North Macedonia Nightclub Fire: A Tragedy That Calls for Better Burn Rehabilitation

North Macedonia Nightclub Fire : Burn Survivors deserve more: The critical role of physiotherapy in recovery.

The North Macedonia Nightclub Fire: A National Tragedy: On March 16, 2025, a devastating fire engulfed the Pulse nightclub in Kočani, North Macedonia, killing 59 people and injuring over 150 others. The fire, triggered by indoor pyrotechnics, spread rapidly due to flammable materials inside the club, trapping patrons in a deadly inferno. Survivors suffered from severe burns, smoke inhalation, and trauma, marking this as one of the worst disasters in the country’s recent history.

While authorities focus on investigating the cause and implementing fire safety reforms, another critical issue remains burn rehabilitation. The physical and psychological impact of burns lasts long after the flames are extinguished. Physiotherapy plays a vital role in ensuring survivors regain mobility, strength, and quality of life.

The Lifelong Impact of Burn Injuries

Burn injuries don’t just cause immediate pain; they also lead to long-term complications that affect every aspect of a person’s life. Some of the most common issues burn survivors face include:

1. Scar Formation and Contractures

Burn wounds heal by forming scar tissue, which can become thick and tight, limiting movement.If untreated, contractures (permanent stiffness) can develop, making it difficult to walk, lift objects, or even perform daily activities like eating or dressing.

2. Muscle Weakness and Stiffness

Prolonged bed rest and immobility in the hospital lead to muscle atrophy, where muscles shrink due to lack of use.Without proper exercise, survivors struggle with balance, coordination, and endurance.3. Lung and Respiratory ProblemsMany victims of house fires or nightclub fires suffer from smoke inhalation injuries, damaging their lungs.Physiotherapy includes breathing exercises and respiratory therapy to strengthen lung function and prevent conditions like pneumonia.4. Mental Health ChallengesBurn injuries are traumatic, and many survivors experience post-traumatic stress disorder (PTSD), depression, and anxiety.Lack of confidence due to scarring and physical limitations can lead to social withdrawal.These issues make burn physiotherapy crucial in recovery. Without rehabilitation, survivors may struggle with disabilities that limit their independence, ability to work, and overall well-being.

How Burn Physiotherapy Helps Survivors Recover

Physiotherapy for burn victims is not a luxury—it is a necessity. Proper rehabilitation ensures survivors regain strength, flexibility, and independence. Here’s how physiotherapy helps:

1. Early Mobilization to Prevent Stiffness: The sooner patients start moving, the lower the risk of stiffness and muscle loss.Simple stretching exercises and assisted movements help maintain joint flexibility.

2. Scar Management Techniques: Massage therapy and compression garments help keep scars soft and flexible.Special silicone sheets and pressure bandages can reduce thick scarring.

3. Strength and Endurance Training: Survivors need progressive exercises to regain their muscle strength and stamina.Bodyweight exercises, resistance bands, and aquatic therapy can be used to rebuild strength safely.

4. Pain and Respiratory Management: Breathing exercises help patients clear mucus from the lungs, improving oxygen flow.Stretching, hydrotherapy, and electrical stimulation can reduce chronic pain from burns.

5. Psychological Support Through Movement: Physiotherapy isn’t just about the body; it also boosts mental health.Engaging in physical activities helps burn survivors regain confidence and social skills.

Kanu Kaushik ( Senior Physiotherapist, CEO of Kinesio Prehab Institute & Physiotherapy Clinical Chains) would like to suggest the Macedonian Society to focus & Improve Burn Rehabilitation

While physiotherapy plays a critical role, many North Macedonia Nightclub Fire burn victims struggle to access proper rehabilitation. Society must take action to ensure every survivor receives the care they need. Here’s how:

1. Build More Burn Rehabilitation Centers: Many hospitals lack specialized burn rehab units.Governments should invest in dedicated burn physiotherapy clinics within major hospitals.

2. Train More Physiotherapists in Burn Care

Not all physiotherapists are trained in burn rehabilitation techniques.Medical schools should introduce burn physiotherapy training programs.

3. Increase Public Awareness

Many survivors don’t know they need physiotherapy.Public campaigns should educate families on the importance of burn rehab.

4. Make Physiotherapy Affordable

Burn rehabilitation can be expensive, leaving many victims without care.Governments should ensure insurance covers physiotherapy for burn survivors.

5. Introduce Community Support Programs

Survivors need mental and emotional support as they recover.Local organizations should host support groups, mentorship programs, and community rehab sessions.

The Path Forward: Turning Tragedy into Change

The North Macedonia nightclub fire is a painful reminder that burn injuries require more than emergency care—they demand long-term rehabilitation and support.

Survivors deserve more than just survival—they deserve a chance to rebuild their lives. By improving access to specialized burn physiotherapy, training professionals, increasing awareness, and providing financial support, we can ensure that burn victims receive the best possible recovery care.

It’s time for governments, healthcare professionals, and communities to come together and invest in comprehensive burn rehabilitation for North Macedonia Nightclub Fire survivors. When society prioritizes physiotherapy, burn survivors can heal—not just physically, but emotionally and socially.

“A tragedy should not define a person’s future. Rehabilitation does. Every burn survivor deserve a second chance at a full life.” — Kanu Kaushik