Archive for category Rehabilitation
No money for support to the most vulnerable: Europe’s funding crisis for rehabilitation of torture victims
As Europe is facing a historically high influx of refugees – many of whom are survivors of torture – the need for proper care and rehabilitation of torture victims is greater than ever. Yet, there is a serious funding shortage across the continent, which has left a growing number of torture rehabilitation centres in dire financial straits. According to the International Rehabilitation Council for Torture Victims (IRCT), if states do not reverse this trend, we will see an acute loss of support services to those vulnerable and most in need.
“The cut in funding over the past five years has affected our work drastically and we have had to reduce the number of staff as well as patients. But now, it affects our actual existence. The facts are very simple: today, we have enough money in the bank to continue our work throughout September, but not in October.”
This is how the Director for Programs at French rehabilitation centre and IRCT member Parcours d’exil, Jérôme Boillat describes the centre’s current funding situation. A situation that could very well lead to its closure and leave hundreds of traumatised torture victims untreated.
Across the English Channel, London based Refugee Therapy Centre has also fallen victim to the funding crisis. After more than 15 years of providing psychological therapy and associated treatments to thousands of refugees and asylum seekers, the centre is now forced to downscale its work to three days a week. Going from operating five days a week to only three days inevitably means leaving behind torture victims in desperate need of help.
“The success of our work can be measured by the smiles made possible after interventions to heal the psychological and emotional wounds of those whose basic human rights were violated by torture and persecution. To continue with essential humanitarian work, our centre desperately needs financial support,” says Refugee Therapy Centre’s Clinical Director and CEO Dr Aida Alayarian.
The two situations in France and the UK are far from the only examples of torture rehabilitation centres scrambling for funding. At least 11 IRCT member centres and numerous programs that have helped thousands of torture victims across Europe have either lost funding or are predicting major cuts that will inevitably affect torture victims.
In Austria, upon learning that it may lose vital funding from the EU, an IRCT member is sharing its grim forecast: “If this funding were to be cut or stopped, we would have to reduce our support to survivors of torture drastically. As it is, there is hardly any funding for this target group on a local or national level. The only funding sources are international bodies and even their funding is being cut,” the centre explains and continues:
“Much of our work is in refugee shelters and no other Austrian organisation does the exact same kind of work. Referrals cannot be made because the only other organisation in our country working in this field has also very limited resources and they have their own clients. There are hardly any doctors or social services which have intercultural competencies.”
Europe is currently experiencing a massive increase in numbers of refugees and asylum seekers, driven by conflict, humanitarian crises and human rights violations, particularly in the Middle East and Africa. While Eurostat figures found that around 945.000 of asylum seekers entering the EU between 2002 and 2012 were victims of torture, there is no longer any doubt that this number will be much higher in 2015.
However, the urgent treatment and rehabilitation of torture victims is not adequately covered by EU member states, despite their obligations under international human rights and EU law.
The responsibility to provide rehabilitation to torture victims lies with the state. Yet in almost all EU countries, insufficient resources are being earmarked to provide specialised health services to vulnerable groups, including torture victims. This leaves rehabilitation centres to fill the gap.
“We know that a significant percentage of asylum seekers and refugees in the EU are torture victims and require access to rehabilitation services as early as possible. Our European member centres are doing their best to help as many people as possible, but sadly, many of these centres have had to cut their support services to torture victims due to a lack of funding,” says Miriam Reventlow, Advocacy Director at the IRCT.
The funding shortage affects traumatised refugees and asylum seekers at various stages. In Germany for example, newly arrived refugees and asylum seekers are among the groups that will be hit hard by a reduction in funding.
“The German state still has no early identification system for vulnerable groups, especially not for torture survivors. When it comes to rehabilitation of torture survivors, the competences and capacities of the regular healthcare system are still far behind the actual need. Moreover, there exists no funding for this type of work by the German government. By law, refugees have limited access to the regular health care system until the moment they are granted a residence permit. Psychosocial therapy centres try to cover this gap, while at the same time navigating through political changes,” explains Christian Cleusters from German rehabilitation centre Medical Care Service for Refugees Bochum.
So what can be done to ensure that as many torture victims as possible receive the treatment they need?
According to the IRCT, the answer is simple: every country in the EU will have to recognise their obligations under international human rights law and EU law and designate adequate resources within their healthcare budgets. But also, the EU institutions play a key role in providing sufficient funding and need to uphold their support to this important field of work.
“If we don’t generate more support, thousands of torture victims risk having current treatment programmes interrupted or will be unable to access rehabilitation services in the first place. European countries all have a responsibility to ensure that there is enough funding to provide rehabilitation to victims of torture, and we need them to take this responsibility seriously,” says Miriam Reventlow.
In the UK, when asked how the Refugee Therapy Centre has helped them overcome their trauma, one torture survivor explains: “The group has helped me confront my problems and let go of the past. Now I can think of the future.”
For another survivor, the treatment has simply improved his quality of life: “I do not feel ashamed of being myself anymore and I can sleep a little better now.”
With less funding and no action from European leaders, the question is how many torture victims will be prevented from receiving the treatment they need to fully recover from their past trauma and be able to find a new path of life in their host country.
Nearly three weeks since the 26 June campaign swept the world, we continue to receive photos from the big day. As always, various torture rehabilitation centres across the globe came out in force to celebrate and honour victims and survivors of torture, and their photos offer a unique insight into some of the many activities and events that took place.
Under the theme ‘Right to Rehabilitation’ the International Rehabilitation Council for Torture Victims’ member Albanian Rehabilitation Centre for Trauma and Torture dedicated a special exhibition to the sufferings of victims of the communist regime. The exhibition included photographs, names and faces of people who were initially persecuted for political reasons and then imprisoned and executed without trial.
At the University of South Australia, nearly 300 people attended an event co-organised by the university and local rehabilitation centre Survivors of Torture and Trauma Assistance and Rehabilitation Service (STTARS). Regional Representative of the UN High Commissioner for Refugees (UNHCR), Thomas Albrecht delivered the keynote speech, discussing the global challenge of refugee protection, with specific focus on providing sustained support to survivors of violence and torture.
IRCT member The Canadian Centre for Victims of Torture hosted 26 June events that saw around 140 participants, including survivors, experts and community members come together to discuss and learn about the consequences of traumatic experiences as well as the successes and challenges associated with helping torture survivors overcome their past. The day included a photo exhibition, a set of discussions, and theatrical and musical performances.
IRCT member in Russia, The Committee Against Torture organised a series of peaceful organisations in Nizhny Novgorod, Orenburg and Yoshkar-Ola dedicated to 26 June – complete with red balloons. In Moscow a similar event was organised together with Amnesty International.
In Sri Lanka, HRO Kandy held a poster exhibition themed “Justice & Dignity for all” in the days leading up to 26 June. The exhibition, which attracted more than 3,500 visitors in the course of two days, depicted the rights of individuals through posters drawn by school children. The message that HRO Kandy wanted to share with the visitors was: “Say No to Torture”.
We encourage you to share your photos and stories with us either as a comment here or on our World Without Torture Facebook page.
Every day and across the globe, women and girls are tortured and ill-treated. For some, rape is part of their ordeal and their rehabilitation path is often solitary, while governments, communities and families struggle to respond to their needs. With the support of a generous donor, 16 IRCT rehabilitation centres in 14 countries are helping thousands of these women and girls to take control of their lives through a range of activities.
Can design and sewing workshops contribute to the rehabilitation and empowerment of female victims of torture and sexual violence? If you ask two torture rehabilitation centres in Cameroon and Pakistan, the answer is yes.
For the past year, the centres have organised self-help workshops and activities with focus on how to generate income aimed at women who have been subjected to various human rights violations. The idea is to empower them to become economically independent and take control of their lives – something that also has a positive effect on their self-esteem.
The training and support provided by the programmes in Cameroon and Pakistan have proven very popular. Last year, more than 1,600 women and girls participated in an array of activities that fit with the needs of their community, including IT training, music lessons, beautician courses and small-business management.
The two centres are not the only IRCT members to run these types of events. Across the world, another 14 rehabilitation centres have implemented similar projects.
Centres in India, Iraq, Lebanon and South Africa have organised workshops led by doctors and social workers to discuss prevention and the consequences of sexual violence on women’s health, while a centre in Sierra Leone is practicing healing ceremonies to alleviate the traumatic memories of the victims and promote peace and reconciliation within the community.
As a survivor who is part of the program in Iraq, explained: “When I arrived at the centre I felt that my family and I were drowning in the sea. The centre has been like a ship that has led us to the beach where we could start a new life.”
At another centre, a woman described how she “was completely demoralised and overwhelmed by suicidal thoughts” when she came to the centre. “I thought my life was worthless after facing the stigma of having been raped twice. However, the workers at the centre helped me get my life back,” she told.
Women and girls’ empowerment is crucial to creating better and prosperous societies, but gender equality is far from a reality in many places. Women’s rights continue to be neglected with the United Nations estimating that as many as 35% of women worldwide have experienced some form of violence.
Empowerment is widely considered a very effective approach to treat and support victims of violence. Whether it is training activities and seminars to help women become economically independent or treatment and healing to help them recover from their trauma, there is a great need to support female victims of torture and ill-treatment. With so many women worldwide having experienced some form of violence, this response must equal the size of this global problem.
So far the 16 IRCT members have treated more than 3,000 women and 1,200 children subjected to torture and sexual violence. We are still to see how many small business owners or beauticians the events and seminars have fostered, but for many in Cameroon and Pakistan things are looking brighter.
Just as we have seen in previous years, creativity played a big role in marking this year’s 26 June campaign. Thousands of people across the globe joined the torture rehabilitation movement in showcasing both the resilience and creativity of survivors and caregivers alike.
The UN International Day in Support of Victims of Torture on 26 June is the day in which people and organisations from around the world commemorate and honour victims of torture. For many, it is also a chance to celebrate the achievements of the movement.
Across the globe, members of the International Rehabilitation Council for Torture Victims (IRCT) organised a diverse range of events that included picnics for torture survivors, vigils, dance and music events, as well as theatre.
26 June is also a time for entire communities and families to come together, and for children to sing dance and play. Some centres had poster competitions, face painting, kite-making and musical performances, especially for and by children.
Dance, song and theatre in particular have become popular ways of celebrating 26 June. Last year, when over 100 organisations took part in the campaign, many chose to mark the day with cultural performances. These events can generate a huge amount of interest, as the public and media can learn about the experiences of survivors first hand, in an original and artistic way.
But more importantly, dance and theatre are great ways of engaging torture survivors and allowing them to process their trauma, which is why many health professionals include movement as a type of therapy for clients.
In Tibet, one centre put on a play about the struggles of political prisoners, while another centre in South Korea organised a colourful and musical day in honour of victims and survivors of torture.
There are endless ways of showing support for the anti-torture movement, and each year on 26 June we are blown away by the creativity that individuals and organisations across the globe demonstrate when they organise their events.
We hope to share more photos from this year’s 26 June events, and in the meantime we encourage you to share your photos and stories with us either as a comment here or on our World Without Torture Facebook page.
It is time to put a face to torture victims and reclaim their need for and right to rehabilitation – a right guaranteed under the UN Convention against Torture. As part of this year’s 26 June campaign, we are sharing the stories of survivors and care providers to show how providing rehabilitation services to torture survivors is a right and responsibility for all.
For many torture victims, seeing the perpetrator brought to justice and receiving compensation and reparations for the trauma suffered is an essential step in their rehabilitation. Yet, seeking justice can often be a traumatic experience for a survivor, or been seen as a waste of time. The psychosocial support provided by IRCT members to those seeking justice and reparation plays a hugely important role in changing this perception.
The Independent Medico-Legal Unit (IMLU), a governance, health and human rights non-profit organisation based in Nairobi, Kenya is one such centre. IMLU supports torture survivors during sometimes lengthy legal cases by offering them group or individual therapy.
In 2014, IMLU provided psychosocial support to a group of nine ex-servicemen from the Kenyan Air Force, who were detained, imprisoned and tortured after a failed coup attempt in Kenya in 1982. Thanks to IMLU, the group overcame the strong feelings of shame and stigma they had experienced, and eventually felt so empowered that they decided to share their stories with the world.
When IMLU first met the group members, they were going through legal proceedings in the form of a civil case, suing the government over wrongful dismissal and ill-treatment. Most of the group members had never spoken about the torture they experienced after the coup attempt and were hesitant to engage in therapy.
IMLU counsellors provided the group with psychosocial support and education about the impact of torture, which helped them normalise their feelings and experiences. Because of this, the group was able to start building trust with each other and the counsellor, which meant they could start to process the trauma.
As a final component of the process, IMLU helped the men let go of any part of their story or feelings that they no longer wished to hold on to. The men chose to write letters to their perpetrators, which they then burned in a letting go ceremony.
IMLU’s group therapy empowered the men to move on and rebuild their lives. They have now formed a society, which they hope to use to help other torture survivors and assist them in rebuilding their lives.
IMLU continued to provide the men with peer counselling training in order to further empower the group to reach out to other torture survivors.
“I am tired of it, tired of my body. Tired of my soul. I can only see that it’s getting more and more sick as time goes by.”
Much research has been done on the link between physical exercise and mental health. So far, focus has largely been on how an active lifestyle may help alleviate symptoms such as depression and chronic pain, but a group of Danish researchers have gone in a different direction, introducing traumatised refugees to the relatively unknown Basic Body Awareness Therapy.
Basic Body Awareness Therapy (BBAT) is a form of physiotherapy that is often used for psychiatric patients in Scandinavian countries. Stemming from different movement systems of Western and Eastern traditions, it focuses on movements related to posture, coordination, free breathing and awareness.
Over a period of 14 weeks, four physiotherapists at the Competence Centre for Transcultural Psychiatry in Copenhagen took a group of traumatised refugees from Iraq, Saudi Arabia and Lebanon through weekly 90-minute BBAT group sessions.
A mainly nonverbal therapeutic process supported by short talks, BBAT is believed to strengthen the patients’ confidence in their own resources. Echoing this, the Danish sessions led to a growing self-confidence among the participants, with some even beginning to feel a sense of control over their own bodies.
“I have learnt how to concentrate myself away from pain. It starts by lying and thinking about
the skin and about something nice. Then everything goes away,” explained one of the participants.
“After all the traumas my body has been through, I feel good that it is still working,” said another.
Traumatised refugees are likely to suffer from (symptoms related to) Post-Traumatic Stress Disorder (PTSD). As a consequence, their interest in participating in activities they once enjoyed has diminished.
For some participants, being part of a group not only motivated them to go to the sessions, but also helped them through the exercises.
“In my case, it’s better to be in a group. When we start doing the exercises, I am focusing on how the others are doing them and my attention is there. I don’t think about my pain during that moment. The thought of pain is distracted by their presence, because they are there.”
Others, who were initially cautious of group sessions, were positively surprised by the unity and solidarity that came from being part of a group.
“In the beginning we were wary of each other, because we didn’t know each other.
Afterwards, when we got to know each other, it got better. I was scared of receiving therapy in
a group, but I think it was a good experience.”
So what can we take away from the Danish study?
After the 14 weeks, the majority of participants expressed satisfaction with BBAT. Some felt happier while others had experienced increased body awareness helping them to reduce or cope with the pain.
“The physiotherapy that we are used to normally involves you going to a physiotherapist to get a massage. And this is something totally different, that you should learn to know your body and react according to the problems you have.”
In terms of participants, the study was small, but what it lacked in numbers it made up for in depth, enabling participants to express any progress or regress they experienced during the BBAT sessions. The encouraging results of the qualitative study suggest the need for further research on BBAT and traumatised refugees.
A bigger study could give us the certainty. But for now, it seems that BBAT could be a key component in the treatment of traumatised refugees.
To read the latest issue of Torture Journal click here.
Around the world, conflicts and humanitarian crises result in migratory flows of millions of asylum seekers, refugees and internally displaced persons every year. According to health professionals and researchers, as many as 35% of refugees worldwide could be victims of torture.
It used to be that those lucky enough to be near a torture rehabilitation centre were able to seek treatment, but in many places the number of victims of torture has now reached a point where the need for rehabilitation exceeds the services available.
To support victims of torture, the International Rehabilitation Council for Torture Victims (IRCT) last year adopted and promoted a policy on the Right to Rehabilitation in accordance with the United Nations Convention against Torture (UNCAT) Comment 3.
The policy highlights the obligation of states to ensure that victims of torture have free and prompt access to rehabilitation services. Sadly, as the rehabilitation sector is facing a funding crisis, this commitment is more important than ever.
For many rehabilitation centres, the future is not looking bright. They operate in situations where their fate is continuously uncertain and because of a reduction in funding, some of them are even at risk of closing.
Yet, getting states to fully commit to the rehabilitation of victims of torture is not an easy task. This is something that becomes particularly apparent in countries where torture is carried out by the state, and where health professionals and rehabilitation service providers are constantly under threat.
Whether it is doctors being arrested and tortured simply for trying to save lives in Syria or rehabilitation centres in Latin America being exposed to threats and other intimidation tactics, it is clear that access to health and in particular, the right to rehabilitation is far from a reality in many parts of the world.
So how do we face these challenges?
An important step is to change the way that everyone from states and governments to the people they govern perceive torture and rehabilitation for torture victims. Those who believe that the practice of torture can be justified must be reminded that it is a serious human rights violation that can never be tolerated.
In addition, decision makers need to understand that rehabilitation should not be a service provided mostly by civil society organisations if and when international agencies and philanthropists decide to fund it. In fact, each and every state has a responsibility to ensure that torture victims everywhere have free and prompt access to rehabilitation services.
Without this change in attitude, political will and appropriate funding, we cannot guarantee that victims of torture receive the rehabilitation services they need.
And without offering rehabilitation to victims of torture, we are denying hundreds of thousands of people worldwide their last and only hope to reclaim their life and dignity, lost at the hands of perpetrators.
“Emotionally I felt so much rage. All I thought about was revenge. I was constantly in a defensive mood. Everyone who knew me had to walk on eggshells.”
For A.M. in Armenia, torture did not just take its toll on his body, but on his mind too. The trauma from being tortured made him an angry and defensive person who mistrusted almost everyone with severe consequences for his family and community.
A.M.’s story is far from unique. Across the globe, torture rehabilitation centres help thousands of victims of torture each year.
What makes torture such a heinous crime is the fact that its impact goes far beyond the immediate physical or psychological pain. Torture can have serious long-term physical and mental health consequences for the victims.
Here are six ways that torture can affect a person:
The story of A.M. illustrates how torture and abuse can leave a victim angry and defensive years after the crime took place. The smallest things can trigger a reaction and start an argument. Family and friends will often be fearful of the victim, leaving the person isolated and ostracised. Social isolation and loneliness can have a negative impact on a person’s physical, mental and social health.
An anxiety disorder differs from normal stress and anxiety.
Torture survivors who suffer from an anxiety disorder are likely to feel a constant and unsubstantiated worry that causes significant distress and interferes with daily life. They will often struggle with recurring nightmares or flashbacks.
For some, certain sounds or sights associated with the trauma can trigger severe anxiety attacks or emotional numbing. This could be the sight of a person in uniform or the sound of footsteps approaching. As a vicious cycle, an anxiety attack is worsened by the fear of having another one.
A person suffering from anxiety will try to avoid social situations for fear of being judged, embarrassed, or humiliated.
Depression is widespread among survivors of torture. People suffering from depression often lose interest and pleasure in activities and are unable to work, sleep, study, eat, and enjoy life. They also feel worthless or find it hard to concentrate. At its worst, they may experience recurring thoughts of death and suicide.
For different reasons, torture victims suffering from depression are often reluctant to seek treatment, which can have serious consequences for their health, including self-harm and insomnia. Research also shows that the longer a person waits before seeking treatment, the greater the damage can be in the long-term.
Emotional numbing and avoidance
A torture survivor suffering from emotional numbing and avoidance will go to great lengths to avoid any thoughts, conversations, activities, places or people that trigger a recollection of the trauma. The survivor may be profoundly emotionally constricted and detached. This can lead to social withdrawal and isolation.
A person suffering from hyperarousal symptoms has an extremely heightened alertness of his or her surrounding environment and can easily be startled.
Hyperarousal symptoms are usually constant and not triggered by an event or episode. The symptoms can leave the torture victim feeling stressed and angry, and not able to sleep, eat or concentrate. In addition, the person will often struggle with carrying out simple daily activities, such as getting dressed or going to the supermarket.
A person suffering from hyperarousal symptoms may also experience irritability or have outbursts of anger.
Some 51% of torture victims suffer from sexual dysfunction, which is particularly common among those who have suffered sexual torture or rape. It can also be linked to depression and post-traumatic stress disorder (PTSD) or it can be a direct result of an assault.
Sexual dysfunction affects not only the relationship between victims and their partners, but may also affect the way victims interact with family, friends and colleagues. In addition, it is likely to affect their confidence, their enjoyment in life, and their morale. Instead, they will often feel isolated and alone.
Many of the symptoms mentioned above are common in torture victims who have been diagnosed with PTSD. Other PTSD symptoms include insomnia, intrusive thoughts, nervousness and feelings of helplessness.
This is, however, just a small part of something much more complex. The psychological effects of torture vary from person to person which means that treatment should be the result of an individual assessment. Many torture rehabilitation centres offer holistic treatment that takes into account the individual needs of their clients.
In the case of A.M., he was able to rebuild his life and cope with his anger after seeking help at IRCT member centre FAVL.
“Thanks to FAVL, I have been granted a new spirit in life and have dampened the raging anger I had inside me,” said A.M. “Therapy has played a major role in getting me better again, rebuilding my relationships and becoming who I want to be.”
Girls and boys. They go by no name, but their faces are marked by scars from bayonets, whips or knives. Some escaped hatred and indifferent smugglers, others survived shipwrecks and overcame barbed regulations protecting the borders.
(All photos are kindly provided by Pierre Duterte)
In his latest photo book, Le Phototherapeute, French author and medical doctor, Pierre Duterte paints a portrait of young victims of torture through his conversations with one of them, a patient known as “Junior”.
Like Junior, the children have escaped countries riddled with war and conflict. Safe in France, they no longer fear for their lives, but being alone in a strange country, they are met by a new threat: the loss of identity. Confronted with a new language and a new culture, they are lonely souls with no family nor friends to turn to.
As Duterte writes, battling traumatic memories that have since turned into nightmares, they risk becoming the forgotten children in a society that believes it has met its duties by giving them a place to stay and food to eat.
Duterte has worked with torture victims for more than 20 years and throughout his career, he has treated thousands of clients. In 2007, he released a book about his experiences as a therapist working with torture victims.
In Le Phototherapeute, Duterte, who is also a photographer, uses photos of nameless children to illustrate the complexities of his patients. As to reiterate that Junior could have been any of the young victims of torture he has met, the book has no photos of Junior.
Perhaps frustrated with the way that institutions have failed to treat these children, Duterte points to the trauma and horror that young victims of torture struggle with, before and after their escape. With his patients in mind, he describes the unexpected effects of placing the young shattered souls in front of a mirror. Looking at themselves, some of them are unable to recognise their own reflection.
Le Phototherapeute gives the reader an insight into the troubled life of young torture survivors and what it takes to restore both their physical and mental health. It is a compelling read that also serves as a reminder to us that these children have a very lengthy rehabilitation process ahead of them and that they need all the support they can get. If we have any hopes of them recognising themselves in the mirror we need to start by helping them rebuild their identity and escape their nightmares.
To find out more about Le Phototherapeute, click here.