Forged by Fire: Burns Injury and Identity in Britain, c.1800-2000

Throughout the past two centuries, Britons have experienced personal and collective tragedies involving burns and scalds, which have been connected to British culture and society and rooted in the habits and design of home, workplace, war and play. This project will investigate how burns have shaped identity: individual, urban and group. In 19th-century Britain, the mortality rate for burns injuries was 50%. Between 1900 and 1950, of an annual 100,000 burnt and scalded people, 20-30,000 were admitted to hospital; 2,000 died - over half were children. Today, burns injuries make up 175,000 of all A&E visits. There are 16,000 hospitalisations; 300 (2%) die. On the surface, this is a story of progress, yet in some ways this is just skin deep. Unlike other aspects of public health, there has been little progress in burns prevention. According to burns pioneer Dr Leonard Colebrook in 1950, these statistics reflected peculiarly British practices: tea drinking, open fires in homes, and widespread use of inflammable, raised-nap cottons. Not only is meaning attributed to the causes, but the material culture of burns, from changing fuels to the resultant technologies that shape how we live, is also tied into what being modern meant at key moments in the wider chronology of British history. For emergency services, emerging hazards meant pooling information and devising countermeasures, informing the design and construction of new, safer homes and workplaces - this project will examine how these decisions were reached.

While burns incidents have influenced the professionalisation of ambulance and fire services, little is known about their roles in co-ordinating life-saving and treatment. Moreover, given that many ambulance services evolved out of municipal fire brigades in the early 20th century (including our three cities), both services are ripe for comparative scrutiny to better understand their joint roles as first responders to emergencies. Alongside this, priorities around treatment have shifted from resuscitation and isolation in the 1840s, when the first 'burns unit' was established in Edinburgh (1845), to infection control and shock prevention in the 1890s, and reconstruction in the 1940s, each shift introducing new specialists to burns teams. Gradually, as mortality rates began to fall noticeably after the Second World War, the ultimate goal of burns practitioners also changed from survival to full rehabilitation and psychological recovery.

Despite this progress, burns remain a visually distinct, sensually assaulting and emotionally overwhelming injury, with significant effects on mobility, the self and identity. They also have a significant bearing on psychological wellbeing, not only of the injured, but those involved in fire rescue and burns treatment. Burns are felt to be horrific and iconic. Self-immolation in particular jars our collective and emotional response, but might also inspire people. In 2010, Mohamed Bouazizi set himself on fire in protest at police treatment in Tunisia. In doing so, he has been said to be the human spark for the Arab Spring and its darker wake. Indeed, rarely are burns just individual tragedies. They can galvanise collective action, as they did following the 1981 New Cross fire, which claimed 13 young lives and is recognised as having helped create a Black British identity. The 1987 King's Cross fire was the first fatal fire on London underground, and killed 31 people and injured 100. It transformed health and safety regulations in London's transport network and led to the founding of the Healing Foundation (1999), a charity working for people who have sustained burns injuries. The recent establishment of support groups suggests a more collective and consoling experience of burns, yet our cultural image of the 'burns victim' remains that of a solitary, tragic, and mysterious figure - of Miss Haversham and spontaneous human combustion.

The research subject uniquely ensures a humanities project that will benefit groups beyond academia. Through our varied and non-academic outputs, 'Forged by Fire' offers a wide reach, impacting on the work of policy makers, fire services, burns physicians, third-sector groups, former patients and their families, schools and workplaces, and the wider public.

The team is uniquely placed to deliver genuine impact for a history of burns project. The PI has made close links with the Burns Collective, a newly-established national burns initiative linking units in Birmingham, Bristol and UCL, funded by the Healing Foundation. The CI will use his connections with the fire and rescue service via service associations, charities and heritage groups. More importantly, these links will enable people in these organisations to create their own histories, through oral histories organised and supported by the project team, which has ties with the Oral History Society. Interviews will be deposited with the British Library and local archives, and offers a resource for professional training. These diverse narratives, evidencing experience, have a place in the recovery process employed by group therapy. Other than in behavioural and mental health circles, this technique is unusual, with patients with burns injuries from the 1940s only the second such grouping organised into collective therapy. Group support and patient narratives continue to be used by patient organisations and evolve; a process which, through our links with Changing Faces, we will develop by offering to share at meetings, relaying historical narratives which capture the diversity of experiences.

Free public exhibitions are part of our core impact strategy and rely on RF1's curating experience. An exhibition, based on 1000 photo essays (dated 1940s-80s) of the material culture surrounding individual burns events, will visit Glasgow, Birmingham and London. It is our aim that the exhibition will not only develop links between the academic sector and our planned venues (The Library of Birmingham, London Fire Brigade Museum, and the Mitchell Library, Glasgow), but also contribute to their profile and community importance. Furthermore, select and suitable material from the exhibition, as well as other project material, will be displayed at annual pop-up events organised by our home institutions to connect them with their neighbourhoods. In addition to embedding impact locally in the urban centres that form our case studies, our exhibition strategy will do the same in Leeds.

The project can also make a sustained difference to prevention strategies, potentially feeding through to national policy. The research will consider the ways in which burns knowledge evolved historically, through literature, newspapers, court records, and prevention and first-aid activities. Some innovative prevention strategies remain dormant because it is assumed we inhabit similar, modern homes, but given the diversity of housing stock in our three chosen cities; the project offers to inform and develop new prevention initiatives. Through our established and developing associations with local fire services these refreshed strategies will reach schoolchildren and workplaces. Project members will offer talks tailored sensitively to each audience. Fire prevention and basic first aid activities - building on our proven record of medical simulations created by MESH's former public-outreach officer Julia Hyland - will aim to engage such groups with the experience and treatment of burns in their own communities. We will commission Birmingham artist Sarah Silverwood Taylor to produce a graphic novel reconstructing and anonymising 4-6 stories from across the two centuries. The publication, as well as postcards and posters based on its illustrations, will be distributed through our fire service partners, primarily in schools in our three cities, and material will also be made available for digital download.