severe burns require: (1) immediate cooling; (2) assessment of burn size (% TBSA) and depth; (3) IV fluid resuscitation (Parkland formula) for burns >15-20% TBSA to prevent burn shock; (4) wound care (debridement, antimicrobial dressings); (5) skin grafting for full-thickness burns that cannot self-heal; (6) pain management (opioids); (7) infection prevention; (8) nutritional support; and (9) rehabilitation (physiotherapy, occupational therapy, psychological support). Burns affecting >40% TBSA have very high mortality without specialist care.

How can burns be prevented?

The most effective prevention strategies: cleaner cooking fuels (LPG, electric stoves eliminate most cooking fire burns); fire-resistant building materials and clothing; smoke alarms and fire sprinklers; hot water thermostat regulation (40°C for domestic hot water); workplace fire safety systems; fire safety legislation and enforcement; and education about burn first aid. These interventions are cost-effective and their combined application could prevent the vast majority of burn deaths.

Why are children so vulnerable to burns?

Children — particularly aged 5-9 — face elevated burn risk because: they naturally explore their environment without understanding danger; are short (at risk of pulling boiling pots down from stoves); have thinner skin that sustains deeper burns at lower temperatures; are frequently near cooking fires in LMIC settings; and cannot escape effectively. Child-specific prevention measures: safe kitchen design; stable stove placement; supervised play areas away from cooking; cool bath water for infants.

What are acid attacks?

Acid attacks involve throwing corrosive acid (sulphuric acid, nitric acid) at a victim — causing severe burns to the skin and face. They are predominantly a form of gender-based violence against women and girls. Countries with highest reported incidence include Bangladesh, India, Pakistan, Cambodia and Colombia. Victims require: immediate decontamination (water irrigation); emergency medical care; prolonged reconstructive surgery; prostheses for destroyed tissues; and extensive psychosocial support. Legal restrictions on acid purchase and sale have reduced attacks in some countries.

How do burns cause disability?

Burns cause disability through: contractures — scar tissue that restricts joint movement as wounds heal, causing permanent functional limitation if untreated; facial disfigurement causing social exclusion and psychological disability; limb loss in severe electrical or circumferential burns; neurological damage from electrical burns; and inhalation injury causing respiratory disability. Physiotherapy initiated early — preventing contractures — is essential but severely lacking in LMIC burn care settings.

What is inhalation injury?

Inhalation injury — from breathing hot gases, steam or toxic combustion products in fires — occurs in approximately 30-50% of flame burn patients and dramatically worsens prognosis. It causes: airway burns and oedema (upper airway obstruction); chemical injury to bronchi and alveoli (lower airway disease); systemic toxicity from carbon monoxide and cyanide. Early endotracheal intubation prevents fatal airway obstruction. Inhalation injury more than doubles burn mortality.

What is the burn care infrastructure gap?

Specialised burn centres — with intensive care, surgical grafting, nutritional support and rehabilitation — are concentrated in high-income countries. In most LMICs, burns are managed in general wards without burn expertise, specialised dressings, skin banking or rehabilitation. The International Society for Burn Injuries (ISBI) has developed emergency management guidelines for resource-limited settings and trains health workers in LMICs.

How does GMJ News cover burns?

GMJ News covers WHO burn data, clean cooking fuel links to burn prevention, burn care standards and rehabilitation access. Burns are a significant public health challenge in Georgia — where wood and coal burning for cooking and heating, industrial workplaces and domestic accidents cause substantial burn morbidity. PHIG's accreditation work addresses burn care quality in Georgian hospitals.

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Burns

Q: How many people die from burns each year?

WHO estimates approximately 180,000 burn deaths per year. Burns cause millions more non-fatal injuries requiring medical attention — many resulting in prolonged hospitalisation, disfigurement, contractures and disability. 95% of burn deaths occur in LMICs, where prevention measures, first aid access and burn care infrastructure are weakest.

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Burns cause approximately 180,000 deaths per year — with the vast majority (95%) occurring in LMICs, where cooking over open fires, kerosene lamps and unsafe working conditions are the dominant risk factors (WHO). Beyond deaths, burns cause profound suffering: hundreds of thousands suffer non-fatal injuries annually, many resulting in prolonged hospitalisation, disfigurement, contractures and disability. Children and women in LMICs bear the greatest burden — burns from cooking fires and scalds are among the leading causes of hospital admission and disability in low-income countries.

Key messages

180,000 deaths per year

Burns cause approximately 180,000 deaths per year globally — with 95% occurring in LMICs where open cooking fires, kerosene lamps, unsafe workplaces and scalding liquids are the dominant risk factors (WHO).

Children and women most affected

Children and women in LMICs bear the greatest burn burden. Burns from cooking fires and scalding liquids are among the leading causes of disability-adjusted life years in children. Women face burns from kerosene explosions, cooking accidents and — in some contexts — intentional acid or fire attacks.

Prevention is primary

Most burns are preventable: safer stove designs, fire-resistant clothing, smoke alarms, hot water temperature regulation, workplace safety and fire safety legislation dramatically reduce burn incidence. Prevention is far more cost-effective than treatment.

Wound care and grafting

Severe burns require: immediate cooling (15-20 minutes with cool running water); resuscitation with IV fluids; wound debridement and dressings; skin grafting for deeper burns; pain management; infection prevention; and prolonged rehabilitation. Burn care infrastructure is severely limited in LMICs.

Intentional burns

In some regions, acid attacks and intentional burns — predominantly targeting women and girls — are a significant cause of severe disfigurement and disability. These represent a category of gender-based violence requiring both medical and legal/social responses.

WHO response

WHO's Global Burden of Disease study and the International Society for Burn Injuries (ISBI) provide the evidence base for burn prevention and treatment policy. WHO includes burns as a priority injury in the Violence and Injury Prevention programme.

Key statistics

180K

burn deaths/year

WHO

95%

of burn deaths in LMICs

WHO

type: scalding (most common non-fatal burn)

WHO

11M

burns requiring medical attention/year

ISBI

of all injury deaths from burns

WHO

5-9yr

highest risk age group for burn injuries

WHO

Burn mortality rate by WHO region (per 100,000 population) — WHO

Source: WHO Global Health Observatory. SE Asia and Africa have the highest burden.

Glossary of key terms

Burn degree
WHO/ABABurn depth classification: superficial (epidermis only — red, painful, heals in 1 week); superficial partial thickness (into dermis — blisters, very painful, heals in 2-3 weeks); deep partial thickness (deeper dermis — reduced pain, needs grafting); full thickness (all layers — painless, requires grafting).

TBSA (total body surface area)
WHO/ABAThe percentage of body surface area burned — the primary parameter for fluid resuscitation calculation (Parkland formula). Estimated using the Rule of Nines (adults) or Lund-Browder chart (children). Burns >15-20% TBSA require IV fluid resuscitation.

Cool water first aid
WHOImmediate first aid for burns: cool the burn with running cool water for 15-20 minutes. This reduces depth of burn injury and pain. Do NOT use ice (causes tissue damage), butter or toothpaste (increase infection risk), or ice water.

Skin grafting
WHOSurgical procedure transplanting skin from an unburned area of the body (autograft) to cover full-thickness or deep partial-thickness burns. Essential for burns exceeding the body's self-healing capacity. Limited availability in LMICs.

Acid attack
WHO/UNHCRIntentional chemical burns from corrosive acids thrown at victims — predominantly women and girls — as a form of gender-based violence. Causes severe, permanent disfigurement. Requires specialised surgical reconstruction and psychosocial support.

Parkland formula
ABA/WHOThe standard fluid resuscitation formula for major burns: 4 mL × body weight (kg) × %TBSA burned = total fluid in 24 hours (Ringer's lactate). Half given in first 8 hours, half in remaining 16 hours. Life-saving in major burns.