Health professionals on the front line: learning to identify and report torture in Israel

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.

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