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Reconstructing hope

By Monideepa Sahu

Agni Raksha devotes itself to burns victims, who need expert and expensive reconstructive surgery, besides counselling and emotional support. Women are often the victims, battling both physical and emotional scars, and forced by circumstances to return to the very husbands who inflicted the damage

Rekha, 28, moves stiffly, covering her horribly disfigured face with a shawl. One of the fortunate few to survive deep burns all over her body, she lives in constant pain and fear. Her burnt skin and underlying tissues have contracted, causing deep scars. Strictures in her arms, legs and neck make each movement painful. Once a happy, healthy young woman, Rekha now hides in her home fearing horrified stares from strangers. During a quarrel, Rekha’s alcoholic husband had set her on fire. Compelled by poverty, lack of education and societal pressures, she returned from hospital to live with the same man.  

“There are many burns survivors like Rekha, who shy away from facing life for complex reasons,” says social worker Chitra who manages Agni Raksha, a Bangalore-based NGO that helps burns victims. “We try to address their physical as well as emotional problems and seek ways of rehabilitating them into mainstream society. Their concerns are rarely explored by policymakers and researchers.” 

In 1965, a little girl suffered a fire accident. Years of physical and mental trauma and many painful reconstructive surgeries later, she grew up to be Dr Prema Dhanraj, Professor and Head of Plastic Surgery at CMC, Vellore. Dr Prema founded Agni Raksha in 1999.  This Bangalore-based NGO assists burns victims by providing reconstructive plastic surgery. While assisting burns victims with medical treatment, this charitable organisation also strives to ease their emotional trauma by providing a warm, friendly environment where they can learn to become economically productive. Medical care, home nursing, physiotherapy, counselling and occupational therapy are combined and offered free of charge to help rehabilitate victims into mainstream society. They are currently managing with their own resources and individual donations. 

“Rehabilitation of burns survivors is a complex process,” says Chitra, who is inspired by her courageous elder sister, Dr Prema Dhanraj. “They are traumatised and suffer from depression. Most burns victims are women from poorer families. Many are victims of homicidal attacks by their husbands. Male burns victims are fewer in number, mainly victims of industrial accidents and chemicals burns. At Agni Raksha, all are welcomed and treated with affectionate care.” 

Burns cause severe damage to the body and spirit of the victim. The damage often extends to internal organs such as the muscles, eyes, bones and reproductive organs. 

“Reconstructive plastic surgery can make their limbs freer, repair damage to other organs of the body and enable them to work and lead a more normal life,” says Dr Mahesh A, assistant professor and head of the department of plastic surgery at the Dr B R Ambedkar Medical College in Bangalore. He provides voluntary care to burns victims at Agni Raksha. “Reconstructive surgery can also give them a more normal and pleasing appearance, thus increasing their self-confidence and self-image. Yet such complex surgeries are beyond the means of poor burns victims.” The ‘before’ and ‘after’ photos of Dr Mahesh’s patients at Agni Raksha stand testimony to the change wrought by surgery. 

“This is a vast and complex social issue,” says Chitra. “We cannot be judgemental and there are no clear-cut solutions to their problems.” These burnings are often perpetrated in the heat of the moment after a violent quarrel. The men are often alcoholics who lash back when their wives upbraid them for the habit. Nagaraj, 38, a petty shopkeeper, who comes to Agni Raksha for treatment, is a polite and soft-spoken man to all appearances. His hand was severely burnt when he tried to immolate his wife after a petty drunken quarrel. He still cannot control his urges and continues drinking. 

The case of the women is truly tragic. Social conditioning, lack of family support, lack of education and financial independence and their own fears and trauma, force many women burn victims to return to the very husbands and families who set them on fire. These women are frightened and unhappy, yet they have few choices. They approach Agni Raksha seeking solace, friendship and peer support. Seema, 22, a data entry operator, who took her baby and left the husband who had attacked her is “one among a thousand cases”, says Chitra. “She does not want to return to her violent husband. Yet she is under constant family pressure to return.”  

Children have often watched their fathers setting their mothers on fire. Sometimes the children also get burnt while trying to save their mothers, adding to the magnitude of the tragedy.  

Burns reconstructive surgeries are expensive, time-consuming and require a high degree of surgical skill. Private hospitals and the doctors and surgeons qualified to treat them, prefer to concentrate on the more lucrative and glamorous areas of plastic surgery, Dr Mahesh points out. The majority of burns victims are poor and cannot afford reconstructive surgery.  

Affordable medical care is provided for burns victims at government-run facilities. However, due to lack of resources, hospitals cannot offer burns victims individualised attention for their emotional trauma and related problems. A long-term holistic approach is needed for their full physical and emotional recovery and assimilation into mainstream society. Burns patients who do survive after treatment in government burns care facilities often do not continue their treatment after discharge from hospital due to lack of motivation and extreme poverty. They languish as invalids at home.  

This is where Agni Raksha can help. Take the case of Prema, 31, who was given minimal chances of survival. Opting to spend the last days with her family, she miraculously survived, but with severe deformities. At Agni Raksha, she met others like herself, and gained friendship and courage. After several rounds of complicated surgeries by Dr Mahesh, she regained free movement of her limbs and her appearance improved dramatically. Today she helps with the accounts at Agni Raksha and counsels other burns victims. 

(Names of all burns victims have been changed to protect their identities) 

(Monideepa Sahu is a Bangalore-based freelance writer of both fiction and non-fiction, with a variety of interests including social issues and literature)

Infochange News & Features, October 2009