Treatment of esophageal burns

In West Africa, esophageal burns in children are undoubtedly a frequent and serious underestimated pathology.
This is evident from the experiences gained by KiCo members in Guinea-Conakry, Gambia, Mali, Burkina Faso, Guinea-Bissau and Ghana.

How do these esophagus burns occur in children, adolescents and even adults?

Well it is easy to get corrosive soda in the West African countries.
The caustic soda (NaOH), for example, is imported into Guinea by the large concessionaires who extract bauxite (aluminum ore). Via a "gray" market the indigenous people get it easily and cheaply.
However, the caustic soda is used by African women for totally different purposes. Mainly for mixing with eg palm oil to obtain artisan soap. Or for fixing the paint when manufacturing batik. Sometimes even to bleach hair or to remove the hair from the skin of dead animals. The sheet is then used, for example, to make a djembe (a musical instrument for drumming).

The corrosive soda is usually not properly stored away under lock and key. In addition, caustic soda looks like granulated sugar or when dissolved it is odorless and colorless and can be regarded as water. Consequently and unfortunately children accidentally swallow the product leading to terrible mouth and esophagus burns. Incorrect doses also lead to dangerous concentrations in the soap.

How does KiCo help these children and young people?

The patients must be divided into two categories.

A group with moderate narrowing of the esophagus that can be dilated and a group where the opening of the esophagus is only possible with advanced surgical intervention (coloplasty or gastroplasty). A gastric tube is applied to the first group of patients so that the patient can be fed back. At the same time, an infinite wire is applied through the nose and comes out through the gastrostomy. Then (sometimes months) dilatation until the esophagus can pass food back. The patient can then eat and drink normally again by mouth. KiCo provides the suitable stomach probes and equipment to dilate. Dr. Balla Moussa Touré (Guinea) was taught this technique at the Gasthuisberg University Hospital in Leuven by Prof. dr. Toni Lerut. Both have taught this technique to Dr. Samateh (Gambia) and Prof. dr. Yéna (Mali). Dr. Bandré (Burkina Faso), Dr. Amoah (Ghana) and Dr. Sabali (Guinea-Bissau) were also recently taught the technique.
This technique has the great advantage of having little or no need for technological infrastructure such as endoscopy and is therefore extremely suitable for use in third world countries. KiCo wants to further learn this technique in the other West African countries.

In the second group of patients, reconstruction of the esophagus is necessary. In addition to experience with these interventions by the medical teams involved, an advanced technical infrastructure is also required (eg ICU ...). KiCo has been a patient in Belgium in 2004 and in 2009 by Prof. dr. Have Lerut and his team treated. Considering the large number of patients and the high cost of the total operation (flight, stay, surgery, aftercare, paperwork), KiCo is looking for a suitable equipped location in West Africa.