Acid Attacks In India: Will The Skin Donation Give A ‘New Lease Of Life’ To The Survivors?

Nearly a decade back, when Pragya Prasun started her workshop for counselling acid attack survivors and creating awareness around gender-based violence, it shook her to learn how countrywide transplant coordinators are oblivious to skin donation. And in a country like India, where 14 cases of acid attacks were registered per month in 2021, “it’s imperative that people talk more about skin donation”.

In 2006, Pragya was 23 years old and newly married when acid was thrown at her face while travelling from Varanasi to Delhi. The man was a rejected suitor, who followed her to Agra, where she was admitted to an ICU. Later, after spending over three months at Safdarjung Hospital and with multiple visits to Chennai for her recurring treatment and surgery, Pragya was drained following the traditional treatment of dressing and grafting for burns.

“When doctors attempt to treat patients with burns without a skin transplant, the process is often extremely painful and most of the time, it does not lead to full recovery. It is also economically challenging for many families as many victims belong to the economically weaker sections of the society,” says Pragya, the Jharkhand-born activist.

India sees as many as 70 lakh people suffering burn injuries every year with a mortality figure as high as 1.4 lakh. The figures were revealed by union minister Harsh Vardhan while inaugurating the Burns and Plastic Surgery Block of AIIMS (Delhi) in 2021. Further, in India, where the social inequalities among the genders are high, about 80 per cent of patients suffering from burns are women and children who are often victims of acid attacks, reports the National Burns Centre.

Burn injuries take a prolonged rehabilitation and skin donation could be a quick way to aid the process of healing.

“For acid attack survivors, skin donation can give them a new lease of life,” says Pragya, who started the Atijeevan Foundation in 2013 to reach out to women, who have been victims of the heinous gender-based violence.

Over the years, Atijeevan has funded crucial surgeries like skin grafting, hair transplant and even reconstructive surgeries for over 250 acid attack survivors from across the country hailing from various parts of Uttar Pradesh, Delhi-NCR, and West Bengal besides offering counselling services to them.

Six years back, the organisation started a 'Donate Your Skin' campaign to create awareness around skin donation. “While people are keen to donate their kidneys, eyes, and other organs, they are oblivious that they can do the same with their skin,” says Pragya, who received the Nari Shakti Purashkar in 2019.

Even though the skin is the largest human organ, awareness of skin donation is very low in India. Despite the fact that the country contributes to a huge global burden of burn-related deaths and the survival of burns patients critically depends on the availability of skin, it has an acute shortage of skin for such patients.

“For skin donation, there need not be tissue and blood match between donors. Yet, due to lack of availability of the same in skin banks, doctors at private hospitals do not prescribe you the same as it may require months to find a donor,” says Pragya. She also adds that “people have this notion that if you take away the skin, there is nothing left of a deceased but it’s not the case.”

The skin consists of two layers namely the outer epidermis and the inner dermis. During harvesting, the retrieval team takes only the epidermis and a part of the dermis. Further, unlike other donated organs, skin can be preserved in skin banks for up to five years providing flexibility to surgeons, who can use it for various burn cases.

One of the oldest burns units, at KEM Hospital, Mumbai, became operational in 1981 and India’s first Skin Bank was set up at Sion Hospital, Mumbai in 2000. Though India now has around 67 burn centres and more than half in the private sector their geographical distribution and service availability are uneven. 

In 2014, ahead of the Lok Sabha elections, one of Pragya’s workshops succeeded in raising the issue of skin donation to a member of the BJP cabinet. Upon assuming power, under the direction of the then newly formed government, a few skin banks were set up in Chennai. However, Pragya says that due to a lack of skin donors, accentuated by the deadly coronavirus pandemic wave, those banks are running empty hands.