Jocalyn Clark urges the global health community to press for high level change in legislation regarding acid violence.
At a recent social function benefiting the Acid Survivors Foundation, I learned about an insidious worldwide problem that barely figures on the global health radar, but should.
Acid violence, sometimes called acid throwing or an acid attack, involves throwing or pouring acid onto a person with the intent of killing or maiming them. The effects are heinous: the corrosive acid, usually sulfuric or nitric acid but sometimes bleach or petrol, melts skin, the eyes, ears, and bone, disfiguring the victim and often destroying their ability to speak, eat, see, and hear. The mental health consequences are as bad as the physical, it is reported, especially if the perpetrator is someone known to the victim, like a boyfriend, husband, or father. Fear, anxiety, depression, the inability to work or go to school, and the social isolation and stigma associated with disfigurement are wide ranging effects that greatly impact victims. They are often abandoned by their families and communities, and physical disfigurement is often permanent. Meeting several acid violence survivors at the charity event, and reading the Foundation’s materials that included photographs of others – mostly young girls; I found this heartbreaking.
That acid violence almost entirely affects women, and that the acid is thrown at the face to destroy what is seen by many as a woman’s most important asset, her beauty, makes it a particularly horrific form of gender-based violence. Acid violence is often retaliation for women exercising rights such as spurning sexual advances or rejecting a marriage proposal, or to do with family land or dowry demands. In other words, it’s a true denigration of a woman’s rights and identity.While the impacts on a victim are massive, the scale of the problem is difficult to trace, as many women fail to report the attack to the police for fear of reprisal, and governments tend not to keep official statistics. The Acid Survivors Trust International estimates there are approximately 1,500 acid attacks a year globally. The Acid Survivors Foundation reported about 300 attacks per year in Bangladesh and declining, but in India and Cambodia, Pakistan, parts of Africa, the Middle East, and South America they are understood to be increasing. A 2013 news report said acid violence has skyrocketed in the UK, with a tripling of the number of NHS hospital visits for acid attacks in 6 years, attributed in part to the growing number of immigrants from Asian regions where acid violence is more prevalent. Recognition that the problem is not just one of developing countries has been aided by the UK campaign and foundation of Katie Piper, a young English woman severely injured in an acid attack arranged by her ex-partner, and by the subsequent Channel 4 documentary “My Beautiful Face.” The 2012 Academy Award-winning documentary short, Saving Face, brought needed attention to the global nature of the problem of acid violence.
Community-based organizations like the Acid Survivors Foundation are to be hailed for providing victims legal, medical, counseling, and monetary assistance. That said, many developing countries where the problem is most prevalent do not have adequate medical facilities to treat acid burn victims (Uganda, for example, has one hospital to treat burns in the entire country). As a result, it’s especially important to press for change at a broader level.
A comprehensive report from Cornell University says there are two factors in addition to gender discrimination related to the prevalence of acid violence: one, impunity for acid attack perpetrators and two, easy availability of acid. These give clues to how the global health community can act to support broader legislative change and prevent such horrible acts of violence against women.
Bangladesh is considered a leader in legislative reform having criminalized acid violence in 2002, which was followed by India and Cambodia in 2011 and 2013, respectively. Other countries should be urged to develop laws that adequately punish perpetrators, and are consistently enforced. In addition, it is important to legislate to restrict ease of access. Similarly to how advocates called for the regulation and ban of pesticides in an effort to reduce suicide rates, it is necessary to support efforts to ban or restrict the sale of acid. Legislation can restrict ease of access, but this also must include the responsibility of businesses (i.e., factories) to limit the criminal use of their acid products, says the report. Support for this type of change is especially important since acid is widely available and very cheap in many countries.
Jocalyn Clark (@jocalynclark), a former Senior Editor at PLOS Medicine and former Assistant Editor at BMJ, is since November 2013 executive editor and scientific writing specialist at icddr,b in Dhaka, Bangladesh. She declares no competing interests.