Posts Tagged refugees

Triumphing over adversity to deliver rehabilitation to those in need in Iraq

“When we succeeded, funders asked us to open other centres, as they saw the impact of what we were doing. It was the first time people were speaking about torture. The word torture had been forbidden, the previous government forbid people to talk about it.”

When Salah Ahmad founded a rehabilitation centre in the city of Kirkuk in the Kurdistan Region in northern Iraq in 2005, it was the beginning of a journey that would lead to the establishment of a network of nine branches throughout Kurdistan-Iraq.

Since 2005, these centres have provided services to more than 20,000 men, women and children. It is a remarkable success, but has not been an easy journey for the organisation, which is now called the Jiyan Foundation for Human Rights.

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Salah Ahmad With Kids in Chamchamal (Courtesy of Jiyan Foundation for Human Rights via Flickr creative commons licence)

Salah recalls that when the Kirkuk centre was founded in 2005, after the fall of Saddam Hussein’s regime, people were still living in fear. “I had a patient who came to me and told me he needed my help, but said I had to promise not to write down anything. I asked why and he said, ‘Because I am afraid if they come back they will know everything about me.’”

Yet the Kirkuk centre went from strength to strength and funders like the German Government, EU and the UN recognised the need for more centres like it. All the centres have the same system in place and provide psychological, medical, legal and social support. Some have specific programmes to respond to the needs of torture victims in the area. One of these programmes is an inpatient clinic for women victims of the so-called Islamic State (ISIS).

The programme came about through the work the Jiyan Foundation is doing in the Khanke refugee camp near Dohuk in Northern Iraq, which is home to over 18,000 internally displaced persons (IDPs). Many of the women living in the camp have been liberated from ISIS and have had horrific experiences.

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(Courtesy of Jiyan Foundation for Human Rights via Flickr creative commons licence)

“They are in a very bad state. They lost everything, their life, their city, their health. These women have been sold, raped, every awful thing you can imagine. ISIS destroyed them as human beings,” Salah says. He realised they needed specialist help, having seen how many of the women were committing suicide, and that one two-hour session each week was not enough to help them.

The Jiyan Foundation started a centre 300 km away from the camp where the women could go for different periods of time and could bring their children with them. The recommended length of a visit is eight weeks and Salah says the intensive therapy has made a big difference in their lives.

“It is important to get them out of the camp, because there they only speak about their problems. We take them in small groups, because the cases are so complicated and difficult. Then they can get follow up treatment when they go back to the camp. This clinic is now more than a year old and we have helped more than 100 women this way.”

Yet just finding the money for transport to get the women to and from the camp is an ongoing challenge for the Jiyan Foundation team. The lack of infrastructure in general makes getting things done, and done quickly, difficult. Salah says, “You have to start from zero all the time. This makes the costs higher. The government cannot help because we have such a big financial problem. We have a large number of IDPs and refugees. We don’t have the capacity, it is too much for us.

“When we started the Kirkuk Centre there was no infrastructure. To build up the foundation in a country like Iraq is not easy. Sometimes you can need up to two months to get to speak with the authorities to get an agreement to get something done.”

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Delivering aid to IDPs who escaped the Sinjar region. (Courtesy of Jiyan Foundation for Human Rights via Flickr creative commons licence)

Despite all of this Salah says the Jiyan Foundation is going in the right direction, “In these 11 years we have succeeded in doing a good job in many ways and we support thousands of people.”

The Foundation is named after Jiyan, the Kurdish word for life and it is clear that the work that Salah and the 170 staff members working in the centres are doing, is bringing life and healing to Kurdistan.

 

Jiyan Foundation is a member of the International Rehabilitation Council for Torture Victims. For more information visit their website www.jiyan-foundation.org or follow them on Facebook.

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Transit and trauma: Supporting refugees in Serbia

Late last year – as hundreds of thousands of refugees were passing through Serbia on their way to Western Europe – we spoke to Bojana Trivuncic, a psychologist and project manager at local rehabilitation centre International Aid Network (IAN), about helping refugees arriving in the country. At the time of the interview, IAN was the only organisation providing psychological support to refugees transiting the country. Now, 10 months on, we have caught up with Bojana to find out if the situation has changed and if IAN is still reaching out to refugees through its mobile team unit.

WWT: When we last spoke, your centre was providing medical first aid and psychological support to refugees in parks and shelters. Are you still doing this?

BT: Yes, we still provide these services in the parks near the bus station in Belgrade. Unfortunately, we have fewer resources now than last year. Since April this year we’ve only received emergency funds from the UNVFVT [United Nations Voluntary Fund for Victims of Torture], allowing us to only work once a week.

WTT: We are so sorry to hear that. Are you still using the mobile unit despite lack of funding?

BT: Yes, the weekly visits are through our mobile team. The team consists of a medical doctor, a nurse and a psychologist. The nurse also acts as an interpreter because she speaks fluent Arabic. Sometimes we also have a Dari interpreter, but we don’t have enough funds to finance two interpreters for every visit.

WWT: It sounds like the lack of funding really has affected your work with refugees.

BT: Yes it has. We aren’t travelling to the north where we used to work due to lack of funds, but there is still a great need for our services in the parks in Belgrade.

Refugees in Belgrade (Courtesy of International Aid Network)

Refugees in Belgrade (Courtesy of International Aid Network)

WWT: The issue of refugees traveling through Europe is no longer front page news. Now the focus is on those who have made it to countries like Germany etc. What is the situation like for refugees in Serbia?

BT: The closure of the borders didn’t stop the refugees’ transit through Serbia towards the EU countries. However, their journey has become more difficult and uncertain, given that most of them decided to reach their destination with the help of people smugglers. I don’t know the exact number of refugees who are currently in Serbia, but approximately more than 2000 refugees or migrants are here, mostly waiting to go to Western Europe. Many of them pay smugglers to illegally cross the Hungarian border, but many of them have been ‘pushed back’ to Serbia from Hungary. In June, the number of refugees allowed to start the asylum procedure in Hungary was reduced to 15 per day at each border crossing. This means that many refugees are trying to enter the EU illegally with the ‘help’ of smugglers.

WWT: Where are the refugees coming from and do they talk about why they are fleeing their countries?

BT: In the parks, the majority are from Afghanistan, Iran, Pakistan, Morocco, etc. They are fleeing armed conflicts, terrorist attacks or looking for a better life. There are also refugees from Syria and Iraq fleeing war.

WWT: Have any of them been tortured or ill-treated?

BT: There are torture victims who have been tortured in the country of origin, but many of them have also been tortured in transit countries such as Bulgaria and in Hungary. Some of them, when illegally crossing the border to Hungary, have been beaten and returned to Serbia.

WWT: What kind of physical and mental condition are they in?

BT: Their health problems are acute mostly. During the warm weather, they had stomach problems such as diarrhoea. They also suffer from skin infections, pain in their legs and body, allergies, insect bites, etc. When we talk about mental problems, they usually focus on their last experience, which is often something bad, like a bad experience with smugglers or authorities in transit countries. They want to share with us their thoughts, feelings and their stories.

WWT: I can only imagine that they must feel incredible frustrated. Are they still hopeful of a better life?

BT: Well, they are frustrated because they can’t cross the border legally and only a small number of people per day is allowed to start the asylum procedure in Hungary. One month ago a group of 100 refugees demonstrated and walked from Belgrade to the north of Serbia, close to the border to demonstrate and show their frustration with the fact that they cannot cross the border to Hungary.

Refugees awaiting registration in Presevo, Serbia (Courtesy of Johannes Grunert used via Flickr creative commons license)

Refugees awaiting registration in Presevo, Serbia (Courtesy of Johannes Grunert used via Flickr creative commons license)

WWT: You no longer travel to the border, but are you able to tell us what the situation is like there?

BT: The situation there is very bad. The refugees, including women and small children, live in tents in open air, in unhygienic conditions, close to one of the two so called “transit zones”, waiting to be allowed access to the asylum procedure in Hungary.

WWT: Previously you said the Serbian public generally had a positive reaction to the refugees. Do you think that is still the case?

BT: The issue of refugees is no longer front page news in Serbia like it isn’t in other European countries. In these parks where we operate, people are generally friendly towards migrants, or at least indifferent.

WWT: What about the Serbian government. Has it changed its stance on refugees?

BT: The borders with Macedonia and Bulgaria are still very much controlled by our authorities in order to prevent refugees crossing illegally. Since the law on asylum was established in 2008, 30 refugees have been granted asylum and 40 subsidiary protections in Serbia. In the first half of 2016, eight refugees have been granted asylum in Serbia and 14 refugees have been granted subsidiary protection. So the number is increasing and that is a good thing, but still the asylum procedures are very slow, and the integration programme is not very efficient. There is an absence of regulations facilitating integration of refugees.

WWT: Finally, is there a particular person or family whose story really affected you or was especially powerful?

BT: There are so many young boys who have left their families – so full of hope that they will find a better life somewhere in Europe and that they will be able to help their loved ones in their home country. For me it is very sad to know that they have such an uncertain future ahead of them and are not aware of it. They have been travelling for months. One boy was pushed back four times from the Hungarian border, one of the times he was beaten, and still he believes that something good is waiting for him in some European country… he is not giving up… it is so brave and so sad at the same time.

 

We would like to thank Bojana for taking her time to speak with us. You can find out more about IAN and the work they carry out by visiting their website.

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On the forefront: Helping refugees rebuild their lives in New Zealand

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With its remote location – far away from war and conflict – New Zealand is rarely mentioned in discussions about refugee quotas and resettlement. But each year a small number of refugees arrive in the country, where they are welcomed by local rehabilitation centre Refugees as Survivors New Zealand (RASNZ) at the National Refugee Resettlement centre in Auckland.

We recently spoke with RASNZ CEO Ann Hood about the treatment of refugees and asylum seekers in New Zealand, many of whom have fled torture and ill treatment, and how RASNZ is helping them overcome their trauma and settle in a new country.

As the CEO of RASNZ, Ann oversees 45 staff and 60 volunteers, providing newly arrived refugees with psychosocial and mental health assessments, brief therapeutic interventions and orientation to life in New Zealand.

RASNZ’s job is to ensure that refugees receive the psychological support they need to adapt to a new country and get the best start for themselves and their families. Something that is vital for those who have experienced torture and other forms of trauma. In addition, RASNZ also supports former refugees who continue to struggle with their traumatic past, despite the passing of many years.

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RASNZ CEO Ann Hood.

WWT: The National Refugee Centre provides a wide array of health services to improve the physical and mental wellbeing of your clients. How do these services help vulnerable people to settle in a new country?

AH: We firmly believe that if the aim is for people to participate in society they need to be mentally and physically well. Otherwise, they aren’t able to learn the language, cope with a job or simply manage everyday life. The health aspect has to be addressed in order for people to live productive lives.

WWT: How does this work in practice?

AH: We have two clinical teams. One team is based at the Resettlement Centre, providing assessment and brief therapy. The other is based in the community in Auckland, covering the whole city, and is able to treat people over a longer period of time. For many traumatised refugees it is often down the track that they need support and treatment. Some don’t need our services for 10 years because they need to meet their basic needs first.

There is also a non-clinical community team mainly made up of former refugees. This team provides services within the community such as psycho education, introductory health programmes, support with education and employment and lots of engagement in activities. For young people we have the youth team with sports and mentoring programmes. For adults we run support groups, such as sewing groups for women and training in road codes and computer use.

WWT: We tend to often talk about refugees, but you also treat asylum seekers. As clients, how do they differ from refugees?

AH: When it comes to asylum seekers we tend to work with them particularly during the determination process as this is when they’re really struggling. Their future and fate is in the hands of the government. And they lose a lot of hope and faith during this process.

WWT: You actually worked at RASNZ as a clinical psychologist before taking a job elsewhere for 10 years. You returned last year as the CEO. How do you think the sector has changed since you first started working?

AH: I’ve seen a change in who are coming as refugees. New Zealand doesn’t take many people from Africa now, but focuses mainly on people from Burma, as well as refugees from Afghanistan and Colombia and asylum seekers from Sri Lanka. The government has also changed its policy on specific issues over time. Like now, New Zealand no longer accepts unaccompanied minors.

WWT: Speaking of the government. New Zealand has such a strong history of protecting human rights and an equally good refugee settlement programme so we were a bit shocked to find out that the country only takes 750 refugees every year.

AH: In general, there is an overwhelming support for refugees in the country and when the government recently announced that it would increase the intake of refugees, there were great expectations about the number. It is fair to say there was an outcry when the government announced it would only increase the intake from 750 to 1000 refugees. New Zealand takes a very small number of refugees but I think that its resettlement programme is well regarded and we provide a very good service and system. From the moment refugees arrive in the country they get New Zealand residency and have access to the full range of health services.

Refugees in Hungary (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

Refugee crisis: New Zealand has agreed to increase its intake of refugees from 750 to 1000 (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

WWT: It sounds like an efficient system with a strong focus on health and rehabilitation. Does this mean that you have the backing and support you need or do you still face challenges?

AH: We constantly need more money and run at a deficit. My number one priority is getting resources, and not just resources but sustainable resources. We can only employ people for the amount of time that we have money. Regarding our services, there is also a great need for clinical training and various aspects of working with trauma victims. Our team need to be up-skilled, such as being trained in the Istanbul Protocol. We work closely with lawyers and doctors, but at the moment we don’t have any doctors in New Zealand – as far as I know – who are trained in Istanbul Protocol, so it’s crucial.

We are relatively small with just two services in New Zealand and New Zealand is pretty isolated. So sometimes it can feel like we are a long way from the action. I think it’s really important to get that international perspective and to understand not only what’s happening around the world in terms of refugee and asylum issues, but also how other organisations are working and how we can work more collaboratively and support each other. Basically to keep up to speed. I would like our organisation to be able to grow in terms of research and advocacy, but at the moment we just don’t have the resources.

About RASNZ

RASNZ has helped resettle United Nations quota refugees since 1995 and is one of just two services in the country providing treatment to refugees. Under international humanitarian conventions, the centre’s clinical team additionally delivers specialist mental health services for convention refugees and asylum seekers either in detention or with cases before the Refugee Appeals Authority. The centre has to date provided support to thousands of people.

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Sanctuary and Sustenance: Photographing the journey towards a better life

The United States-Mexico border at San Ysidro, in the county of San Diego, is the busiest land border crossing in the western hemisphere. Every day, these people, who come in search of protection and a better life arrive in San Diego; one of the many cities that have seen an increase in refugees and asylum seekers.

The inspiring and shocking stories of some of these people have been captured by photographer Misael Virgen and were until recently on display at the La Mesa Library in San Diego.

The photo series focus on the journey from the points of entry to San Diego, beginning with the border and the airport. A collaboration between the organisation ART WORKS Projects and International Rehabilitation Council for Torture Victims (IRCT) member Survivors of Torture, International (SURVIVORS), the photographs are San Diego’s version of the international project Sanctuary and Sustenance, which tells the stories of some of the more than 60 million people currently without a permanent home because of war or persecution.

“The images help us share several of the thousands of stories of newcomers to our community,” explains Niki Kalmus, Community Relations Manager of SURVIVORS.

SAN DIEGO, CA-NOVEMBER 09, 2015: | A Sudanese refugee is greeted by her family where they reunited at Lindbergh Airport in San Diego for the first time in years. At 23, she arrived with her two young boys. | (Misael Virgen/ San Diego Union-Tribune)

A Sudanese refugee reunited with her family at San Diego’s airport. Courtesy of Misael Virgen/ San Diego Union-Tribune

“We want San Diego to understand the long, arduous journeys our clients, refugees, asylum seekers, and all migrants make to rebuild their lives in our city. We also want to show that the lives these migrants lead are very similar to our own. The images Misael captured demonstrate how torture survivors’ lives are hardly different from the lives of you and me.”

SURVIVORS and ART WORKS Projects hope to raise awareness of the challenges faced by refugees and asylum seekers, as well as of their resilience, to spark conversations about collective responsibility, welcome newcomers to communities, and encourage policy-makers to act in favour of fundamental human rights for refugees and asylum seekers.

“So far we have been able to reach many people who had never heard of SURVIVORS. The clients featured in Misael’s photography were excited to raise awareness about torture survivors, and came to see the exhibits when they were unveiled. One of the clients is highly involved with advocating for the rights of transgendered individuals, the reason she was tortured and forced to flee her home country,” explains Niki.

According to her, the exhibition, which was shown at La Mesa Library throughout the month of June, has inspired lots of visitors to get involved.

“Many of them now volunteer at SURVIVORS or have sought more information from us about how they can help torture survivors. Lots of people commented that they had no idea this was still an issue today, and especially not that it reached our community.”

Exhibition at Carmel Valley Library

The Sanctuary & Sustenance Exhibition in San Diego. Courtesy of SURVIVORS.

Sanctuary & Sustenance is a multimedia projection of photography, film, music, and words, launched on June 20, 2013 in honour of World Refugee Day in cities around the world.

Through photographs, moving graphics, and music, viewers have an opportunity to trace the journey of a family during the catastrophic events of displacement, on a path to sanctuary, and through the long process of rebuilding life in a new community. Across the world, it aims to raise the public consciousness of these issues and facilitate conversations about the collective responsibility to welcome refugees and encourage policy-makers to act in favour of fundamental human rights for refugees and asylum seekers.

Niki says that in San Diego, SURVIVORS does its best to educate the public about torture and its consequences.

“We raise awareness through community outreach such as this exhibit to let our community know that torture survivors are an underserved and often invisible part of the population. The most important thing we can do is simply understand that they are among us and spread the word about the important work of SURVIVORS and torture treatment centres throughout the world. We believe that by raising awareness about the existence of torture survivors in our very neighbourhoods we can create a more welcoming community.”

SURVIVORS is currently seeking other locations to show the exhibition. You can find out more about the Sanctuary & Sustenance project by clicking here, see more of the work from the exhibition by going to Misael Virgen’s website or get the latest news from SURVIVORS by following them on Facebook.

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World Refugee Day: More funding needed to support traumatised refugees

To mark World Refugee Day we look back at our conversations with two European rehabilitation centres – both working tirelessly to provide much needed support and treatment to refugees who have fled armed conflict, violence and torture. Sadly, a number of rehabilitation centres across Europe have had their funding reduced, preventing them from treating traumatised refugees.

When Europe first experienced a rapid increase in refugees seeking protection within its borders, some countries rushed to reintroduce border control and tighten immigration laws. Razor-wire fences were constructed and the military deployed to prevent refugees from entering. However, at the same time, European NGOs worked tirelessly to provide support and relief to those who had made it to the continent and they continue to care for newly arrived refugees, many of whom are deeply traumatised.

Making a difference in Hungary

One of these NGOs is International Rehabilitation Council for Torture Victims (IRCT) member centre the Cordelia Foundation, which is based in Budapest, Hungary. The centre offers psychiatric and psychosocial care to torture survivors. When we spoke to the centre’s Medical Director Lilla Hardi late last year at the peak of the European refugee crisis, she told us that many of the newly arrived refugees were in a bad state mentally.

“They are very exhausted and desperate,” she said. “I think aggressive manifestations in their behaviour might happen due to their traumatised and desperate state. This situation is another trauma contributing to their already unbalanced mental state and earlier traumatisation.”

Refugees in Hungary (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

Refugees in Hungary (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

Like other organisations in the country, Cordelia staff have travelled to the border between Hungary and Serbia to help refugees in detention.

“In one of the detention centres we met a Syrian family of 12 who had been transferred from the border that very day. The head of the family used to be a high-rank public service person in his country. They had witnessed the beheading of about 500 persons in their city,” said Dr. Hardi.

“All of the family members were seriously traumatised and showed serious symptoms of PTSD. One of them had lost a lower limb and had a temporary prosthesis; another suffered from diabetes and needed insulin urgently. We asked one of the nurses to monitor him and to give him the insulin that he had brought himself.”

Only one provider of psychological support in Serbia

In Serbia, local NGO International Aid Network (IAN) has been providing medical first aid and psychosocial support to refugees through a Mobile Team Unit in parks and shelters in Belgrade and at the Croatian border.

While many organisations provide medical and legal aid to refugees, IAN, which is a member of the IRCT, is the only one providing psychological support.

Refugees in Belgrade (Courtesy of International Aid Network)

Refugees in Belgrade (Courtesy of International Aid Network)

“At the moment we are working with refugees at the Berkasovo-Babska border crossing. At the beginning we worked in a park in Belgrade, which was the biggest informal gathering place of refugees, and in Principovac, a refugee shelter near the Croatian border,” said IAN psychologist and project manager Bojana Trivuncic in November last year.

“Some of them were tortured in the country of origin and during their transit in Iran and Bulgaria. In Syria for example, many refugees were tortured in some kind of prison by members of President Bashar al-Assad’s regime. The methods are brutal. Many of them told me that they were tortured with electro shocks. In Afghanistan, many refugees were tortured by ISIS or the Taliban,” explained Bojana.

“When basic needs are not satisfied, like food, clothes and shelter, a person cannot deal with emotions or trauma. For me it is ok to be there for them, to help them with their basic needs, and of course to be there for them if they want to talk, to share their problems and traumatic experiences, and to calm them if they are fearful.”

To support refugees we need more funding

The responsibility to provide rehabilitation to torture victims lies with the state. Yet in almost all EU countries, insufficient resources are being earmarked to provide specialised health services to vulnerable groups, including torture victims. This leaves rehabilitation centres to fill the gap.

“We know that a significant percentage of asylum seekers and refugees in the EU are torture victims and require access to rehabilitation services as early as possible. Our European member centres are doing their best to help as many people as possible, but sadly, many have had to cut their support services to torture victims due to a lack of funding,” says Miriam Reventlow, Director of Governance and Policy at the IRCT.

With NGOs struggling to help the record high number of refugees, it is clear that European leaders have to come together to offer to commit to ensuring that refugees who have been subjected to torture can fully recover from their past trauma and be able to find a new path of life in their host country. If not, we risk that thousands of refugees are left untreated.

“European countries all have a responsibility to ensure that there is enough funding to provide rehabilitation to victims of torture, and we need them to take this responsibility seriously,” says Miriam Reventlow.

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OMEGA: Celebrating 20 years of torture rehabilitation work in Austria amid Europe’s refugee crisis

“We see ourselves as a bridge between the current need for support and the sustainable integration of refugees and migrants into our society. Our main responsibility is to improve the mental and physical health of migrants and refugees, as well as their social and economic integration into the host society.”

This is how CEO Dr. Emir Kuljuh describes Austrian rehabilitation centre Omega – Transcultural Centre for mental and physical Health and Integration. Based in the city of Graz, Omega has been treating victims of torture for the past 20 years. Its focus is on health and follows the World Health Organization’s (WHO) definition that, ‘health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.

“Torture is one of the most distressing and psychologically annihilating expressions of human conduct. Torture is a phenomenon, which dehumanises its victims, leaving them with serious and lasting psychological and physical wounds. It poses a serious obstacle to the advancement of human rights, including civil and socioeconomic rights,” says Emir Kuljuh.

Covering all these aspects, the centre offers a range of services including medical treatment, psychological, psychiatric, psychosocial and psychotherapeutic counselling, social work, integration assistance, outreach and mobile care in refugee and emergency shelters.

Staff from Omega

Staff from Omega

Since treating 144 clients in its first year, the demand for Omega’s services has drastically increased and the centre now provides treatment to more than 1,600 people a year.

“Our target group is people with different residence permit status, such as asylum seekers, persons with subsidiary protection and immigrants with a permanent resident permit. We dedicate particular attention to women, young people, victims of torture and to unaccompanied minor asylum seekers,” explains Emir Kuljuh.

Austria has seen a rapid increase in refugees, asylum seekers and migrants in the past year. The country received 85,500 applications for asylum in 2015. This is the third highest number of applications per capita in Europe after Hungary and Sweden and has resulted in the authorities adopting a new and tougher approach to border control.

The influx of refugees and asylum seekers, however, has not led to more treatment options for traumatised refugees. Austria is facing challenges of providing care and support to this group with Omega being one of just a few torture rehabilitation centres in the country. Emir Kuljuh points to the fact that there are guidelines for the reception of asylum seekers including recommendations concerning persons who are torture survivors, but that European member states, including Austria, are failing to implement them.

“Existing structures and organisations need to be strengthened to be able to provide quality care to more victims of torture and their families. We hope that sufficient care and support will be provided to survivors of torture, even though the situation in Austria and other partner countries is challenging.”

He says that despite international law prohibiting the use of torture, it continues to be widespread. This makes Omega’s work even more important. If it can assist clients in overcoming their trauma, which will allow them to function on a daily basis, that is a job well done.

“The lower socio-economic status of many of our clients coupled with unsatisfactory housing conditions, restrictions on access to employment and training opportunities have a negative impact on their health and wellbeing. Our goal is to promote self-reliance so that they can access the Austrian health, education, labour market and social assistance independently.”

Omega celebrated its 20th anniversary on 9 December last year. To find out more about Omega you can visit their website: http://www.omega-graz.at/ 

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Treating refugees: How NGOs are supporting refugees in Hungary

The use of riot police, the construction of a 175 km razor-wire fence and threats of deportation. These are just some of the harsh measures taken by the Hungarian government to curb the influx of refugees entering the country. Meanwhile, Hungarian NGOs are providing much needed support and relief to the refugees who have made it to the country. One of these NGOs is IRCT member centre the Cordelia Foundation, which is based in Budapest. The centre offers psychiatric and psychosocial care to torture survivors. We spoke with the centre’s Medical Director Lilla Hardi about travelling to the Hungarian border to help out at the front line.

“We have seen a huge number of refugees at the railway stations in Budapest and have heard that the situation at the border is really catastrophic and chaotic.”

In an email, Dr. Lilla Hardi explains why she and 11 colleagues from the Cordelia Foundation rehabilitation centre decided to travel to the border between Hungary and Serbia last month. They made two trips to assess the refugee situation and to offer their support to those in need of rehabilitation services.

On their first trip they were denied access to the refugees. However, on their second trip they managed to treat a number of people each day.

Refugees in Hungary (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

Refugees in Hungary (Courtesy of International Federation of Red Cross and Red Crescent Societies used via Flickr creative commons license)

According to Dr. Hardi, most of the refugees she saw seemed to be doing relatively well physically, but suffered from serious mental health problems as a direct result of the traumatising events they had experienced.

“Many of the newly arrived refugees were in a very bad state mentally. They were very exhausted and desperate,” she writes. “I think aggressive manifestations in their behaviour might happen due to their traumatised and desperate state. This situation is another trauma contributing to their already unbalanced mental state and earlier traumatisation.”

Empirical studies by the Chamber of Psychotherapists in Germany echo this assessment, suggesting that at least half of the refugees coming to the country have mental health problems because of the trauma suffered in war or during their dangerous escapes. An even bigger number of these refugees have been subjected to human rights violations, including torture, says the Chamber.

In the ongoing political debate, there seems to be hardly any focus on early identification of torture victims among newly arrived refugees and no coordinated response schemes are available. Currently, the work carried out by the Cordelia Foundation and other organisations in support of traumatised refugees is largely done on a voluntary basis. This shows how urgent the need is for States to acknowledge their obligation and provide the resources and mechanisms to support and protect victims of torture.

However, in Hungary, the government’s response to the crisis so far has been to close off a railway track used by tens of thousands of refugees to enter the European Union on foot. This is all part of its crackdown on refugees coming from Serbia.

Refugees in Hungary (Courtesy of Peter Tkac used via Flickr creative commons license)

Refugees in Hungary (Courtesy of Peter Tkac used via Flickr creative commons license)

Personally, Dr. Hardi did not experience any hostility from Hungarian police, but she notes how strange it is to see police officers wearing masks and gloves. “They wear them in the belief that it prevents them from getting ‘contaminated’,” she explains.

The fact that Hungarian police officers find it necessary to wear masks and gloves to protect themselves from disease and contamination illustrates the general lack of compassion for the refugees coming to Europe and the lack of understanding there is for what many of them have been through.

“In one of the detention centres we met a Syrian family of 12 who had been transferred from the border that very day. The head of the family used to be a high-rank public service person in his country. They had witnessed the beheading of about 500 persons in their city,” writes Dr. Hardi.

“All of the family members were seriously traumatised and showed serious symptoms of PTSD. One of them had lost a lower limb and had a temporary prosthesis; another suffered from diabetes and needed insulin urgently. We asked one of the nurses to monitor him and to give him the insulin that he had brought himself.

The team from the Cordelia Foundation also alerted the local authorities to the fact that the family needed help.

“We introduced them to our local therapist and our psychiatrist who is in charge of our clients on a weekly basis. She has been taking care of the family since then. We immediately wrote a short medical report on their state ordering them to be released as they belong to the vulnerable group. However, the authorities did not release them. Instead they extended their stay in detention by another 30 days.”

With the situation in Syria unchanged and other armed conflicts continuing to disrupt the Middle Eastern and Sub-Saharan region, hundreds of thousands are left with no other choice than to flee war, violence and human rights abuses, torture being one of them.

When asked what she thinks will happen, Dr. Hardi replies:

“Nobody knows. The situation is permanently changing.”

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No money for support to the most vulnerable: Europe’s funding crisis for rehabilitation of torture victims

As Europe is facing a historically high influx of refugees – many of whom are survivors of torture – the need for proper care and rehabilitation of torture victims is greater than ever. Yet, there is a serious funding shortage across the continent, which has left a growing number of torture rehabilitation centres in dire financial straits. According to the International Rehabilitation Council for Torture Victims (IRCT), if states do not reverse this trend, we will see an acute loss of support services to those vulnerable and most in need.

“The cut in funding over the past five years has affected our work drastically and we have had to reduce the number of staff as well as patients. But now, it affects our actual existence. The facts are very simple: today, we have enough money in the bank to continue our work throughout September, but not in October.”

This is how the Director for Programs at French rehabilitation centre and IRCT member Parcours d’exil, Jérôme Boillat describes the centre’s current funding situation. A situation that could very well lead to its closure and leave hundreds of traumatised torture victims untreated.

Across the English Channel, London based Refugee Therapy Centre has also fallen victim to the funding crisis. After more than 15 years of providing psychological therapy and associated treatments to thousands of refugees and asylum seekers, the centre is now forced to downscale its work to three days a week. Going from operating five days a week to only three days inevitably means leaving behind torture victims in desperate need of help.

“The success of our work can be measured by the smiles made possible after interventions to heal the psychological and emotional wounds of those whose basic human rights were violated by torture and persecution. To continue with essential humanitarian work, our centre desperately needs financial support,” says Refugee Therapy Centre’s Clinical Director and CEO Dr Aida Alayarian.

The two situations in France and the UK are far from the only examples of torture rehabilitation centres scrambling for funding. At least 11 IRCT member centres and numerous programs that have helped thousands of torture victims across Europe have either lost funding or are predicting major cuts that will inevitably affect torture victims.

Syrian refugees. (Courtesy of Freedom House used via Flickr creative commons license)

Syrian refugees. (Courtesy of Freedom House used via Flickr creative commons license)

In Austria, upon learning that it may lose vital funding from the EU, an IRCT member is sharing its grim forecast: “If this funding were to be cut or stopped, we would have to reduce our support to survivors of torture drastically. As it is, there is hardly any funding for this target group on a local or national level. The only funding sources are international bodies and even their funding is being cut,” the centre explains and continues:

“Much of our work is in refugee shelters and no other Austrian organisation does the exact same kind of work. Referrals cannot be made because the only other organisation in our country working in this field has also very limited resources and they have their own clients. There are hardly any doctors or social services which have intercultural competencies.”

Europe is currently experiencing a massive increase in numbers of refugees and asylum seekers, driven by conflict, humanitarian crises and human rights violations, particularly in the Middle East and Africa. While Eurostat figures found that around 945.000 of asylum seekers entering the EU between 2002 and 2012 were victims of torture, there is no longer any doubt that this number will be much higher in 2015.

However, the urgent treatment and rehabilitation of torture victims is not adequately covered by EU member states, despite their obligations under international human rights and EU law.

The responsibility to provide rehabilitation to torture victims lies with the state. Yet in almost all EU countries, insufficient resources are being earmarked to provide specialised health services to vulnerable groups, including torture victims. This leaves rehabilitation centres to fill the gap.

“We know that a significant percentage of asylum seekers and refugees in the EU are torture victims and require access to rehabilitation services as early as possible. Our European member centres are doing their best to help as many people as possible, but sadly, many of these centres have had to cut their support services to torture victims due to a lack of funding,” says Miriam Reventlow, Advocacy Director at the IRCT.

The funding shortage affects traumatised refugees and asylum seekers at various stages. In Germany for example, newly arrived refugees and asylum seekers are among the groups that will be hit hard by a reduction in funding.

“The German state still has no early identification system for vulnerable groups, especially not for torture survivors. When it comes to rehabilitation of torture survivors, the competences and capacities of the regular healthcare system are still far behind the actual need. Moreover, there exists no funding for this type of work by the German government. By law, refugees have limited access to the regular health care system until the moment they are granted a residence permit. Psychosocial therapy centres try to cover this gap, while at the same time navigating through political changes,” explains Christian Cleusters from German rehabilitation centre Medical Care Service for Refugees Bochum.

So what can be done to ensure that as many torture victims as possible receive the treatment they need?

According to the IRCT, the answer is simple: every country in the EU will have to recognise their obligations under international human rights law and EU law and designate adequate resources within their healthcare budgets. But also, the EU institutions play a key role in providing sufficient funding and need to uphold their support to this important field of work.

“If we don’t generate more support, thousands of torture victims risk having current treatment programmes interrupted or will be unable to access rehabilitation services in the first place. European countries all have a responsibility to ensure that there is enough funding to provide rehabilitation to victims of torture, and we need them to take this responsibility seriously,” says Miriam Reventlow.

In the UK, when asked how the Refugee Therapy Centre has helped them overcome their trauma, one torture survivor explains: “The group has helped me confront my problems and let go of the past. Now I can think of the future.”

For another survivor, the treatment has simply improved his quality of life: “I do not feel ashamed of being myself anymore and I can sleep a little better now.”

With less funding and no action from European leaders, the question is how many torture victims will be prevented from receiving the treatment they need to fully recover from their past trauma and be able to find a new path of life in their host country.

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An alternative way to treat victims of torture

“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.

The new issue of Torture Journal is now available from www.irct.org

The new issue of Torture Journal is now available from http://www.irct.org

“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.

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Right to rehabilitation still not a reality for most victims of torture

Around the world, conflicts and humanitarian crises result in migratory flows of millions of asylum seekers, refugees and internally displaced persons every year. According to health professionals and researchers, as many as 35% of refugees worldwide could be victims of torture.

It used to be that those lucky enough to be near a torture rehabilitation centre were able to seek treatment, but in many places the number of victims of torture has now reached a point where the need for rehabilitation exceeds the services available.

To support victims of torture, the International Rehabilitation Council for Torture Victims (IRCT) last year adopted and promoted a policy on the Right to Rehabilitation in accordance with the United Nations Convention against Torture (UNCAT) Comment 3.

The policy highlights the obligation of states to ensure that victims of torture have free and prompt access to rehabilitation services. Sadly, as the rehabilitation sector is facing a funding crisis, this commitment is more important than ever.

The Za'atari refugee camp, Jordan. (Courtesy of UNHCR/Brian Sokol, via Flickr Creative Commons)

The Za’atari refugee camp, Jordan. (Courtesy of UNHCR/Brian Sokol, via Flickr Creative Commons)

For many rehabilitation centres, the future is not looking bright. They operate in situations where their fate is continuously uncertain and because of a reduction in funding, some of them are even at risk of closing.

Yet, getting states to fully commit to the rehabilitation of victims of torture is not an easy task. This is something that becomes particularly apparent in countries where torture is carried out by the state, and where health professionals and rehabilitation service providers are constantly under threat.

Whether it is doctors being arrested and tortured simply for trying to save lives in Syria or rehabilitation centres in Latin America being exposed to threats and other intimidation tactics, it is clear that access to health and in particular, the right to rehabilitation is far from a reality in many parts of the world.

So how do we face these challenges?

An important step is to change the way that everyone from states and governments to the people they govern perceive torture and rehabilitation for torture victims. Those who believe that the practice of torture can be justified must be reminded that it is a serious human rights violation that can never be tolerated.

In addition, decision makers need to understand that rehabilitation should not be a service provided mostly by civil society organisations if and when international agencies and philanthropists decide to fund it. In fact, each and every state has a responsibility to ensure that torture victims everywhere have free and prompt access to rehabilitation services.

Without this change in attitude, political will and appropriate funding, we cannot guarantee that victims of torture receive the rehabilitation services they need.

And without offering rehabilitation to victims of torture, we are denying hundreds of thousands of people worldwide their last and only hope to reclaim their life and dignity, lost at the hands of perpetrators.

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