The invisible wounds of corrosive assaults

The psychological consequences experienced by acid attack survivors are more painful and difficult to recover from than the physical injuries. Moreover, the long-term treatment of the survivor's mental health via antidepressants, antipsychotics or anxiolytics becomes a significant financial burden. Despite the strict enforcement of laws governing the Acid Control and Acid Crime Prevention Act 2011 under the Pakistan Penal Code, around 200 acid attacks per year suggest a need for a stronger legal framework.

Recently, a brutal acid attack on an on-duty doctor in Quetta caused a stir across the country. Social media has been flooded with posts, interviews and public opinion polls. Some doctors have protested and demanded the implementation of adequate safety protocols at their workplaces. Other respondents linked this safety issue as a contributing factor to the increasing brain drain of qualified healthcare providers from Pakistan.

The perpetrator of this heinous crime was killed in a police encounter, while the trauma, scars, acceptance by society, body-image distress, answering the masses' questions and the unforgettable flashbacks of the incident will definitely have an impact on the remaining life of the survivor. Post-traumatic stress disorder, anxiety, sleep disturbances, depression, social exclusion and suicidal thoughts are very common mental repercussions of corrosive assaults.

This was an acid attack that came to light because the incident took place at a hospital and was captured on the CCTV camera. But many attacks remain unreported and unveiled due to fear, social stigmas, familial suppression and lack of trust in the justice system. More than 1,000 acid attacks were recorded in this country over a ten-year period. Among them, around 80% of the victims were female, which classifies it as gender-based violence. The causal factors for the acid attacks on females, as revealed by some local non-governmental organisations and the Human Rights Commission of Pakistan, are marital discord, declining marriage proposals, dowry, family feuds, infertility and the birth of daughters.

Although penalties and laws against the unregulated sale of corrosive materials and acid attacks in Pakistan are very strict, continued incidents hint towards two possibilities: either law enforcement or its surveillance is lax, or there is need for a stricter legal framework.

The Supreme Court of Pakistan ordered a centralised digital monitoring system for the sale of corrosive agents via biometric verification, which is a praiseworthy decision, but the implications of this strategy will be difficult. An unreliable power supply for charging biometric machines and insufficient technical knowledge can impede the effective implementation of biometric technology. So, this order must add back-up parameters such as manual logging of the customer's name, CNIC number, residential address, contact details, quantity purchased and the purpose of purchase in a governmentally provided register at every shop or store selling corrosive agents. The sale of corrosive substances must be dealt with in the same way as narcotics. This data must be periodically collected, reviewed and retained for a defined period. Comparing the quantity of corrosive agents obtained by sellers with the quantity sold to customers, verifying customers' details and confirming the actual use of the purchased quantities should be crucial components of random spot inspections. The chemical suppliers of concentrated corrosive agents must also be registered to ensure the rationalised sale and purchase.

There should be a public awareness campaign on social media, television channels and in newspapers regarding the penalties for the illegal sale or purchase of corrosive agents, reporting mechanisms for victims or their families and the legal consequences for the offenders. It is also important to promote ethical education through morally grounded documentaries to combat the growing problem of toxic masculinity.