“Go ahead,” Chanchal Paswan tells the photographer. “I want the world to see what has happened to me.”

The 18-year-old’s face is a mess of pain and ravaged flesh, a mouth that can barely open and spaces where her eyelids and ears were located before they were destroyed by the acid thrown at her.

Remarkably, this same face is also a source of defiance. In the weeks since the teenager was attacked by four young men, she has put herself forward as part of campaign demanding the government do more to prevent such assaults and to punish the culprits. She has insisted people do not look away.

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Acid-throwing is not a crime that is unique to India. From Afghanistan and Pakistan to Bangladesh and parts of South East Asia, there are hundreds of cases of lives being destroyed in this wretched way. Almost without exception, it is women who are the victims.

In India, activists estimate there may be as many as 1,000 attacks a year. Until recently there was no separate crime of acid throwing and data was not collated. Yet in the aftermath of the gang-rape of a Delhi student, an incident which triggered debate about the position of women in society, new legislation was passed, recognising acid-throwing within the Indian penal code and setting a punishment of 10 years imprisonment.

Campaigners believe the government can do much more. Seven years ago, India’s highest court directed the government to take steps to prevent such attacks and yet nothing has been done to restrict the sale of acid. “We are not satisfied,” the court said in February.

Chanchal was attacked as she slept alongside her 15-year-old sister, Sonam, who is partially-sighted, at their home in a village ten miles from Patna in the state of Bihar, where her father is a day labourer. Her alleged attackers were four young men, one of whom had proposed to her a year earlier and who was apparently angered by her rejection. Her sister was injured too and will also likely be scarred for life.

Sitting on a bed at a charity-run guesthouse close to the hospital in Delhi where she came to see a specialist, Chanchal said she had been taunted by the young men and that they mocked her as she made her way to computer classes, four miles from her home. As she recounted her story, her mother and father stood next to the bed, anguished beyond measure.

“I started going to computer class to help me get a job. My dream was of becoming a computer engineer and supporting my family,” she said. “What has happened to my dream now?”

As in many incidents of acid throwing, the issue of caste was also a factor. Chanchal’s family are Dalits, previously known as untouchables and traditionally located at the bottom of Hindu society where they receive widespread discrimination and persecution. Her alleged attackers were from a higher caste.

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“The boys would often taunt and torture me. They would pull my scarf and call me names. I protested to them,” she said. “One man would say to me ‘You take too much pride over your face. I will spoil it for you’.”

She added: “These boys often said they came from a higher caste family and that we were lower caste. They would say ‘You are Dalits, you are powerless. Whatever we do, we will be able to get away with’.”

On 21 October last year, the alleged attackers crept into Chanchal’s home at night while she slept on the terrace. One of them held her legs, another her arms and a third threw acid in her face. Some of it splashed onto the arm of her sister.

“I did not know it was acid. It felt like someone had thrown hot water or oil on me. I was trembling and there was smoke coming off my body,” she Chanchal.

Awakened by the screams of her daughters, Mrs Paswan ran to them and started throwing water on Chanchal, desperately trying to douse the burning. She said neighbours came and watched but did nothing to help. “For us this was an acid attack but for them it was like Durga puja (a Hindu religious festival). It was like watching a festival,” said her mother, Sunayana.

The teenager’s attackers apparently made no effort to run away. “They were just laughing and enjoying the moment,” said Chanchal. “They said, ‘Look, what we say we will do, we do’.”

Chanchal was taken to Patna Medical College and Hospital but her family said she was only given basic treatment and staff refused to admit her until the following morning when television cameras arrived. The teenager said that even then some of the staff taunted her, saying to her: “ What status do you have?”. The hospital did not respond to requests for comment.

At Delhi’s Safdarjang Hospital, where Chanchal was brought with the help of an NGO, the teenager has already undergone surgery to release the constriction of her lower eye-lid.

“She has lost all her face,” said Dr Rakesh Kumar Kain, a cosmetic surgeon who is part of a team that treats 20 such cases a year and which has been developing new techniques. “She has no lips, eye-lids, the skin on her neck has fused with her chest. Also there is some loss of vision.”

The doctor said victims also suffer intense emotional trauma. “If a mother has been attacked with acid, sometimes children will refuse to recognise her,” he said.

Sitting in his office where he keeps a photographic record of other cases on his computer, Mr Kain said the severity of injuries depended on two factors – the strength of the acid and the amount of time it was on the flesh.

He said that in Chanchal’s case the burns were deep. “She will need at least 15 operations,” he said. Chanchal’s sister will also need to undergo operations to release her elbow that has become fused and for skin grafts along her arm.

Pragya Singh, who was attacked with acid seven years ago by a member of her extended family who was angry by her decision to get married, said victims needed emotional and financial help. Yet she said the authorities needed to do more to prevent the attacks.

“If there was life imprisonment or the death penalty that might help,” said Mrs Singh, who currently lives in Bangalore. “Also, things like sulphuric acid are too easily available. Anyone can get it.”

Alok Dixit, of the recently-formed Stop Acid Attacks campaign, said that in addition to punishing victims, the government also needed to provide free medical treatment and even jobs for those who have been attacked. “There is no policy to minimise the pain these people suffer,” he said.

Subhas Chakraborty, of the Kolkata-based Acid Survivors Foundation India, said several state governments, including West Bengal and Goa, had taken steps to control the sale of acid. “But the central government and the other state government have not done anything,” he said.

In Chanchal’s case, police in Bihar said four men have been charged over the attack. The officer dealing with the case ended a telephone call when asked for further details and the state’s police chief did not respond to calls.

The office of chief minister Nitish Kumar said the case was “a criminal matter” and failed to say if anything was being done to control the sale of acid. The federal government’s ministry of women and children’s development said it could not immediately respond to questions.

Chanchal has to return to Delhi in May for her second operation, one that will release the scar tissue that has fused her neck to her chest. She and her family make the trip back and forth to Bihar by a 12 hour train journey.

She said despite what had happened she was determined to somehow try and continue her studies. “I will go back to school,” she said. “I will cover my face if I have to.”