Posts Tagged ptsd
In the heart of Sweden’s third biggest city, Malmø, lies one of the Swedish Red Cross Treatment Center for persons affected by war and torture. Every day the centre provides specialised treatment to torture survivors from all corners of the world. Since the centre first opened its doors in the late 1980s, it has helped nearly 5,000 traumatised men and women who have escaped violence and persecution, war and armed conflict.
On some occasions, the trauma from torture will not rear its ugly head until decades after the incident, explains Anette Carnemalm, Head of the centre in Malmø, which is a member of the IRCT. She has seen this happening with many of her clients, particularly women victims of torture, who only start to suffer from trauma and depression years later when their children are grown up and their time is no longer filled with caring for them on a daily basis. This shows in the group of clients that the centre treats.
“Of course we have many clients from the Middle East, but there are still many clients from the Balkans, especially women who survived the war,” says Anette. “What happens is that when a family arrives, the woman is consumed with looking after the family. When the children move from home the woman will often experience an existential crisis, which can lead to the trauma and depression that was left dormant for so many years.”
Knowing this, it is perhaps not surprising that Anette predicts that we will see a similar thing with Syrian women 20 years from now.
While the consequences of torture haven’t changed, the refugees coming to Sweden have. Before the war in the Former Yugoslavia, there were the dictatorships in Latin America during the 1970s, which saw an influx of refugees from this part of the world. Today, many of the refugees coming to Sweden are from Syria, Iraq and Lebanon, as well as Somalia and Eritrea.
“It’s been a year since Sweden saw a great raise of influx in refugees arriving in the country, but we only started receiving clients much later, which is a natural consequence of refugees trying to integrate and settle. Not until they’re beyond the acute crisis will they seek help for trauma symptoms,” says Anette and continues: “The real influx in clients will be seen in a year or two from now.”
Unlike other Red Cross centres in Sweden that take many asylum seekers waiting for their case to be processed, the centre in Malmø treats a higher number of people with permanent residency. In fact, Malmø is Sweden’s most multicultural city and in the inner city there are residential areas, which are home to a large number of families with an immigrant background, as well as students and artists.
Despite this, Sweden at present has the lowest denominating standard in the EU when it comes to asylum seeking law, after just recently having introduced increasingly strict legislation on immigration. For many traumatised asylum seekers, this means they face a great deal of uncertainty, which often hinders their treatment.
“It is important to create a safe environment for a client in order for them to seek treatment, but it’s very hard in the present situation to convey that this is not a threatening environment, when it does seem threatening for a refugee who is here alone and doesn’t know if he or she will be allowed to stay,” says Anette, as she points out that the situation for centres like hers is also uncertain. Even though her centre has so far been protected from any funding cuts, there are no guarantees.
“The political climate has changed and we now see political parties objecting to our funding so we don’t know where we’re heading in this sense.” So far, the centre has managed to expand to meet a growing demand for its services and today it has 22 staff, 19 full-time and three part-time. Their work has made a difference to not only many of their clients, but also to the torture rehabilitation movement.
“We see our efforts make a great difference in our work with the Istanbul Protocol, documenting torture, but also when a patient tells us that they are feeling better. It is immensely rewarding working, or even just sharing a coffee, with a person who has survived such terrible circumstances. See them fighting to get their life back, improving their relationship with their family and regain some of the trust that has been lost.”
“It is clear that Anette treasures her work despite the challenges that her and her colleagues face: “From here I don’t know where to go. I’m with the Red Cross and I am doing this job, and I don’t know where I would want to go that could be any better. It’s a very rewarding job, but obviously also very strenuous. As the Head of the centre it is very important to ensure that my staff don’t get too overwhelmed or stressed and stay healthy.”
Work challenges and strict immigration policies aside, Anette does hope that her centre, as well as the global rehabilitation movement will become better at sharing knowledge and influencing the current political climate.
“I hope that our knowledge will influence the political debates to a larger extent and that we can convey our knowledge about torture and rehabilitation to the rest of the world so we can change people’s opinions and understanding. There is this political movement, which is global, but there is also a growing knowledge of trauma, which is a good thing. We do a lot of lectures and people are always taken aback when they hear about our work. They didn’t know… so we need to be better at sharing knowledge and raising awareness.
“I hope that we continue to build our scientific knowledge about trauma and how best to help. As an example, there is a lot of research on how to treat PTSD among war veterans, but not much research on how to treat PTSD among people in exile – people who are supposed to integrate in a different country. What is it like to suffer from trauma in a different country, without your family and your social network, not knowing the culture nor the language?”
It is clear that the rehabilitation sector still has work to do in terms of developing and sharing its knowledge about trauma among refugees and asylum seekers and what the best treatment methods are. It is also clear that centres like the one in Malmø have a key role to play in doing so.
Anette Carnemalm was among the presenters at the IRCT 10th International Scientific Symposium, which took place from 4-7 December in Mexico City. The Symposium brought together more than 350 participants from across professions, sectors and countries.
In the autumn of 1991 and six months before the three-year long war broke out in the former Yugoslavia, 16-year-old E.B. was living in a city in Croatia, with her Serbian father and Croatian mother. During this time, Serbs in the area were routinely persecuted by the Croatian police, soldiers and paramilitary because of their ethnicity. E.B.’s family were among those singled out by the authorities.
On several occasions, E.B’s family were targeted by the police and military. Armed officers entered their home and made death threats in front of E.B. and her sister. “They told me that they were looking for arms. They threatened me and my children. They did not show me the search warrant. At that time small crosses were put on apartments in which Serbs lived and we were marked and exposed,” recalls E.B.’s mother.
In October 1991, the police came to the house and took E.B.’s father away. Thirteen days later his body was recovered. The pathologist’s report found that he had been tortured and thrown into a river while he was still alive. E.B. was involved in the search and identification of her father. As a result, she lived in a constant state of fear. “I told my mother to stop asking the authorities about my father, they could kill us too,” she says.
Following her father’s death, the police continued to threaten the family, going as far as to subject her mother to interrogation. Growing up in an environment of constant intimidation, combined with the loss of her father and the circumstances under which he died, E.B. developed symptoms of post-traumatic stress disorder. She received treatment from a child psychiatrist in Zagreb and finished her secondary school education, but dropped out of university because she was unable to cope with the events of her past.
It was 15 years later in 2006, when E.B. and her mother, along with E.B.’s then eight-year-old son, came into contact with the Rehabilitation Center for Stress and Trauma (RCT) in Zagreb.
RCT was contacting people who could potentially serve as witnesses in war criminal trials. After meeting E.B., the care providers quickly realised that she was struggling to cope, dealing with symptoms including restlessness, low levels of confidence and an inability to make decisions. They also diagnosed E.B.’s mother with severe post traumatic stress disorder symptoms.
To ensure E.B. and her family received the support they needed, RCT Zagreb took a group approach. A social worker and psychologist visited the family twice a month and occasionally they were supported financially. The RCT also organised a support network for E.B.’s son and for her mother, and the family began to cope better with daily life.
The centre continues to support the family through a follow-up treatment programme for torture victims that agree to be witnesses in war crime trials. RCT Zagreb also supported the family in seeking compensation for the death of E.B.’s father. Unfortunately, they lost the case and were ordered to pay the trial costs. It is a sad reality that these verdicts are often given to discourage victims to seek justice for crimes committed against them.
The war in the former Yugoslavia turned hundreds of thousands of people into victims of displacement, disappearances, torture and rape. Yet, there is a large number of families like E.B.’s that have not received rehabilitation and compensation for their suffering.
RCT Zagreb works with the populations at risk, emphasising the effects of social reconstruction in post-conflict communities and reducing social exclusion, so that people like E.B. can rebuild the pieces of their lives and begin again.
“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.
While July was an incredibly busy month for the anti-torture movement, one story stood out beyond the rest: the trauma experienced in Gaza amidst the current context of war.
Over 1,200 people are dead in the war in Gaza, the majority of whom are civilians. Families are being torn apart by the war, cities are being destroyed and support mechanisms which typically assist rehabilitation and rebuilding are being destroyed at a ferocious rate.
The IRCT has three centres in the Palestine-Gaza territory – all have felt the effects of this war first hand.
In order to show the strain the people on the ground are under, the IRCT published a story summarising the strain the centres face and the growing problem of trauma which has spread throughout Gaza – trauma which would normally be treated but cannot be effectively in this instance due to the relentless destruction present every day.
The IRCT will continue to monitor the situation in Gaza closely and will encourage the international community to remember the importance of rehabilitation and support mechanisms which assist society in regaining strength.
The situation in Ukraine has been unstable ever since anti-government protests began last year.
Yet now, with the continued battles in eastern Ukraine between pro-Russian separatists and Ukrainian forces, torture reports and incidences have been extremely prevalent on the radar.
In order to gather some perspective on how often these incidences of torture are reported, the IRCT spoke to its member in the region about the realities of torture in eastern Ukraine and what the international community could be doing to stop this crime.
Still in Europe, our most popular blog this month focused on the possible fallout human rights organisations in Europe could expect with the recent changes in the European Parliament.
To give a full and fair perspective on the possible changes, we spoke with IRCT Advocacy Advisor Elena Zacharenko, based in the IRCT’s European Affairs Office, who outlined the main changes in the european political landscape and speculated how these alterations may impact on the priorities of human rights organisations.
It seems like a long time ago already when hundreds of human rights groups united around the world to campaign for the end of torture.
However it was only last month when thousands of people across the globe voiced their support and solidarity for victims of torture and condemned the practice of torture perpetrated in a variety of contexts.
The main theme for the 26 June campaign was #NoMoreImpunity, a theme replicated across all the IRCT materials for the day – many of which are viewable in the photo blog summarising the highlights of the day.
Since April we have been publicising ten hard-hitting, insightful, harrowing stories from female survivors of torture and sexual violence of the Rwandan Genocide in 1994.
Twenty years after the genocide these brave women, and many more throughout Rwandan, are still seeking therapy and justice. But it is thanks to the provision of therapy that many of these women are overcoming their past.
We focused on ten stories over the exact 100 day period of the genocide, each with a different theme and experience. All of the stories are featured in the IRCT’s latest publication of Torture Journal, which you can read in full here.
July signalled a positive step towards the global fight against impunity with Sweden adopting a new law which grants them international jurisdiction to try perpetrators of torture, no matter how historic the cases of torture may be.
The law, which is expected to be expanded upon once more in January 2015, was welcomed by the IRCT as a positive step in assuring victims of torture receive justice and redress for their torture.
The IRCT also wishes to congratulate the Swedish Red Cross who were instrumental in assuring this law was possible.
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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.
Many questions come to mind when thinking about torture. What methods are used? Where does it happen? Who does it? Who are the victims? We have answered many of those questions in this blog.
But how do victims overcome the trauma from torture? Or the physical sequelae left by brutal methods of torture? There are probably as many questions and doubts surrounding rehabilitation as there are about torture itself. Here are some of the answers.
1. What is rehabilitation?
Rehabilitation is simply ridding of the effects of torture – it is to empower the torture victim to resume as full a life as possible. Torture rehabilitation can take a variety of forms. In approaching it through a holistic approach, rehabilitation can include medical treatment for physical or psychological ailments resulting from torture; psychosocial counselling or trauma therapy; legal aid to pursue justice for the crimes; or programmes and activities to encourage economic viability, among others.
2. Why do torture victims need special treatment?
In many contexts, torture survivors seeking rehabilitation can only receive regular care and many physicians will not realise they are in the presence of a torture survivor. The risks associated with that are many and much has been written about that particular issue. In brief, not all therapeutic approaches have been described as useful in the treatment of victims of torture. Also, therapeutic procedures can easily recreate the torture experience, putting the torture survivors at risk of re-traumatisation.
The questioning, the testing instruments used, the physical space, the power relationship between the clinician and patient, etc., all have the potential to recreate the torture conditions, thus undermining the positive benefits of therapy. In some of situations, the treatment administered by non-specialized clinicians can even lead to harmful effects to the survivor.
3. What is the right to rehabilitation and is it an enshrined right by law?
In the first instance, the UN Convention Against Torture and other Cruel or Inhuman, Degrading Treatment or Punishment outlines the rights of an individual, outlaws torture, and promotes respect for the human rights of an individual.
Article 14 defines precisely that rehabilitation of a victim is a state responsibility which should be enforced in every complaint of torture. It reads:
“Each State Party shall ensure in its legal system that the victim of an act of torture obtains redress and has an enforceable right to fair and adequate compensation including the means for as full rehabilitation as possible.”
However, while there is a right to rehabilitation defined on paper by the UN, the right is not necessarily granted – even among the 154 state signatories. Also some countries have not ratified the convention into their national legal systems, and other countries have not signed the convention altogether.
4. What are some of the main forms of rehabilitation?
Rehabilitation programmes vary depending on the context in which the support is implemented, the resources available to the organisation issuing the programmes, and the nature of rehabilitation needed by the torture survivor. However some main forms of psychological and physiological support include: counselling; therapy, individually or group; psychotherapy; social reintegration programmes; medical assistance; artistic classes; exercise programmes; yoga; and much more.
5. Do the rehabilitation programmes work?
Yes. Targeted, tailored programmes of rehabilitation do not only allow the torture survivor to overcome their ordeal, but it can also allow their family, friends, or community to rebuild.
You only have to look at some of the stories from survivors of torture to realise that rehabilitation is fundamental is ensuring a victim of torture can live their life as fully as possible. You can read some stories of survivors by clicking this link.
6. Is rehabilitation ensured across the globe?
No. Even among the 154 state parties (across 80 different countries) to the UN Convention Against Torture and other Cruel or Inhuman, Degrading Treatment or Punishment, rehabilitation is not assured – at least not by the state. Across the world, some statistics point to torture being practiced in around 90% of the countries. Many of these do not provide adequate services for redress and rehabilitation through the state, so the responsibility falls onto anti-torture organisations – such as the IRCT members – who must move survivors past their experiences of torture, often with limited resources and under the watch of authoritarian regimes.
7. What is the IRCT, and what is its role in torture rehabilitation?
The IRCT is the largest membership-based civil society organisation to work in the field of torture rehabilitation and prevention. It is their mission to ensure there is access to rehabilitation services and justice for victims, and to contribute to torture prevention. Currently, the IRCT consists of 144 members across 74 countries.
8. How many people have been treated by the IRCT?
With members spread across more than 70 countries and the risks associated with the safety of torture survivors, accurate data collection is a significant challenge for the IRCT. However, figures gathered in the past suggested that more than 100,000 torture victims have been helped by IRCT member organisations across the globe on a single year.
9. Who can rehabilitation benefit?
The physical and mental after-effects of torture are far reaching but so are the benefits of rehabilitation. The victims but also their families, friends and sometimes their entire communities. There may be different approaches necessary in the rehabilitation programmes, and there may be different obstacles to rehabilitation, but the benefits can be felt by any victim of torture. To be as inclusive as possible, members of the IRCT network therefore tailor their programmes to best suit the contexts in which they operate.
10. Through rehabilitation, prevention and justice, can there be a world without torture?
Yes. The world can be rid of torture just like it was rid of slavery. Undoubtedly, the journey is long and full of obstacles, but with the right mix of rehabilitation, justice and prevention, the vision of a world without torture can be realised.
It’s called Operation Sovereign Borders. “It will steadily be put into effect and I am confident we can stop the boats,” says Major General Angus Campbell, who will be running the new operation. Recently promoted to a three-star general, the military leader had previously served in Australia’s forces in the Middle East and East Timor.
It sounds like a dangerous military operation. They’re trying to “stop the boats,” like an impending invasion. But it’s not. Full of military language and coded with imagery of the shores of Australia being overwhelmed, Operation Sovereign Borders is the new Coalition government’s plan to divert boats of migrants and asylum seekers from ever stepping foot on Australian soil.
“If the government is successful in doing this, then conceivably there will eventually be no asylum seekers in the Australian mainland, and the mainland detention facilities will close, and we won’t provide counselling to asylum seekers,” says Bowen Summerton, Asylum Seeker Services Coordinator at Association for Services to Torture and Trauma Survivors (ASeTTS). ASeTTS, an IRCT member in Perth, Western Australia, currently has access to provide counselling and other mental health services for asylum seekers in detention in the region. However, with a different government and policy, this may change – an extremely worrying situation for torture survivors who seek asylum in Australia.
Asylum seekers and refugees are clearly a fraught issue in Australia. So much so that many have claimed the recent election of opposition leader Tony Abbott, whose campaign slogans echoed the “stop the boats” rhetoric, was as much about tax and political infighting as it was a referendum on the current immigration policies. More than 17,000 people arrived by boat in 2012, the majority from Iran, Afghanistan, India and Sri Lanka. This was up from around 4,500 the previous year.
Currently, all people who are unauthorized to be in Australia – whether arriving by plane, overstaying visas or coming by boat – are detained. Previously, there were some exceptions, namely the health of asylum seekers.
“Long term detention is significantly correlated with poor mental health outcomes regardless of a background history of torture and trauma,” says Bowen. ASeTTS has access to the three immigration detention centres in the Western Cape, of the total of eight in the Australian mainland, and alternative and community detention in the region. For those victims of torture in detention, they can provide counselling and, depending on needs, access to a psychiatrist.
Research strongly suggests that detention of asylum seekers greatly worsens health, particularly mental health, with many reporting systems of depression, anxiety and post-traumatic stress disorder. These are common psychological effects of torture, which are also greatly exacerbated in detention settings.
“Assisting recovery from torture and trauma is generally more difficult in detention, regardless of the length of time, because of the environment, which can counteract attempts to restore safety, meaning and dignity,” he says.
However, despite the risks of trauma and the health needs of asylum seekers, the new government has promised to end the exceptions. All unauthorized immigrants will be detained, many of them in the off-shore detention and processing facilities in Christmas Island, a territory of Australia, Nauru, an island nation in the Indian Ocean, or Papua New Guinea.
It’s far too politically easy to say simply “stop the boats,” backed by military might. Rather than quick slogans and three-star generals, Australia needs to assume the more difficult responsibility to international human rights obligations. As the Australian Human Rights Commission describes, “The Australian Government has obligations under various international treaties to ensure that their human rights are respected and protected… These rights include the right not to be arbitrarily detained.”
Asylum seekers need to be screened for traumas, such as previous cases of torture, to ensure that they are both, not detained, but importantly, given access to appropriate care and treatment as soon as possible.
By Tessa, Communications Officer at IRCT
Meeting new people outside IRCT or outside the circles of human rights work, we’ve found people have a number of questions about what the IRCT does and, more simply, about the issue of torture around the world. “Is there still torture?” they ask, often astounded that there is. For many, the term ‘torture’ invokes ideas of medieval torture chambers and the rack or the Iron Maiden.
Ten of the most common questions we get are the following:
Sadly, yes, torture continues as a phenomenon today. In fact, torture takes place in the majority of countries in the world – as many as 90% of countries, estimates former UN Special Rapporteur on Torture Manfred Nowak. Furthermore, Nowak estimates that in as many as half of those countries, torture is a rampant and systematic problem.
2. Where does torture occur?
Torture most often takes place in places of detention – whether in the initial police lock-up, interrogation rooms, prison systems or other places where people are deprived of their liberty. This allows torture to remain a “secret” or “hidden” problem in the world [PDF]; places of detention are often well outside the realm of the public view and therefore escape public condemnation.
The United Nations defines torture in the UN Convention Against Torture, and other Cruel, Inhuman or Degrading Treatment and Punishment as:
“… ‘torture’ means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.”
4. How are people tortured today?
While such techniques from the Middle Ages are no longer used on a large scale, the techniques of torture are still just as cruel, inhuman and painful to the victim. Furthermore, modern torture techniques are often designed to leave as few marks as possible to avoid possible future prosecution for the crimes. The Istanbul Protocol, the international guidelines for documenting torture, discusses torture methods under the following categories: beatings and other blunt traumas, beating of the feet (falanga), suspension, other positional tortures (such as being detained in a small cage or box, being forced to stand while arms are stretched high), electrical shocks, tooth torture, asphyxiation, rape and sexual torture. Other practices, such as hooding, humiliation, being stripped naked, threats to oneself or family, mock executions, simulated drowning (waterboarding) and sleep deprivation are also common torture methods that leave no external marks behind.
5. Why do people torture?
“The main aim of torture is to destroy the self-esteem of the person. The torturer tries to destroy the personal integrity by methods that cause maximum physical and mental pain and ensure gravest humiliation.”
While this is the main aim of torture, as described in Atlas of Torture, the goal of such pain and humiliation may vary. Police may torture a person to extract a confession for a crime or implicate others in a crime, as is a common practice in many countries, such as the Philippines; people may be tortured for information, as was the excuse used by the U.S. for the CIA torture programme in the so-called ‘war against terror’; armed forces may use rape and sexual torture to destroy the social fabric of communities. Or, state officials may employ torture as punishment for acts that person or a third person is believed to have committed.
6. Who commits torture?
For a case to be described as torture, the crime must be committed by a public official or a person acting in an official capacity, such as a state authority like police officers, soldiers, armed militia, among others. This also may include teachers, healthcare workers, paramilitary groups or prison guards.
The victims of torture can be anyone – any person simply in the wrong place at the wrong time can become a victim of torture. However, there is no doubt that some groups are at particular risk of torture, for example, the poor. As the IRCT stated in The London Declaration on Poverty and Torture, poverty is one of the major factors that keep people particularly vulnerable to torture and other ill-treatment. “Most of the victims and survivors of torture belong to the poorest and most disadvantaged sectors of society,” Nowak said in the 2011 Global Reading for 26 June.
This is, generally speaking, because poverty makes people vulnerable to abuses and leaves them without the ways and means of defending their rights. Other factors can marginalise people, leaving them vulnerable to torture; this includes groups such as women, children, the elderly, religious, ethnic or sexual minorities and political opposition groups, among others.
8. What are the effects of torture?
There has been a growing body of scientific research on the physical, emotional, and mental effects of torture. The physical effects of torture depend greatly on the method of torture used. Certain types of torture are related to specific symptoms and signs. For example, for survivors of falanga, a type of torture where the soles of the feat are beaten, effects may include smashed and broken heels, later causing slow and painful walking for only limited distances.
The psychological consequences are frequently persistent and invalidating. The prevailing manifestations include anxiety, depression, irritability, emotional instability, cognitive memory and attention problems, personality changes, behavioural disturbances, neurovegetative symptoms such as lack of energy, insomnia, nightmares, sexual dysfunction, and “survivor’s guilt”.
In other words, torture represents an extreme life stressor and exposure to torture increases the risk of developing psychiatric symptoms and subsequent dysfunction, social problems, marginalisation and poverty. We know that not everyone exposed develops psychiatric manifestations but that a number of genetic factors, including vulnerability to stress, proneness to anxiety, developmental deficits, previous psychiatric history, incapacitating physical consequences, quality of social environment and individual coping efforts, all play important roles. Furthermore, the more prolonged, repeated, and unpredictable the experience of torture is, the more traumatic it is and more serious the psychiatric consequences are likely to be.
9. What is rehabilitation?
We believe that all torture survivors and their families have a right to rehabilitation. Rehabilitation is simply ameliorating the effects of torture – it is to empower the torture victim to resume as full a life as possible.
Torture rehabilitation can take a variety of forms. In approaching it through a holistic approach, rehabilitation can include medical treatment for physical ailments resulting from torture; psychosocial counselling or trauma therapy; legal aid to pursue justice for the crimes; or programmes and activities to encourage economic viability, among others.
10. What can I do to help?
There are many ways in which supporters can help. The first and most direct help is of course donations to the IRCT for our work.
Another way in which supporters can help is to simply share the stories of torture survivors or human rights defenders. International support from the World Without Torture community can create unending pressure on authorities to live up to their human rights obligations, such as stopping torture, ending harassment of human rights defenders, or bringing perpetrators to justice, among others. Your tweets, Facebook updates, letters to state leaders: these are all ways in which we can together create unceasing pressure on authorities to stop torture.