The streets of Islamabad’s "Blue Area" are typically wide, straight boulevards lined with greenery and the mansions of diplomats and politicians. In one such street is a simple but large house rendered in plain white with no distinguishing markings aside from its street number.
Inside reside a number of courageous people engaged in a most basic struggle for survival.
"It’s as though someone has poured boiling tea on me…over and over again," recalls Nazeeran, a woman from the village of Tehsil in south Punjab now fighting for her life at a refuge run by the Acid Survivors Foundation. Earlier this year she was doused in concentrated acid that caused severe burns to her face, shoulders and forearms. The acid continued to burn through her body for 10 hours, the time it took to finally obtain medical care at a hospital.
Nazeeran’s head is no longer recognisable. It resembles a lump of melted wax with mixed hues of pink, red and brown. She lost both of her eyes and her mouth is now a small immovable opening surrounded by the flesh and muscle that fused together when the acid dissolved her face. It is very possible that Nazeeran will die within the next few months.
Every year many thousands of Pakistanis, overwhelmingly women, fall victim to acid and other burn attacks. Such attacks are a result of the extreme poverty and low literacy rates of rural and tribal Pakistan. Many of the men implicated in attacks are unemployed and engaged in substance abuse, such as glue sniffing or hashish. It is not unusual for women in these communities to do both the household and agricultural work.
Young women and girls are often married to men with existing partners or children. Acid attacks are used as a means to marginalise those who complain or are perceived to be a threat to other family members. The attacks, typically to the face, gruesomely disfigure the victim and can lead to serious infections, disabilities and ostracism by family and community.
According to the Foundation, 40-50 per cent of acid burn victims who are not immediately treated die, mostly because families refuse treatment or because the victims live in remote areas far from medical facilities.
"Our patients are mainly from the Saraiki Belt [a large rural region]of south Punjab and north Sindh," says Samina Afzal Naz, manager of the refuge. The Acid Survivors Foundation also receives victims from the states of Sindh and North Western Frontier Province.
The Saraiki Belt is one of the agricultural heartlands of Pakistan where acid is used as pesticide because it is cheap. One litre of concentrated acid costs around 10 rupees per litre — or around 15 Australian cents. While minimal safeguards are technically in place, in reality there is close to no regulation of its sale. This makes it a dangerously accessible lethal weapon for those with malicious intentions.
The Foundation has helped 150 burn victims since it was founded last year, 53 per cent of whom are women, 23 per cent children, and 24 per cent men. Most of the children are collateral victims of attacks on their mothers.
A range of health professionals volunteer their time: from psychologists who work to convince victims to seek or continue treatment, to plastic surgeons who try to repair the horrendous tissue damage caused by the acid attacks. Victims require several extensive operations to end the burning that continues to eat away at the tissue and bone under their skin even weeks after an attack. This is followed by skin grafting. Initial operations for a patient with old wounds cost around 45,000 rupees (AU$703); for patients with recent wounds, the figure rises to around 500,000 rupees (AU$7807). Medication costs victims 25,000 rupees (AU$390) each month.
"Most of the attacks are directly or indirectly due to domestic violence," says Natasha Simonsen, an Australian working with UNICEF in Islamabad who volunteers at the Acid Survivors Foundation. Other causes include spurned sexual advances, and land, succession or marriage disputes, although attacks are usually the result of a number of comingled factors.
A male relative demanded that Kauser, a mother of two, surrender her farming property. "I refused [earlier in the day]. At 2 in the morning he returned and threw acid on me." Her entire face, forearms and parts of her shoulder were totally burnt. "I was burning for 2 hours before I managed to reach the local hospital." Kauser was eventually transferred to the main hospital of Multan, the notoriously dirty and ill-equipped Nishtar Hospital. "I was given an ointment treatment [for the burns]for one day after which I was told to leave and do it myself." She is lucky to still have eyes, although the acid damaged her eyesight. Her son, who was sleeping with Kauser at the time of the attack, also suffered serious acid burns to the face.
Nazeeran, mentioned earlier, was attacked by the nephew of her husband’s first wife because the latter thought she was usurping her position in the household.
According to the Human Rights Commission of Pakistan, in 2006 two thirds of reported acid attacks were committed by husbands against their wives, up from just under half in 2005. The figure is believed to have risen further in the time since then.
Only last week a young woman from rural southern Punjab was kidnapped, raped and had acid thrown on her face because she refused a classmate’s marriage proposal. The assailants are in police custody but there is little hope that justice will be served.
The Punjab Legislature passed a resolution in 2003 proposing that acid burn cases be treated as murder but it has yet to be enacted into legislation. Other laws limiting the purchase or sale of acid have been proposed by the Punjab and Federal parliaments but have never been implemented.
A bill regarding violence against women was introduced by Information Minister Sherry Rehman in 2005, but it does not mention acid attacks and has yet to be passed. There are presently no laws or bills before Pakistan’s parliamentarians that factor in the mental trauma or loss in quality of life suffered by acid burn victims.
Unsurprisingly, there are only 28 cases of perpetrators being brought before the courts for acid attacks. In most of these, victims were put under pressure to drop their case in exchange for marriage or re-inclusion into their society. Assailants are rarely prosecuted.
Sadly, acid attacks are just one of several types of violence suffered by women in Pakistan.
A scandal has erupted in the state of Baluchistan following revelations that several women were buried alive in a string of honour killings in the last two years. While the practice was condemned by many Baluchistan Assembly members, a number have defended it. Senator Israrullah Zehri described the murders as "part of our custom" and Senator Jan Mohammad Jamali said that the issue was being "unnecessarily politicised."
The three leading ministers of the Federal Senate Committee on Human Rights conducting an investigation into the murders failed to attend the first hearings held two weeks ago. And of course, in the shadows, is the Taliban’s very open chauvinism towards women in the tribal agencies of the North Western Frontier Province.
It will take a quantum leap of political leadership before mainstream Pakistani society confronts the war it is waging with its own women. But with most in the grip of abject poverty, big inprovements could be a long time coming.
To donate money and items to the Acid Victims Foundation of Pakistan go to their website.
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