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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 26  |  Issue : 1  |  Page : 83-86

Acid attack on women: A new face of gender-based violence in India


1 Department of Forensic Medicine and Toxicology, King George's Medical University, Lucknow, Uttar Pradesh, India
2 Department of Plastic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
3 Department of Forensic Medicine and Toxicology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India

Date of Web Publication11-Mar-2019

Correspondence Address:
Dr. Raghvendra Singh
Department of Forensic Medicine and Toxicology, Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijb.ijb_13_18

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  Abstract 


Introduction: Acid attack in women is a burning issue in the present scenario. It is the most heinous form of violence against women. This study was designed to know the victim's profile, motives behind the acid attack, and the role of restorative treatment in improving their living standards. This study also makes people aware about the program running for acid attack survivors in Uttar Pradesh.
Materials and Methods: This is a retrospective observational, analytical study of acid attack victims who were admitted to the plastic surgery department between July 2012 and June 2017 following the assault, 52 cases were included in this study period.
Results: Roughly more than 50% of cases recorded were <30 years of age, while the most common age group involved was 18–28 years age group. Relationship problems were the most common reason for the attack. All cases of acid attack survivors were disfigured; 78.8% were visually impaired. Bilateral blindness occurred in eight cases. A total of 65% of the victims belong to urban areas. More than 90% of cases were suffering from more than 2% burn over the face. Surgical correction was done in all cases to improve them functionally and cosmetically as far as possible.
Conclusion: In spite of several laws and schemes, a continuous increase in number of acid assault in North zone of India is a matter of serious concern. Along these laws and schemes, strategies for social upliftment against orthodox culture should also be adopted.

Keywords: Acid attack, gender-based violence, victim


How to cite this article:
Singh M, Kumar V, Rupani R, Kumari S, Shiuli, Yadav PK, Singh R, Verma AK. Acid attack on women: A new face of gender-based violence in India. Indian J Burns 2018;26:83-6

How to cite this URL:
Singh M, Kumar V, Rupani R, Kumari S, Shiuli, Yadav PK, Singh R, Verma AK. Acid attack on women: A new face of gender-based violence in India. Indian J Burns [serial online] 2018 [cited 2019 Jul 19];26:83-6. Available from: http://www.ijburns.com/text.asp?2018/26/1/83/253842




  Introduction Top


Acid attack is a worldwide problem affecting all irrespective of age, caste, and religion. It is the most heinous form of gender-based violence against women. Perpetrator's aim is not to kill the victim but to leave her in a pathetic condition. Injuries on the body heal and leave scars not only on the body but also physically and psychologically the whole personality of the survivor affected. Male victims were commonly affected in most of the countries, but in Bangladesh, Taiwan, Cambodia, and the USA (Newyork), females were the most common victim.[1] Violence against women has become a critical issue of discussion at every platform in recent world. Despite the existing laws and banning of over counter sale of acid, this horrific crime has been on the rampant rise in India.

National crime records bureau reported 45 cases of acid attack in 2014. In 2015,249 cases were reported from all over India, out of which 61 cases were reported from Uttar Pradesh.[2] Compared to women throughout the world, women in India are at higher risk of being victims of acid attacks, 72% of reported acid attacks in India have involved women.[2] In India, about 350 cases are legally reported per year, while separate research conducted by an organization Acid Survivors Foundation India, estimated approximately 500–1000 cases per year in India, excluding unreported incidents.[3] There is no reliable national database to combat acid violence on a sustained basis as many cases go unreported.

This study is a retrospective observational, analytical study. We have studied the whole profile of the victim; hence, this study is designed to know the problems faced by the victims, motives behind the attack, and the role of restorative treatment in improving their living standards. This study also sensitizes about the programs running for acid attack survivor in the Uttar Pradesh under which free treatment is provided without any cost limits. The study was carried out in Lucknow and surrounding areas of North zone. Lucknow, itself is the capital of Uttar Pradesh and a major metropolitan city and tertiary care center which encompasses a large portion of the population of the region of Northern India


  Materials and Methods Top


This study was performed at the Department of Forensic Medicine and Toxicology. In collaboration with plastic surgery, clinical records of all these patients were studied retrospectively over 5 years from July 2012 to June 2017. During this period, a total of 52 cases of acid burn have been reported for surgical correction in our tertiary care center. These cases were evaluated on the basis of their demographic profile, injuries and their severity, motives, and psychosocial impact. Effectiveness of restorative measures used for cosmetic and functional improvements was also assessed.


  Results Top


A total of 52 cases of acid attack have been treated from July 2012 to July 2017. Among these 52 cases, 48 cases were injured grievously by acid attack, and 4 were suffering minor injuries by attack. It was found in [Table 1] that maximum number of cases 36.5% were found in 20–30 years age group. About 23.1% and 11.5% of cases were reported in the age group of 31–40 and above 40 years, respectively. 27 victims were married. Majority of acid attack cases occurs in urban area than rural area. In this study, 65.4% of cases occurred in urban area and 34.6% of cases in rural area. About 42.3% of cases were attacked by one-sided lovers. Dowry cases and marital dispute cases are 3.8% and 3.8%. Family-related disputes were the cause in 1.9% of cases. About 30.8% of cases were due to property/money dispute, and 17.3% of cases were attacked for other reasons such as neighbor disputes and socially motivated causes.
Table 1: Basic characteristics of patients (n=52)

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In [Table 2], disfiguration of the face was found in 100% of the victims who came for the treatment. The ocular involvement was present in 78.8% of the cases, eight of them with bilateral blindness, loss of hearing in 15.4% of cases, throat injuries in 9.6% of cases, and in 5.8% of cases genitals were also affected.
Table 2: Distribution of patients according to physical injuries (n=52)

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In [Table 3], it was found that none of the victims were found mentally sound, all were depressed, anxious, insomniac, etc. Some were anxious and depressed as they lost their vision; hence, they considered themselves as a burden on the family. 1.9% lost their job, 5.8% were ostracized by the society, 3.8% of cases lost their married life due to acid attack, and 5.7% of cases attempted suicide.
Table 3: Distribution of patients according to psychological problems (n=52)

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In [Table 4], it was found that most of the acid attack victims were severely affected and recovery of beauty was the next option, the priority was to make the patient functionally able. Scar revision and split skin graft (SSG) done in every case. Ectropion release, Z-plasty, and perioral contracture release were done in more than 70% of cases. Neck contracture release, expander insertion, expander removal, and flap insetting done in 7.7% of cases. Flap cover is done in about 15.4% of cases. Eyebrow creations and corrections were done in 38.5% of cases.
Table 4: Distribution of patients according to surgical treatment (n = 52)

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In [Table 5], all 52 cases were functionally improved, while in only four cases cosmetic improvement had been done as they were suffering from minor injuries.
Table 5: Outcome of treatment (n=52)

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  Discussion Top


In the present study, more than 65% of cases were below 30 years of age group, and out of them, maximum number of cases 36.5% were found between 20–-30 years age group, which is similar to the findings of other studies in spite of their smaller sample size.[4] This clearly indicates that maximum victims were of this age group in such type of heinous crime data. This is the age of early adulthood when women are maximally exposed to the male dominant society. Even, they attract to each other. Some healthy relationships also flourish in between few one-sided affairs. These one-sided affairs often faced denial from women and thus hit the ego of men. Females are usually considered as a second-class citizen in this male dominant society, influenced by cultural and social norms. These norms award males to be aggressive, powerful, controlling and thus contribute to a social acceptance of dominant part of our society. Unlike the Ugandan pattern but similar to Hong Kong pattern majority of assaults in our study were the result of relationship dispute.[5],[6] Ignorance and justification of sex-linked offenses by our society are also precipitating factor for such heinous crime. We reported that majority of cases were belonging to urban areas. Other study also reported the urban dominance of acid attack cases.[4] As we know that the pace of urbanization with migration of more and more individual leads to increase crime rate in urban areas. Not even in developing country, the developed country also reported a recent increasing trend of acid attack in their metropolitan cities.[7] In rural India, Indian mythology and scriptures, which teach a woman to respect and obey their male counterpart, such as a woman should eat only after him, should walk behind him in public, etc., are prevalent, unlike the urban areas. When these people migrate to urban areas, these male individuals are more reluctant to accept the equality of gender and often indulged in these types of cold premeditated assault. Besides, its easy availability and illegal sale of acids over-the-counter are also some additional contributory factors. Being a tertiary care center, all of the victims are referred to our setup from other health center for the cosmetic and functional reconstruction; hence, the face was involved in all cases in our study. Other studies have also reported with the face as the most common part affected.[5],[8] In some cases, jealousy of these perpetrators has crossed to such extent that they throw or pour acid over the genital region. These cases were also associated with the sexual assault. Physical damages are repairable but the damages, which are inflicted over emotions of the victim, completely destroyed the hopes and dreams of her innocent mind. Acid attack is a deadly nuisance against her alluring appeal. It destroyed her identity, self-esteem, and confidence immediately and on the long-term prevalent stigma of justifying the violence against women, forces her to live a life of socialeconomic sequestration. Level of this stigma is so strong that their faces not only become roadblocks to the social life but also a major brunt on their livelihood; hence, an initiative called Skill Not Scars has to be launched, which urges the employers for the job of these acid attack survivors. SSG is the most common surgery which has been done in all these cases. Z-plasty, ectropion, and perioral release have been done for relieving functional impairment. Flap cover is done for the injuries which are bone deep. In cases where adjacent healthy skin is available, expander insertion, expander removal, and flap in setting techniques were done to improve cosmetically. In every case, multiple procedures have been done to improve the patient functionally and cosmetically as for as possible. After surgeries, 100% of cases became functionally improved, but cosmetically, none of them got their original appearance back.


  Conclusion Top


Several laws and schemes, such as restriction of sales of acid, harsher punishment for the perpetrators, and free access to healthcare facilities to acid attack victims, have been laid by our lawmakers; however, the main focus should be restricted to prevention. Several measures, such as strengthen the NGOs, electronic, print, and social media campaigns, should be adapted to change the orthodox sociocultural norms, which are justifying the violence against women.

Laws have been made to relieve the victim with financial help in the form of compensation. Uttar Pradesh government came ahead to help these victims a little more as they launch a scheme named Rani Laxmi Bai Mahila Samman KoshYojana which helps the victims by not only giving the compensation but also provide free treatment without cost limits. This scheme also offers compensation to the dependants of the victims who died.

Laws made schemes made so what remains? What we have to do? We have to do the strengthening of the implementation of the rules and regulations. Implementation demands the role of each one of us if we see over-the-counter sale of acid we should complain the authorities and authorities need to take strict action. Prevention is always better than cure.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mannan A, Ghani S, Clarke A, Butler PE. Cases of chemical assault worldwide: A literature review. Burns 2007;33:149-54.  Back to cited text no. 1
    
2.
National Crime Records Bureau. Ministry of Home Affairs. Crime in India 2015 Statistics. Chapter(1):(22).  Back to cited text no. 2
    
3.
Patel M. A desire to disfigure: Acid attack in India. Int J Criminol Sociol Theory 2014;7:1-11.  Back to cited text no. 3
    
4.
Restrepo-Bernal D, Gómez-González A, Gaviria SL. Deliberate burning with acid. New expressions of violence against women in Medellín, Colombia. Series of cases. Vertex 2014;25:179-85.  Back to cited text no. 4
    
5.
Asaria J, Kobusingye OC, Khingi BA, Balikuddembe R, Gomez M, Beveridge M, et al. Acid burns from personal assault in Uganda. Burns 2004;30:78-81.  Back to cited text no. 5
    
6.
Young RC, Ho WS, Ying SY, Burd A. Chemical assaults in Hong Kong: A 10-year review. Burns 2002;28:651-3.  Back to cited text no. 6
    
7.
Shokrollahi K. Perspectives on acid attacks in the UK. Scars Burns Healing 2017;3:1.  Back to cited text no. 7
    
8.
Karunadasa KP, Perera C, Kanagaratnum V, Wijerathne UP, Samarasingha I, Kannangara CK, et al. Burns due to acid assaults in Sri Lanka. J Burn Care Res 2010;31:781-5.  Back to cited text no. 8
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

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