Tales from inside a burns ward: Kitchen accidents that aren’t always accidents

On the fifth floor of the Burns and Plastic Surgery Block at Delhi’s AIIMS, each bed holds a story of suffering—and sometimes survival. Some women are nursing raw wounds from LPG cylinder blasts, some from cooking ‘accidents’. The wounds are visible—red, raw, stitched, grafted—but the deeper trauma is not. Every patient carries their scars on the slow, grinding road to recovery.On a weekday morning, Dr Maneesh Singhal, professor and head of the department of plastic, reconstructive, and burns surgery at AIIMS New Delhi, moves briskly between OT and OPD in his scrubs. The AIIMS burns block can now handle up to 5,000 burn emergencies annually.Singhal says women patients outnumber men in burn emergencies. “We see domestic issues, suicidal cases, interpersonal conflicts, and family disputes. But the case history can change. We can only document what the patient tells us. For example, a patient may initially say someone poured oil and set them on fire, and the next day they may change their story. We are not investigators,” he points out. His observation is borne out by data. In 2019, over 23,000 people in India died from fires — about a fifth of the global total. A 2022 Lancet study noted that women aged 15-49 in India face a burn injury burden that is three times higher than men. This month, Nikki Bhati, a 26-year-old woman from Greater Noida, died from severe burn injuries after allegedly being set on fire by her husband and in-laws. She initially reportedly told hospital authorities that her burn injuries were caused by a gas cylinder blast at home. Soon after, a 32-year-old nurse was set ablaze and is currently battling for her life in a Delhi hospital. Gaurav Ahuja, project convener of non-profit Rotary Restoring Smiles which recently collaborated with the hospital to treat burn cases, remembers a 26 to 27-year-old female patient last year who was blamed for giving birth to a girl child. When she returned home with the baby, her in-laws poured acid on her. The upper part of her body was completely burnt. The husband and mother-in-law are now in jail. “Attacks like these on women are common. For this woman, life will remain hell for years to come, even if the in-laws serve a jail sentence. No matter how many surgeries are performed, the trauma and social stigma does not go away,” says Ahuja.In the burns block, women—wives, mothers, sisters, daughters—arrive bearing the scars of domestic life. Questions linger in the air — what was her life really like before the accident? Was it an accident? Pregnant women are not spared either. “In some cases, families don’t want the pregnancy to continue, and these women can become victims of burns,” says Dr Vandana Kapoor, plastic surgeon and senior resident at AIIMS who has seen 8-9 pregnant women come in for burn care in the last one year. “Most of their husbands are alcoholics and not at all present during the care. Burns in pregnant women are more severe because an abortion adds to the mortality risk of the patient,” Kapoor says.One of the biggest challenges in restoring skin after fire or acid burns is the lack of adequate skin donations. The AIIMS skin bank, says Singhal, gets only about two or three donations a month. “No matter what technological advancements or surgical skills we have, treating burns of more than 40-50% body surface requires skin substitutes,” he explains. Cadaver skin harvested from skin banks plays a crucial role in burn treatment as it is cost-effective. “Artificial skin is at least 100 times more costly,” says Dr Singhal. Acid burn victims, he notes, carry the greatest burden. “They require multiple surgeries, costly dressings and artificial skin which is not always available,” he says. While the Supreme Court has mandated that no acid attack survivor should be denied treatment, the reality is that smaller hospitals lack both resources and the wherewithal to treat burn survivors. “Big institutes like AIIMS can handle that, but smaller institutes can’t,” points out Dr Singhal.