Posts Tagged human rights
Editor’s Note: This is the sixth in a regular series from centres involved in the Peer Support project (more fully described in our earlier blog here). See other previous posts in this series here, here, here, here and here.
“Our mission is to help, and when we feel that someone is trying to help us, this creates a good feeling and gives us wings for go on our mission”
In everyday life, working with victims of torture generates stressful moments. Why? Because we are always confronted with persons whose needs are many and varied, and our ability to cover their needs are often very limited. Our mission is to help, but we cannot always do so. This spirit of bitterness depletes us little by little. We remain marked by a sad story of life, a crippled body and a suffering soul.
How do we unload our soul? How do we free ourselves from what we have gained and what ails us?
All these questions arose in my mind many years ago. Ever since, I always tried to find new answers, new solutions. I started my work for victims of torture 13 years ago as director of MRCT Craiova Romania. Eight-hundred twenty-nine patients are registered at our centre. Every year we regularly assist 140 people with approximately 660 medical consultations and 2,400 physiotherapy sessions. The services are provided by the organization staff consisting of 11 persons. For information on who we are and what we do you can to our website: www.icarmed.ro.
One of the major problems I faced during all these years was to retain staff considering that the financial resources for salaries were always poor. In these circumstances, I think it is important for employees to have a job that comes with love, and to be part of a team in which everyone is united with the other for better and for the worse. This is a difficult goal to achieve, but great things are an accumulation of little things and I think that every step is important.
One step was to devise a questionnaire in order to try to know more about the mood of the team — hardships in facing problems that grind desires and aspirations. For me this questionnaire was and is useful. I chose this way of communication because often, when we stand all together, with all eyes glued to us when we speak, we find it difficult to express what we think, what we are upset about and what we want. The questionnaire is outlined on the bottom of this blogpost, and might be interesting for debate to improve it or maybe as a tool for partners in Peer Support Project.
Another important step is our participation to the Peer Support project, which is driven by a valuable team of project managers and trainers from whom we acquire knowledge. We learned best practices and applied them in our daily work to improve the well-being of the organisation.
We learned when to use the clinical intervision method, which helps us find better solutions to resolving the difficult cases. Since February, we have had monthly clinical intervision sessions.
After the Barcelona training, we realized that is very important to have a defined strategy for stress management in our organisation.
Another positive aspect of the Peer Support project is that we feel good to see how the three leading organisations (IRCT, Antares, bzfo) made their experience and expertise available in support of the six newly participating organisations to acquire similar skills. It simply feels so good when you see that someone wants to do something for you!
By Simona Smarandache, Director of MRCT Craiova Romania
- NAME ……………………………………………………
- DATE OF EMPLOYMENT………………………………………………………
- DATE OF COMPLETION…………………………………………………..
- WORK PROGRAMME ……………………………………………………….
- Do you know your responsibilities according to your job description? Institutional Code of Conduct? Organizational Code of Conduct?
- Describe the activity which you perform in the centre:
- What problems do you have regarding your activity, who/ what generates them, what solution do you think there are for resolving them?
- What dissatisfactions do you have?
- What are your expectations?
- Do you want to continue your activity within the centre? If YES, for how long? For a short/ medium long period of time? What are your aspirations?
- How do you see your activity in the future?
- What does MRCT Craiova represents for you?
- Do you have disagreements with your colleagues? But complaints about them?
- Do you have disagreements with your superiors? But complaints about them?
- Do you have disagreements with the director of the centre? But complaints about him/her?
- Are you satisfied with the working conditions, with the working environment in the centre? What are your suggestions and wishes in this respect?
- Do you have family problems? Are these problems related to your work place?
- Do you have any health problems? What are them? Are these problems caused by your work?
- Are you satisfied with your salary? Do you feel it is according to your efforts?
Editor’s Note: This is the fifth in a regular series from centres involved in the Peer Support project (more fully described in our earlier blog here). See other previous posts in this series here, here, here and here.
My colleague Tony is preparing for his second week of training in Intervision .Shortly after that, we will host a visit by the programme trainers and leaders in which we hope to move the lessons learned through our organisation by offering training to key staff. Much more on that in the next blog post!
As we have a small team in our North East of England Centre where Tony and I work, we are very easily able to pilot different approaches to work. For some time we have been organising regular Away Days for both staff and volunteers. We have sometimes gone to a retreat centre out in the countryside away from the city of Newcastle upon Tyne, where we are based, and we most often use this time for reviewing and planning our work programmes.
As a result of the Self Care training programme that Tony has been involved in designing, which I mentioned in the previous blog. As a result, we decided to arrange a smaller Away Day for the Clinical Team – those working therapeutically with survivors of torture. I now see this as an integral part of the broader Peer Support Project.
After some discussion, we decided we would go to each other’s homes to meet and that the host would prepare lunch. I was worried that we were invading each other’s personal space and even adding additional stress to each other, but soon saw that we all enjoyed taking care of our colleagues by the simple act of offering food. We are open to moving to a neutral venue, but so far the positives of going to each other’s homes have been substantial.
By now, we have met in this way three times. Each meeting has been valuable. The sense of distance from work by being in each other’s homes has helped us to get a deeper connection to each other that allows an intimacy that is very important in helping us support each other.
We structure the time based on a loose version of Intervision, where each worker can speak uninterruptedly about the impact that our work has on them, the challenges they face and the detail of the therapy they are trying to achieve. In the end, questions asked and comments are made in the spirit of Intervision.
We have been able to share thoughts and feelings that we find difficult to disclose even to our clinical supervisors —while they are often very experienced therapists and supervisors with an interest in trauma, they usually aren’t specialists in torture trauma therapy.
We have discovered that we were frightened of hurting them with the horrible details of the torture our clients have experienced. Yet we were holding such material inside ourselves, and we were unwilling to tell even our closest colleagues in case of adding to their burden.
Now we seem more able and willing to share such material and also our reactions to working as therapists with that.
In one meeting, I recall saying that there are times when I feel like I don’t want to hear any more about torture for a day. One of our teams shared that they will often go for a walk along the riverside near our offices when they need a break. I often make an espresso and look out of the window at the world passing by, and near our offices there is much to see. Nearby is a hotel where many people, who want to go to parties in our city, will stay and they often wear fancy dress – sometimes I see 10 men dressed as Superman, or in clothing for playing tennis with huge inflatable tennis rackets.
That helps me to see the funny side of this world that isn’t tainted by torture and is a valuable part of putting our work in proportion, as well as encouraging a sense of humour.
The away days have helped us to become a closer, more understanding and more supportive team.
Next week, we have a further such Away Day for the Clinical Team. I’ll ask if I can take some photos for this blog.
By Alan Brice, Centre Manager, North East Centre, Freedom from Torture
Editor’s Note: This is the fourth in a regular series from centres involved in the Peer Support project (more fully described in our earlier blog here). See other previous posts in this series here, here and here.
I work for Freedom from Torture (previously known as the Medical Foundation for the Care of Victims of Torture) as Manager of our centre in the North East of England in Newcastle upon Tyne. We have a big centre in London and others that are smaller around the country in Birmingham, Manchester and Glasgow. More than 50,000 survivors of torture have been helped since we started our work over 25 years ago. We employ about 170 staff (the majority are part-time) and are delighted to have about the same number of volunteers working with us.
We have been developing a training programme for staff on Self Care recently. Tony Wright, who is in my team in the North East Centre, was involved in its design and delivery. Tony is a therapist who also leads training initiatives for us in the North East. The Self Care programme is designed to help staff know more about how working with survivors of torture — hearing their stories, feeling their distress, typing reports documenting torture — impacts on each member of staff. With greater understanding and greater awareness of the damage that can be done to staff, the programme then encourages staff to reflect on how they can be healthier in the work.
When we heard of the Peer Support Project, we were both very interested to be involved. As the Centre Manager, I am also a therapist and am part of the National Clinical Secretariat that oversees clinical issues in the organisation. Taking care of our clients means taking care of each other. If we are not healthy and working to our best we cannot support our clients through the terrible traumas they have experienced. It was a really valuable addition that Celine Conaghan, our Human Resources Manager, was also keen to join the Peer Support project team.
We learned a lot in the week in Barcelona – the trainers worked us pretty hard – and we began to think differently about how to organise ourselves to help each other better. Having the chance to talk with staff in other organisations across Europe was really valuable. It gave us ideas and perspectives that we did not expect. Hearing about the Intervision approach and discussing how others have applied it, made us interested in applying it to our own context.
We did manage to have a little time away from the subject of Peer Support project and many of us went to la Sagrada Família, the amazing church designed by the architect Gaudi. Attached are a couple of photos from our visit there – the light flooding into the building through the stained glass is astonishing.
We noticed a statue near the entrance that was very evocative of the suffering we encounter in our work.
Tony and I found the Foundation of the Catalan artist Antoni Tapies, who was born in Barcelona. One of his pieces of art, a rolled up mattress, reminded us of the experience of many people forced to flee their homes across the world to find safety, food and welcome and who can take just a few items like such a mattress with them.
Back home the three of us have carefully discussed how we can introduce the learning from Barcelona into the work of our organisation. In the North East we have established regular Away Days for the staff team when we can get away from the office and hear each other’s concerns and achievements also. Nationally across the organisation, Celine has sent lots of information around so that staff and volunteers are informed and involved. We want them to be as excited as we are. We are looking forward to the Project Support Visit, which we hope will be in June. During that visit we intend to introduce aspects of Peer Support to the Senior Managers of the organisation and to selected teams. By then Tony will have been on his second additional training on applying Intervision, and we plan to roll out that training across the organisation after that. Next time we blog we will be explaining how our Away Days are working.
By Alan Brice, Centre Manager, North East Centre, Freedom from Torture
“You are here to speak about the theme of torture?”
The question comes loud and clear from the receptionist at the receiving desk of the Ministry of Justice and Human Rights in Lima, where I just handed in the passports of our delegation and explained that we have a meeting with the Vice-Minister of Human Rights in Peru. I am positively puzzled by the frankness.
I am in Lima for the IRCT to support member centre Centro de Atención Psicosocial (CAPS) in following up on the implementation of the recommendations on rehabilitating torture survivors issued by the Committee against Torture (CAT) to the PeruvianState in November 2012. Following-up in this case essentially means discussing with the Peruvian government how they have received the recommendations and which steps they intend to take to implement them.
For this purpose, we had asked rehabilitation expert and researcher Dr Nora Sveaass to accompany us. Dr Sveaass is a well-known personality within the anti-torture movement. Her expertise is crucial in meetings like these.
Some days earlier I had met with Dr Nora Sveaass and Dr Carlos Jibaja, Director of CAPS. After a lot of coordination by email before the trip, we were finally able to sit down all three of us in CAPS’ yellow office building in Lima. The following week we would be meeting with the Vice-Ministry for Human Rights, the Ministry of Foreign Affairs, the Ministry of Health and the Ombudsman. All four are key players in respect to the implementation of the CAT recommendations and the broader objective of ending torture in Peru. We discussed the strategy for the meetings as well as the current political climate in Peru.
Back at the Ministry, sitting in a spacious meeting room with the Vice-Minister for Human Rights and four of his colleagues, we experience one of the sacred moments in the work against torture — a door of political will is opened. The Vice-Minister and his staff were very forthcoming, the discussion was constructive and a clear interest to cooperate was expressed. Although it is only words at this stage, these are the kind of moments you recall and repeat to yourself when things are stuck and human rights feels like a lost cause to the world.
If words are followed by action, the work in Peru might be a milestone in the realisation of the right to rehabilitation for torture survivors, which can be replicated by governments across the globe.
The past year the IRCT, in close collaboration with member centre CAPS, has been working specifically towards ensuring the availability and accessibility of rehabilitation services for torture survivors in Peru. About a year ago, in May 2012, we wrote about reporting to the Committee on Economic, Social and Cultural Rights (CESCR) to demonstrate how torture is a direct violation of the right to health.
In November 2012, the IRCT and CAPS submitted another alternative report on Peru, this time to the Committee against Torture (CAT). In this report, we again assessed the rehabilitation services for torture victims provided by the Peruvian government and offered recommendations as to how the system can be improved to benefit all victims of torture in the country. To present the report before the Committee and to stress the importance of its content, a colleague from CAPS travelled to Geneva. The presence of our members in Geneva often has a powerful effect because this gives the opportunity for them to personally meet with the Committee members and give more detailed and concrete explanations about the situation in their countries. In doing so, we managed to bring to the Committee’s attention some of the shortfalls and the lack of access to specialised rehabilitation services in Peru.
In the end, CAT issued four concrete recommendations to the Peruvian government on rehabilitation access. This provided an important international expert validation of our work in pushing for torture survivors’ access to proper rehabilitation services at the national level in Peru. The meetings we had with officials of the Peruvian government provided for yet another step in the right direction.
With the adoption of General Comment No. 3 on Article 14 of the United Nations Convention against Torture, which clearly stipulates the obligations of states in respect to providing rehabilitation services for torture survivors, and with concrete recommendations on rehabilitation given to the Peruvian State, we have come a long way.
While all still remains on paper and in diplomatic words, opening doors for cooperation in the political sphere are crucial for creating change on the ground. Let’s see what 2013 brings in terms of implementing the talk.
For four weeks every March, Geneva turns into a buzzing hub of global human rights dialogue and deliberations. Human rights defenders, national human rights institutions, diplomats and other stakeholders descend on the city for the main annual session of the UN Human Right Council. This is where international human rights standards are negotiated, States monitor and discuss thematic and country specific human rights situations and human rights defenders go to bring attention to the most recent developments on enjoyment of human rights across the globe.
With such a stage it is naturally difficult to single out specific events to highlight, so this snapshot is deliberately viewed from the perspective of the IRCT and our main priority areas around torture rehabilitation and prevention. From this perspective, four very different events stood out at the recent session that may have a great positive impact on the global anti-torture work:
The Council addressed the issue of redress and rehabilitation for torture victims in a consensus resolution, negotiated by the Danish government. The resolution stands out with its very strong language on access to rehabilitation services, and, among other things, encourages States to make appropriate rehabilitation services promptly available without discrimination, to support rehabilitation centres and to do this through a victims-oriented approach, thus putting victims’ needs at the centre of the process.
This should be seen in the context of the more detailed and comprehensive General Comment 3, adopted by the UN Committee against Torture in November 2012, which address the broader issue of redress. Taken together, these two documents provide advocates of rehabilitation for torture victims with the political support by the global State community (the resolution) and the technical elaboration of the obligation (the General Comment) to demand the realization of the right to rehabilitation from their respective governments.
In another important consensus resolution, the Council addressed the issue of protection of human rights defenders. This resolution featured significant improvements from previous resolutions. For torture rehabilitation organisations operating in difficult environments, where they fear for their safety as human rights defenders, this resolution may provide some additional arguments in their daily advocacy on this issue.
The March session is also the time where the Special Rapporteur on Torture presents his annual thematic report to the Human Rights Council. This year’s report focused on torture in the health care setting and exposed practices of torture and ill-treatment in various contexts, such as against LGBTI persons, in drug rehabilitation centres, in mental health facilities, in access to reproductive rights and general provision of pain relief treatment.
Like many other sub-themes of torture and ill-treatment, this one also proved to be highly controversial, especially with many States that tend to take a very restrictive view of the torture definition. Furthermore, there seemed to be some confusion about the specific meaning of some sections of the report, which suffered from the restriction of addressing a problem of such magnitude within 20 pages. Hopefully, the Special Rapporteur’s report will manage to open the world’s eyes to the torture and ill-treatment inflicted on these vulnerable groups and kick start a debate on how best to prevent and respond to such violations in a fashion where health professionals are made part of the solution instead of viewed as the problem.
Last but not least, the March session was the venue of the second act of an initiative started by UK-based IRCT member Freedom From Torture (FFT) with the support of the IRCT. Here, FFT produced analytical reports on the torture situation in countries of origin of their main client groups at their UK centres. These reports, which are based on forensic documentation of the clients in accordance with the Istanbul Protocol, are used for the dual purpose of building background information for asylum cases and promoting changes on the ground in the country of origin to the benefit of future generations and as an important element of reparations (guarantee of non-repetition) for their clients.
In the first act was a very well received report on Sri Lanka to the UN Committee Against Torture in 2011, which greatly contributed to a very strong examination of the Sri Lankan government. The second act was a report on the situation in Iran, which made a significant contribution to the work of the UN Special Rapporteur on Iran and which was officially launched during an event at the Human Rights Council in March. It is truly remarkable to see the impact that these reports, based on medical evidence, have in a context at the UN where most reports and assertions are, at best, based on interviews and anecdotal information. It is very easy for States to claim that victims of torture and ill-treatment are lying to an interviewer because they want to hurt the government, but when faced with overwhelming forensic medical evidence produced by independent health professionals in a third country they tend to get more quiet and shy away. I, for one, can’t wait for FFT to launch their third act — a feeling perhaps not shared by governments that torture.
I can safely say that this is the most exciting and promising Council session that I have experienced since the very first session in 2006. And I am looking very much forward to the next Council session in June where the IRCT in collaboration with Penal Reform International will host an event where torture rehabilitation specialists will evaluate and discuss how to best implement the right to rehabilitation and what role UN human rights mechanisms can play to support these efforts.
Growing pains: Austrian centre examines its organisational structure to cope with its growing client base
Editor’s Note: This is the third in a regular series from centres involved in the Peer Support project (more fully described in our earlier blog here). See other previous posts in this series here and here.
In Arabic, “Hemayat” means protection and support. Hemayat is a politically independent and non-profit organisation based in Vienna, Austria. We provide interpreter-mediated psychotherapy, psychological consulting and medical support for survivors of war and torture.
Working in this field means to be confronted not only with the trauma of our clients, but also with their current situation. The insecurity of their asylum process makes it difficult to create a safe space in the therapeutic setting. Sometimes it forces the therapists to fight for the rights of their patients to stay. Asylum seekers are not allowed to work, which forces them to live in poverty. Right wing parties and parts of society view asylum seekers as people who want to exploit the social welfare system. All this puts pressure not only on the patient but also on the therapist.
As an organisation, we are confronted with far more people who seek our help than we can accommodate. It has been like this for years although the organisation has constantly been growing. But growth also means that we need new structures. In 2012 our therapists, psychologists and our psychiatrists treated – oft with the assistance of trained translators – 692 people from 46 different countries.
When we received the invitation to participate in the Peer Support Project, we thought that this could be a space to learn about the experiences of other centres and how they deal with similar problems. We also hoped for practical advice in our restructuring. Once the Peer Support Project started, the project led our attention towards the topic of staff well-being. As mentioned above, our staff works in an extremely challenging field. To relieve some of the stress caused by this type of work, we held supervision on a regular basis. The Peer Support Project also introduced us to a new tool: the intervision model.
As we are taking the first steps in the change of our structure, we also want to implement the intervision model in our centre. In April, a meeting for all staff is scheduled to discuss the intervision model, and we hope that we can soon report that it is working. In addition, we hope that this model will help our staff to cope even more effectively with the stress presented by our work.
By Nora Ramirez Castillo (psychologist, responsible for the first interviews and coordination with therapists and translators Hemayat)
No state support, little funding: how Bulgaria centre manages to treat torture victims in trying times
Editor’s Note: This is the second in a regular series from centres involved in the Peer Support project (more fully described in our previous blog here).
In Bulgaria, the problems of asylum seekers and refugees are not being sufficiently discussed. Yet, the problems of torture victims are even more neglected. The attempts to initiate and sustain a dialogue on this vulnerable group of people with Bulgarian state institutions that deal with asylum seekers and refugees have until now been met with disregard. There is no Bulgarian municipality or state-run institution that provides funding for the support of torture victims.
This is the environment in which Assistance Centre for Torture Survivors (ACET) — the only Bulgarian organisation that offers services to torture victims — is trying to develop a rehabilitation programme. Over the last couple of years, the team of ACET has gone through serious funding-related challenges and difficulties.
The team of ACET consists of five psychologists, a psychiatrist, a social worker who is responsible for a great part of the administrative work, and three translators. All of them work part-time. Over the last years, since the professionals have started working part-time, the rehabilitation programme of ACET serves just more than 100 people per year and the consultations take place at the office of ACET, at the Reception Center of the State Agency for Refugees, and at the Special Home for Temporary Placement of Foreign Nationals in Busmantsi.
When we learnt about the option to take part in Peer Support project, our team saw an opportunity for support as ACET was not able to provide its team with stress prevention activities. Due to financial difficulties, we had stopped receiving clinical supervision and having the weekly meetings of the team, as most of the consultants could not invest more time than stipulated for meetings with the clients of the rehabilitation programme.
This is why we saw in Peer Support project as an opportunity for overcoming the fragmentation of the team and its gradual marginalisation, and a chance to create a new model to deal with stress. In addition, the exchange of experiences with colleagues from various European rehabilitation centres has always been inspiring for us, and this project has given us such an opportunity.
During the needs assessment visit in November 2012, we already experienced the advantages of our participation in the project. With the help of the Peer Support project team, we managed to identify some important steps towards improving the communication within the organisation and the planning of our activities. We have identified steps for improving the management of the organisation, the delegation and distribution of administrative tasks that — in the context of a restricted budged — should be managed by the clinical specialists. As a result of the Peer Support project team and the offered recommendations, we renewed the weekly meetings of the team.
The training in the method of intervision during our meeting in Barcelona has enabled the decrease of tension among the team members and triggered ideas about how to overcome the accumulated problems. With the help of the intervision technique, we managed to constructively overcome the misunderstandings in the team related to the communication strategy with the still quite unresponsive Bulgarian state institutions that deal with asylum seekers and refugees.
We are now looking forward to ANTARES’ visit in order to gain insights about creating a pre-accession training for everybody who will become part of our team in the years to come.
By Kristina Gologanova, social worker and assistant project coordinator, Assistance Centre for Torture Survivors (ACET)
Editor’s Note: A French version of this blog is available for download here (Une version française de ce blog est disponible en téléchargement ici) [DOC]
Ali Aarrass is a Belgian-Moroccan citizen currently held in a Moroccan prison, where he is regularly subjected to various forms of inhuman and degrading treatment.
His ordeal began in 2006 when he was arrested for the first time in Spain for smuggling weapons into Morocco. Released on bail, he was arrested for the second time in April 2008 by Spanish authorities, following an international arrest warrant issued by Morocco.
That time, he was accused of being involved in terrorist activities. This accusation was based on a list of suspects provided by Abdelkader Belliraj after being subject to torture. However, after a two-year investigation, the Spanish court found no evidence proving that Ali was guilty. Yet, Moroccan authorities still insisted on his extradition.
In a preliminary decision of the UN Human Rights Committee issued in late 2010, the Committee requested that Spain not extradite Ali before any further consideration was taken on his case because of the high risk that he would be facing torture in Morocco.
Despite a formal recognition of his innocence by the Spanish justice system and a high risk of being subjected to torture if extradited to Morocco, Spain proceeded with his extradition on 14 December 2010.
The feared violation of Ali’s fundamental rights unfortunately immediately occurred. Ali was secretly detained and interrogated under torture by Moroccan police. Therefore, he was not only a victim of torture, but also a victim of a serious violation of his procedural rights.
The use of forced confessions obtained under torture was the only legal basis for his conviction of being involved in terrorist activities.
Ali reported being subjected to torture during his detention by Moroccan police and referred his case to the UN Committee against Torture. Thereafter, the Moroccan authorities ordered a medical examination, which was conducted by three Moroccan doctors. While their assessment did not confirm the allegations of torture, it strongly questioned the credibility of the original medical. Indeed, the medical report does not seem to rely on any standard derived from international law, such as the Istanbul Protocol, the common name for the Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, an internationally recognised standard for conducting a forensic medical and psychological examination in a torture case.
Facing this situation, Ali’s lawyers — members of a Belgian human rights organisation “Jus Cogens” – called for the IRCT’s support in early 2011, in the context of the project “Forensic Evidence Against Torture” (FEAT).
This liaison between lawyers and an independent medical expert, established by the IRCT, has enabled a thorough and substantial criticism of the three-page Moroccan expertise within a very short time frame. Thus, lawyers have been able to use this “counter-report” before national and international courts.
The forensic expert was selected among the members of the Independent Forensic Expert Group (IFEG) established by the IRCT in 2008. This group is composed of highly-qualified health professionals trained on the medical procedures contained in the Istanbul Protocol.
The forensic expert concluded that the report ordered by the Moroccan Attorney General did not meet the requirements of the Istanbul Protocol. Indeed, he notes that the report only contains very basic information on Ali’s medical state, without bringing any kind of psychological and psychiatric assessment to the analysis.
The expert therefore recommended that a new medical and psychological examination should be conducted in accordance with the Istanbul Protocol and by a doctor experienced in the field of health expertise on victims of torture and inhuman and degrading treatment.
In order to give more weight and credibility to the counter-report issued by the IFEG expert, a second counter-report was carried out by a Moroccan doctor, also member of the IFEG. He confirmed the conclusion of the first international expert stating that the report conducted under the Attorney General’s orders was not in conformity with the Istanbul Protocol.
Yet the submission of forensic expert reports and statements in compliance with the Istanbul Protocol is sometimes simply not enough. It is up to the courts to recognise them as evidence.
The case of Ali Aarrass is an obvious example. Despite the production of two independent expert statements by international independent health professionals, the Moroccan courts effectively ignored allegations of torture at all stages of the trial.
Seeing the bad faith with which Moroccan authorities have been handling the case, Ali’s lawyers are quite pessimistic about the future of the case. Indeed, they are not expecting the justice system to leave the possibility of national authorities recognising the torture suffered during Ali’s first interrogations in Morocco. It is likely that Ali will serve the 12-year sentence, as decided by the appeal court.
Morocco does not seem to respect its international legal obligations, particularly with regard to the Convention against Torture, which the country ratified in 1993. The obligations to investigate and to provide as full means as possible for the rehabilitation of victims are not optional.
Ali Aarrass continues to suffer daily abuse, and inhuman and degrading treatment inside his prison. However, despite the continued threats and actual abuse, he never hesitates to speak out on his situation.
Many organisations, lawyers, family members who support him, and Ali himself, can still hope that the international bodies will eventually recognise the violation of Ali’s fundamental rights and offer him an opportunity for full rehabilitation.
It began perhaps with a 63-page report [PDF]. Jointly produced by The Public Committee Against Torture in Israel (PCATI) and Physicians for Human Rights – Israel, the report found that health professionals in Israel are often involved in ill-treatment and torture.
This was a glaring contradiction of their roles and obligations as health professionals. But contradictions are perhaps the standard in the context of the human rights in Israel and Occupied Palestinian Territories (OPT).
But many human rights defenders and organisations from all sides are trying untangle these contradictions and point a way forward. While many steps need to be taken to ensure an end to torture in the region, one way forward is an end to impunity for these crimes. And for the perpetrators to be held to account, torture must be recorded, documented and reported.
The IRCT is no stranger to training health and legal professionals in using the Istanbul Protocol – the common name for the Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment – in producing forensic medico-legal reports in cases of alleged torture. The document was developed in 1999 with assistance from more than 75 experts and spearheaded by the Human Rights Foundation of Turkey, an IRCT member, and Physicians for Human Rights. The Istanbul Protocol is the set of standards and procedures to identify symptoms of torture for use as medical evidence in legal proceedings. The IRCT and partners worldwide have trained thousands of health and legal professionals on the use of this manual. [download a copy here]
But the project plan and the context are indeed unique, says Dr Joost den Otter, IRCT’s Clinical Director and Head of Health. Joost is heading up IRCT’s partnership with PCATI, who is running the project to train around 17 health professionals, targeted toward those professionals that speak Arabic, working in the OPT or willing to work with interpreters. All of them ready to assess detainees and prisoners from the OPT held within Israeli detention facilities. While a typical training session in the Istanbul Protocol will be just a single day, he says, the current project with PCATI lasts two years and involves four training sessions for the 17 participants, and any other legal or health professionals that are welcome to join. Participants also have to complete two assessments a year using the Istanbul Protocol procedures in cases of alleged torture. They also must write a scientific paper on torture for a peer-reviewed, academic journal in their particular health field.
“Health professionals are on the frontlines,” explains Joost. “These are the people who, rather than contribute to torture, must be doing their best to fight it. And further to that, spread their newly-gained knowledge to their colleagues.”
And the context of training Israeli health professionals on how to properly assess torture allegations is a bit tense. Some feel a contradiction or opposing senses of loyalty to the Israeli state, in which they are a citizen of, and reporting human rights violations.
“There is a perceived connectedness to the perpetrators. The ‘ticking-time bomb scenario’ is definitely in the air,” Joost says, referring to the oft-cited though clearly refuted [PDF] argumentation that torture is necessary in cases of immediate threats against citizens. Although the participants have been very eager and enthusiastic about the training on the Istanbul Protocol, they have reported a hesitancy to share this fact with their friends and family.
PCATI itself, unlike the IRCT, is not a health-based organisation, but a legal one. They have long been trying to gain access to the courts for victims of torture. They have filed approximately 800 complaints alleging torture by the General Security Service, but the courts have not yet taken one up.
Many of the health professionals also feel a sense of frustration after identifying a victim of torture – there are extremely few options for torture victims to access rehabilitation services.
“In this context, most torture happens in Israeli prisons, but torture is also rampant in Palestinian territories, where it may be even more difficult to access appropriate after-care.”
PCATI is not a member of the IRCT as they don’t offer rehabilitation services, but across hour-long checkpoints is the Treatment and Rehabilitation Centre for Victims of Torture in the West Bank, which Joost visited during his most recent training in the area. There are two more IRCT centres in the Palestinian Territories – Gaza Community Mental Health Programme and Jesoor Transcultural Right to Health also in the Gaza Strip.
But borders in the region are an obstacle. Joost, on this most recent trip, spent 90 minutes waiting at a checkpoint coming from Ramallah to Jerusalem. On a bus with a dozen girls making the trip to school, he felt his mere 90 minutes during this one-time trip was almost of no consequence compared to their twice-daily, five-days-weekly journey.
A fraught and tense context, of course, but one in which those on the front lines – the doctors, psychologist and other health professionals – can move forward on ending impunity and bringing the perpetrators of torture to justice.
It’s probably safe to say that all jobs are stressful at one point or another. But, as one of the missions of the IRCT is to improve the quality of holistic rehabilitation for torture victims around the world, stress is decidedly a factor that can get in the way.
Stress, ‘burn-out’, or even trauma, is a great risk when one works in this field. Like many professions, staff can be overworked; but in torture rehabilitation, working everyday with those who may be deeply traumatised by an experience of torture means there is a great risk of trauma transferring to the professional helping them. It’s understandably difficult to distress after a hard day, especially when the needs are great and ever-growing.
Additionally, trauma centres have often come from a grassroots need, rather than traditional healthcare structures, says Prof Dr Christian Pross, a member of the UN Subcommittee for Prevention of Torture, in a 2011 manual on the issue [PDF]. While filled with zeal and purpose, trauma centres sometimes suffered from a lack of proper organisational structure, causing additional stress, friction and confusion.
Thus, enter the Peer Support Project. Based in Europe, the project aims to train and provide other forms of support to torture rehabilitation centres. To provide the best possible holistic rehabilitation for the victims of torture, it is simply necessary to ensure that those who carry out this work on the ground – the medical doctors, psychotherapists, administrators, secretaries, among others – that they have the stress management tools and needed organisational structures around them to get the job done best.
At the moment, the Peer Support Project is halfway through its course. The project kicked off in July 2012. As a first step, the needs of each of the participating centers were assessed. Representatives from the three partners that designed the project – the IRCT, ANTARES Foundation of the Netherlands, and bzfo of Germany – visited each centre and spoke to staff on the ground over the course of three days. What, simply, were the difficulties that the organisation and their staff were experiencing? As a result of the assessments, the partners of the project directly engaged with local staff (both management and therapists) in helping them to create supportive organisational structures, introducing new tools such as stress management techniques and intervision (this concept refers to have, within a team, inter-collegial consultation without an external supervisor) and assisting them in the ongoing process of implementing these tools.
“When we applied for the PEER SUPPORT project, we thought it a wonderful opportunity to address something that is at the hub of our organisation but which often goes unspoken.
When I received notification that we had been selected for the project, it dawned on me that perhaps this was not such a great idea, and then when I learned that it was going to potentially add a lot more work to an already over-loaded agenda I wasn’t sure if it had been a good idea at all.
The first day of the assessment visit by Winnifred Simon (ANTARES), Nora Balke (bzfo) and Helene de Rengervé (IRCT) left us feeling justified in the decision that we took. At the end of the three days I was left with hope that this project will serve us very well to not only become a healthier work environment but a healthier organisation. We are looking forward to the training and to furthering the work of this worthwhile initiative in the coming year”
- Greg Straton, SPIRASI, Ireland
SPIRASI, based in Ireland, is one of the six participating centres in the project. The others are Assistance Center for Torture Survivors (ACET) – Bulgaria; Freedom From Torture (FFT) – United Kingdom; HEMAYAT – Austria; Medical Rehabilitation Center of Torture Craiova Romania (MRCT) – Romania; and Parcours d’exil – France.
The assessment was just the first step. In December 2012, each centre sent staff to a full week of training in Barcelona. “Working together in Barcelona was very inspiring for us,” said Kristina Golona of ACET. “The exchange of the management practices helped us to consider how to improve the situation of ACET’s staff, even without financial resources”. Furthermore, a system of monitoring on quality management and intervision through video-conferencing is already on-going and will last throughout the project.
“We were looking forward to exchanging experiences and opinions with other centres,” said Cecelia Heis of HEMAYAT. “It was interesting to learn how they organise themselves, under which conditions they work, and which difficulties they are confronted with.”
And many other activities are in the works: a flexible network of organisational counsellors and supervisors, familiar with the special needs of centres working with traumatised victims of torture and refugees; further training for therapists on ‘intervision facilitation’, who shall then in turn train the staff from their own centres; and a final conference in November 2013 to conclude the project.
The Peer Support project intends to improve the well-being of the staff, just as much as the sustainability of the organisations involved. From now on, staff members of one of the participating centers will regularly share their experiences through this process. The aim of these blog posts is to inform others working in trauma and torture rehabilitation on the process and outcomes of the project and to make them aware of the importance of stress and quality management policies. The ultimate goal is, as always, improved care and treatment for the victims of torture. So, stay tuned for these contributions.
In the meantime, interested centers or individuals are very welcome to contact the PEER SUPPORT project coordinators for more information: Helene de Rengervé (email@example.com) or Marnix de Witte (firstname.lastname@example.org) IRCT, tel: +32 2 230 15 04