Hidden scars: Master's student Haydn Tilley is researching the psychological effects of burns on adults.

Master's student Haydn Tilley believes the staff in the Burns Unit at the Red Cross War Memorial Children's Hospital deserve medals - just like their young charges.

These are the survivors of shack fires and accidents involving hot water, vehicles, paraffin or electricity.

Many of the small patients will be disfigured for life. Others are luckier. But as chief medical officer of the burns unit Professor Heinz Rhode says, everyone who is burnt carries a scar - a psychological wound. For Tilley, a trainee clinical psychologist, it's the scars within, the "plethora of intense psychological trauma concomitants" that are of concern.

Burns are third most common cause of injury in this country; 400 000 people suffer from burn injuries every year. It's more than the population of Pietermaritzburg. Of these, 85% live in rural or informal settlements where there is limited infrastructure and which, says Tilley, substantially increases the risk of being burnt. Rural burn victims are also at a disadvantage because specialised treatment facilities are located in the cities.

His master's thesis investigates the more longitudinal affects of burns; the psychological effects on adults.

"Burns are often excruciating injuries and, in addition to the physical pain and the long and uncomfortable rehabilitation, the disfigurements force them into assuming a different physical and social identity."

He believes a deeper understanding of burns is essential. Often the psychological needs are not prioritised in the light of the serious medical treatments that have to take place in order to physically heal the burns.

"We need to mobilise the resources available to meet needs."

He has been able to contribute to these resources. Working in the Red Cross burns unit last year, Tilley interviewed 10 parents of burn survivors and staff assigned to the unit, asking what information was needed, and what should be disseminated to the public.

The result was a "psycho-educational" booklet, which is used as a clinical community intervention.

"Information is the intervention," Tilley emphasises. The booklet tells parents what to expect from the burns unit - and how to contain some of their children's difficulties.

"Some of the parents don't know what a skin graft is, or how complicated some of the treatment procedures are. It's also sometimes difficult for a parent in shock to know what to do."

Published in English, Afrikaans and isiXhosa, it is a welcome resource, especially in some communities where burn survivors carry a cultural stigma.

As part of his commitments to his David and Elaine Potter Fellowship (awarded to postgraduate students working to make a difference in civil society), Tilley is putting together a seminar on the psychology of burns, harnessing expertise in the area on a variety of fronts.

One of his guests will be jazz singer Thandi Klaasen, whose face was disfigured by acid after a premeditated attack on her some years ago. The December 5 seminar will also bring together professionals working in the area, integrating the narrative of burn survivors as well as the current state of knowledge. It will include representatives from the World Burn Foundation and staff of the Red Cross burns unit.

Tilley's master's degree will examine the effects of burns on adults, the hidden wounds that sometimes evade healing - and the healers.