As the number of conflicts around the world rises, so do the numbers of people seeking asylum. One particular region aimed for by many asylum seekers is Europe, with Germany accepting the most asylum seekers in 2013.
Yet simply accepting asylum seekers and refugees is not enough – their health condition must be documented, as well as any traumatic experiences, so these refugees are not abandoned in their new home. In this context the right skills to document torture become paramount, and two IRCT members in Germany are offering training courses to improve the documentation of torture in Germany.
According to a survey of the United Nations, Germany was, with 109,600 new asylum applications in 2013, “the largest single recipient of new asylum claims among the group of industrialized countries”.
In 2013, the Federal Bureau for Migration and Refugees presided over 80,978 asylum cases. Only 1.1 % of the applicants were granted full asylum; 12.3 % received refugee status; and 11.4 % received other residence permits. A total of 38.5 % were denied asylum and for another 36.7 % “formal decisions” were made.
Figures show that the majority of these asylum seekers come from regions where there is ongoing war, crisis, or political, religious or ethnical persecution. Such countries include Syria, the Russian Federation (mainly Chechnya), Afghanistan, Iran, Pakistan, Iraq, Somalia, and Eritrea. Also many Roma from Serbia and others from Bosnia and Herzegovina seek asylum.
Between thirty and forty percent of these refugees and asylum seekers in Germany are severely traumatized. Many have, either in their home countries or on their journey to Europe, suffered torture and other severe human rights violations. Survivors of torture often show serious psychological and psychosomatic symptoms and also sometimes physical consequences of torture, and are therefore in urgent need of help.
However, according to a report of the International Rehabilitation Council for Torture Victims (IRCT), 72% of the centres for the treatment and rehabilitation of traumatized refugees and torture victims, questioned in Europe and beyond, state that there is no special “procedure in place to identify victims of torture within the national asylum procedure”.
Helping maintain standards
Recognised standards for the examination and documentation of alleged torture cases – such as the Istanbul Protocol and an analogue model and curriculum for Germany “Standards for the examination of psychologically traumatized persons (available in German only)” – have existed since 2001. Since then trainings under both standards have been realised in Germany by the Chamber of Doctors and Psychologists, together with IRCT members Center for Treatment of Torture Victims (bzfo) in Berlin and the Medical Care Service for Refugees Bochum (MFH).
There is a lack of trained experts on the forensic documentation of torture and when, though rarely, courts call for expert opinions on asylum processes, any health professional can be called. However, not every health professional specialises in the effects of torture, thereby rendering a great number of reports and medical certificates insufficient in these matters.
It is crucial for the therapeutic success as well as for the asylum procedure to identify victims of torture and other severe human rights violations at an early stage. Otherwise, time will already have passed before torture survivors go through any examinations, leading to the consequence that their trauma may become chronic.
Psychological consequences of torture
Not every torture survivor shows psychological or physical disorders, nevertheless the absence of physical or psychological consequences of torture does in no way proof that torture has not taken place. Those victims which have undergone a psychiatric-psychological examination though predominantly show severe symptoms, the most common being post-traumatic stress disorder (PTSD).
Besides an adequate therapeutic treatment, it is further necessary that the refugees concerned benefit from the full range of possibilities offered by rehabilitation and the acknowledgement, socially as well as legally, of the injustice that has been done to them. The denial of acknowledgment and justice can have severe negative effects on the therapeutic process of victims of torture. To tackle this, in 2011 the Medical Care Service for Refugees Bochum (MFH) has established a work area called “Justice heals” which deals with the predominant problem of impunity of perpetrators all over the world.
In order to close the gap between needed knowledge and lack of training possibilities in Germany concerning the preparation of medico-legal reports, the Professorship for Medical Ethics of the Friedrich-Alexander University in Erlangen-Nuremberg (FAU) and the Center for Treatment of Torture Victims (bzfo) in Berlin – together with the Medical Care Service for Refugees Bochum (MFH) – are offering interdisciplinary seminars on the examination and documentation of torture.
These seminars are addressed in particular to physicians of all fields as well as psychologists, jurists and other professionals which potentially having to deal with survivors of torture. The seminars provide insight into the main features of legal, psychological and somatic aspects of the documentation of torture, complemented by workshops for the respective topics. The International Rehabilitation Council for Torture Victims (IRCT) has taken over patronage for the seminars.
Berlin: 28. – 29. June 2014
Haus der Demokratie und Menschenrechte
Greifswalder Straße 4
Düsseldorf: 5. – 6. July 2014
Ärztekammer Nordrhein | Tersteegenstraße 9
Munich: 26. – 27. July 2014
EineWeltHaus | Schwanthalerstr. 80