Posts Tagged rehabilitation
“You have to listen to a lot of horrible stories and accounts. Do you have a space for processing them?” asked a psychotherapist I had been interviewing as part of my research. He was asking me how I was coping with the heavy topic I had to deal with during my fellowship. Like many of my interviewees, he is a psychotherapist who works with survivors of torture. On that day, he had been telling me about his experience with patients who had been subjected to sexual violence as a means of torture. During what had become a very normal day for me at the International Rehabilitation Council for Torture Victims (IRCT) office in Copenhagen, his emphatic question hit me so unexpectedly that I did not know what to say.
Barbara Giovanelli recently completed a Hilton Prize Coalition Fellowship with the International Rehabilitation Council for Torture Victims (IRCT). In her blog post published on the Hilton Prize Coalition website, Barbara reflects upon her research projects aimed at capturing stories of sexual torture victims, working alongside IRCT member organisations.
(From Hilton Prize Coalition, by Barbara Giovanelli)
I had joined the IRCT as an intern in February 2016. For five months, I contributed to the work of various IRCT teams with my knowledge on gender-based violence. I devised fact-sheets for advocacy activities, contributed to policy documents, participated in the evaluation of grant reports and completed background research for fundraising. As I found out more and more about the intersection of gender, sexual violence, and torture, my supervisors and I came up with a new project for the rest of my time in Copenhagen: for the last two months of my internship, I conducted a study on the specific psychosocial and health consequences that sexual methods of torture can cause. After a summer break, I re-joined the IRCT team for four more months through a Hilton Prize Coalition Fellowship in order to conclude the research and turn its outcomes into a final report.
I interviewed over 20 experts working in rehabilitation centers on sexual methods of torture. Although I used a comprehensive questions guide to structure the interviews, I did my best to let the experts talk freely about their first-hand experiences. Most of the interviewees were psychologists; others were doctors, social workers or lawyers. Many of them work in difficult circumstances, facing hostile political environments or critical financial situations. Once, for instance, an interview had to be postponed several times because my interviewee was called to an emergency intervention in the conflict-torn region of North Kivu in eastern Congo.
When I analysed all the rich information that I had gathered and looked for emerging themes and trends, I came to understand that there is one central and very sad aspect that accompanies almost all crimes of sexual torture: the fact that very often, victims do not report them.
While reporting a crime would be the first step, not only to claim justice, but also to allow the healing process to commence, feelings of shame and the fear of social stigmatisation deter survivors from disclosing their experience of abuse. In most societies, everything that has to do with sexuality is a very private issue and is strictly defined by social norms and taboos. “So they hide their stories and suffer in silence,” one of the experts explained.
To start breaking the silence and deconstructing the stigma around sexual torture, the outcome of my fellowship is a report that shares the knowledge of distinguished experts and draws conclusions on a phenomenon that is widely under-represented in research. The report also includes a series of case stories to illustrate the devastating consequences of sexual torture on the health and social life of survivors, and identifies particular needs resulting from the devastation.
At the conclusion of my fellowship with the IRCT, I now know the answer I would give that psychotherapist. It is not easy for anyone who has to deal with such crimes, but the work I did at my desk in Copenhagen is nothing compared to all the efforts undertaken by you, the front-line aid workers who may be reading this, and most of all by you, the survivors. I deeply admire your strength and courage. It was truly an honour for me to learn from you and help you share your experiences.
About the Hilton Prize Coalition
The Hilton Prize Coalition is an independent alliance of the 21 winners of the Conrad N. Hilton Humanitarian Prize — working together globally to advance their unique missions and achieve collective impact in humanitarian assistance, human rights, development, education and health. Through its three Signature Programmes — the Hilton Prize Coalition Fellows Programme, the Disaster Resiliency and Response Programme and the Storytelling Programme – the Coalition is continually leveraging the resources, talents and expertise of each of its members to innovate new models for consideration.
For more information please visit their website.
“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.
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.
“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.”
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.
In France, IRCT member centre Parcours d’Exil uses a vast range of methods to treat their clients. Among these approaches are art therapy, language classes and cultural events, which can help accelerate torture survivors’ recovery. For one torture survivor art therapy proved the key to easing his fears and allowed him to deal with the horrific trauma of his past.
In August 2015, Parcours d’Exil was contacted by a volunteer of Iranian descent working for the Red Cross, who had benefitted from one of the centre’s training programmes. She asked the centre to make an emergency appointment for an Iranian asylum seeker who had arrived in France two days before.
On the day of the consultation, asylum seeker N appeared to be in a state of fear, incapable of uttering a word, watchful of everything and everyone and crying all the time. He made it clear that he was afraid of the therapist and he showed signs of being afraid he was being watched and threatened.
As the consultations went on, N slowly started to communicate with the help of an Afghan translator, who the centre had chosen to avoid bringing back his memories of the Iranian “aggressor”. He managed to tell the therapist about the traumatic events he had endured.
Parcours d’Exil quickly realised that verbal communication would be complicated, and could hinder therapeutic cooperation as they brought back N’s impressions of the interrogation. Centre staff decided to introduce him to their art therapist. Art therapy, in this particular form, proved to be the real entry point, helping N to accept and engage in the broader therapeutic process at the centre.
In their first meeting, N and the art therapist found themselves sitting on rugs, drinking tea while listening to classical music.
It became clear that N patient presented a post-traumatic dissociative disorder. He complained of anxiety, insomnia and post-traumatic nightmares (in which he found himself, for instance, in a bunker without any light), memory disorders and an inability to focus, which forced him to write down everything. He could not take the bus or metro for fear of not being able to exit it. He also complained of being unusually irritable, always fearing that the person he was speaking to would try to take control of him.
Like many other patients, N did not want any medication, having been exposed to “harmful” treatments in the past. Furthermore, he had been hospitalised in a psychiatric ward after two suicide attempts before being incarcerated. External elements exacerbated his symptoms, particularly when he learned of his mother’s hospitalisation back in Iran.
In order to familiarise him with Parcours d’Exil’s Health Centre, he was invited to attend French courses and music workshops that the centre organises, while continuing the art therapy. It soon became clear that participating in these classes, within the reassuring frame of the centre, had become a “necessity” for him, and his social behaviour changed dramatically.
He never missed any of the cultural visits organised by the centre, and he was gradually able to socialise again and regain some confidence. He put himself forward to sing Persian songs during music classes, started to communicate in French during the French for Foreign Speakers sessions and decided to try to learn how to play the piano.
Like in many cases, one simple detail or situation can easily trigger bad memories. During a French language lesson, N was shown a picture of a bathtub. He immediately froze and was overcome with an immense sadness.
Although the nightmares were a constant reminder of his imprisonment and torture, the courses enabled him to recover the long-forgotten feeling that life could be seen through a positive lens. Along with psychotherapy, art therapy, music and French language lessons were key aspects of the positive outcome of his treatment, in terms of his quality of life and speed of recovery.
All the more so given the fact that his case was extremely complex, and such patients often take years to recover. On numerous occasions, N was able to talk about the improvements in his life, and how he behaved and felt about himself. It took less than six months for N to make this progress.
N’s story confirms the idea that Parcours d’Exil promotes: That the inclusion of artistic and creative activities is a powerful catalyst to accelerate self-reconstruction.
UN International Day of Non-Violence is marked every year on 2 October. At World Without Torture we regularly share the stories of those who have experienced acts of violence that have changed their lives forever, so the effects of torture can’t be forgotten or ignored. Today, the story of Palestinian AA reminds us that for some, violence is seen as a tool of oppression and fear and torture is seen as an effective means of interrogation. It is because of this that days like the International Day of Non-Violence are important, it is because of people like AA.
In Jerusalem in January 2014, 17-year-old Palestinian AA was walking home from football training with his cousin when they were attacked by soldiers who first shot them in the feet and then told them to get on the ground. As they called for help a dog was unleashed on them. They allege that a group of ten Israeli soldiers beat them with their rifles and stood on their bullet wounds.
AA’s cousin describes how they were then blindfolded and dragged to a military camp. “I was put in a room and interrogated violently; my clothes were torn. I had one wound in my hand, three on the right side and seven on my left thigh and area around my knee.”
The interrogators refused to believe they had been playing football and tried to force them to admit they had been throwing stones at the soldiers. They were told that if they confessed to these charges, they would not be beaten. They both refused to sign the confession, which was written in Hebrew so they could not understand it, and were continuously beaten for four more hours.
They were eventually brought to a hospital where they received medical care. AA’s cousin was operated on and woke up at 2pm the following day to find himself handcuffed in bed and under the supervision of eight soldiers. AA had three infected bullet wounds in his left thigh and was kept in hospital for a week, with his hands and legs handcuffed the entire time aside from when he was brought meals. During this time they were not allowed to have any visitors.
They were then transferred to a court and met by their lawyer who petitioned the court to release them since no indictments had been brought against them. Both were still in need of serious medical care and were transferred to a hospital in Jordan where they received treatment for two months. AA needed stitches on his head and his right thigh bone was fractured, while his cousin also needed stitches, had a fractured hand and torn hamstring. His legs were also badly damaged from the bullet wounds.
When returning from Jordan, they were not allowed to travel via the airport in Tel Aviv so they had to cross the border between Jordan and the West Bank as they both have West Bank identification cards. En route they were arrested by Israeli intelligence officers and brought to a settlement near Jerusalem. They were then interrogated for three hours and allege they were forced to confess to charges stating they had been trying to attack a military camp.
In the presence of their lawyer they were transferred to Ofer Prison, an Israeli facility in the West Bank where they were detained for 18 days until a deal was struck between their lawyer and the military prosecutor to prevent their families from pressing charges against the soldiers. They were both sentenced to 70 days in prison and fined 3,500 shekels and subsequently released in June 2014.
Today, AA and his cousin are receiving treatment from a psychiatrist and psychologist, as well as individual behavioural therapy at IRCT member centre, the Treatment and Rehabilitation Centre for Victims of Torture (TRC Palestine). They still struggle to process what happened and the impact their injuries have had on their lives as AA has not been able to return to school or play football again.
Sadly, the story of AA and his cousin is far from unique. As the Israeli-Palestinian conflict continues so does the violence, which affects thousands of people. TRC Palestine works with many people like AA and his cousin to reduce the devastating physical and psychological consequences of torture and politically motivated violence, as well as the retaliatory behaviour of the victims through its treatment and rehabilitation programme.
With no prospect of peace between the two sides and violence continuing, the work of organisations like TRC Palestine provide invaluable support and a glimmer of hope to the many victims of violence.
Honduras is one of the poorest countries in Latin America and ongoing human rights violations have forced thousands of people to flee the country. Based in the capital, Tegucigalpa, IRCT member CPTRT offers relief and support to those affected by violence and torture.
For a country of less than 10 million, Honduras faces some big challenges. High rates of poverty and unemployment, as well as a poor human rights record have led to thousands of Hondurans fleeing their country. For those who stay, organised violence, rape and torture are real threats.
This is the harsh context, in which organisations like the Centre for Prevention, Treatment and Rehabilitation of Victims of Torture and their Relatives (CPTRT) operate.
Founded in 1995 by doctor, politician and human rights activist Juan Almendarez, CPTRT has become a leader within its field and a strong voice in the fight against torture. The centre employs a team of doctors, psychologists and social workers, as well as a group of volunteers.
Over the years, this team has successfully treated thousands of victims of torture and violence, but it is often a case of too much demand and not enough supply. CPTRT is one of just a few torture rehabilitation centres in Honduras, and as the national health system does not recognise torture as a health problem, there is little specialised treatment or rehabilitation available.
A paradox perhaps, given the many accounts of torture that CPTRT encounters. Gustavo N. Peña, Psychologist and Project Coordinator at CPTRT says the centre deals with many different types of victims, “from those who speak out against human rights abuses to the families of those in prison, students and those deprived of liberty”.
Since the army ousted President Manuel Zelaya in 2009, the country has struggled with violence and unrest. The majority of victims of violence are women, children and the young people as well as activists and political leaders. Women and children in particular are often vulnerable and easy targets for the perpetrators who are usually never punished.
To change this, holding perpetrators responsible is a key issue for the CPTRT. The centre is committed to fighting impunity and by providing technical and legal assistance, it does everything it can to help its clients get access to justice but this is not easy as many victims do not want to speak out.
“Fundamentally, torture contributes to the development of a widespread sense of insecurity and fear that paralyses citizens and stops them from demanding justice. The population prefers to keep silent about the abuses that it is subjected to,” says Gustavo N. Peña.
In addition to its legal and technical assistance, CPTRT looks at the physical, cognitive and emotional health of its clients, using medical, alternative and psychological treatment to individuals and their relatives. It also runs capacity building programmes with various community group
Looking at a recent report from the World Health Organization (WHO) on health worker-to-population ratio in Honduras, it is easy to see why CPTRT’s services are in demand.
According to the WHO, there is an extreme shortage of physicians, psychologists and psychiatrists in the country with as little as 20.8 physicians per 10,000 population. And to make matters worse for the many Hondurans exposed to torture, most of the physicians do not have the knowledge to recognise torture or carry out rehabilitation of torture victims.
Juan Almendarez, Director of CPTRT has previously spoken about how, “The number of human rights violations by the military is rising, and the threat is greater and growing because military police operate with their faces covered and without visible identification, which fans impunity.” Gustavo N. Peña agrees that this culture of impunity is a challenge to eradicating torture in Honduras saying he believes that, “Torture is seen as a mechanism of investigation, as well as punishment”.
Today, CPTRT is a key player within the Honduran human rights movement and despite the daily challenges they face, centre staff continue to dedicate their lives to making a difference; as Alba Mejia, Assistant Director at CPTRT says, “Wherever there is injustice, we need to fight it and turn it into a positive change”.
Five and a half years on from the ousting of former Libyan President Muammar Gaddafi, the country remains in an unstable state, facing the threat of IS and political infighting. Gaddafi was killed in February 2011 and on this year’s anniversary of his death, interim president Abdul Jalil insisted his government had, “opened our arms to all Libyans, whether they supported the revolution or not”. Acknowledging this message of inclusion, let’s not forget the many people with links to Gaddafi who were targeted in the aftermath of the dictator’s death. One of these people is HH who was tortured by the police.
HH was just 18 when Gaddafi died and her family was one of many to be persecuted because of their connection to his regime. The fact that they also belonged to a minority ethnic group made their situation even more dangerous. Immediately after Gaddafi’s death HH and her family were threatened and harassed by the new authorities who wanted them to leave the country.
Her father was captured in 2014 and not released until 2016; she believes he was tortured during this time, though he never spoke about it. Soon after his release he was murdered on the street. After her father was taken away, HH was also arrested by the police and taken to prison. Over the course of a month, she was interrogated, sexually assaulted and beaten. Her head was shaved and she received death threats constantly. She was also forced to witness other family members being beaten.
Sadly, her story is far from unique. A UN High Commissioner for Human Rights report on Libya released in February 2016, found that killings and torture are being committed with impunity by “a multitude of actors – both state and non-state”.
HH was released a month later and knew she needed to leave the country if she was to survive. Along with a close relative she made her way to Croatia, but the trauma of what she had experienced made day to day life impossible. HH was referred to the International Rehabilitation Council for Torture Victims (IRCT) member centre Rehabilitation Center for Stress and Trauma (RCT) in Zagreb by the Red Cross.
When she arrived at the centre she was suffering from depression, insomnia, nightmares and a loss of appetite. She also struggled to form relationships with people as she felt like she couldn’t trust anyone. She had physical injuries as a result of the sexual assault but like many victims of sexual violence, refused to speak about what she had experienced.
RCT Zagreb provided social, medical, psychiatric and psychological support to both HH and her relative – also a victim of torture. The centre found accommodation for both of them and staff worked hard to establish trust so they could start the treatment and help HH integrate in Croatia. She was enrolled in a language course and received help to search for a job.
Through her therapy she began to deal with her grief at losing her family and the promising future she once had in Libya, where she was an ambitious student. A year and a half later and thanks to the work of the RCT Zagreb staff life had become more manageable for HH. She left Croatia in 2016, hoping to find a better future in Germany.
While HH escaped the violence and left her life in Libya behind, an article in The Guardian suggests that many people are losing hope in the country. In the article, which was written around the time of the five-year-anniversary, one student who supported the revolution said, “Some people say they want to go back to the time of Gaddafi. I don’t. Where I want to go is out, out of the country.”
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.
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.
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.
In 2015, a record 1.2 million refugees applied for asylum in the EU, most of them fleeing from torture, violent conflict, persecution and repressive regimes in the Middle East, Asia and Africa. Despite legal obligations to support torture victims applying for asylum, many European countries have failed to provide adequate reception conditions and treatment for the trauma caused by torture. One of these countries is France where, according to a new report, the absence of an early identification procedure is the reason for many of the problems experienced by torture victims seeking asylum.
“In our view the French authorities do not ensure that torture victims receive the necessary treatment for the damage caused by torture.”
This is how Director of Development at French rehabilitation centre Parcour d’Exil Jerome Boillat describes the current situation in the country. According to him, more can and should be done to help torture victims seeking asylum. His sentiments are echoed by a new report looking at the challenges faced by torture victims seeking asylum in the EU.
According to the report, released by the International Rehabilitation Council for Torture Victims, the absence of an early identification procedure is at the root of many of the problems experienced by torture victims seeking asylum in France, as well as many other countries. Early identification could ensure that victims are provided with adequate housing and located in regions and cities where they can access rehabilitation services.
Yet, the country still has no specific assessment procedures or mechanisms that authorities can use to identify vulnerable applicants, aside from girls and women who have experienced female genital mutilation.
This means that many asylum seekers are housed in hotels through emergency schemes but there is also a worrying number of asylum seekers who end up homeless as local authorities and NGOs are unable to pay their hotel fees. Homeless asylum seekers have to rely on civil society or relatives for shelter.
Jerome Boillat says that, “Homeless torture victims find it particularly difficult to meaningfully engage in the rehabilitation process due to their extremely precarious situation. Although the French government aims to increase the number of asylum seekers housed in regular reception facilities to 55 percent by 2017, we are concerned that even this figure might not be achieved.”
Torture victims already struggle throughout the asylum process. They are unable to work and find it difficult to maintain and develop relationships with others because they cannot trust them or prefer to be alone. Although asylum applications in France have not increased as sharply compared to other countries in the EU, it is clear that the country is struggling to provide adequate care and meet basic needs like accommodation for refugees and torture victims.
The French authorities have been trying to improve the system over the last two or three years and have expressed a willingness to engage in dialogue with NGOs like Parcours d’Exil. However, with unrest continuing in several countries the refugee crisis shows no sign of easing. Torture victims who are not identified will continue to miss out on rehabilitation and be unable to process their asylum request unless changes are made quickly, as those in need continue to fall through the cracks in the system.
To read the report in full, click here.
In our Fighting Torture series, we speak with people from around the world and from a number of professions who work with and support survivors of torture. What does their work mean to them and what are the biggest challenges they see in the anti-torture and rehabilitation movement?
Alba Mejia is the Assistant Director of the Centre for Prevention, Treatment and Rehabilitation of Torture Victims and their Families (CPTRT), in Honduras, a member of the International Rehabilitation Council for Torture Victims. She tells us how securing funding for the sector continues to be a challenge and how the Honduran military, which runs the country’s prison service, is more focused on punishment and vigilance, rather than rehabilitation.
Q: What is your profession and where do you work?
I am a social worker, and hold a master’s degree. I am currently working at CPTRT where many of our clients are in detention, deprived of liberty.
Q: How long have you worked in torture rehabilitation and human rights?
I have worked with torture victims since 1995, which is the same year that CPTRT was founded.
Q: How did you end up doing this work?
This work is the culmination of activities I have been involved in throughout my life as a human rights defender. When I was young, I participated intensively in the fight for the rights of workers in the health and education sectors. I also worked in the defence of higher education students, where I observed how groups of young people were tortured when they were forcibly recruited into the military. That is why I got involved in the movement that fought to make military service voluntary rather than obligatory.
In addition, all my social engagement has been related to the prevention of violence against women and I actually founded the movement, “Women for peace/Visitación Padilla’, which I was involved in for 15 years. As part of my work with CPTRT, I have been in contact with people deprived of liberty and I have seen the consequences of torture on the bodies of victims. This is why I now feel committed to defending their rights.
Q: Can you give us an example of how you have seen your work make a difference?
Sometimes I run into people who have been deprived of liberty who I have interacted with during different workshops. When they see me they stop and greet me, they remind me of the experiences they have gone through and how the CPTRT’s support has positively affected their lives.
Q: How has this work changed you since you started?
This work has strengthened my convictions about the need to deeply engage in changing national and international structures, which are the cause of the exploitation, oppression and repression of those impoverished in the world.
Q: Tell us about the situation for torture survivors in Honduras?
At CPTRT, we refer to the people we work with as being ‘deprived of liberty’. Their situation is critical and they do not enjoy the full right to rehabilitation. Lack of access to education, health care and employment are also serious problems. These issues are further exacerbated due to overcrowded living conditions in prisons and detention centres. All of this constitutes cruel, inhuman and degrading treatment, which is very close to torture.
Q: What is a typical day in the office/field for you?
In my management position, I regularly meet with my colleagues to co-ordinate meetings with state operators so we can maintain institutional communication with other organisations to handle and define strategies for dealing with torture cases.
Q: What do you think are the biggest challenges facing the torture rehabilitation sector in Honduras?
The biggest obstacle is that unfortunately the government has delegated the administration of the penitentiary system to the military. If the possibilities for rehabilitation before were minimal, now they have been reduced even more because the military focuses on punishment and vigilance, rather than rehabilitation.
Q: What do you think are the biggest challenges facing the torture rehabilitation sector in general?
Globally, there is not enough funding for the rehabilitation of victims. This is then reinforced by the limited influence that can be exerted to ensure that states make funding available for the rehabilitation of torture survivors.
Q: According to various surveys, many people do not think torture is such a big problem; that it is a thing of the past; or some even think that it is necessary. What would you say to them?
Torture is an experience that stays with the survivors for their entire life. Regardless of how much therapy they receive, their brain will always remember the suffering and the horror of such a traumatic experience. Torture affects the behaviour of survivors and often does not allow them to be happy because they have to deal with many fears that stay with them for their entire lives.
Q: And finally, many of us do care about torture survivors and victims. How can we support the anti-torture/torture rehabilitation movement?
By example. We should try to be defenders of human rights, both in the office and outside the office. Wherever there is injustice, we need to fight it and turn it into a positive change.
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.
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.
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.
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.