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“The psychological effects of torture are most serious…the worst scars are in the mind…”

24-06-2005 Interview

Audio interview with the ICRC's medical coordinator for health in detention, Hernan Reyes.


    On the occasion of the United Nations Day in Support of Victims of Torture (June 26), Hernan Reyes, the ICRC's medical coordinator for health in detention, talks about the ICRC's work in favour of those suffering torture and ill-treatment.  

 1 In your experience, what is the value of ICRC medical visits to detainees who have gone through torture or ill-treatment?
If we are talking about medical visits, I think we need to say that torture indeed has ill effects, bad effects on the health of those people who are tortured and that's why ICRC strives to include a physician on any visit where torture is indeed the issue. If torture is the issue there should definitely be a physician on board. This is for two reasons: first of all, of course we want to document what is happening, to try to intervene, to prevent torture, and for this we need documentation which is credible and done by a physician who knows his job; and the second reason, I think, is even more important. Of course, we cannot " untorture " people. People who have been tortured have been tortured, but just to explain to them we are doing this for future generations is not really very convincing. To have a doctor on board will allow us to explain to the person why he or she can no longer be harmed, why he has trouble in certain positions when he is asleep in bed and, of course, a we have a whole panoply of psychological effects of torture which of course also need to be explained and which the person perhaps will want to have advice on, and this is the least we can do. ICRC is one of the privileged organizations with access to victims of torture while they are still in custody, while they are still possibly in danger of being retortured. So the very least we can do is to answer questions such as: " Will I be able to have a child again after what they did to me? " , " Will I be able to sleep again without having nightmares? " , " Will I be able to move my arms and play football again? " . And all these questions of course can only be answered by a physician who will in many cases have to examine the person and then even though we have no tools to make proper diagnoses on certain things, we can at least provide advice, certain exercises can be done while in custody, certain things to do and not to do and I think this is definitely a very important, and just as important if not more so, than actual documentation.

2 How have the methods of torture and ill-treatment evolved during the last 30 to 40 years?
Well they have evolved in certain w ays and then again they have stayed the same in several ways. Let me explain. Physical torture, brutal torture, torture as you imagine it in the lay public was very much present in the 70s and 80s and it is still around. By brutal torture I mean these physical methods of torture that leave scars and leave what we call traces of torture on the victims, which are very visible and for this reason many countries have sort of moved away from these methods of physical torture because they do not want to leave evidence of torture. On the other hand, some countries don't give a hoot, if I may use the expression, and just keep on torturing because they feel they have low accountability in the first place and ICRC is unfortunately confronted with these situations. As for the other countries which have evolved into this more subtle, if I may say so, forms of torture, which do not leave visible evidence. It is around psychological torture and, of course, we now know after many years, but I will probably come back to that, that psychological torture probably leaves traces in the mind that are much worse than any scars you can have on your body. So we are confronted definitely with this psychological torture, as an entity which people try to use to avoid precisely leaving traces that they will have to be accountable for.
 3 Has the mobilization against torture been successful in diminishing its practice or, on the contrary, are we experiencing an erosion of its prohibition?  
A short answer is " no " and " yes " . Let me explain. Unfortunately, no, mobilization against torture has not diminished torture. It has diminished in some places because the situation has changed, because these places had the political will to do so and, of course, ICRC chips in and participates in this endeavour. But unfortunately globally I must say no, we are definitely not seeing a reduction of torture and yes we are seei ng an erosion or at least some governments are trying to erode the protection against torture, and to erode the prohibition of torture by saying in certain exceptional circumstances there should be some kind of allowance, some kind of acceptance that certain methods, particularly physical and psychological ones can be used for the public good and the protection of nation sovereignty or whatever. So unfortunately we have indeed come across this now and we are confronted with an erosion of the prohibition of torture.
 4 Apart from physical harm, what is the long-term legacy of torture or ill-treatment for the victims?  
It was back in the seventies when several organizations started interviewing and trying to rehabilitate victims of torture coming from Asia, from Latin America, from Africa, Middle East and other places, and these medical groups, that we must say they were medical groups, came across a surprise in their work. They expected physical torture which was then very brutal and very visible was to leave the most lasting effects on the body. Although this was true, they found that the psychological effects, those non-visible effects, were in fact much more serious and I remember Mr. Gustav of Sweden said " the worst scars are in the mind "  and indeed this is something we felt. Physical torture and psychological torture go together. Physical torture has physical effects and also has psychological effects. Psychological torture has psychological effects obviously, but also physical effects, and what these medical groups around the world have found and which we, ICRC, can definitely confirm, is that the worse effects are the psychological ones, and the torturers know this and, as we said, in some cases, they try to change the methods so as not to leave any physical scars. But they definitely try to leave the psychological ones, saying after what we did to you, for example, no-one would ever wa nt to sleep with you again, will never want to have your child or inversely to the woman, after what we did you, will never be able to have a baby again. And I mean just imagine the impact this has on a young, militant or non-militant who has been tortured with electricity, suspended whatever. They don't care about the suspension. They don't care any more about the pain, the electric pain, but this idea that maybe they will be shunned by their village, shunned by their spouse, or shunned by their future husband or wife, who they never be able to approach again, that is definitely the most lasting scar.

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