The shame is not mine, it is yours [Medical Foundation client]
The Medical Foundation for the Care of Victims of Torture (the Medical Foundation) is the world’s largest torture treatment centre, and the only human rights organisation in the UK dedicated solely to the treatment and rehabilitation of survivors of torture and organised violence.
The Medical Foundation offers medical consultation, examination and forensic documentation of injuries, psychological treatment and support, and practical assistance to torture survivors. Its clinical services include psychiatry, clinical psychology, counselling, individual and group psychotherapy, physiotherapy and specialist child and family therapies. Since its inception in 1985, some 45,000 people have been referred to the Medical Foundation for help.
In addition to its clinical work, the Medical Foundation seeks to raise awareness of torture. Its substantial archive of reports documents the systematic use of torture and the consequences for those who survive.
Accountability for torture is a key component in torture prevention, and it is therefore essential that survivors of torture, or the families of those who were tortured and have now died, are able to obtain justice in respect of the abuses they or their loved ones have suffered.
The effects of torture
Torture impacts on the individual and beyond, to their family, community and society.
At an individual level, psychological consequences of torture include a loss of bodily or psychosocial control, typically leading to a profound sense of helplessness and powerlessness, a loss of trust, isolation (including complete withdrawal from or diminished communications, which in turn impacts on the ability to form or maintain personal relationships – including within marriage, with children and within the community more widely), grief at the loss not only of others but also of the self, a sense of guilt, shame or humiliation, anxiety, depression (which can include suicidal leanings), intrusive phenomena such as hearing voices, flashbacks and nightmares, difficulties in recollection, emotional numbness and avoidance of any place or situation which might trigger memories of their torture.
At a physical level, consequences of torture can include injuries, illness, disability, chronic pain and the contraction of life-threatening diseases as a result of torture, such as HIV/AIDS.
Torture and its clinical consequences can lead to an inability to function in everyday life, including the inability of a survivor to work and meet their own or their family’s economic needs, to participate in family life or social networks, to fulfil daily roles and activities such as cooking for themselves, or to undertake roles as parents in looking after children. This loss of function can therefore affect livelihood, self-esteem and the individual’s relationships. The consequent isolation this engenders can by exacerbated by rejection in some cases by family, friends and community as a result of disclosure of abuse, particularly in the case of sexual torture.
Finally, torture attacks one’s core identity and integrity and produces a profound loss of meaning in life. As one of our clients put it:
Who am I? What am I? Not a man, not a husband, not an animal, but not human – I am zero. I am already dead, life has no meaning, what is the point of living.  Â
In addition to the personal impact of torture, family members may experience harassment, intimidation and deep distress as a result of the torture, including unresolved grief in cases where the victim’s body is never found. Families can also experience strain in caring for the victim or their dependants.
The potential impact of torture on adults and minors can be long-term, and for some, in addition to past suffering and damage, the losses of future potential are permanent due, for example, to disability, illness or severe psychological distress or inability to form relationships or inability to conceive as a result of torture. In the case of a child, healthy emotional development can be severely affected by torture, sometimes leading to enduring psychological difficulties in adulthood.
The various consequences of torture require recourse to a broad array of healthcare services, including psychiatry, clinical psychology, psychotherapy, counselling, individual, family and group work, physiotherapy and other physical therapies.
The benefits of justice
Many clients of the Medical Foundation fled their countries after experiencing torture precisely because of their attempts to expose the injustices perpetrated by oppressive regimes and to hold them to account. For them, any avenues to seek reparation could provide recourse to justice they were denied. By contrast, denial of reparation can be experienced as a double injustice.
Psychologically, justice and reparation can play a significant role in the recovery process of torture survivors. The potential benefits of justice can be threefold:
(i)Â Â Â The prospect of redress – For many torture survivors it is essential to know that they have a choice – the possibility to seek justice and reparation. The availability of accessible mechanisms itself can be experienced as acknowledgment and commitment by the State to uphold the right to reparation.
(ii)Â Â Â The process of seeking redress per se can be therapeutic. The process can afford the victim control in initiating the complaint, taking responsibility in directing the strategy of the procedure and seeing the perpetrator as a defendant having to answer for their actions.
(iii)Â Â Â Obtaining justice – holding perpetrators accountable can enable not only access to other reparation measures, but also challenges impunity. Compensation can provide victims of torture public acknowledgment of their survival, facilitating the re-establishment of their dignity, self-esteem, trust in others and belief in the world as just. For some, money can also alleviate poverty and help those suffering hardship, disability and impaired functioning as a result of the violation.
A public and official recognition of harm done and the condemnation of perpetrators contribute to a sense that events are unmasked, the truth is told and a legacy of the past is acknowledged and remembered. This is particularly important to survivors who experience torture as secretive, their pain and suffering as invisible or hidden – something no one can bear to listen to, no one wants to believe and something the world turns a blind eye to.
The value of justice is summed up by one of our clients:
It would mean that they did not win, they did not destroy me, they will be the ones who have to answer – so the world will know what they did – we are human beings, not ants that can be crushed like we are nothing…
Reparation and the law
International law indicates that States must provide justice, reparation and rehabilitation in respect of acts of torture for which it is responsible. Despite this, access to justice can be problematic or illusory. The Medical Foundation’s clients are very often unable to seek redress in their own countries for a number of reasons. In many cases, those responsible for investigating allegations of torture are also the abusers, with the prospect not only that the complaint will not be properly investigated, but also that the individual will experience further abuse as a result of making the complaint.
In many cases the country’s judiciary does not enjoy independence from the Executive or is subject to interference or abuse from law enforcement or security personnel. In addition, the country’s legal system may lack the appropriate remedies and mechanisms to ensure the proper functioning of an action, or is otherwise unable to guarantee the safety of those bringing the action. Physicians operating in detention facilities and charged with recording injuries may not be able to act freely and independently, with the result that physical evidence of torture will not be forthcoming. In many other cases still, torture survivors have fled their country in order to protect their own lives, and so are simply not in a position to make a complaint to the appropriate authorities even where such a complaint would be properly investigated.
In the words of one of our clients:
You don’t know what it is like in my country – justice? [laughs]. This means nothing when there is a corrupt government, no law, police are criminals, there is nowhere safe – who do you go to? You have to just run.
Access to justice through regional and international judicial bodies can also be difficult for many survivors of torture.
The remit of the International Criminal Court in respect of torture is limited to conflict-type scenarios, encompassing war crimes, where a grave breach of the Geneva Conventions must be shown to have taken place, or a crime against humanity, involving a widespread or systematic attack directed against any civilian population. As a result, many Medical Foundation clients who have suffered torture in detention at the hands of a repressive regime will never have recourse to this or similar criminal tribunals. Even where a torture survivor’s claim falls within the Court’s remit, prosecutorial investigations tend to be aimed at leaders rather than individual, low-level perpetrators, with the effect that many torturers will remain unaccountable for their actions. Finally, criminal processes are aimed at the success of the prosecution, and although some models facilitate a degree of victim participation, the process itself is not victim-centred. As a result, many torture survivors will be left feeling sidelined or used by a process that did not fulfil their hopes or sense of justice.
In addition, although regional human rights Courts are able to hear actions for torture, such bodies are of limited capacity, issue awards of damages which may be nominal only, and permit actions only against signatory States, not specific perpetrators.
Finally, the right of an individual to make a complaint to international human rights treaty bodies such as the UN Committee Against Torture, the Human Rights Committee, the Committee on the Elimination of Discrimination Against Women, the Committee on the Rights of the Child and the Committee on the Elimination of Racial Discrimination is dependent on whether the State itself has agreed that the respective treaty bodies can consider complaints relating to the treatment of an individual. While the treaty bodies are an important element of the international human rights system, even where the State has accepted the right of individual petition, such bodies are unable to impose a tangible or enforceable penalty over and above public sanction.
Concluding comments
Civil action for damages is one aspect of reparative remedies which States can provide to survivors of torture or their families. It is not for everyone. For a vast majority of our clients their health, severe trauma and vulnerability following torture prevent them from considering or seeking-out avenues of complaint. Many are struggling to survive – just to regain a sense of self and dignity. A small minority, at certain stages in their recovery, may be emotionally robust enough to consider seeking redress, but most fear further emotional setbacks by having to relive their memories and going through legal procedures. For those clients who may consider seeking redress, many fear further reprisals and remain intensely preoccupied with the lack of safety for themselves and family members, many of whom remain in the country of origin and have endured harassment, torture and ill-treatment because the client has fled.
For those survivors of torture who want to and are able to pursue an action, however, the enactment of the Torture Damages Bill would be of enormous value in recognising and upholding the inherent dignity and humanity of the individual, whilst at the same time sending out a strong message that torture is wrong and that torturers cannot act with impunity.
It is therefore vital in the fight for accountability that the international framework be supplemented by domestic legislation such as the Torture Damages Bill, and that survivors of torture be able to bring an action for redress in the UK where justice in their country of origin is not accessible or achievable.
For these reasons, the Medical Foundation supports the adoption of the Torture Damages Bill.
May 2008
Post published in: News