Assault by burning in Dhaka, Bangladesh.

Assault by burning in Dhaka, Bangladesh, occurs in a variety of forms, resulting from various causes and motives. A total of 311 cases of intentional burns from the Burn Unit of Dhaka Medical College Hospital from April 2004 to May 2011 (6 years) were studied by retrospective and prospective observational review. The majority of victims (68%) were female. Concentrated sulphuric acid was the most commonly used chemical for attack. Disfigurement was the principal complication (mortality, 4%). Dowry-related issues, divorce and other marital quarrels were frequent backgrounds for assault by burning. Kerosene oil was used to ignite 78 girls or young women, most often related to conflicts over dowry (mortality 97%). A total of 102 victims (32%) in all burn groups were attacked because of dowry-related issues. Intentional contact burns were often inflicted on domestic servants. Although physical morbidity and mortality were not reported in contact and other types of burns, psychological disturbances were reported in all victims. A few victims had been assaulted prior to receiving burns, and fractures and deformities were also present on examination at the time of presentation for burn treatment. Ophthalmic injury, with frequent visual impairment, was very common in cases of chemical attack. Legal and social support for victims and their families are frequently inadequate to compensate for losses. Clearly, more attention in our community should be focussed on the prevention of burn assaults, adequate compensation and medical care for victims, as well as speedy retribution for perpetrators.