by: Yagoda Oleksak

Pan-seared in butter, baked with vegetables, grilled with dozens of spices, Tilapia has become one of the most popular seafood main dishes globally and is only expected to grow in demand. While this flavourful fish has become a favourite for many because of its culinary versatility and rapid farming potential, a new purpose for this aquatic animal is emerging from the ocean floor. 

Every day, over 30,000 people suffer from burn injuries, accumulating to 11 million new cases yearly, and causing upwards of 180,000 deaths annually. Death by burns is one of the leading causes of mortality in the world and, despite the seriousness of that fact alone, it is representative of a much greater public health issue. Two-thirds of the burden of burns disproportionately stems from lower and middle-income countries. The lack of trained surgical staff, anesthetics, and other vital equipment has left many healthcare workers fighting, what seems like, a tsunami with a bucket. While efforts have been made to reduce burn prevalence, there remains a scarcity in these countries of effective, accessible treatments for minimizing disability and mortality due to burns. As this public health issue worsens like a cyclone, it seems that the tempest will tip this ship of healthcare overboard… but the blueish-grey-scaled Tilapia fish emerges, steering it from the eye of the storm and becoming a beacon of hope in fighting the current. 

In 2016, in Fortaleza, Brazil, a 23-year-old male arrived at the burn treatment centre with severe superficial and deep partial burns. Dr. Edmar Maciel Lima-Junior and his team used Nile Tilapia Fish Skin (NTFS) to treat and dress the patient’s wounds after sterilization and irradiation processes. It was thought that the non-infectious microbiota, high levels of type I collagen— an important protein in maintaining connective tissue, and tensile strength of the fish skin made it an excellent candidate for a xenograft—a tissue sample from another species used for organ donation. Sure enough, they were right. The NTFS led to a faster and better recovery that did not require painful dressing changes and faced no risks of rejection. These incredible results intrigued Dr.Lima’s team so they decided to extend the case study to controlled and clinical trials. 

The follow-up studies included more patients in the same burn clinic. They found that NTFS, again, led to quicker recovery time, lower pain intensity, a reduced need for anesthetics and analgesics, and no need for dressing changes. Most importantly, the NTFS was far superior in treating burns than silver sulfadiazine cream—  a common antibacterial cream for treating burn victims requiring expensive and painful daily reapplications. These findings could revolutionize how to treat second and third-degree burns more effectively and economically. NTFS is far cheaper and more accessible than current treatments; making it the perfect tool for healthcare workers in middle and low-income countries where access to expensive medications and typical porcine xenografts is limited. NTFS can be easily and sustainably sourced from Tilapia fish farms, in large quantities, that would otherwise be discarded as waste products. As studies continue to emerge in support of this research, it seems as though there is hope for bridging the chasm of disparities in medical treatments globally, one Tilapia at a time. 

Inequalities in public health exist in every country, stemming from any number of factors involved in social stratification; socioeconomic, cultural, and political differences only account for the tip of the iceberg. However, according to the World Health Organization, middle and low-income countries have had massive leaps in bridging these inequalities by simply improving healthcare knowledge, accessibility to services, and making use of available resources. While this concept may seem obvious, it may allude to something more subtle, something that the Tilapia fish in Brazil have already begun to uncover. 

The answer to bridging these health disparities may not lie in fixing every system uniformly but in reinventing them to meet the needs of their unique demographics. Rather than synthesizing entirely new medications and fighting policies to acquire expensive medical resources in Fortaleza, Dr. Lima’s team turned to the flora and fauna— creating a brilliant scientific innovation that meets the population’s needs sustainably and effectively. As scientists continue to innovate and propel medicine forward, they help us come to an important two-fold conclusion; that there are many different ways to solve the same problem and that sometimes to move forward we must stop to look at what has been in front of us. Mother Nature is the best chemist of all, and implementing her help in finding creative ways to overcome longstanding challenges is exactly the kind of symbiosis science needs. 

Looking back at the dinner plate now, you might find yourself faced with the Tilapia— once an unassuming seafood course now-turned skin saviour. It’ll serve not only as a great pairing for roasted potatoes or steamed rice but also as a reminder of the amazing scientific potential that is uncovered when humanity integrates nature into solving societal problems.

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