Archive for October, 2012
The day saw an unprecedented number of organisations around the world come together to mark the day, to stand in solidarity with survivors of torture and to remind the world that rehabilitation for torture survivors not only works, it is a right to which they are entitled.
As Joost Martens, IRCT Secretary-General says in his foreword to the report,
Each year, on 26 June, we pause to commemorate and honour the victims of torture, both historic and present. The day has been marked since 1988, which was the first anniversary of the United Nations Convention Against Torture, signed on 26 June 1987.
Yet today, despite its absolute prohibition, torture continues to be a global phenomenon: both physical and psychological torture is prevalent in over half the world’s countries. This is a disgrace in the twenty-first century.
Its victims are men, women – often targeted by rape and other sexual torture, and also, children. Torture victims are disproportionately from marginalised groups, in particular the poor, but also minority groups, such as ethnic, religious and sexual minorities.
The day gives us a time to pause and remember those who have suffered, and stand with those who continue to suffer, for, the effects of torture continue long after the actual act has happened.
These are some of the photos we got from 26 June events around the world:
What is keeping the global torture rehabilitation movement from embracing complementary and alternative medicine (CAM)?
Survivors of torture often have an increased need for mental and physical healthcare due, in part, to complex sequelae of trauma; but, often they also face socio-economic and cultural impediments to access to expensive and unfamiliar western healthcare resources. Put that way, the case for the use of the cheaper and culturally sensitive alternative medicine practices in the treatment of torture survivors seems clear. But, are these practices effective? That is the question being asked at an article published in the latest issue of TORTURE, a scientific journal, by a team of researchers at the Boston University Schools of Public Health and Medicine [PDF].
The shortcomings of (un)conventional western medicine
Aside from its significantly higher costs, it is important to be aware that western medicine isn’t anywhere near an ideal for the treatment of all torture survivors. Some of the barriers may include “language, cultural perceptions of illness,” and, most importantly, “unfamiliarity with western medicine.” For a large majority of torture survivors, western medicine may in fact be more “alternative” than Ayurveda, yoga, music therapy, acupuncture or t’ai chi, to name a few.
Furthermore, for a western medical practitioner it may be difficult to diagnose an exact cause of chronic pain when both physical and psychological factors are contributory and when the right treatment might depend on the patient’s own interpretation of illness. The authors state that “Given the complexity of the resulting diagnosis, it is not surprising that conventional treatments, including pharmacological and psychological therapy, though sometimes helpful, are at times insufficient.”
A mind-body healing approach
CAM modalities promise to compensate for some of the shortcomings of western medicine by offering a cost-effective “mind-body healing approach”, where health is viewed as an “ongoing process encompassing interdependent physical, psychological, and social factors.”
The researchers at Boston University looked at a significant body of scientific evidence on the efficacy of several CAM modalities applied to the treatment of torture survivors and refugees. Despite the shortage of scientific knowledge in this area, their review outlines several promising results and encouraging experiences.
When survivors report a psychological dissociation from the body, a common result of torture and trauma, it seems that massage therapy and bodywork might prove to be the most effective method at hand. Or, when a torture survivor reports disturbed sleep (and up to 80% do), cost-effective and easy to implement yoga practices have been reported to reduce stress and sleep disturbance, as well as being beneficial in the treatment of anxiety (reported by up to 93% of survivors), depression (66%), PTSD and chronic pain.
In the face of growing demand for torture rehabilitation services and diminishing funding streams, the question remains: what is keeping the global torture rehabilitation movement from embracing complementary and alternative medicine?
At the IRCT, we have often reiterated the link between poverty and torture: those in poverty are among vulnerable populations at great risk of being tortured, and torture itself can often push people into further poverty by impinging on their mental and physical well-being.
Over at Freedom From Torture, a member of the IRCT and a UK-based rehabilitation centre, they have pointed to another example of how poverty and torture are sadly intertwined: the poverty of torture victims in the UK makes it increasingly difficult for rehabilitation to be effective.
For the 2012 UN International Day for the Eradication of Poverty, recognised every year on 17 October, they discussed their soon-to-be-released research on how “both the impact of poverty on our clients’ mental health and rehabilitation, and exactly how being a survivor of torture affects the way individuals are able to cope with poverty.” They found that:
Many participants in the research described feeling that as asylum seekers they are treated as somehow inhuman by the government and the communities they live in, which they believed had worsened their mental health problems:
Outside [Freedom from Torture] it’s as if they are making us remember our hardships every day, and you can easily become crazy.”
Read there full blog post here at the Freedom From Torture website.
Danish troops did in fact witness abuse of civilian detainees at the hands of Iraqi troops during the conflict.
This has been verified by a video tape released yesterday in Danish media, provided by a former military intelligence officer, which shows Danish troops witnessing and commenting on a beating by Iraqi soldiers.
These new facts directly contradict the testimony of Lt. Col. John Dalby, commanding officer of Operation Green Desert in Iraq, who claimed at the end of 2011 that Danish troops had not witnessed abuse. While a military officer claims Dalby himself had seen the video tape, which was recording by troops under his command, Dalby today has denied this, claiming he first saw the video on TV2 News this morning.
But the question we ask ourselves is, what does this mean for the victims of torture and abuse in Iraq? Currently, 11 Iraqi citizens have sued the Danish military for colluding with torture. The cases concern the transfer of the 11 Iraqis by Danish troops to Iraqi forces, where they were tortured. The suit alleges that the Danish troops transferred the Iraqis despite the clear likeliness that they would be tortured in Iraqi custody.
This newly released video would corroborate the claim that Danish troops had previously witnessed abuse and thus had knowledge that torture and ill-treatment were likely. In the video, a Danish soldier sees Iraqi troops beating a civilian. Then, he turns and comments, “Did you see? They certainly get a beating” (In Danish, “Har du set, de får bare nogle hug”).
The IRCT collaborated with forensic experts and attorney Christian Harlang, who represents the 11 Iraqis, to compile high quality medico-legal reports that verified that they had in fact been tortured following the transfer.
“My examinations of the eleven Iraqis left me in no doubt that they had been physically and mentally tortured,” said Jørgen Lange Thomsen, Professor of Forensic Medicine at the University of Southern Denmark, who took part in the examinations.
We hope at the least that this new information get the Danish judicial system moving, after several blocks and delays have hindered the process of these torture victims from accessing justice.
See also our previous blog post on the allegation of torture from 11 Iraqi citizens against the Danish military
Meeting new people outside IRCT or outside the circles of human rights work, we’ve found people have a number of questions about what the IRCT does and, more simply, about the issue of torture around the world. “Is there still torture?” they ask, often astounded that there is. For many, the term ‘torture’ invokes ideas of medieval torture chambers and the rack or the Iron Maiden.
Ten of the most common questions we get are the following:
Sadly, yes, torture continues as a phenomenon today. In fact, torture takes place in the majority of countries in the world – as many as 90% of countries, estimates former UN Special Rapporteur on Torture Manfred Nowak. Furthermore, Nowak estimates that in as many as half of those countries, torture is a rampant and systematic problem.
2. Where does torture occur?
Torture most often takes place in places of detention – whether in the initial police lock-up, interrogation rooms, prison systems or other places where people are deprived of their liberty. This allows torture to remain a “secret” or “hidden” problem in the world [PDF]; places of detention are often well outside the realm of the public view and therefore escape public condemnation.
The United Nations defines torture in the UN Convention Against Torture, and other Cruel, Inhuman or Degrading Treatment and Punishment as:
“… ‘torture’ means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.”
4. How are people tortured today?
While such techniques from the Middle Ages are no longer used on a large scale, the techniques of torture are still just as cruel, inhuman and painful to the victim. Furthermore, modern torture techniques are often designed to leave as few marks as possible to avoid possible future prosecution for the crimes. The Istanbul Protocol, the international guidelines for documenting torture, discusses torture methods under the following categories: beatings and other blunt traumas, beating of the feet (falanga), suspension, other positional tortures (such as being detained in a small cage or box, being forced to stand while arms are stretched high), electrical shocks, tooth torture, asphyxiation, rape and sexual torture. Other practices, such as hooding, humiliation, being stripped naked, threats to oneself or family, mock executions, simulated drowning (waterboarding) and sleep deprivation are also common torture methods that leave no external marks behind.
5. Why do people torture?
“The main aim of torture is to destroy the self-esteem of the person. The torturer tries to destroy the personal integrity by methods that cause maximum physical and mental pain and ensure gravest humiliation.”
While this is the main aim of torture, as described in Atlas of Torture, the goal of such pain and humiliation may vary. Police may torture a person to extract a confession for a crime or implicate others in a crime, as is a common practice in many countries, such as the Philippines; people may be tortured for information, as was the excuse used by the U.S. for the CIA torture programme in the so-called ‘war against terror’; armed forces may use rape and sexual torture to destroy the social fabric of communities. Or, state officials may employ torture as punishment for acts that person or a third person is believed to have committed.
6. Who commits torture?
For a case to be described as torture, the crime must be committed by a public official or a person acting in an official capacity, such as a state authority like police officers, soldiers, armed militia, among others. This also may include teachers, healthcare workers, paramilitary groups or prison guards.
The victims of torture can be anyone – any person simply in the wrong place at the wrong time can become a victim of torture. However, there is no doubt that some groups are at particular risk of torture, for example, the poor. As the IRCT stated in The London Declaration on Poverty and Torture, poverty is one of the major factors that keep people particularly vulnerable to torture and other ill-treatment. “Most of the victims and survivors of torture belong to the poorest and most disadvantaged sectors of society,” Nowak said in the 2011 Global Reading for 26 June.
This is, generally speaking, because poverty makes people vulnerable to abuses and leaves them without the ways and means of defending their rights. Other factors can marginalise people, leaving them vulnerable to torture; this includes groups such as women, children, the elderly, religious, ethnic or sexual minorities and political opposition groups, among others.
8. What are the effects of torture?
There has been a growing body of scientific research on the physical, emotional, and mental effects of torture. The physical effects of torture depend greatly on the method of torture used. Certain types of torture are related to specific symptoms and signs. For example, for survivors of falanga, a type of torture where the soles of the feat are beaten, effects may include smashed and broken heels, later causing slow and painful walking for only limited distances.
The psychological consequences are frequently persistent and invalidating. The prevailing manifestations include anxiety, depression, irritability, emotional instability, cognitive memory and attention problems, personality changes, behavioural disturbances, neurovegetative symptoms such as lack of energy, insomnia, nightmares, sexual dysfunction, and “survivor’s guilt”.
In other words, torture represents an extreme life stressor and exposure to torture increases the risk of developing psychiatric symptoms and subsequent dysfunction, social problems, marginalisation and poverty. We know that not everyone exposed develops psychiatric manifestations but that a number of genetic factors, including vulnerability to stress, proneness to anxiety, developmental deficits, previous psychiatric history, incapacitating physical consequences, quality of social environment and individual coping efforts, all play important roles. Furthermore, the more prolonged, repeated, and unpredictable the experience of torture is, the more traumatic it is and more serious the psychiatric consequences are likely to be.
9. What is rehabilitation?
We believe that all torture survivors and their families have a right to rehabilitation. Rehabilitation is simply ameliorating the effects of torture – it is to empower the torture victim to resume as full a life as possible.
Torture rehabilitation can take a variety of forms. In approaching it through a holistic approach, rehabilitation can include medical treatment for physical ailments resulting from torture; psychosocial counselling or trauma therapy; legal aid to pursue justice for the crimes; or programmes and activities to encourage economic viability, among others.
10. What can I do to help?
There are many ways in which supporters can help. The first and most direct help is of course donations to the IRCT for our work.
Another way in which supporters can help is to simply share the stories of torture survivors or human rights defenders. International support from the World Without Torture community can create unending pressure on authorities to live up to their human rights obligations, such as stopping torture, ending harassment of human rights defenders, or bringing perpetrators to justice, among others. Your tweets, Facebook updates, letters to state leaders: these are all ways in which we can together create unceasing pressure on authorities to stop torture.
How IRCT Pakistan member is confronting the country’s problems
Upon meeting Khalida Salimi, she almost immediately thanked me for being among the ‘young people’ entering into the field of anti-torture work.
“We need more young people to eventually take over for us,” she explains. Salimi views the anti-torture movement as just that – a movement of human rights defenders worldwide, where new, young people must take up the cause and move forward the great strides the elder generation has started.
Salimi herself started working in this field around 20 years ago. She founded the Pakistani centre SACH Struggle for Change in 1994 as part of the growing movement for human rights in her country. She is a trained sociologist, which explains her commitment to a multi-disciplinary approach to the rehabilitation of torture survivors in a field largely dominated by doctors and lawyers. A multi-faceted view, she says, is highly necessary when working in a country beset by large-scale and ongoing poverty, armed conflict while acting as a recipient of a massive population of Afghan refugees from the long history of conflict in the neighbouring country.
Among those various views on how to tackle the problem of torture, Salimi has dedicated herself to continued engagement with all levels of both civil society and government. “A holistic approach,” she explains, “means we need to address and reach the police, the judiciary, the prison systems and then of course the medical professionals and lawyers.”
Reaching the police in particular has been a long—term process, one most recently partially supported by the Non-State Actors (NSA) project from the IRCT, of which SACH is a member. Initially, SACH had to reach out to the police authorities to offer them training on sensitisation of human rights and the law. Now, she reports, the relevant government authorities are reaching out to SACH and requesting further training from the NGO.
“They (police authorities) have moved from denial to acceptance that torture exists and it is a problem.”
The project has assisted Salimi’s organisation in producing manuals for police training to continue the ongoing process of ingraining a culture of human rights. “At the very least, we should ensure a baseline – that the police understand that there is a right to life, a right to dignity.” Now, several police stations in Islamabad have posters with the definition of torture, translated into Urdu, hanging on their walls, thanks to the work of SACH. And in February of this year, the organisation held a training session for nearly 50 prison staff from 8 prisons in the Faisalabad region on the definition of torture, the effects of torture and on improved prison management techniques.
And this is indeed a long and ongoing process, she emphasises, especially in a country that has fundamental challenges in its capacity to address several problems. Take the UN Convention Against Torture (UNCAT), for example. SACH was fundamental in convincing the Pakistani government to sign and ratify the treaty, a process that took many years. Part of that challenge, Salimi says, was convincing the relevant government authorities that Pakistan could indeed comply with the Convention.
The UNCAT, among the fundamental international treaties that prohibits the use of torture, obligates the states that have ratified it to report on certain requirements. Has that country criminalised torture in their domestic laws? Have they neglected to investigate claims of torture? Has the country rendered individuals to a third country where they could have been tortured? The monitoring of the UNCAT obligations requires that countries report on these issues regularly.
The government authorities in Pakistan, she says, attributed their reluctance to sign and ratify the UNCAT because they worried about having the ability to respond to these reporting requirements. But they did it in the end: on 23 June 2010, Pakistan ratified the treaty. One year later to the day, SACH, in coordination with several other civil society organisations, held a workshop with several government ministers to facilitate their reporting to the United Nations on the Convention.
However, SACH’s engagement isn’t limited to the government and preventing torture, but also working with the victims of torture around the country. One aspect of holistic rehabilitation to which they are committed is engagement with torture victims and their families through livelihood training.
“We don’t want to simply give people fish; we need to teach them to fish.”
Many of the survivors they work with have been given a small subsistence allowance through the UN Refugee Agency (UNHCR). Through technical and financial cooperation with the IRCT, they have worked with dozens of survivors to improve their skills to create viable small enterprises.
“These are small-scale enterprises, such as vegetable carts in the markets. But we meet with the survivors and analyse their skills. Then we provide a basic adult education, such as understanding the finances of pricing items.”
Overall, it is the potential for the global movement that most excites Salimi. Through the NSA project the IRCT is facilitating capacity development for centres through exchanges and sharing knowledge with other centres around the world.
The torturers can always come up with new ways to torture people, she says, so the networks of torture rehabilitation centres around the world can help the caregivers make sure they stay ahead.
“The perpetrators are powerful, while the care providers may not have the resources, power and time. But by building our networks and becoming connected, the caregivers are united against torture.”
Hanging on the wall in Steen Holger Hansen’s office is a hunk of twisted metal.
“It’s part of a German aeroplane shot down by the Americans during World War Two,” he notes. “It was found in Southern Denmark just ten years ago, although it crashed more than 60 years ago. I wrote the death certificate for the German pilot, and he was finally buried properly.”
Dr Hansen’s office is lined with similar objects; objects that, for him, tell stories. As a forensic pathologist at the University of Copenhagen, he is in some ways a story-teller, and a historian. His mission to Cambodia last year was of particular historical significance: he had to find evidence of torture, evidence that victims had been brutalised by state authorities, from more than 30 years ago, during the Khmer Rouge era.
Dr Hansen took part in the forensic investigation mission to Cambodia last year as one of three health and medical experts, which included Marina Staiff of Switzerland and Pierre Duterte of France. Dr Staiff and Dr Duterte were tasked with the psychological assessment of 11 clients of the Transcultural Psychosocial Organization (TPO); Dr Hansen was there to conduct the physical examination of those clients.
When he traveled last year to Cambodia, he says, he approached the task – that of examining those claiming torture to verify their allegations – through near-endless research. He read all the books he could find on the country’s devastating history, the four years of Khmer Rouge rule from 1974 to 1979, during which half the population was killed in labour camps and through extrajudicial executions and torture.
He also visited the infamous Tuol Sleng Genocide Museum, a former high school turned torture centre during the Khmer Rouge period. There he noted particular leg shackles – metal bars in a D-shape. One part of this story.
He was particularly pessimistic about this task, he says. He read crushing personal testimonies from that four-year peiriod. But he was in doubt about his possible role in helping them.
“This was more than 30 years ago, and I thought I would probably not be able to do anything. Even with very recent torture, there can be difficulty in finding physical confirmation in an examination.”
Getting the evidence
TPO, an IRCT member, sits in a tall, modern building in the capital Phnom Penh. They offer a vast array of psychosocial services, in particular for victims of sexual and gender-based violence and victims of the genocide of the 1970s. They are providing assistance to victims of the genocide who have come forth as witnesses in the Extraordinary Chambers in the Courts of Cambodia (ECCC), the tribunal that, since 2007, has been tasked with trying former Khmer Rouge officials on crimes against humanity, including war crimes, murder, torture and genocide. There are many thousands of survivors of the genocide who have registered as witnesses in the cases.
The 11 clients that the three doctors examined were among these thousands registered in ‘Case 002’ at the ECCC. The hybrid tribunal brings together the Cambodia judiciary and international experts to assist in the ongoing trials of Khmer Rouge leaders. Only one case – Case 001 – has concluded. The ECCC found Khang Khek Leu, often called ‘Duch’, guilty of crimes against humanity, including murder and torture. During the regime, Leu ran the Tuol Sleng prison.
Dr Hansen tells me that Tuol Sleng, now a museum, provided much of the research he conducted alongside the examination of the 11 clients. There, he says, an estimated 20,000 people were detained during those four years of whom there are only seven known survivors . The rest were killed, either through devastating incarceration, torture, and murder or labour camps. But it was in Tuol Sleng that Hansen saw the D-shaped leg shackles. These particular shackles were also depicted in the art work of Vann Nath, one of the handfuls of survivors of Toul Sleng.
On all of the clients that claimed they were shackled during their torture were small scars along their ankles. They were extremely faint. But they were there.
“These marks were consistent with their testimonies. We say that findings are consistent with claims of torture. We do not directly say, ‘Yes, these people were tortured.’ That is the job of the judiciary. But yes, all the shackle scars were highly consistent with the allegations.”
Further clients had marks of burns caused by metal rods. Others had marks from arms binds around their elbows. The physical scars of torture, nearly 30 years after they occurred, still testify to their agonizing experiences at the hands of the Khmer Rouge. Old scars can still tell stories.
Forensic evidence at the ECCC
It is not known yet if this forensic evidence will be used in the ECCC in Case 002. Three top Khmer Rouge leaders are one trial: Ieng Sary, former foreign minister; Nuon Chea, the regime’s second in command; and Khieu Samphan, a former head of state. A fourth, Ieng Thirith, who was the social affairs minister, was found unfit to stand trial, reportedly because she has Alzheimer’s, and was dismissed from the case. All four are more than 80 years old.
Although it remains a possibility, Dr Hansen is doubtful over whether he will be called to testify to the tribunal. The use of forensic documentation is still not well-enough understood throughout the world, even among the judiciary, and with a witness list numbering well over a thousand, there is still much evidence to go through. The process allowed anyone with an allegation to come forth, provide testimony and register as a witness; it included allegations of war crimes, genocide, murder, rape, other sexual violence, forced marriage, forced labour, and massive accounts of neglect resulting in starvation and death from untreated medical needs.
However, regardless of whether or not he testifies, Dr Hansen remains extremely positive about the experience. “We now know that you can confirm torture allegations that are nearly 30 years old. We know that we should not discount the possibility of finding forensic evidence even from such old cases. People often ask me, ‘How can you read about these cases?’ People say, ‘It’s just so terrible to read this.’ It is terrible. But we should read and learn, and then you can help. What I’m saying is just that these stories should never be forgotten.’
Tessa, a US citizen living in Denmark, is Communications Officer at the IRCT.