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Poor access to support systems causes high mortality among women with burn injuries ,(downtoearth)

In 1998, India was the only country in the world where fire was among the 15 leading causes of death. Even almost two decades later, incidents of burn-related injuries remain an “underserved and underrepresented category of violence”, according to a new study by the International Foundation for Crime Prevention and Victim Care (PCVC)—a Chennai-based non-profit organisation.

Going by the conservative estimates, about 100,000 women die of burn injuries in India every year. Tamil Nadu is one of the worst-affected states, with Chennai alone witnessing 100-150 burn cases every month. Women in the age group of 15-50 are most prone to fire-related deaths. Unfortunately, most women succumb to their injuries because of inadequate and unresponsive support services and not because of physical injury only.

Why are women the worst sufferers?

While mortality rate among women is higher than men, the follow-up rate (post discharge) among women is very low. Getting into the root of the problem, the study finds out that there’s also a “long history of misrepresenting self-inflicted or homicidal burns in women as kitchen accidents”.

Women, who are victims of domestic violence, often tend to conceal the real cause of burn injury because they lack financial independence and are not empowered with the requisite information to address such an issue. They are also subjected to discrimination within the society.

In some hospitals, as the study found out, women ward is separate and men are not allowed. With no continuous care givers around, the patients are forced to depend on her natal family. But sometimes, their natal families, too, are not able to take care. There are cases where women have been abandoned by their husbands post the burn incident.

Substances responsible for burn injuries

On doing a study across four states—Tamil Nadu, Telangana, Maharashtra and Delhi—it has emerged that the substance responsible for the burns are mainly kerosene and gas leakage from non-ISI branded small cylinders. Though Delhi became kerosene-free in 2014, kerosene is easily available in neighbouring cities such as Noida.

Problem lies in lack of infrastructural support

Outlining the lack of infrastructural and institutional support for the victims and survivors, the study revealed that often, due to the absence of hospitals within a short distance and lack of scope for getting first aid, burn cases become more complicated, leading to death. Even when the patients get access to hospitals, the facilities are not adequate to provide holistic treatment. For instance, the researchers in Telangana found that the conditions in burns wards of two major government hospitals in Hyderabad—Gandhi Hospital and Osmania Hospitals—are “quite deplorable” with no proper beds and post-surgery facilities.

Lack of rehabilitation and psychological support

Most hospitals do not have post-burn rehabilitation services which are crucial for full recovery. It was found in a Delhi hospital that for the last two years no patient from the burns ward has been referred to the psychiatry department. Moreover, patients don’t avail services of psychiatry or psychology departments in hospitals because of procedural bottlenecks.

What’s making situation worse is the lack of any mechanism to deal with psychological stress. Medical practitioners across states are unanimous in their argument that physiotherapy, psychiatric and psychological support is necessary for an overall recovery of burn victims. Under such circumstances, treating burn injuries is not enough. Hence, the PCVC has been stressing on the need for a holistic support system for women burn survivors in the country.

Loophole in existing legal system

While acid attacks are included as a non-bailable offence under sections 326A&B of the Criminal Law Amendment Act (2013), the same is not true for kerosene or alcohol burns, which constitute a large percentage of total burns cases.

Need for an integrated response

The experts suggest building a comprehensive system with “collaboration between legal, state (police and health institutions), non-state (private hospitals and NGOs) and family institutions to address issues at the level of creating awareness”.
They also call for devising methods to empower the survivors and look at policy changes and macro-level interventions
They recommend looking at the legal definition of disability so that fire burn victims are included within this category.
The expert also emphasise the need to create a community of survivors where they can help each other and give each other strength.

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