“When I started to work on this issue, I was traumatized at least for one year” – Interview with Monira Rahman of the Acid Survivors Foundation Bangladesh

Bettina Frevert, Roland Berger Foundation: Mrs. Rahman, you are the Executive Director of the Acid Survivors Foundation located in Dhaka, Bangladesh. What exactly is it the ASF does?

Monira Rahman: The Acid Survivors Foundation (ASF) is a centre of excellence with a vision of Bangladesh free from acid violence, where burn victims, especially women and children, live with dignity. It is an independent, non-government, non-profit organization, set up as a Trust in the year 1999 and registered with the NGO Affairs Bureau of the Government of Bangladesh. It is the only specialized NGO in Bangladesh working to prevent acid and burn violence; empower survivors, especially women and children; and campaign for the prevention and elimination of this sort of violence. The ASF works with an integrated approach, using a holistic (bio-psycho-social) multi-stakeholder approach backed by research, experience and evidence.

Roland Berger Foundation: How and where do you help the victims?

Rahman: The ASF runs a 20-bed licensed hospital specialized on acid and burn violence victims, which is fully equipped for standard burn care services including plastic and reconstructive surgery, though in a very low-resourced set up. Since an overwhelming majority of the victims are impoverished, the ASF Hospital offers completely free services benefitting around 700 acid victims annually (including survivors from previous years).
The ASF has provided treatment, education and rehabilitation opportunities to a large number of survivors. Many victims are now professionally active in the ASF itself and beyond. Survivors are represented in the governing body of the ASF. They are now in leading positions in ASF management and program implementation. The ASF has also transformed many ‘survivors’ into ‘survivor ambassadors’ who function as a platform for a collective voice to demand justice, protect rights, and act as an agent for prevention and integration into family and the society. Victims of an acid attack living in remote rural places now have access to psychosocial support from these ‘survivor ambassadors’.

Roland Berger FoundationYou mentioned the rural areas of Bangladesh. What role does money and independence play in preventing acid attacks and helping victims?

Rahman: Economic empowerment is vitally important for the acid survivors to gain respect from their family, from peers and from the community. The ASF provides a monthly educational stipend to motivate acid survivors to continue their education. The ASF also arranges vocational trainings to enhance their vocational skills. To build leadership skills of the selected survivors, the ASF also arranges social skills, life skills and leadership skills training. Based on the feasibility assessment of the survivors, the ASF provides a one-time grant to selected survivors to establish Income Generating Activities. The ASF also seeks employment and places them in jobs.

Roland Berger Foundation: What are some campaigns you organize in order to prevent acid attacks from occuring and how effective are they?

Rahman: The ASF’s multi-dimensional and multi-stakeholder prevention campaign has contributed to significant reduction of the number of acid attacks over the years. Before the ASF prevention campaign started in 2002, there were over 500 recorded attacks. In 2012 the number decreased to around 100, which nevertheless remains a grave concern with one attack in every three days. The challenge is to sustain the downward trend and eliminate this violence of unspeakable nature.

Roland Berger Foundation: How come you picked up this work and decided to dedicate your life to this cause?

Rahman: I first met a victim of an acid attack in the year 1997. Her name is Bina Akter. Half of her face was terribly disfigured and she was partially blind. I was shocked and horrified. First I thought it was an accident, but when I came to know the story I had mixed feelings. Bina Akter was not the target of the acid attack. Her cousin Mukti was the target as Mukti refused a love offer of Dano, a young man known as a petty muscleman in the community. One night Dano broke into the house and tried to attack Mukti with acid. But Bina, who was also sleeping with Mukti, woke up due to the hue and cry made by Mukti during the attack and fought with Dano to protect her cousin. Unfortunately, Bina sustained a major burn and Mukti also received a minor burn on her hand. Dano was caught red handed and was handed over to the police.

As I said, it was a mixed feeling – the feeling of agony with a question of how a human being can do this to another human being and the feeling of amazement to see the courage of Bina Akter and her statement regarding the concept of beauty. Bina motivated me to dig to the root cause of the issue and discover the consequences of the problem.

Roland Berger Foundation: And what did you find out?

Rahman: I found that acid violence is a vicious and one of the worst forms of gender-based violence attributed to a combination of three inter-related factors: gender inequality and discrimination in a predominantly patriarchal social structure; easy availability of acid; and deficit in effectively punishing the perpetrators.
Acid violence is a heinous act of burning, deformation and destruction of the face and other parts of the body of the victims, often causing disabilities and deaths by throwing acid as a means of revenge for resisting sexual harassment, refusing marriage proposals, or the failure to pay dowry, etc. Acid violence is a form of vengeance for other types of social conflicts like disputes over land or other properties between families, neighborhood conflicts or even political rivalry – and in most cases the women, young and adolescent girls and female children are the victims. It is a criminal act resulting in huge psychological and moral breakdowns as well as a deep sense of insecurity of the survivors.
Acid violence takes place in many societies but very few have faced it head on. Before the late nineties, acid throwing was not recognized as a form of violence against women in Bangladesh either, until the Acid Survivors Foundation was set up on 12 May 1999 as the first organization to challenge this scourge. Since then, the ASF has emerged as a global pioneer in tackling the problem of acid violence.

Roland Berger Foundation: How many people work at the ASF?

Rahman: At present, the ASF has 72 full time staff members. Out of 72 members, 18 are themselves survivors of acid attacks. Survivors are also represented in its governing body and management level. The ASF started with two staff members in the year 1999 and is planning to increase the number from 72 to 100 by the year 2015 for wider coverage of the issue and to address other forms of burn violence along with acid violence.

Roland Berger Foundation: How many acid attacks occur annually? How many patients do you treat?

Rahman: When the ASF started its journey the number of attacks was increasing at the rate of 40% each year until the year 2002. In the year 2002 alone around 500 people were attacked with acid. But thanks to the ASF and the successful prevention campaign of mobilising the government, media, and civil society including celebrity groups and students, the number of attacks is decreasing since 2003. Last year, the ASF recorded 98 persons attacked with acid. However, given the nature of domestic violence, it is estimated that the number of actual attack might be much higher. In the last 14 years we have identified nearly 4000 acid survivors and provided medical, legal and rehabilitation services to nearly 2500 acid survivors.

Roland Berger Foundation: Where do you get your funding from? Who supports you financially, medically, publicly?

Rahman: The ASF was fostered by UNICEF and the Canadian International Development Agency (CIDA) since its inception. UNICEF still continue to provide funding, but CIDA has stopped due to a change in their focus in Bangladesh after 10 years of their direct financial support. Mainly bilateral donors support us, for instance the Dutch Government, the Danish International Development Agency (DANIDA), the GIZ, Department for International Developement (DFID-UK), AUSAid etc. Currently DFID, AUSAid, and UNICEF are our main donors and some CSR of multinational and local agencies are also supporting us from time to time.

Roland Berger Foundation: Do you work together with the Bangladeshi government? Have there been any achievements you and the ASF are proud of?

Rahman: Yes, the ASF is one of the very few NGOs who are working closely with the Bangladeshi Government. The ASF’s rights-based campaign has led to many unprecedented institutional and policy reforms.  Thanks to the ASF’s persistent efforts, Bangladesh is the only country to have enacted two laws in 2002 — one that heightens criminal penalties and improves criminal procedures and another that controls the availability of acid. In order to implement these laws effectively, the ASF works with the National Acid Control Council of the Government, the highest level inter-ministerial body and its district committees. The National Acid Control Council and the Social Welfare Ministry have created a special fund to compensate the medical, legal and rehabilitation costs. However, survivors’ access to these resources is still insignificant. As such, the ASF’s role to advocate meeting the needs of each survivor remains a continuous process.
When the ASF started there was no official statistical data on acid attacks. In the year 1999, the ASF developed a notification and referral service to identify any new attacks. The ASF also developed a database where it keeps record of every recorded incident and details of the persons attacked with acid.

Roland Berger Foundation: Have you run into any problems during your work?

Rahman: We have faced many obstacles on our journey and are still facing some of them:
When I started to work on this issue, I was traumatized at least for one year. I could not speak of any other issue than acid violence. I was always carrying water with me in suspicion that I might be attacked with acid and I would have to wash my body with water. When on the way, I was always looking back over my shoulder to see if anyone was following me. This is the most stressful job that I ever carried out, but it is also the most rewarding job when we see a smile on a half meted face. We have created an open environment in the ASF. We cry together, especially when we see very young children who were attacked with acid, but we also celebrate together when we see that a victim has fully recovered and was rehabilitated successfully.

Roland Berger Foundation: What about society – has there been any change in attitude?

Rahman: People have a negative attitude towards disfigurement. Most survivors face hostile or insensitive behavior from the society as disfigurement is considered a curse. Our identity is our face, so when a person’s face is affected by acid, she or he loses her or his identity. In this context, it is our challenge to rehabilitate and reintegrate acid survivors into mainstream society.
In the beginning, the government was also reluctant to accept acid violence as a social crime. The ASF transformed many survivors to ‘change agents’ and they are playing an active role in advocacy and bringing long-term changes in social attitudes towards violence against women and disfigurement. Over time, the ASF has experienced that when we are persistent, dedicated and creative to make people realize their role and responsibility, we can change the adverse situation and use it in favor of the acid survivors.

Roland Berger Foundation: What is your goal concerning the number of acid attacks in Bangladesh?

Rahman: The ASF intends to reduce the number of acid attacks to below 50 by the year 2015 and eventualy eliminate acid violence from Bangladesh. We want to put acid violence issues in the museum and use what we have learned on our journey to combat any form of gender based violence.

Roland Berger Foundation: How can one help to achieve your goals and to support your work?

Rahman: The ASF needs financial, material and technical support to help acid survivors. The ASF counts on any amount. I still remember our early days – when there was no donor. But we were encountering more than one attack every day. The victims needed emergency medical care and we didn’t have money to support them. One day, we went to a garment factory and explained the situation – the workers donated one day’s wages to the ASF! The ASF also needs professional support like plastic surgeons, burn surgeons, burn specialised nurses, physiotherapists, occupational therapsists, psychologists, criminilogists, social and clinical researchers etc.

Roland Berger Foundation: On a different note, you are currently working on trying to establish a mental health care center in Bangladesh. Are there no such existing institutions? Why do you believe it is necessary to establish such an institution?

Rahman: ‘No Health without Mental Health’. The World Health Organization (WHO) defines health as “Complete wellbeing of physical, mental and social health and not merely the absence of illness and diseases”. According to the World Health Organization (WHO), mental health refers to “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”. We should also consider economic consequences of mental health losses. A recent study by the World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16000 billion over the next 20 years.
In Bangladesh we only have one mental health hospital for 160 million people, located in Dhaka, which has 150 beds. They mostly treat people with severe psychiatric problem. There is no service for people who have psychological problems and who need clinical and therapeutic services. Few private clinics provide services to people who are drug or substance users. My aim is to develop a model as a center of excellence to provide different therapeutic services such as music and art therapy, drama and dance therapy, gardening, occupational therapy, physiotherapy etc., along with modern clinical management of the patient. In addition, I would like to provide counseling and guidance to family members/caregivers. To prevent the myths/disbelief concerning mental illness, I would like to create social awareness raising and community education programs and advocate for the enactment of the law to prevent discrimination and violation of human rights of persons with mental illnesses and people with mental health problems.

Roland Berger Foundation: The collapse of the factory buildings which is responsible for the deaths of 1000 textile workers and injuring 3000 more just a few weeks ago raised an outrcy of shock throughout the world. In your opinion, what should be done to prevent further incidents like this one and how can the workers and their families be helped?

Rahman: I see both the building collapse in Savar in May 2013 and thefire in Tazreen Textile Factory and the deaths of 120 people in November 2012 as a violation of human rights of the workers and negligence of the owner. The accused personnel should be prosecuted and punished so that other people will be cautious in serving their responsibility. Relevant government agencies should be responsible for these incidents and they should be made to comply with building codes. The apex body of the Garments Industry – Bangladesh Garment Manufacturers and Exporters Association (BGMEA) – should be responsible for ensuring a workers’ friendly environment in those factories. Workers should be aware of their rights and be confident to protest in such situations when they are forced to work in a risky environment.
The losses in these tragic incidents not only affected the victims/survivors, but also their families – especially the children. One study shows that at least 288 survivors need mental health support. Many of them have lost one or more limbs and they need long term treatment. Media reports that the support they are receiving is severly inadequate in terms of the physical, psychological, economic and social consequences. Recently, two rescuers were reported admitted in the Mental Health Hospital because they are suffering severe mental illness. Many more are in danger of developing Post Traumatic Stress Disorder. Unfortunately, no counselling services were provided to these people to help them to cope with this tragic situation. A rehabilitation center should be developed immediatley to provide comprehensive support services to these people (victim’s family/survivors and their family, community, media people, rescuers etc).

Roland Berger Foundation: Lastly, is there anything you would like to still share with us?

Rahman: Not now, thanks.

Roland Berger Foundation: Mrs. Rahman, thank you for this interview.

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