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What the bones remember: Doctors from IRCT partner PCATI share their experiences of documenting torture
Detecting signs of torture, often years after they have been caused, can be a tough task. However, due to advancing techniques in medical documentation of torture, physicians are able to establish the injuries inflicted by torture and the best methods of rehabilitation. Three physicians from IRCT partner Public Committee Against Torture in Israel (PCATI) share their experiences.
For Dr Revital Arbel, torture was not something she had witnessed when her work with PCATI first begun. “Although I have been working in the field for years, particularly with victims of sexual assault, I will always remember a case following the pregnancy of an Eritrean refugee who was raped in Sinai,” she says.
“When she came in to deliver the baby she was accompanied by an interpreter for the first time, and they told me the story. Slowly the things she had been through in Sinai began to sink in. Like other refugee women imprisoned in Saharonim, she had not been able to undergo a termination of pregnancy at an early stage.”
Just as Dr Arbel realized realised the suffering, she received an invitation to participate in the first-ever training program in Israel for physicians and psychologists teaching ways to locate and diagnose torture victims.
The training, an ongoing project organised by PCATI and the International Rehabilitation Council for Torture Victims (IRCT), provides training in the forensic aspects of torture. The knowledge is used to identify victims and to provide evidence in court or in other formal examinations, such as applications to the United Nations to receive refugee status.
Arbel now knows much more about torture in Israel and around the world than she thought possible. “Torture leaves marks,” she says, “and these remain in the body many years after the event. The interrogators may be careful not to leave blue bruises, but today we can also identify what’s under the skin – what the bones remember.”
A personal relationship with torture
For clinical psychologist Dr David Senesh, he understands torture all too well. Captured and imprisoned in an Egyptian jail for 40 days during the 1973 Yom Kippur War, Dr Senesh has a personal relationship with torture which enhances his professional, medical understanding of its effects.
“I’m post-traumatic,” he says openly. “The guys who were held prisoner with me can’t figure out what I’m doing; how what we went through brought me to identify with the experience of occupation and treat Palestinians who have undergone torture. But from my perspective it’s a logical continuation.”
Neurologist Dr Bettina Birmanns, who works in the same hospital as the other physicians in Jerusalem, attempts to explain why she found herself repeatedly dealing with the topic of torture. “I’m increasingly convinced that when a state permits torture, it damages the fabric of the state and destroys trust between citizens the authorities. Even if ‘regular’ citizens do not believe that they will be affected, the fact that someone in an official position is allowed to use serious violence and deliberately cause someone else pain and suffering, damaging their inner kernel and soul – and we know that this happens – that destroys society. I cannot accept that.”
The three doctors admit that they paid a heavy emotional price for their participation in the series of workshops. Alongside theoretical sessions discussing methods of torture around the world, trainee participants also diagnosed actual cases, engaged in role-playing exercises, and confronted professional and personal dilemmas.
“There’s a reason why the training program attracted relatively long-serving physicians,” Arbel suggests. “I think this work demands maturity, and I’m glad that I didn’t suggest that any of our interns join it. Maturity is important in order to act properly and cope with the difficult exposure to the people involved and their stories. You also require moderation – you cannot be too extreme in either direction, but need a mature view of life.”
‘You just can’t ignore torture anymore’
But they feel that with trainings such as these – and with the sharing of knowledge and mechanisms to ensure states comply with their anti-torture obligations – torture can be stopped across the globe.
“You reach a point where you just can’t ignore [torture] anymore,” says Dr Birmanns. “You hear the traumatic stories, and you see the victims after they were tortured – what they experienced has an impact on their health, their psychological condition, and their relations with their wives, children, and with society at large.”
“People undergo personality changes. They’ll never be the same as they were before they were tortured. They were all imprisoned afterwards and didn’t receive treatment. So first they are tortured during interrogation, which results with various kinds of problems. And then their imprisonment kind of freezes the situation, and when they are released all kinds of issues and experiences erupt and those around them don’t know how to cope with it. People are happy to see them out of jail, but they are not really the same people who went into jail, partly because of the torture.
“I still believe that a law-abiding state should not deliberately cause pain and suffering and ruin someone’s life. There should be a border that remains uncrossed, beyond any discussion.”
A new video from the European Center for Constitutional and Human Rights (ECCHR) uses compelling interviews with leading professionals in the anti-torture field not only to explain the rights of torture victims, but to highlight existing barriers to torture rehabilitation.
The video, which features Dr. Mechthild Wenk-Ansohn from BZFO, an IRCT member, and IRCT patron and former UN Special Rapporteur on Torture Manfred Nowak, discusses what rights torture survivors have under the United Nations Convention Against Torture.
“Torture is one of the most serious human rights violations,” says Manfred Nowak in the piece. “Because of this, torture survivors are in need of whatever support and rehabilitation is available to overcome their experience of torture.
“Yet most of the time, rehabilitation is provided by centres in urgent need of money. There needs to be force on to states to provide full rehabilitation.”
The ECCHR is a human rights group which focuses on providing human rights litigation to hold state and non-state actors accountable for the violations of the rights of the most vulnerable.
It is their hope that with video pieces, such as this, more people will understand just how prevalent torture is around the world and what ore needs to be done to stop it.
You can watch the video below.
Despite being the shortest month of our calendar, February has been packed with important news stories, statements and developments across the anti-torture movement.
We summarise some of our most popular blogs, social media content and news releases below. Simply click the relevant links and pictures to read the full stories.
Ever wondered what can be achieved through rehabilitation? Ever wanted to know exactly what can be done to help victims of torture overcome their past? Or have you simply questioned how many centres across the globe offer torture rehabilitation services?
This month we collected the top ten questions asked by our readers about anti-torture work and answered them with links to our work. Just click the picture or this link to read more.
Another popular story this month came from the IRCT whose President, Suzanne Jabbour, has been awarded the prestigious North-South Prize from the Council of Europe in recognition of her lifelong commitment to preventing torture.
The award, which will be presented this Spring in Lisbon, Portugal, has a long list of famous previous winners including Kofi Annan and Bob Geldof.
Suzanne is overjoyed with her victory and we want to thank everyone who joined us in congratulating Suzanne on this award. Read the full story here.
A prison guard takes a detainee from his or her cell, escorts them to a roulette-style wheel listing different methods of torture, and spins the wheel to determine just how much pain should be inflicted on the prisoner.
This ‘Wheel of Torture’, which uses torture as a game, came to light in the world media this month following an inspection of prisons in the Philippines and shocked human rights groups worldwide.
The practice not only showed us how torture is still being reinvented and adapted in sadistic ways, but also showed just how little is being done in the Philippines to stop torture. You can read our full blog on this, and the statement from human rights defenders in the country, by clicking this link.
A story we shared on Facebook this month garnered much attention – the vivid, hard-hitting documentary ‘The Act of Killing’ achieved must deserved recognition from the British Academy of Film, Television and Arts (BAFTA) this month, receiving the award for Best Documentary at the latest awards ceremony.
Click our status below to watch an interview with the filmmaker Joshua Oppenheimer following the award.
We caught up with IRCT member the Kirkuk Center for Torture Victims in Iraq this month to see what they are doing to help survivors of torture in the region.
The newest member of the IRCT movement, the Kirkuk Centre have extensive links across the north of the country to aid victims of torture from all backgrounds, from those affected by the war in Iraq, to the recent influx of Syrian refugees in the region.
It comes as part of our ‘On the Forefront’ series, which you can see all the entries for by clicking this link.
Incredible news from Tunisia this month, who passed a new constitution promoting equal rights for women, freedom of religious expression, and freedom from torture – all ratified just three years after revolution.
We joined world leaders in congratulating Tunisia on this move which will hopefully push other contries to follow the lead.
However in Bahrain, which also experienced uprisings against the government three years ago, the situation of ill-treatment of protestors and limits to freedom of expression has not changed.
Protests continue on a daily basis, and the three-year anniversary since the beginning of the protests was tragically marked itself by further protests and excessive crackdowns from the authorities.
Bahrain needs to change now. It simply cannot wait any longer. Read the full story by clicking the picture or clicking this link.
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Despite a strong government crackdown on protestors, over 300,000 people took to the streets of Bahrain’s capital Manama on 14 February to mark the three-year anniversary of the Bahraini protests.
And despite three-years of torture, imprisonment, and even deaths of protestors, the demonstrations against the government do not seem to be slowing down.
But also what is not slowing down is the government’s resistance to relinquishing power to the people. On the anniversary march alone, over 50 people were injured by rubber pellets and tear gas fired by police.
The last three years have seen the Bahraini government, the House of Al Khalifa, use extreme force over protestors whom are campaigning for respect for human rights. In every protest, the government has repelled the protestors with the use of force. The result over three years is shocking: according to data from The Bahrain Center for Human Rights (BCHR), 93 people have died; more than 2,200 political prisoners remain in detention; and torture and enforced disappearances remain widespread on a daily basis.
The Bahrain Center for Human Rights (BCHR) has tracked the uprising since day one and Maryam Al-Khawaja, Acting President of the BCHR following the arrest of President Nabeel Rajab, knows in detail the harm the government can cause.
Her father, prominent human rights defender Abdulhadi al-Khawaja, has been imprisoned since April 2011 for allegedly plotting a coup during the pro-democracy protests. Maryam’s sister Zainab – who was recently released from detention – still faces a string of ‘anti-government’ charges. They are just two cases out of thousands who have been silenced by the government.
“People seem to assume that somehow the Bahrain revolution failed but I do not think it is fair to assess the revolution as ‘failed’,” said Maryam Al-Khawaja in a piece to World Without Torture. “It is just an inconvenient revolution – a revolution which is happening in a country which is solidly linked to the interests of the West in terms of oil, trading and so on that it would prove problematic to recognise as an active, powerful movement.”
Three years on, her assessment certainly still seems accurate. Aside from the occasional news report online, the world seems oblivious to Bahrain: the country is still portrayed as a safe haven for foreign investment and tourism; and large-scale international events, such as the Formula One Grand Prix, still continue to uphold the myth that Bahrain is free from unrest.
Yet the sheer numbers of protestors marking the importance of the ‘revolution’ tell a different story about the realities of Bahrain: its people want a democratic change from the 230-year-old Al Khalifa rule.
With human rights coming into question on a daily basis, it is a change that is needed – now, not in another three years.
In the blog this week we profile the newest member of the IRCT network, the Kirkuk Center for Torture Victims, offering torture rehabilitation in northern Iraq.
Founded in 2005, the Kirkuk Center for Torture Victims is an important multi-branched organisation offering rehabilitative services to victims of torture in the region. It is the second IRCT member in Iraq, and was founded with support from the Berlin Center for Torture Victims, a leading European institution caring for survivors of torture, persecution and genocide.
The Kirkuk centre offers services tailored to a wide variety of social groups including female and young victims of torture, victims of genocide, refugees who are survivors of torture, and many more.
Quite simply, thanks to extensive support programmes, there is no one the centre cannot help. This openness has been highlighted once more with their recent treatment of an influx of Syrian refugees at the centre whom, despite fleeing their homeland in large numbers, have had the same excellent treatment from the Kirkuk centre.
The deep understanding of the challenges refugees particularly face is perhaps ingrained in the centre’s beliefs thanks to the experience of Salah Ahmed, founder and chairman of the centre.
Himself being of Kurdish-Iraqi origin, Salah Ahmad fled his home country in 1981 and sought refuge in Germany, where he studied pedagogics and later on became a psychotherapist. At the Berlin Center for Torture Victims he has treated hundreds of survivors of torture from all over the world.
After the fall of the Saddam regime, Mr. Ahmed returned to his hometown Kirkuk where in 2005 he established the first rehabilitation centre for survivors of torture in Iraq.
Until today, he still recalls one of his first patients, a young woman who had been imprisoned, tortured and held a sex slave for more than 10 years by Saddam’s security forces.
“She had had multiple abortions and given birth to three children in prison. It took more than one year of intensive therapy until I saw this woman smile for the first time”, recalls Salah Ahmad. “She was my first patient in Kirkuk and the biggest challenge of my professional career.”
Since these first days, the Kirkuk Center has come a long way. “Many things have changed since the first patient walked through our door,” Salah says. “The political and the security situation in Kirkuk and in Central Iraq is really worrying. But we have been able to help more than 11,000 patients in six cities in north Iraq.
“When I travel through my country and visit the big cities in the north, I think that hope always dies last. What we have built in this country during the past 10 years is incredible.”
The game of the ‘Wheel of Torture’ is simple: a prison guard takes a detainee from his or her cell, escorts them to a roulette-style wheel listing different methods of torture, and spins the wheel to determine just how much pain should be inflicted on the prisoner.
It sounds like a macabre gameshow in a dark future where “30 seconds of hanging” and ”20 seconds of beatings” are used for entertainment. But as recent news has shown, this game is a reality – and it may not be an isolated incident, one anti-torture union claims.
Following reports of the torture wheel’ earlier this week, the United Against Torture Coalition (UATC) in the Philippines is concerned that while the torture wheel is an extreme example of torture, it exists in a context where there is room for further practices like this to exist.
“The existence of secret detention facility indicates the government’s reluctance to ensure full implementation of the Anti-Torture Law [which gives room for] routine and widespread use of torture and ill-treatment of suspects in police custody,” the statement reads.
The coalition – a union of over 30 human rights groups including IRCT members Balay Rehabilitation Center and the Medical Action Group (MAG) – believe that while the 2009 Anti-Torture law is in place in the Philippines, it is having minimal impact on the prevention of torture.
“Four years since the law took effect, the number of cases brought to court against perpetrators remains a drop in the bucket,” the statement continues. “The government has overlooked zero-tolerance of torture and full implementation of the Anti-Torture Law, and has further set the stage of existing culture of torture impunity in the Philippines.”
The ‘wheel of torture’ discovery inside the Philippine National Police Laguna Provincial Intelligence in Biñan, Laguna province, has seen 44 detainees complain to the prison authorities. However, unofficially, the number of victims of this cruel practice could be much higher.
The officers involved in the case will be dismissed, but this is not enough to redress the victims, or to stop a similar situation of torture developing in the future.
There needs to be full investigations into this incident which sees offending officers disciplined for their actions, to ensure justice for the victims. There needs to be routes to rehabilitation for the victims also so, no matter what their experience, they can overcome their experience of torture. And there needs to be comprehensive reviews of the current state of policing in the Philippines, particularly in detention facilities, to prevent this torture happening.
It is an argument echoed by through the statement from the human rights defenders: “There needs to be more diligent implementation of the Anti-Torture Law. Currently the policy of “zero tolerance” is just to draw away the attention of the public and international community of the government’s failure to eliminate torture in the country.”
Through more than 140 rehabilitation centres across the globe, the International Rehabilitation Council for Torture Victims (IRCT) is the largest international network against torture, providing rehabilitation, justice and hope to victims of torture all over the world.
Although under the same umbrella, each of these organisations is unique and operates in a variety of contexts. There are centres working around the clock to deal with humanitarian crises – such as Restart in Lebanon, or the Institute for Family Health in Jordan, which are currently struggling to respond to the challenging influx of Syrian refugees, many of them victims of torture, and groups working with the victims of long past dictatorships, such as those of Latin America in in 1970s.
There are also centres focused on healing entire communities through group therapy and counselling in places where armed conflict created deep societal wounds, and centres who are working with victims of terrible, and often covered-up, state torture, in countries usually assumed democratic and free from torture.
The range of focus areas is vast and, to counter this, so are the different methods of rehabilitation: there are traditional methods of rehabilitation, from psychotherapy and counselling, to group projects focused on rebuilding a community; there are innovative programmes such as yoga sessions which offer physical solutions to long-term pain; storytelling classes and artistic events across centres allow survivors of torture to express their pain in a personal and enlightening way; and projects such as the natural growth project, run by Freedom From Torture, which allow survivors of torture to find their place in the world by reconnecting them with nature and society.
Despite the differences, these organisations share an aim: to create a world without torture.
Over the coming weeks we will be focusing on particular torture rehabilitation centres from across the globe, giving an insight into how they operate and the work they complete on a daily basis.
Every week we shall turn our attention to a different centre and showcase how the centres and programmes work within varying national and local contexts, with different target groups, and use a range of methods to address the effects of torture on individuals, families and communities.
Torture has far-reaching consequences. Rehabilitation too has a far-reaching impact, one which can assist a person, a family, a community, and even a region, in moving on from their past and into a pain-free life once more.
Join us from next week as we go behind-the-scenes of the centres.
This month has seen us fighting torture in the dental chair, calling for prompt investigations of torture in Ukraine, and welcoming a new member centre to the IRCT.
Below are a selection of the most popular stories from World Without Torture over the past month. Simply click the pictures and links to read the relevant piece.
Odontology and documenting torture
The most popular post this month focused on the increasingly sophisticated methods of torture exercised today, notably those which aim to go undetected by torturing the teeth of a victim.
But for the past 20 years, odontologists at the University of Copenhagen have been documenting the cases of torture they have seen so there is a better understanding of the increasing number of torture methods which aim to be impossible to identify.
Torture – coming to a cinema near you
With documentary The Act of Killing receiving an Oscar nomination – and fellow torture network Freedom From Torture discussing latest torture-themed film The Railway Man in the Guardian newspaper – we looked at just how realistic torture is being portrayed by the film industry today.
IRCT calls for investigations into reports of torture in Ukraine
As the anti-government protests in Ukraine continue, so do reports of state torture against protestors in the capital of Kiev.
With the help of a local newspaper in Kiev, the IRCT issued a statement calling for thorough and proper investigations into the torture claims. The IRCT continues to monitor the situation as it develops.
Calls to protect IRCT members in Bolivia and Mexico
Further calls of safety and investigation came from the IRCT this month to ensure the safety of staff across two centres in Bolivia and Mexico.
The Institute for Research and Therapy of Torture Sequels and State Violence (ITEI) in Bolivia reported a series of intimidating phone calls and death threats which have been present for almost three months now, and are calling on state officials to assue the necessary safety of human rights defenders at the centre – particularly in light of the robbery of the centre director (read more here).
In a similar vein, there have been concerns from IRCT member Colectivo contra la Tortura y la Impunidad (CCTI) that their staff are being defamed and targeted by the state. The IRCT called for the safety of the centre and for the necessary prosecution of those responsible for the alleged intimidation.
Working alongside the media to end torture
Another extremely popular blog this month came as an accompaniment to the publication of the stories of two torture survivors in Al Jazeera English (iPad edition). The stories of Damchoe and ‘AK’ – from Tibet and Armenia, respectively – explore two entirely different reasons for torture in two contrasting locations, but both stories follow their incredible path to recovery even in the face of extreme adversity.
Thanks once more to Al Jazeera English for working with us. If you have an iPad, you can download the magazine by clicking this link.
Helping Syrian refugees in Jordan
The conflict in Syria has created a huge refugee crisis, with almost 2.5 million refugees pouring into neighbouring countries. Jordan has accepted the bulk of the refugees – over 800,000 of them – and IRCT member Center for Victims of Torture (CVT) has been documenting the healing processes of these refugees from their branch inside Jordan.
However there have been some positive developments over the refugee crisis, notably the UK’s decision to accept Syrian refugees as soon as possible.
New IRCT member welcomed
The IRCT welcomed new member the Kirkuk Centre for Torture Victimsbased in northern Iraq. It is the second IRCT member in the country and will provide treatment to all victims of torture, particularly important with the influx of Syrian refugees to the region.
The centre has already helped around 2,000 victims of torture, over half of whom are women and children.
Also this month
We heard from IRCT Regional Coordinator for Europe, Mushegh Yekmalyan, about his recent trip Montenegro to report on the progress human rights defenders are making surrounding torture prevention in the Western Balkans.
Australia’s tough stance on migrants arriving by boat was featured once more, particularly as the policy as been hailed as a victory – all the while ignoring the human rights of the people the policy punishes.
Torture rehabilitation in the Western Balkans – stories, challenges and the importance of working together
As part of his work as IRCT Regional Coordinator for Europe, we hear from Mushegh Yekmalyan as he travelled to the small town of Petrovac, Montenegro, to discuss anti-torture work from three torture rehabilitation centres and around 20 other human rights organisations in the Western Balkans.
Meeting new people is always an exciting experience, especially when you get the chance to hear from fellow human rights defenders and how the work we are all part of has aided rehabilitation, recovery and revival among people and communities.
The three-day roundtable meeting, organised by the International Aid Network (IAN), an IRCT member, was the final event of a three-year torture prevention project in the Western Balkans.
Torture survivors were present at the meeting. It was particularly moving to hear the problems of de-humanisation in their stories, the help provided by rehabilitation centres to mend the damage torture causes to families and communities, and who should be providing the rehabilitative services in the region.
The problem of de-humanisation
In many legislations, mentally disabled people have no right of appealing an assessment of their mental disability – an assessment often made by doctors who may have even not seen them and have come to a conclusion on the basis of some paperwork that was done by others.
The same is also true about the justice system where judges often do not see the person alleged to be mentally disabled, so just base their judgements on an opinion of a doctor.
The shocking reality that only the legal guardian has a right to appeal such decisions constitutes the very fact of de-humanisation as the person has no right to protect himself/herself when the rest of the world seems against you.
This situation was abused thousands of times in authoritarian regimes to de-humanise political opponents and dissidents, who were not just imprisoned but were simply sent to the psychiatric wards where nobody could see them and hear from them. Unfortunately this loop hole still exists in modern times and there is always a risk of having a person locked up in a psychiatric ward because of human error or abuse.
Addressing the far-reaching effects of torture
The crime of torture can not only traumatise the direct victims, but also their families and communities. In general, after years of repression, conflict and war, regular support networks and structures have often been broken or destroyed.
Providing support to survivors of torture and trauma can help reconstruct broken societies. Rehabilitation centres therefore play a key role in promoting democracy, co-existence and respect for human rights. They provide support and hope, and are a talisman against terror and torture.
It was fascinating to hear how the IRCT members in the region are engaging with communities damaged by conflict and torture in the Balkans. Much of the work focuses on remote villages where social workers, accompanied by doctors, are frequent visitors to families affected by torture in an attempt to make the survivors of torture feel integrated into their community. This work is often supported by UN agencies and other donors, and much work is being accomplished thanks to these close ties.
The war-torn Balkans have numerous stories from torture survivors who were former prisoners of war, or civilians caught in the crossfire. The victims not only suffered from the violence of conflict, but also humiliation from their communities because of their victim status.
The responsibility to provide rehabilitation
But who should offer support and provide rehabilitation? In many contexts where the survivors of torture are still within the same country and even often within the same municipality where the torture happened, a need of proper protection of the survivor and the caregiver must be guaranteed. However, in many contexts where the state has a blind eye to the problems of torture – and perhaps even supports the punitive actions of police force and paramilitary – the support must come from human rights organisations and networks working outside the state structure. This is why the rehabilitation centres not only in the Balkans but also across the globe are so important – they provide help where it seems like there is no room for hope.
Many IRCT member centres are on frontline and often are overwhelmed by horror stories of war, violence, torture and ongoing brutalities. But collective understanding of the importance of the work they do at meetings like this help them to carry on and help those in need.