Burns: The Journey of Rehabilitation Is Equally Challenging

Kathmandu: Like every winter morning, Ramila was busy in the kitchen. At the moment, seconds after lighting the gas stove, a loud explosion echoed through her ears. In an instant, flames engulfed her body…! “I don’t remember anything after that… I only realized that what had happened when I woke up in a hospital bed. At the moment my body was barely recognizable. This pain was unbearable,” she recalls, revisiting those painful memories.

When she regained consciousness, she found herself in a hospital bed with severe burns on her face, neck, chest, and right arm. Doctors informed her family that her condition was critical. At the moment her mind was paused, unable to think and process anything.

Battling Emotional Turmoil

The few months that she spent in the burn ward at the hospital felt like a harsh punishment. Used to spending time with family, she struggled with the isolation of hospital life, constant monitoring by nurses, and the relentless physical pain. “Burns pain was one thing, but sympathy in the eyes and words  of people who came to visit hurt me even more. At the moment, I felt, I would never be the same again. Even if the wounds healed, the scars and their impact would stay with me forever,” she says.

Human beings have always seen themselves through others’ eyes, with society constantly present in their minds. Ramila was no different. Beyond the physical agony, she suffered from the way society seemed to view her. Whenever she thought of her old appearance, her friends, and her life before the accident, not only her body but also her heart seemed to burn. “Whenever I looked at myself, I felt disgusted. I kept asking why I had survived at all,” she says, “There were times when I didn’t wanted to live. I struggled with severe mental distress. The support of a few friends and my family gave me the courage to keep going. Otherwise, I don’t think I would have had the strength to return to society.”

Her legs still do not function properly. The structure of her face has changed permanently. She frequently needs hospital visits as her skin tightens over time. Yet she remains determined. Now, she runs a small online business and also teaches part-time. As a teacher, she is a beloved figure among the children. The woman who once lost the will to live because of society’s judgment now believes that “the most beautiful person is a confident person.” Viewing her survival as a second life, she dreams of dedicating it to social service.

Hundreds of people in Nepal become victims of burn injuries every year. According to Kirtipur Hospital’s data, domestic fires, gas leaks, hot oil, electrical accidents, and acid violence leave many seriously injured. Yet the social and psychological struggles they face after treatment receive far less attention.

According to Dr. Kiran Nakarmi of Kirtipur Hospital, burns affect not only the body but also a person’s confidence. “Many patients are afraid to socialize after treatment,” he says, “They feel as though everyone is staring only at their scars and appearance.” Nakarmi had long experience about burns treatment.

Burn treatment in Nepal is both lengthy and expensive, often pushing families into financial hardship according to him. Treatment can cost hundreds of thousands of rupees, forcing many families to take loans or sell property.

Ramila’s family also endured significant financial stress. Support from relatives, friends, and charitable organizations ultimately made her treatment possible.

When Returning to Work Becomes another Battle

Ramila says the pain she experienced after the accident was surpassed only by what she faced when trying to return to work. Before the burn injury, she worked at a private company in Baneshwor, Kathmandu and was considered one of its valued employees. After completing her BBA, she chose to stay in Nepal while many of her friends went abroad for employment. Believing in opportunities at here, she invested in developing her skills and quickly secured a promising job. But, then the accident changed everything…!

After months of hospitalization and recovery, she was ready to return to work. But her employer  refused to take her back. Instead, the company handed her some money and ended her employment permanently. “Even seeing that place now brings back painful memories,” she says.

She spent few months searching for another job, but was rejected repeatedly. According to Ramila, many employers were unwilling to hire her because of the scars on her face and the changes in her physical appearance caused by the burn injuries.

Beyond Physical Recovery

Many burn victims lose their lives because of delayed treatment, lack of specialized care, and financial constraints in Nepal. Even those who survive often face challenges that extend far beyond the hospital. Returning home frequently means confronting social stigma, discrimination, and isolation. Family and community members may treat survivors differently. Employment opportunities become scarce, making financial recovery even more difficult. As a result, many survivors find themselves carrying wounds deeper than their physical scars.

Another burn survivor Ram also experienced social stigma after the fire incident. He recalls being excluded from auspicious family and community events, as people often considered burn survivors a “bad omen.” “After the accident, I was treated differently, as if I no longer belonged in social gatherings,” she says. She witnessed how burn survivors with visible disfigurement are often subjected to hurtful labels like “ghost” or “kurup,” while those with amputations are mocked with terms such as “dundhey,” reflecting deep-rooted stigma and discrimination in society. Ramila shares that she has also gone through several bad experiences.

Need for Government Support

Around 7-8 hundred burn patients are admitted to Kirtipur Hospital every year. Most cases result from gas leaks, electrical accidents, pressure cooker explosions, and similar household incidents. Some patients are survivors of acid attacks and petrol-related violence. According to Dr. Nakarmi during the past 3 years on an average around 700 plus patients are admitted there annually and in every year seven thousand plus patients visits OPD service. “Two years ago, the government allocated a budget of two crore rupees to the hospital. The one-time allocation was sufficient to cover only about two months of operating expenses. However, after that initial allocation, the hospital did not receive the funding again.” Dr Nakarmi said ” It was just not enough for treatment of burn victims.”

According to him, that amount not enough to proper treatment for burns survivors. Lack of enough budgets has also created problems for rehabilitation. Victims have consistently voiced concerns about this issue.

Several non-governmental organizations have stepped in to support burn survivors. One of them is Burn Violence Survivors (BVS) Nepal, which has worked since from 2008 to provide treatment assistance, rehabilitation, and empowerment programs.

According to survivors BVS’s support has been crucial not only for medical treatment but also for helping them rebuild their lives. “My mother sold our goats and buffaloes to pay for treatment. We traveled across Nepal and India seeking care. Sometimes we couldn’t continue treatment because we simply had no money,” recalls burn survivor Jahira Banu, “BVS helped me receive treatment. Today I run a small shop and travel to encourage other survivors like me.”

She shares that BVS played a crucial role in her recovery by providing medical support, physiotherapy, post-burn treatment, psychosocial counselling, and seed money assistance. Such small acts of encouragement and comprehensive support can make a significant difference in the lives of survivors. Therefore, coordinated and sustained efforts like these should be strengthened and ensured across all three tiers of government.

Banu, a resident of Nepalgunj-6, suffered severe burns at the age of 17 because of dowry-related violence. According to Banu, her husband and in-laws regularly abused her over dowry demands before eventually pouring kerosene on her and setting her on fire. Despite enduring unimaginable violence, she survived and rebuilt her life. Today, she serves as a source of inspiration and encouragement for many other burn survivors.

The government’s budget, plans and policies must reflect strategies and funding for reintegrating survivors back in society. Survivors share that death at time feels easier than having to face discrimination and exclusion every day. With the experience of working with burn survivors for almost two decades now, Pratiksha Giri, the executive director of BVS-Nepal says that “While life saving of burn survivors is an important component, the government must look beyond that. It is very necessary for the government to initiate and invest in programs that help survivors re-integrate in the society. Government’s responsibility to help survivor lead a dignified life.“

Author K.C. writes on Society, Culture, Literature, Politics, and Gender issues