A haven for healing the brutality of burning

I can look only at Suma’s face when I first meet her. I am afraid that if I look at the raw, bleeding flesh on the rest of her body, my face will betray me, and she will see the shock and revulsion I feel. Suma is naked. She is sitting on the edge of a plastic chair, holding her melted arms straight in front of her to allow two women to wrap them gently in medicated dressings.

She winces, and the tears crowd her beautiful almond eyes, but she does not let them fall. She grips my hand tightly and thanks me in English when I tell her how brave she is.

I can only think how much more of her body is still to be treated. As they work, the women chat brightly to Suma and me, rapidly translating into Kannada, the local language, the questions they ask me in English. I can see they are experts in the art of distracting from pain.

Livid scars

I can also see, from the livid scars on their necks and arms, that they too have felt Suma’s pain. On the other side of the flimsy screen around Suma, a long row of women wait to have their burn injuries treated.

I am on the third floor of a dusty, nondescript office block, down a side street in the heart of Bangalore. Only the discreet sign, Agni Raksha (Protection from Fire), gives a clue to the presence of a remarkable service which, since it opened in 2006, has treated up to 3,000 women and 1,000 children who are burn victims.

I am the guest of its dynamic founder, social worker Chitra Dhananjay, a woman with a warm heart and a hearty laugh, who believes in action rather than pity.

Her elder sister, Dr Prema Dhanray, the cofounder of the service, had plenty of reason to feel self-pity. An exploding stove left her, at eight years of age, with 50 per cent burns on her face and body. Her devout mother promised God that if her child survived, she would make her a plastic surgeon.

Prema survived, but it took 14 surgeries to reconstruct every inch of her face. She honoured the promise made by her mother. She returned as a doctor to the hospital where she was treated as a child, to specialise in plastic and reconstructive surgery under the same doctor who had treated her.

In time, she became a professor, and head of plastic surgery there. She is now recognised as a world expert on the treatment of burn victims.

The combination of her expertise and Chitra’s passion and commitment, now enables some of India’s poorest women and children to receive treatment they would otherwise be unable to afford. Prema carries out free reconstruction, surgery and skin grafts. The service has a 15-bed residential centre for post-surgical and acute care too.

Outpatient service

Chitra has transformed the big open-plan office floor space into an outpatient service, where wounds are dressed, and occupational therapy and physiotherapy are provided.

In her office, a large photomontage shows women, before and after treatment. It makes for difficult viewing for someone as squeamish as me, but the results are miraculous. It is even more miraculous how this service is, out of necessity, run on a shoestring. Treated burns victims are trained in the treatment of others as nurses, occupational therapists and physiotherapists, for example.

Laughter dominates

I wonder if it is this that contributes to my sense of being in a place of warmth, solace and support. After I adjust to the reality of faces and limbs grotesquely distorted by fire beyond recognition of what we call human, it is the sound of laughter which dominates, rather than a sense of suffering.

There is a very Irish stream of banter and teasing – and the making of endless cups of tea.

I am shocked when Chitra tells me 70 per cent of the burn injuries are self-inflicted in failed suicide attempts. These are, she says, desperate women, whose lives are chaotic and out of control, as a result of combinations of poverty, violent husbands, physical and mental harassment by in-laws, or having children with disabilities.

Other women are victims of homicidal attacks by violent husbands. Children are burned either when intervening and trying to save their mother, or directly by violent family members. It is hard for me to imagine that for Suma, the pain of living was such that a painful self-inflicted death seemed a better option.

When I see her later, shuffling gingerly, she is covered from head to toe, wearing a pretty, loose pink robe instead of the usual sari.

She looks beautiful and about 16, but Chitra tells me she is a 27-year-old mother of three, trapped by poverty in a marriage to a violent alcoholic husband.

The work of Agni Raksha goes beyond providing critical medial treatment for women like Suma. Chitra recognises that these illiterate, unskilled women need an alternative to returning to husbands who set them on fire.

In one section of the centre, there is a bustling sewing workshop and the women proudly show me the bags and purses they are making to sell.

They are good saleswomen and the bags make lovely gifts. I buy plenty to take home.

Other women are given loans to set up fruit and vegetable stalls, or the staple tea stalls of Indian street life.

Fundraising is a constant challenge for Chitra. She would dearly love more suitable accommodation for Agni Raksha, as patients have to be carried up two flights of stairs to receive treatment.

Her priority, though, is to develop therapeutic services to help the women to cope with the physical and psychological scars of their injuries, as well as the cruel hand that life has dealt them.

In the absence of such a service at the moment, she lives in constant dread of the sense of hopelessness she experiences when women die by self-immolation.

Chitra wants to ensure that every desperate woman becomes like one of the purposeful, happy individuals I meet during my visit.

Olive Travers is a retired psychologist, who is currently engaged in child protection training on a voluntary basis in India.

Who are the victims and what is being done for them?

Burn injuries constitute a major public health problem in Third World countries , where 95 per cent of global burns deaths occur. In India, where 75 per cent of the 1.27 billion population lives below the poverty line, the World Health Organisation estimates that 1 million people are moderately or severely burned every year, resulting in 140,000 deaths.

Factors contributing to this are poor living conditions, alcohol abuse, the presence of kerosene for cooking in homes and the use of synthetic fabrics in clothing. Some 80 per cent of burn victims are women and children. Self-immolation is a common form of suicide by women suffering domestic violence or harassment by in-laws about their perceived failure to produce sons. Dowry disputes can result in brides being burned and young girls can be burned with acid if they reject unwanted advances.

Agni Raksha is the only not-for-profit organisation of its kind in India. It provides victims with medical treatment, home-based care, physiotherapy, counselling and opportunities for income generation. It facilitates skin grafting and reconstruction surgeries, and provides an outpatients department and a 15-bed safe haven for post-surgical care. Its outreach service identifies untreated burn victims in the city's slums and educates communities about burn prevention. For more information, email Chitra, the centre's director, at info@agniraksha.org or see agniraksha.org