Sept. 11 -- THURSDAY, Sept. 10 (HealthDay News) -- It's a photo that many credit with helping to end the Vietnam War: A 9-year-old girl, naked and in obvious pain, runs through a street after suffering napalm burns over much of her body.
What the iconic photo -- snapped in 1972 by Associated Press photographer Nick Ut -- doesn't show is the girl's struggle to survive and thrive in the aftermath of that day.
Now 46 years old, Kim Phuc Phan Thai (Kim Phuc to most) spoke recently at a conference of burn survivors and burn care specialists in New York City on the physical and psychological struggle that she went through over the ensuing decades.
"Sixty-five percent of my body got burned," she said in an interview with HealthDay. The third-degree burns left her face untouched but sheared off every layer of skin on her back and left arm, leaving a legacy of permanent scars and recurring pain.
"I should be dead," Phuc said. "I got burned so deep I had to do skin grafts -- mostly from under my leg -- from the 35 percent of my skin that was OK. And from the beginning to the end, including physical therapy, I was in the burn unit in Saigon for about 14 months. And I had 17 operations. But I was spared," she added.
"So now I think, 'I cannot change something that happened to me already. But I can change the meaning."
Phuc has come far and is now a public speaker, peace activist, United Nations Goodwill Ambassador, child welfare advocate, married mother of two, and inspiration to burn injury survivors worldwide. She lives in Toronto, her home since seeking political asylum in Canada in the early 1990s.
Phuc's message of hope resonated with many of those at the conference, held earlier this month by the Phoenix Society for Burn Survivors, the nation's largest non-profit support and advocacy group for burn survivors. The conference was co-sponsored by the Hearst Burn Center at New York-Presbyterian Hospital/Weill Cornell Medical Center and the NY Firefighters Burn Center Foundation.
Besides listening in on Phuc's speech, burn survivors could attend workshops designed to empower with practical information, such as make-up tips to enhance the appearance of affected skin, or hear other survivors' stories of personal triumph over pain.
For example, a number of firefighters and ex-military personnel spoke of their experiences with burn injuries during the course of their work. So did CBS journalist Kimberly Dozier, who was injured while reporting in the Middle East. They also heard from burn survivor and Iraq War veteran J.R. Martinez, currently an actor on the soap opera All My Children.
For her part, Phuc said the events that changed her young life are as vivid today as they were on June 8, 1972, when bombs rained down on her hometown of Trang Bang, north of Saigon.
"They saw that the temple will be next, and they told us to run," said Phuc, whose family had been hiding in the village temple grounds.
"I was in the middle of the group," remembered Phuc, "my brother, my sister, my cousin in front of me, my aunt, my uncles behind. And I stopped."
There was the sound of bombs from South Vietnamese aircraft falling, "and after I saw the fire everywhere around me," Phuc said. "I was so scared. And all my clothes just burned off by the fire. And I saw all my burns. And people screaming: 'Nong qua! Nong qua!' 'Too hot! Too hot!'"
Two of Phuc's cousins died from injuries sustained in the bombing, but Kim was helped by photographer Ut, who helped her get medical attention at a South Vietnamese hospital. She then received more than a year of treatment at the American-funded Barsky Hospital in Saigon.
Phuc beat the odds and survived her ordeal. However, Hearst Burn Center director Dr. Roger Yurt stressed that burn care has improved dramatically in the years since. Patients with serious burns like Phuc now experience a "much more efficient, swifter, and improved treatment process," he said.
"Back in Kim Phuc's time, one usually would add the age of the patient to the amount of body surface that was burned in order to predict mortality," he explained. Using that formula, a 50-year-old patient with burns covering 50 percent of her body faced a nearly 100 percent chance of death.
"Today, however, that same patient would have a 50 percent survival rate -- a doubling of his or her chances," Yurt said. That's due to better anesthetics, better nutrition and respiratory care, as well as more careful monitoring of cardiac function, he said.
The advent of artificial skin products, not available in the 1970s, has also revolutionized skin-graft surgery when used in conjunction with actual skin tissue, Yurt added.
There are also many more burn-care facilities in the United States today. According to the Phoenix Burn Society, over 140 specialized facilities now care for the more than 500,000 Americans who seek medical treatment for burn injuries each year.
Yurt called that a "major advance, because back in the 1970s we would have to send burn patients from New York City, for example, all the way to the army burn center in San Antonio to get treatment. Now we can treat them quickly, right here."
But the single most important change in burn care has been a paradigm shift in the way doctors approach treatment, he said.
"In years past we were concerned about operating too early because patients were so unstable," Yurt said. "We now realize that early and aggressive intervention is actually critical," he explained.
"This has meant that skin grafting has become much more successful, while the occurrence of wound infections has dropped off dramatically," the expert said. "The long-range outcome is much, much better."
Still, Phuc said the legacy of her own wounds linger.
"I still have pain," she said. "Because my nerves are really damaged. They don't work well. So pain in one area spreads everywhere I got burned."
Healthy eating, exercise and an upbeat attitude help her focus away from the pain when it does come, however. And Phuc said that even the pain has its reward.
"The pain I consider as my protection. It humbles me, and helps me to never take my life for granted," she said. "And to share my story."
For additional information and resources on burn injuries and burn care, visit the Phoenix Society for Burn Survivors.
SOURCES: Kim Phuc Phan Thai, burn survivor, conference speaker; Roger Yurt, M.D., director, Hearst Burn Center, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York City; Phoenix Society's World Burn Congress for Burn Survivors, Aug. 26-29, 2009, New York City.