Just after midnight on April 16, 2000, 13-year-old Jannatul Ferdous awoke from her sleep with the sensation that an extra linen sheet was being pulled over her body. Seconds later, excruciating pain enveloped her chest and face. A sudden pain jolted the back of her brother, who was sleeping beside her in the small bed. A cup of battery acid thrown through the window engulfed the young girl and her brother as they lay sleeping. The perpetrator was a young man in his twenties, angry that Jannatul had refused his wedding proposals. Jannatul's family had heard about acid attacks on women, but it was not until after daybreak that her parents realized the severity of the situation and took her to a nearby medical clinic in the rural Lakshmipur region of Bangladesh, several hundred kilometers north of downtown Dhaka. The next day she was treated at the Dhaka Medical College Hospital, having spent hours in the waiting room despite her third-degree burns. Approximately 300 people in Bangladesh share Jannatul's experience each year, and 41 percent of victims are under the age of 18. Tragically, the attack on Jannatul was characteristic for several reasons. It is often the case that attacks take place in the middle of the night, that a nearby family member is also victim to the attack, and that the victim does not get quick or adequate medical attention despite his or her urgent need of it. Further, 78 percent of reported acid violence happens to women, with the most common reasons for attack being the refusal of marriage, the denial of sex, and the rejection of romance. Acid attacks leave victims horribly disfigured. Because most attacks are directed at the face in order to permanently scar the victim and destroy her physical appearance, often times the victim is left blinded. Jannatul is considered fortunate with regard to the extent of medical care she has received: she spent ten weeks in the Dhaka hospital and returned in June, 2001 from a year-long stay in Florida to receive special plastic surgery. Despite this care, permanent scars still mar her face. Even after extensive treatment gauges inevitably remain, making social reintegration and marriage very difficult. Victims usually become depressed and are treated as outcasts by family, neighbors, and friends. Despite the frequency of acid attacks and the high traumatic acuity of each, acid violence is a little known phenomenon; what little is known has not resulted in substantially improved care nor a decreased prevalence of attacks. The following pages document a front line investigation of acid violence in Bangladesh and what is being done about it, with subsequent analysis of the current challenges of intervention programs. Acid violence is among the grossest of human rights violations, and the goal of this examination is to focus the debate and the point of intervention in order to more effectively address the problem. This inquiry draws substantially on privileged interviews conducted by the author in June 2001 with survivors of acid attacks, as well as with those working to help them and to prevent future violence against others A Cheap and Available Weapon A decade ago, acid attacks were committed almost exclusively against women, and only as a crime of vengeance. However, there has been a pronounced increase in acid attacks overall and against men in recent years. Now, nearly 25 percent of reported victims are male. Recently, victims as old as 60 have been targets of this type of violence A cup of acid, usually sulfuric acid poured from any car battery or purchased from auto repair shops, costs only a few cents, and is therefore both a cheap and available weapon. Some perpetrators throw acid in an attempt to obtain the victim's land, believing that the family will be forced to sell their property in order to pay for medical treatment. A common myth both within Bangladesh and in the external development community holds acid violence to be permanently and historically engrained in Bangladeshi society. Such a perspective is clearly inconsistent with historical evidence. Acid violence was first identified as a problem in the region of Bangladesh in the 1960s. Although acid attacks may have occurred prior to this time, political turnover and a lack of documentation preclude conclusive evidence. Demystifying the notion of intrinsic acid violence, or even gender inequality more broadly, is a crucial first step to enabling the alleviation of this problem. The number of acid attacks increased steadily in the two decades following Bangladesh's independence in 1971, from approximately a dozen each year to about 50 per year in the mid-1990s. But in the late 1990s, cases reported by non-governmental organizations (NGOs) and the government shot up to 250 per year and have leveled off at that point since then. Although both NGOs attribute the steady increase of attacks since 1960 to the increasingly public role of women, neither can explain the explosion of cases in the mid-1990s. Representatives of both NGOs assert that while improved NGO efforts to track cases coincided with the increase in reported cases in the late 1990s, there was a real increase in cases not just an apparent increase due to more thorough coverage. NGOs recognize that some cases do go unreported, but given the strength of the reporting system now in place, it is thought that less than 50 cases go unreported each year, putting the total cases at about 300 annually. The 1990s also saw the arrival of the first strong NGO efforts to counteract acid violence. Naripokkho, formed in 1995, is a women's advocacy organization, and the Dhaka-based Acid Survivors Foundation (ASF), founded in 1999, is an NGO spearheading collaborative work against the attacks. Prior to the late 1990s, the lack of an official reporting infrastructure led to inconsistent tracking of acid throwing incidents and made it difficult to trace acid violence as a countrywide phenomenon, even though acid burns were on the Ministry of Health's list of reportable cases. Tracking the cases should theoretically be very convenient, given that acid violence nearly always necessitates hospitalization and that there are few private facilities in Bangladesh. Although victims sometimes do not see the perpetrator, and at other times do not want to mention his name for fear that he will punish the victim's family, victims are usually candid in saying that they received the burns from an acid attack. A Broader Problem While acid violence is treated here as a specific, isolatable human rights violation, it is part of a broader type of brutality and cruelty prevalent beyond Bangladesh. Despite the growing number of male victims, the majority of acid violence and certainly its historical roots are seen as a component of a broader phenomenon of gender violence. According to Ivy Rahman, chairperson of the organization Jatiya Mahila Sagstha in Bangladesh, the "attitude of the male-dominating society towards women has to be changed first to put a stop to acid pouring." And although acid violence was initially thought to be a problem endemic to Bangladesh, it is becoming increasingly identified in other South Asian countries. This is consistent with a broader sphere of gender violence. In India, 174 cases were reported in 2000, a per capita incidence of about 1/15 that of Bangladesh, but an absolute number approaching those of Bangladesh. It has been detected also in Pakistan, Nepal, Cambodia, Vietnam, and Laos. ASF has proposed an international workshop for early 2002 to bring NGO and government leaders together to collaborate on a regional effort to combat acid violence. NGO Efforts to Combat Acid Violence Although the specific approach to countering acid violence varies between Naripokkho and ASF, both have a general five-prong approach: public awareness, case reporting, short-term treatment, long-term treatment, and legal justice. Public campaigns have been successful in educating residents throughout Bangladesh about what to do in case of an attack, as well as conveying the importance of finding competent medical care within three days. Further, through interventions such as a program which recently placed acid survivors and national celebrities side by side at a musical concert, NGOs and national media are attempting to inform society about acid violence and the need to accept victims back into society as survivors Ñ not to reject them and treat them as outcasts. In an effort to provide medical care for acid victims, the Bangladeshi government established a burn unit at the Dhaka Medical College Hospital. This unit, created in the late 1990s, contains 8 beds and employs 3 plastic surgeons. It is the only burn facility in this country of 130 million people; therefore, it is frequently inaccessible to acid victims. Long delays in medical care have hampered recovery for most past victims, and, once provided, the medicine was very limited in scope. The ASF has been instrumental in establishing a response network that utilizes float-planes and other NGO resources to ensure that victims receive treatment at Dhaka Medical College within three days of the attack, and at no cost to the victim or his/her family. The ASF also created and maintains Thikana House, the only care facility exclusively for acid victims. Currently, Thikana provides limited medical care for less serious burns and follow-up care after surgery. Thikana also offers counseling, skills training, and other rehabilitation programs to help survivors reintegrate into society. Within two months, Thikana will open a 15-bed surgery unit at the Center for Rehabilitation of the Paralyzed, thereby eliminating dependence on local hospitals. In the last two years, 50% of all attack victims have benefited from the services of ASF. Victims need long-term as well as short-term care, primarily in the form of specialized plastic surgery. In 1999, European donors sent a group of six Bangladeshi survivors to Spain for six months to receive high-quality care. The intervention, while costly, was very successful in raising morale among the survivors being treated. It also offered hope to those survivors in Bangladesh who had not yet received definitive care. Since then, nearly two dozen survivors have traveled to the U.S. and Europe for six to twelve months to receive long-term care. In March, 2001, Healing the Children, a U.S.-based NGO, sent a 9-person surgery team to Bangladesh that performed 34 high-quality plastic surgery operations in 5 days. According to John Morrison, the Executive Director of ASF, as well as the US Embassy in Dhaka, the trip was highly successful from a treatment standpoint. Morrison hopes to bring physicians to Bangladesh again to perform the operations rather than send patients abroad to the U.S. and Europe, becausedoing so would have a much wider impact for the same cost. He hopes eventually to have a resident surgery team at Thikana comprised of foreign physicians who serve temporary tours of service. Prosecution Until recently, perpetrators of acid violence largely went unpunished. According to Dhaka's The Daily Star on 14 January 2001, "participants at an opinion exchange programme on 'social initiatives to prevent acid pouring'... observed that despite the enactment of a new women repression prevention law, such crime continues unabated thanks to lack of proper implementation of the law and negligence by the law enforcing agencies [sic]." However, some victories have occurred in the past several years. Of approximately 750 reported assaults since 1998, 25 perpetrators have been found guilty. A sentence is commensurate with the extent of burning sustained by the victim, and is usually a life sentence or the death penalty. Of the 25 guilty sentences handed down, 9 have prescribed the death penalty in cases where the victim was partially or fully blinded. Punishment is harsh because acid violence is always considered a pre-meditated crime; a perpetrator must plan out the attack in order to obtain acid and sneak up on the victim. According to both ASF and Naripokkho, the judicial system is the key interface in fighting acid violence. Morrison points out that acid violence was rampant in Europe and the U.S. in the 1800s, but died out by the 1840s due to improvements in police forces and the court system. However, the legal system in Bangladesh, especially in the lower levels of courts, is fraught with corruption, political influence, and delays. In July, the annual world corruption rankings compiled by Transparency International named Bangladesh as the most corrupt country in the world. For example, the case brought against Jannatul's assailant has been held up because the magistrate in her district recently decided to take a two-month vacation. Police and attorneys are known to prosecute scapegoats in place of the accused perpetrator if he or his family has political influence. Some culprits are able to post bail, despite the severity of their cases. According to Naripokkho officials, a prison warden even directed the execution of a scapegoat who was in prison for a minor crime but loathed by the guards, in place of the real attacker, who paid off the warden. Recently, the Bangladesh National Women Lawyers Association, a partner of ASF, has drafted public interest litigation against easy access to acid and presented it to the Bangladeshi government. Although it is currently under review by the Ministry of Law, progress was hampered by the quintannual national election process, which essentially closed the government for several months before and after the October election. In addition to NGO efforts to publicize the inefficiency of Bangladesh's criminal justice system, foreign diplomatic pressure has progressively addressed acid violence. Urging from British dignitaries during recent meetings in Dhaka and London apparently provoked high-ranking Bangladeshi officials, including the Prime Minister, to personally direct the judicial system to devote attention to particular cases receiving high international visibility. While this is a noble start, political pressure on a case-by-case basis is far from a sustainable solution to a problem that claims hundreds of victims per year. The United States Department of State and the United States Agency for International Development have also been active in promoting judicial expedience and financing police training in basic investigative techniques and evidence presentation in courts. According to U.S. officials, "this sorely needed training is Bangladesh's best hope for bringing criminals to justice, thereby sending a message that no society will tolerate such horrors." Conclusion Acid violence is another horrible chapter in the book of human rights abuses in Bangladesh. The NGO efforts launched in the 1990s have led to significant gains in public awareness campaigns and medical treatment, as well as contributed to the creation of an environment of concern, sympathy, and compassion. One especially positive aspect of efforts against acid violence is that Bangladeshis, especially women, have been a strong driving force against them. Explains Dr. Morrison, "Bangladeshis are outright shocked and ashamed that the attacks happen here." Naripokkho officials agree with Morrison. By a similar token, in a society that has historically oppressed women, it is encouraging to see men vigorously campaigning against a crime that predominantly affects women. ASF reports that for its first nine months of operation, it was sustained solely by donations from Bangladeshi people. Since then, it has reached out to international resources, but indigenous support is very strong. Also, Morrison reports that all but two ASF staff members are female and many are acid survivors. Nonetheless, it is concerning that the work of NGOs has not resulted in a significant decrease in the annual number of attacks in the past several years. This is clearly an indication of the complexity of the problem rather than an implication of unworthy efforts against it. In looking for a conclusive solution, we are guided by the words of Bangladeshi physician Dr. Samonta Lal Sen, who believes that proper treatment can improve the condition of an acid victim but the loss inflicted is not completely recoverable. "We have no other option than stopping incidents of acid pouring." While the recent increase in the number of convictions is encouraging, Bangladesh still suffers from a poorly trained police force and a backlogged court system, both rife with corruption. Therefore, most perpetrators still go unpunished. If history is a lesson, a marked decrease in acid attacks will not occur until the Bangladeshi police and legal systems become more quick and effective, the prerequisite for which is probably a revolution at the heart of the Bangladeshi political system.
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