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    The Lancet, Volume 382, Issue 9897, Page 1013, 21 September 2013

    India promises to curb acid attacks

    Dinesh C Sharma

    India is cracking down on the sale of acid to prevent its use in attacks on women. But campaigners say that the country can do much more to reduce this type of violence. Dinesh C Sharma reports.
    On July 26, a 22-year-old woman was attacked with acid by her male stalker in Ghaziabad near India’s capital New Delhi. The woman, who had almost half of her body disfigured with critical burns, is currently recovering in a care home after undergoing surgery at a government hospital in the capital.

    Such attacks against women by stalkers or jilted lovers are not uncommon in India, but this one made headlines as it came barely a week after the country’s Supreme Court asked the government to take stern steps to curb acid violenceThe court—acting on a petition filed by an acid attack survivor—directed that over-the-counter sale of acids be restricted.

    All sellers must record the identity of buyers, reasons for purchase, and quantities sold. Legitimate users like educational institutions, research laboratories, and hospitals will have to follow guidelines for safe keeping of corrosive liquids. The government has assured the court that acids will be treated as poison and brought under the control of the Poisons Act. A new set of regulations called the Poisons Possession and Sale Rules will be implemented soon to regulate all forms of acids (liquid, crystalline, concentrates).

    Easy and cheap availability has made acids a potent weapon in the hands of perpetrators. Acids used in industrial processes and jewellery making are sold in open markets and are used for other purposes such as toilet cleaning. A litre of diluted acid is available for as low as INR 50 ($0·80). However, it is not just about easy availability, say campaigners.

    The underlying reason behind acid attacks is discrimination against women. “Acid violence is a form of gender-based violence, often linked to unequal gender relationships. It is a particularly brutal and shocking form of violence because it is premeditated and planned”, explains Jaf Shah, executive director of London-based charity, Acid Survivors Trust International (ASTI).

    Though it is a severe form of violation of human rights and victimisation of women, it has not been treated with seriousness until now, says Ranjana Kumari, director of the Centre for Social Research, New Delhi.
    Official data about acid violence is lacking because many cases are not reported to police and when reported they might not be classified acid attacks. On the basis of media reports and extrapolations, action groups estimate that the number of acid attacks in India could be as high as 1000 a year.
    Acid victims did not qualify for any government help. Now the Supreme Court has directed that they be paid compensation of at least INR 300 000 ($4760) to help with rehabilitation costs. Survivors and action groups feel the amount is arbitrary and inadequate as treatment could cost several million rupees.

    Besides third and fourth degree burns, most victims suffer damage to their eyes, ears, and nose. In some cases inhaled acidic fumes can severely damage lungs, kidneys, and intestines. “Burn wounds take several months to heal, after which one has to undergo a series of reconstruction surgery costing huge money and needing long-term expenses for gel sheets, anti-scar ointments, and pressure garments”, says Pragya Singh, an acid attack victim based in Bangalore and now a volunteer with Stop Acid Attacks (SAA) campaign.

    In addition to costs, the health-care system is not geared to handle cases of chemical burns. Most attacks take place in rural area and smaller towns, which do not have specialised burn units or isolation wards. “Delhi has just one hospital with a burns ward, which is always filled beyond capacity. Victims from smaller places find it inconvenient and expensive to travel to Delhi and stay for several months for treatment”, adds Singh.

    Plastic surgery expertise to handle cases of extreme disfigurement is also lacking. “I consulted several plastic surgeons in Delhi, Bangalore, Chennai, and Mumbai. Most of the doctors who saw me expressed their inability to treat me”, recalls Singh.

    A policy of zero-tolerance against acid attacks, strict regulation of sale, and a generous rehabilitation package for victims would go a long way towards meeting the challenge posed by acid attacks, feels Suneet Shukla, co-ordinator of SAA.
    The group has suggested a comprehensive Criminal Injuries Compensation Act, which should provide for both interim and final monetary aid for victims of acid attacks and other form of violence against women.

    “India has an opportunity to learn from challenges faced in actual enforcement of laws in countries like Bangladesh”, says Shah of ASTI. Acid attacks in Bangladesh have dropped by 75% since 2002, he says, following the adoption of specific laws criminalising acid violence and limiting accessibility of acid through introduction of licenses. Pakistan and Cambodia have also enacted similar laws.

    G Mohan.

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