Sa Sokha was just 18 and newly engaged when her face was doused in acid, permanently scarring her and altering the course of her life.

Key points: Rights group finds none of victims interviewed received free healthcare

Rights group finds none of victims interviewed received free healthcare At its peak there were 40 acid attacks in Cambodia in 2000

At its peak there were 40 acid attacks in Cambodia in 2000 Victims say they are often pressured into accepting inadequate financial settlements

Her husband-to-be, Kea Samnang, was also injured in the attack, allegedly at the hands of his ex-girlfriend.

Sokha was studying and working as a classical Cambodian dancer, but that is a career path she is no longer pursuing after the attack.

"I am not beautiful anymore," she said.

"I lost everything. My time, my work, my dancing, and school."

Ms Sa's story is just one of 17 featured in a new report from Human Rights Watch, which found that Cambodia was failing victims of acid attacks by denying them free healthcare and justice through the courts.

'There was no free treatment'

Not one of the survivors interviewed for the report had received treatment free of charge at a public hospital, as required under the law.

In 2017, when Ms Sa and Mr Kea were attacked, the head doctor at the burns unit at the hospital "was unaware that acid victims have a right to be treated free of charge", the report said.

The couple spent almost two months there, undergoing five surgeries between them. None of it came cheap.

"There was no free treatment," Mr Kea said.

"Every time they took blood, gave medications, anything, they took money."

Sa Sokha and Kea Samnang underwent five surgeries between them after the attack. ( ABC News: Erin Handley )

Several survivors said that hospitals refused to initiate urgent treatment until the victims could prove they could pay up, the report said.

"Delays in treatment after such attacks are likely to prolong the healing process and can be fatal," the report said.

Health Ministry spokesman Ly Sovann told the ABC all public hospitals were required to treat acid attack victims free of charge.

When asked why survivors reported they had been denied free healthcare, he declined to comment.

Sa Sokha was pursuing a career as a traditional Khmer dancer before the attack. ( ABC News: Erin Handley )

'What hell feels like'

The effects of concentrated acid to the skin can be devastating.

"It instantly melts through the skin and tissue, often down to the bone," the report said.

"Typically aimed at a person's face, the acid quickly eats through eyes, ears, skin, and bone, dissolving flesh wherever it touches."

In the words of one survivor: "This is what hell feels like."

At its peak in 2000, there were 40 cases of acid violence in Cambodia. There was resurgence a decade later, with 36 cases in 2010.

Roem Til was doused in acid by his wife, who says he was physically violent towards her. ( ABC News: Erin Handley )

A 2012 law has helped to curb the number of attacks, in part by limiting the availability of acid — but it is still possible to acquire the harmful substance from markets, motorbike repair shops, rubber plantations and goldsmiths for as little as $1 a litre.

The number of attacks has dwindled to single figures, but fluctuates — last year, just one case was recorded.

The year before, there were seven attacks.

Acid can still be acquired at places like mechanical repair shops. ( ABC News: Erin Handley )

Erin Bourgois, the former project manager of the now defunct Cambodian Acid Survivors Charity (CASC), said the group shut down after an 83 per cent drop in cases between 2010 and 2014, but added that still "many cases go unreported due to fear of retribution from the perpetrator, lack of trust in the police, [and] victims are unaware of services and support available".

She called on the Government to fulfil its legal obligations to victims, but HRW report author Julia Bleckner said the loss of the charity had rendered survivors invisible.

"With the closure of CASC it's basically easy for the Government to pretend the issue is entirely solved, and conveniently allow survivors — and their ongoing serious needs — to be forgotten," she said.

'Love triangles' and stigma

There is a gendered tone to such attacks — a common perception in Cambodia is that acid is thrown as the result of a "love triangle", which affects the way victims are treated by the authorities.

One survivor in the report, who had acid thrown on her by her husband at a busy market, was refused help by passers-by, "until she convinced them that she was the attacker's wife, not a mistress".

While the "jilted lover" trope fits some cases, in Cambodia, men are affected in higher proportion than in countries like India, Bangladesh or Pakistan.

"There's also one particularly gendered aspect to some of the attacks on women," Ms Bleckner said.

"A woman might be victim of recurring domestic violence over weeks, months, or even years and might not go to the police out of fear that her case won't be taken seriously and then she'll be in further danger."

Sometimes domestic abuse escalates to the point where acid is thrown, she said.

"That her complaints won't be taken seriously is a particularly well-founded fear given that Cambodian domestic violence legislation strongly recommends reconciliation and mediation over legal action," she said.

Barriers to justice

Roem Til had acid poured on him while he was sleeping. ( ABC News: Erin Handley )

Not a single survivor interviewed received any compensation through the courts.

A handful of cases have progressed through the justice system, but convictions are rare, the report said.

Several victims reported they were pressured by Government officials to accept inadequate financial settlements outside the court — an issue fuelled by the need to pay medical bills for treatment that should be free under the law.

Justice Ministry spokesman Chin Malin said the Government was ensuring all criminal cases were properly prosecuted — not just acid attacks.

"We realise some cases are settled outside the court due to traditional practices at the local and remote communities [due to] lack of the legal awareness and education," he said.

He said the Government was trying to educate communities and claimed the practice of "reconciling" domestic violence cases was decreasing.

But some cases are hardly straightforward — in one attack reported in local media, Roem Til had acid poured on his face and body as he lay sleeping.

The perpetrator was his wife, whose attack came after prolonged domestic abuse.

Rather than wanting her punished through the justice system, he begged for her to be released in order to help raise their children.

Acid attack cases in Cambodia have been falling in recent times. ( Flickr: iulian circo )

Mental healthcare hard to access

Cambodia's overburdened mental healthcare system also means victims are often unable to receive care for their psychological wounds.

Many victims said they suffered post-traumatic stress and had thought of suicide years after the initial attack.

Moung Sreymom, attacked in 2015, suffered burns to half of her body. The acid burned off her right ear.

She was two months pregnant at the time, and she miscarried. Her young daughter was also splashed in the attack.

"I don't want to live," she told Human Rights Watch.

"I want to die. I only live for my daughter because I love her so much."