An age old practice which is harming children. - Dr Reshma Srinivas, Project Samraksha Skin branding is a traditional practice seen in villages to treat and prevent certain diseases even today. It is surprising that even in the 21st century modern era such inhumane and irrational practices can still be seen. Skin branding is administered by local healer who most commonly uses heated metal rod and inflicts 2 degree burns on various body parts (forehead, abdomen, arms, wrist, legs etc). Depending on the extent of discoloration of skin ,healer chooses the object which includes heated nails, bangles, incense sticks etc. It is practiced mostly in rural areas of Andhra Pradesh, Karnataka and Tamil Nadu to treat physiological jaundice and infectious jaundice. They examine yellowish discoloration of eyes and skin and administer the burn. When it comes to other diseases like abdomen pain, seizures etc. they pray to the deity they believe in and then administer the wound. At our Thalassemia clinic we have 10 kids with these scars. We interviewed one of the parent on how is it practiced and what is the whole perception about the illness. She told us that this skin branding is done by the families who have been blessed by their ancestors to do skin branding. The pass on the practice to their children. They charge around Rs 150 –Rs300 to inflict one burn. She also told us that the person who inflicts burn examines the whole body and then he gets to know where the offending agent causing jaundice lurks. Then (s)he burns the identified area with heated metal rod, so that body is rid of infectious agent. Most common area they burn, is skin over right wrist. It is believed that it is a kind of shock which passes all over the body and removes the offending agent from the site of the burn. Honey, cow dung and ash are advised to be applied on the wound for quick healing. This can lead to several complications like infection transmission, delay the healing of wound, cause allergic reactions, contractures etc. There is significant chance for them to acquire HIV and Hepatitis B as the instruments used are not sterilized between procedures. She told it is strong cultural belief which grandparents imposed upon her and led her to skin branding. The most common cause of jaundice in India is acute viral hepatitis which resolves spontaneously .In Thalassemics, the cause of jaundice is hemolysis of unhealthy red blood cells and has nothing to do with any infectious agent. The known and acceptable treatment for thalassemia is regular blood transfusions. None of the children who underwent branding had any benefit whatsoever. They underwent immense trauma. Believing that the branding procedure will work, their parents often keep them away from regular systematic management making their condition worse. The lucky few come back to the thalassemia clinics. We have to take one step ahead by educating families about the illness, and prevent these hazardous practice to protect our children.