Some of the images below are graphic and show the consequences of acid attacks.

On the morning of December 23, 2014, as a 30-year-old doctor was riding to work in New Delhi, two men on a motorcycle intercepted her scooter. While one grabbed her handbag, another sprayed the contents of a syringe at her face. It was filled with acid. The liquid quickly ate through her skin and facial tissue. She is currently undergoing treatment and may lose the sight in one eye.

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Only five days earlier, a small group of people had gathered outside India's parliament bearing a list of demands. They were survivors of acid attacks and volunteers with the Stop Acid Attacks awareness campaign. Some were detained by the police and allegedly beaten for not obtaining the proper permissions to protest. Topmost among the changes they were calling for was stricter regulation of the availability of acid.

While instances of acid attacks have been reported in nearly all parts of the world, they are particularly endemic to South Asia, with Bangladesh, Pakistan, India and Cambodia having the dubious distinction of the highest number of cases. With harsh punishments and strict guidelines controlling the sale of acid, Bangladesh is viewed as a success story in the making, having seen a steady decline of 20 percent to 30 percent in the past few years. In India, however, the number of reported cases has been increasing despite the existence of laws and directives to curb the horrors of acid violence.

Effective from February 2013, with the insertion of Section 326A into the Indian penal code, acid attacks have been classified as a distinct, specific offence, carrying a penalty of imprisonment for a minimum of 10 years and a maximum of life.

Reliable statistics for the crime are difficult to ascertain. The Indian government confirmed the number of female acid attack victims as 98 in 2011, 85 in 2012 and 80 in 2013. But acid survivor support groups say these figures are misleading and do not account for the many cases that go unreported, as well as those involving male victims.

The Acid Survivors Foundation India (ASFI) has collated data from newspaper reports that indicates a clear growth in the number of cases - with 80 victims in 2010, 106 in 2011 as well as 2012, 122 in 2013 and 130 up until November of 2014. The Stop Acid Attacks campaign claims there have been 386 cases in the period 2013 to 2014.

Historically, acid attacks have been acts of revenge over perceived rejection by a woman. While such cases still form the largest single reason for acid violence, Alok Dixit of the Stop Acid Attacks campaign says cases of professional jealousy and family squabbles have also become motivators, and there has been a rapid rise in cases of men attacking other men. It remains a highly gendered form of violence, however, with perpetrators almost always male, and victims primarily female.

The Supreme Court of India passed a ruling in July 2013, which among other provisions, regulates the sale of concentrated acid in shops, mandates the maintenance of a register recording details of purchasers, and prohibits the sale of acid to minors. But implementation remains a distant reality and numerous investigations have shown that acid is easily purchased in shops, with no questions asked, for as little as Rs 20 (3 cents) a bottle. For hundreds of people across the country, that's all it takes for their lives to be changed irrevocably in a second.

'Before this I was extremely shy, but I don't have that luxury anymore' 

[Karen Dias/Al Jazeera]

Twenty-three-year-old Lalita Benbansi sits in the waiting room of a dimly lit doctor's clinic in Grant Road, one of the oldest neighbourhoods in Mumbai. She wears an indigo-dyed hospital gown and a thin shawl that does little to conceal her injuries. She is scheduled to undergo surgery on her nose the next day, scarred and swollen to twice its original size by an acid attack over two years ago.

With approximately 25 medical procedures behind her, Lalita is approaching the midway point of her treatment plan. Her doctor says she will need about 30 more to repair the damage, including recreating her ears, which the acid melted off. These are aimed only at restoring functionality and preventing infection; the question of cosmetic procedures remains a far-off uncertainty.

Lalita's quick grin and ebullience dim as she describes the series of events that led to her attack.

In 2012, she and her mother travelled to her maternal village in the north Indian state of Uttar Pradesh to attend the wedding of a relative. After a rowdy bout of drinking, a quarrel broke out within the family, particularly enraging an 18-year-old cousin of Lalita's. A small disagreement quickly took on a much darker hue.

"I pushed a girl who my cousin had brought along to the wedding, and was refusing to pay a token auspicious amount at the altar. He took this as the final insult from my family and swore revenge," she explains. Taunting her for the pride she took in her appearance, he threatened to throw acid on her. "At the time I thought it was just something said in the heat of the moment, but he actually made good on his threat," she says, her voice still heavy with disbelief.

Five months later, on November 11, 2012, as Lalita and her mother were walking out to the fields to relieve themselves after dark, two men wearing masks approached her, tackled her to the ground and poured acid on her face while her mother watched, horrified. Lalita says she was able to recognise her cousin's voice and his eyes when she shone a torch in his face.

Lalita was admitted to a local hospital for two months to treat her burns, but the family quickly ran out of savings. Lalita's father Anand, who works as a petrol pump attendant in Mumbai, says with an air of defeat: "I make Rs 4,500 ($69) a month, out of which Rs 1,500 ($22) just goes on rent. How was I supposed to pay for such a long stay in hospital?"

After spending many months in despair at her grandmother's house, without receiving any treatment for her grievous injuries, a relative convinced Lalita to return to Mumbai, where the acid survivors NGO Make Love Not Scars raised funds for further medical care.

On average, a survivor of a medium intensity attack requires at least 15 to 20 surgeries explains Dr Ashok Gupta, who has operated on more than 150 victims of acid violence over his 35 years as a plastic surgeon.

With the cost of each surgery averaging Rs 2-4 lakhs (about $3,000 to $6,000), treatments can be prohibitively expensive. "I've heard of some hospitals charging as much as Rs 6 lakhs ($9,000) for a minor procedure," says Gupta indignantly. Against these daunting expenses, the apex court's order to the government to provide a compensation amount of Rs 3 lakhs ($4,500) per victim is woefully insufficient.

Government hospitals and emergency rooms are also ill-equipped to deal with acid attacks. "Special neutralising agents that can be applied immediately to limit the damage are scarcely stocked in most emergency rooms and ambulances. It all ties into the absence of a basic national advisory body of experts to suggest guidelines for actions in case of an attack," says Gupta.

When acid is thrown on a person's face, the eyelids and lips may burn off completely. The nose may melt, closing the nostrils, and the ears shrivel up. Skin and bone on the skull, forehead, cheeks and chin may dissolve. When the acid splashes or drips over the neck, chest, back, arms or legs, it burns every inch of the skin it touches.

When the wounds from an acid burn heal, they form thick scars that pull the skin tight and cause disfigurement. In 90 percent of cases, the eyesight of the victim is adversely affected, causing blindness. And then there is the psychological trauma. With a high survival rate among victims, acid attacks are rarely carried out with murder in mind. They are intended to disfigure and mutilate - to condemn the victim to a lifetime of suffering.

Lately Lalita has been arguing with her parents about getting a job as soon as her surgeries are completed.

"They aren't going to be around forever and I need to fend for myself," she says. "Before this, I was extremely shy and barely spoke a word to anyone. I don't have that luxury anymore."

'I could feel the liquid seeping into my skin, causing it to melt off' 
[Karen Dias/Al Jazeera] 
When Aarti Thakur saw a man approaching her at the Goregaon train station in Mumbai, she immediately knew something was wrong. She had learned to recognise the signs of danger after being attacked twice by a knife-wielding stranger in only two months. The first time she had been stabbed in the face, and had required 16 stitches. But what happened this time was worse than she could have imagined. 

"I could barely breathe. Everything turned silver black. I could feel the liquid seeping into my skin, causing it to melt off. I ran to a police officer and screamed that I had been attacked again," recalls Aarti in a calm, measured voice. The damage to her face was minimised because she was wearing a scarf wrapped around it. But the acid did burn through her forearms, neck, and parts of her cheeks and eyebrows.

Three years on, Aarti, who is now 25, is fighting a legal battle against the people behind the assault, while trying to raise funds for the surgery she requires. After a year-and-a-half of seclusion in her house, she started working again and is beginning to regain confidence in her skills as well as her appearance. But she remains understandably furious about how the acid attack on her could have been prevented. 

Her ordeal began in 2011, when the son of her landlady professed his love for her. The landlady would insist that Aarti should marry him. Initially laughing it off as a joke, Aarti finally clarified that she was already engaged and turned down his marriage proposal for the third and final time.

The first attack took place shortly after, when she was returning home from her job at an IT company. But she didn't recognise the attacker and the police wrote it off as a simple case of attempted robbery. 

Terrified that she had been intentionally targeted, Aarti decided to move to another suburb of Mumbai with her single mother and younger sister, who were dependent upon her. A second attempted attack took place a little over a month later. This time there was no officer at the station to take her complaint.

Aarti grew suspicious; only a few people knew where she had moved to and her former landlady was one of them. On January 30, 2012, she was shocked to spot her son standing outside her office building. The very next day, a man carrying acid worth Rs 5 (8 cents) in a bottle changed her life forever. 

This time the police finally swung into action, arresting the son, his mother, and two accomplices. Offended by the perceived slight to his dignity, and jealous of her impending marriage, the son allegedly hired two men to procure and splash acid on her as a final act of revenge. 

Subscribing to a patriarchal mindset where women are expected to smile demurely and quietly acquiesce to declarations of love, some men become enraged over such "unrequited love". Nishita Jha, a writer researching gender violence in India, says: "It comes from an innate belief that you can possess the other person. The idea that the woman has agency or autonomy is inconceivable to them. Such as in a rape case, the question of seeking consent doesn't even cross the mind."

Alok Dixit from the Stop Acid Attacks campaign says that often the perpetrators aren't hardened criminals or serial offenders. "There is a sense of impunity involved in acid attacks. Despite the new laws, the attackers have no real fear of punishment, such as in the case of a shooting. Unless it's a high-profile urban case, these attacks are often relegated to the inside pages of a newspaper." 

Despite their relative rarity in proportion to other forms of violence against women, the fear of an acid attack looms large. Jha reveals that she's come across numerous women during the course of her research who don't speak out against street harassment or stalking because they fear reprisal through acid. 

She adds: "An acid attack is not something you can physically move on from or effectively hide. It's not just a question of these men being unable to handle rejection, it's meant to teach a lesson - to mark someone for life."

'The burns hospital was like hell on Earth. Charred bodies would be rolled in'

[Karen Dias/Al Jazeera] 

In May 2014, Reshma Qureshi took a train from her home in Mumbai to Allahabad in Uttar Pradesh, accompanied by her sister, Gulshan. Only 17 years old at the time, she had gone to take her Alim examination, a course based on comprehensive study of the Quran.

It had been a trying few months for the family. About a year before, Gulshan had left her abusive husband, with their two-year-old daughter in tow. But her husband had refused to relinquish custody of their older son and Gulshan had filed a case against him for kidnapping the child.

On the morning of May 19, as the sisters were on their way to the examination centre, they were accosted by Gulshan's estranged husband and three other men. Wielding an open bottle with a clear liquid inside, she says he immediately darted towards Reshma. Recognising what was about to happen, Gulshan attempted to wrestle the bottle away from him, spilling some of the acid on her arms and back. But the men chased after Reshma and poured the remaining contents on her face.

Their mother Khusnoma recalls the next month they spent in Allahabad with despair. "The burns hospital was like hell on Earth. Charred bodies would be rolled in next to her. It was no place for a young girl."

After receiving next to no treatment other than some dressing of her wounds, Reshma was taken back to their home in Mumbai - a two-room apartment that houses all 10 members of the family. She has lost the sight in one eye and the other is barely functional and covered with scar tissue. Doctors are unsure whether it can be saved. 

With close to Rs 5 lakhs ($7,500) spent on surgeries already, the family anticipates another Rs 10-12 lakhs ($15,000-$18,000) in future medical expenses.

Reshma's brother, Aizaz, describes how the process of claiming compensation from the government has been like hammering at a solid titanium wall. In July 2013, the Supreme Court directed state governments to provide Rs 3 lakhs ($4,500) in compensation to victims of acid attacks, a third of which is to be payable within 15 days of the incident and the remainder within two months. But, after seven months of navigating bureaucracy, the Qureshi family have just a small slip of paper bearing a case number to show for it.

The Stop Acid Attacks campaign claims that most states don't have a payment policy in place and that some have no provision for the compensation fund. Out of the dozens of survivors they've helped apply, only four have received any payment to date.

The family has grown exhausted fighting a seemingly losing battle in the face of police apathy. Two of the culprits are still on the loose and the case will remain pending in civil court until they are apprehended. The whereabouts of Gulshan's son remain unknown.

"That man lived with us for many years and knew Reshma was the darling of the family, the youngest and the prettiest. He realised that attacking her like this would break the spirit of the family," says Aizaz. It's a familiar narrative across the country. From family rivalries to caste-based and communal clashes, women's bodies often bear the brunt of the violence.

In the midst of a family dealing with their collective pain, a now 18-year-old Reshma sits quietly as they share her story. She barely speaks to anyone who is not from the family or a friend from before the attack. Nor does she leave the house other than for treatment. She often has trouble sleeping. The family had to pool their money to purchase an air-conditioning unit for the house because of the burning sensation she still experiences.

Reshma's mother wistfully recalls two weddings that have recently taken place in their neighbourhood. "A year ago, she would have been the first one to convince us to buy new outfits, but this time she refused to even attend," she says.

Beyond their physical scars, survivors of acid attacks often suffer from depression, insomnia, nightmares and anxiety about another attack. Feelings of weakness and tiredness, along with difficulties concentrating and memory loss are other side effects. Often, there is a fear of ridicule from the outside world and a sense of shame and loneliness. 

"Almost all acid attacks focus on the face. There's no return from the scars that result from that. A face may not be critical to survival, but it is essential to social survival and that's what attackers prey on," says gender violence researcher Nishita Jha.

Yet psychological counselling for the trauma and depression faced by survivors factors is low on the list of priorities, for the government as well as for NGOs. While informal survivor support groups have sprung up in the past, for many there is little respite from their private hells.

Daulat Khan and Saira Bani: 'It felt like someone had stripped off my skin and sprinkled chili powder inside'

[Karen Dias/Al Jazeera] 

The aroma of frying fish fills Daulat Khan's one-room home in Bandra, Mumbai. It is Saturday lunchtime and she is preparing food for her four children, and her visiting sister Saira Bani, and her five-year-old daughter, Alima Begh. Their sister Reshma couldn't make it but her daughter is staying with them for a few days. Missing from this family meal is any sign of their fourth sister - the only indicator of her existence indelibly marked on their skin.

On October 4, 2010, Najma Jagirdar invited Daulat to her home to call a truce on a disagreement that had been brewing for months. Their mother's property had just been sold and their sister wanted an extra Rs 50,000 ($808) from the proceeds. Wary of their oldest sister, who had a history of behaving violently, the three sisters decided to go together. But after enjoying a home-cooked meal together, the trio began to think they'd judged their sister too harshly.

Then, they say, their sister and her husband Iqbal whipped out a bottle of acid and splashed it on them. Just a year old at the time, Alima, who was sleeping in her mother's lap, was also injured.

"At first we thought it was just cold water, thrown as a silly game," remembers Saira. "But then the ice-cold liquid became unbearably hot. It felt like someone had stripped off my skin and sprinkled chili powder inside."

Daulat recalls a sense of complete confusion; the room was full of smoke and the sisters were unable to comprehend what had just happened.

While the involvement of a female attacker made this a rare case, the aftermath has followed a more familiar path. Their sister spent three months in jail before being released on bail. Her husband wasn't imprisoned. The trial is still ongoing.

Daulat says the family had faced a long history of abuse from their sister and her husband, even before the attack. She says the latter had repeatedly threatened her with dire consequences for refusing to marry him, after her first husband abandoned her. The sisters claim they have also received threats since the attack. They've filed 11 complaints with the police over the years.

While engaged in a protracted and muddled legal struggle, the sisters' main concern is money. Shorn of their savings by the cost of their treatments, they also now struggle to find employment. After two years of being unable to leave the house, Daulat has been looking for jobs since. While she used to work as a make-up artist in malls and for television shows before the attack, she now barely earns Rs 8,000 ($130) a month cooking in people's houses. With an additional Rs 3,000 ($48) a month donated from a charitable trust, Daulat struggles to run a household of five people. The irony of her name isn't lost on her - Daulat means wealth in Hindi.

Scoffing at the idea of re-entering the make-up industry, she says: "Who will hire me to make others look beautiful when I'm so scarred myself. I can't even apply make-up on my own skin, let alone anybody else."

"Gainful employment is the most crucial step of the rehabilitation process," explains Dr Ashok Gupta. "It's a not just a means of becoming self-sufficient, but also of regaining confidence." Advocating for job reservations for acid attack survivors in the government sector, he states that the odds are too heavily stacked against them finding employment elsewhere, especially considering the high rates of blindness in the aftermath of an attack.

While Daulat and Saira have retained most of their vision, the job market hasn't exactly been welcoming. Daulat has had many doors slammed in her face while looking for domestic work. Employers are impatient with court appointments that require a day's absence from work. She explains how the heat from kitchen stoves aggravates her burned skin. "They obviously don't appreciate it if I'm scratching at my wounds while cooking. I try my best to hold off on touching my skin for as long as I can bear it," she says.

While Daulat rarely leaves her neighbourhood other than to make court visits, Saira endures discrimination while commuting on the local train. A few weeks ago, a woman seated next to her told her to use the compartment reserved for disabled passengers, saying she didn't want to catch whatever disease Saira was carrying.

"I told her she's the one with a disease, not me. [Our sister] used to try and tell us what to do as well. She said we were too vain and thought too highly of ourselves in our Western clothes. I know that's why she chose acid to hurt us. Yet I refuse to stop living my life," she says.

Outside the house, Alima plays with a brightly-coloured bucket, oblivious to the scars she bears - just another victim of this corrosive form of violence.

This article first appeared in the February 2015 issue of the Al Jazeera Magazine.

Source: Al Jazeera