Zakia's face looks as if half of it has been rubbed out. What's left is one eye, half a nose and a mouth that can no longer smile. She seldom leaves the house, and when she does she wears an all-encompassing black niqab and sunglasses.
The young mother is just one of the 150 victims of acid attacks reported each year in Pakistan, according to the charity Acid Survivors Foundation – although the true figure is likely to be much higher. It's a form of violence that has spread across the world from Uganda to Cambodia, and the victims are most often women and children.
In Pakistan, Zakia's case is only uncommon because instead of having to spend her life marked by the horrific attack, a British surgeon, Mohammad Jawad, is helping to rebuild her face. The treatment is followed in an Oscar-nominated documentary, Saving Face, Pakistan's first Academy Award nomination
Now a pioneering surgeon in the field, just four years ago Jawad had never seen an acid attack injury, and certainly did not know they happened in Pakistan, the country in which he was born and trained as a doctor. Sitting in his prestigious cosmetic surgery clinic in central London, he tells me about his first case in 2008 at London's Chelsea and Westminster Hospital. Katie Piper, a 23-year-old model, had been disfigured by sulphuric acid thrown by a violent ex-boyfriend.
Despite his years of training, Jawad admits that he was shocked, "I had not seen anything like it before. I had seen bigger burns and on a younger patient, but never facial burns of this nature. Unless acid is neutralised it just keeps going deeper and deeper into your skin. All of the patients I had treated had been the victims of accidents – this was attempted murder." In a pioneering operation, Jawad used Matriderm – a synthetic skin substitute – to re-form her face. It had such impressive results that Piper referred to the surgeon as her "hero".
After hearing about his results another doctor told him that attacks were rife in Pakistan. Jawad had already made frequent trips there to carry out surgery on children with cleft palates, and burns victims who could not otherwise afford treatment. But he did not realise that the availability of acid for use in the cotton industry had led to assaults often linked to domestic violence or revenge attacks by rejected men. He began travelling to Pakistan every three months and holding free clinics (funded by charities including Islamic Help) to perform life-changing surgery. "With these women it was three or four years after they had been attacked," he says. "From the social justice point of view it was diabolical – [in some cases] the guys who did it might be caught, but bribe their way out of it. All I could do is use my skills to patch people up and give them a better face."
On Zakia, Jawad was able to use the techniques he had learned through operating on Piper to carry out the first surgery of its kind in Pakistan. He used Matriderm to smooth her ravaged face, gave her a pair of glasses with a painted eye and attached a prosthetic nose, allowing her finally to show her face in public.
The documentary follows Zakia's attempt to bring the husband who attacked her to justice – and the successful fight by the Acid Survivors Foundation to introduce a law to ensure a minimum prison sentence of 14 years for perpetrators of acid attacks.
Back in the UK, Jawad says he hopes the documentary will highlight the positive work plastic surgeons do every day in the NHS, and all over the world for patients with congenital, or developmental deformities, trauma injuries or cancer. "I want to restore the glory of plastic surgeons. Boob jobs have overshadowed our work restoring patients – their limbs, or breasts from cancer for instance."
The PIP scandal, which has left thousands of women with implants made of industrial-grade silicone – believed to be more likely to rupture and cause toxic contamination – has, he admits, not helped. Although he never used these implants in his own private clinic, Jawad says he was given them to use in his previous work for the Transform Cosmetic Surgery Group.
His work in Pakistan, he says, is a "moral obligation" for doctors like himself who received training in the country almost for free, and then left with their skills to join the NHS. He hopes that other doctors will be similarly inspired by the film. "I wanted to show I was having a great time – training local people and enjoying the work, owning up to my responsibilities and encouraging others to do the same." Then he laughs, "And if I get an Oscar out of it, am I going to say no?"
Saving Face will air on Channel 4 in early April. Dr Jawad blogs at www.mohammadjawad.com
