Jamal Joseph had just finished helping his father remove the snow from the sidewalks and driveway around their home after a recent snowstorm. As the young man carried the snow blower to the basement, a spark from the machine ignited a large can of kerosene, badly burning him and trapping him in a basement hallway.

“I was down there for some time and thought no one was coming,” said Joseph, 21. “I soaked my hood in water and put it over my head so I could breathe, but I was still overcome with smoke and passed out. Neighbors saw the smoke and called 911. Firefighters found me and took me to Harlem Hospital’s Burn Unit.”

He was unconscious when he arrived at the hospital with extensive burns to his face, hands, and right leg and suffering from smoke inhalation. Luckily he was in the experienced hands of  one of  the few specialized Burn Units that practices plastic and reconstructive surgery to manage wounds of African American burn victims.  Led by Dr. Ferdinand Ofodile and Dr. Monqidh Al-Sawwaf, the Harlem Hospital Burn Unit operates with a focus on reducing the severe scarring and the changes in pigmentation that are common in dark skin. The center treats 60 to 80 patients a year.

“Healing in blacks is quite different from healing in whites,” said Dr. Ofodile. “Blacks tend to develop keloids, which are overgrown scars that can spread outside the area of skin damage, and hypertrophic scars, which are scars that thicken.   Discoloration is also very common, which is really emotionally distressing for patients when it affects a part of the body  not usually covered by clothing. We’re extra  sensitive to these issues, so we treat burns aggressively.”

Doctors rate burns as first, second and third-degree, depending on the  severity. Third-degree burns are the most serious and necessitate that doctors immediately cut away the dead or contaminated tissue and perform skin grafting on the affected area.

But, in people with light pigmentation, second-degree burns can often be left to heal on their own.  That’s not so for patients with dark pigmentation, said  Dr. Ofodile. If  left to heal on their own, they develop profound scarring and discoloration.  Therefore second-degree burns in blacks are treated using the same techniques as for third-degree burns.

“They heal faster  and the cosmetic result is improved so it’s psychologically and physically better for the patients and  their chance for a complete recovery is very good,” said Dr. Ofodile.

Medication helps patients manage the pain and ward off infection. Rehabilitation includes compression therapy to promote healing and physical therapy for movement and flexibility.

“I’ve come a long way in three weeks,” said Joseph, who also developed pneumonia and slipped into a coma for several days during his ordeal. “My spirits are high and I’m feeling really great. I saw the other side and because of this team I survived to go on with my life.”

Dr. Ofodile not only treats patients, he also advocates in the community about fire safety and prevention. He points out that national figures indicate that while 13 percent of the population is African American, they make up 22 percent of burn victims.

In his practice at Harlem, he sees elderly poor with inadequate heating in winter using old space heaters or turning on the stove. In the summer younger patients get burns from firecrackers or barbeques. The most common injury for children is scalding.

“I tell mothers all the time: don’t put pots on the front burners with toddlers underfoot, and you can’t carry a hot beverage and a baby at the same time,” said Dr. Ofodile.

February 2011

Update, 2/22/2013: Dr. Ferdinand Ofodile remains as Chief of the Burn Unit at Harlem Hospital.  Dr. Monquidh Al-Sawwaf is no longer at Harlem Hospital.