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Pakistan has a chain of acid attack medical centers it is so common there.
She was attacked by her husband of 15 years on her way home from a garment factory where they both work. “He is a drug addict and has been for a long time. All of the time he asks me for money and for things. He usually beats me to get my money,” she says through an interpreter.
“On that day he again was asking me for money, and I had said no. That day I went to work, finished work, and when I went to leave he was waiting for me. He attacked me with acid straight in my face.”
Lucky, who is 26 and a mother to two young sons, was helped by people on the street. When she got home her village leader told her to go to the police who referred her to a special hospital and rehabilitation centre for victims in the Bangladeshi capital, Dhaka, run by a charity.
Her story is depressingly common for retired British plastic surgeon Ron Hiles, who has operated on hundreds of acid attack victims – mostly women. Last year the small 40-bed clinic in Dhaka, called the Acid Survivors’ Foundation (ASF), treated 700 patients. “There are a lot of women called Lucky and Beauty who come to the clinic who have had their faces destroyed by an acid burn,” he says.
Acid has become a common weapon – partly because it is cheap, a bottle costs about 60 cents, about 40p, and partly because conviction rates are low. The reasons for the attack are varied – from going out without the husband’s permission, neglecting the house or children, to cooking a bad meal.
Mr Hiles saw Lucky seven days after the attack and wanted to operate almost immediately to try to save her eyes. But the anaesthetic procedure had scared her so much that at first she refused surgery.
“I never knew an operation would be needed to heal my face,” she explains. “I never thought my skin would be removed and put on my face. I was afraid I would not wake-up after the operation, and as I have never had an operation before I did not know what it involved.”
Mr Hiles, from Bristol, spends between two and four months of his free time a year volunteering in Bangladesh and has done for the last 27 years. He was already helping a colleague in Dhaka treat the increasing number of women who were coming in with acid burns on their faces and bodies when the special ASF centre was set up, ten years ago last month.
Instead of spending his retirement relaxing, Mr Hiles has been back and forth to the clinic, watching it grow. Back then it had eight beds, now a decade later, the hospital has 40 beds along with a small army of plastic surgeons, burns therapists, nurses and physiotherapists from the UK who come out to treat patients and train local staff.
In the last trip alone, from which he returned last month, Mr Hiles operated on 50 patients, including Lucky and completed around 200 procedures – spending up to seven hours on a case.
“I do this I suppose for the selfish point of view that it’s wonderful to see people coping with life because you have been able to help them a little bit.
“But still I don’t really know how they do cope. It’s a minor miracle – and in some cases a major miracle. I try to put myself in their position sometimes and think ‘What would it be like to have my features completely distorted?’ And of course I can’t. Nobody can. The inner strength that most of these patients find absolutely amazes me.”
Lucky’s surgery was a gruelling seven hours, including a skin graft. The average operation takes three hours and the maximum time has been over ten hours. Many patients often need more than one operation.
Although most victims of acid attacks are 25-35 year old women, more than 5 per cent are babies. Mr Hiles saw one-month-old Durjoy when he was brought to the clinic with his mouth so badly burnt that his chin had melted down onto to his chest. His lips were almost closed, and he cried as he wheezed in and out. He had been force fed acid by his aunt, who was later found to be mentally ill.
Although he desperately needed surgery, the baby was so weak from not being able to swallow his food that doctors had to put him on a high-protein diet and wait until he was stronger.
After three years of complicated operations including mouth grafts and surgery to remould his neck, some performed by Mr Hiles, Durjoy still has to have a feeding tube attached, but is otherwise a healthy and happy four-year-old.
The surgeon adds: “Every story affects me because it is just a horrible example of man’s inhumanity to man. I feel tremendous sympathy to the patients but as a surgeon you have to stand back from that and get on with the job.”
The figures that ASF has managed to collate suggest that acid attacks are on the decrease – in Bangladesh in 2007 they had 186 new cases down from the highest number in 2002 of 490. But these may be the tip of the iceberg. “These are just the ones who are lucky enough to get to the clinic,” he says.
Newspapers in Bangladesh reported 800 incidents of acid attacks in 2007, averaging at more than two per day. And although the clinic only handled around 200 new cases last year, doctors still treated almost 700 patients in total due to the number of returning patients with old wounds along with the team of psychotherapists and counsellors who provide non-surgical care.
Acid attacks were not against the law when Mr Hiles first started working in the country, but after years of campaigns by Acid Survivors Trust International (ASTI), the umbrella charity that supports specialised clinics all over the world, the Bangladeshi parliament has introduced strict laws to regulate the sale and storage of acid, including the death penalty in the most serious cases.
Convictions make the headlines, but they are rare. Last November a court ruled that a man who blinded a woman with acid after she rejected his marriage proposal pay for his crime by having acid put in his own eyes.
Back in Dhaka police are still looking for Lucky’s husband but two days after her surgery she is looking forward to getting back to her children and her old life – without him.
She concludes: “I am in a lot of pain. It is very painful – my face, my eyes, and my arm where the skin was taken. But I hope to recover just like before, before I had acid thrown on me. I am looking forward to that and to returning home. I am in a hurry to get back. I don’t want to lose my job at the garment factory.”