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PREFACE AND ACKNOWLEDGEMENT
According to the annual report from Amnesty International in 1988 torture takes place in more than a third of the countries in the world.
It is a terrifying fact that the purpose of torture is to destroy the individual, to break down the personality. This way anxiety and terror is spread to the rest of society. Even more terrifying is the fact that doctors and nurses offer their knowledge and skills to the torturers for this purpose. The torturers know that torture can destroy the mind without killing the body. The development of methods to achieve this is taking place all the time.
Today it is possible professionally to help people who have been tortured in order that they can have a human existence again. In 1976 the medical work against torture was initiated by the Danish doctor Inge Kemp Genefke and since 1980 she, as head of department, has been leading the professional help for torture survivors. The Rehabilitation and Research Centre for Torture Victims (RCT) was opened in 1982 as the first centre in the world offering treatment to exiled torture survivors and their families. Many other places in the world, professional treatment and support for the survivors of torture have been established. It is obvious that these people have a right to the best possible treatment a society can offer. Longer term this helps to prevent torture in the world.
This book will be seen as a direct follow-up to the UN’s Convention against Torture (adopted by the UN 1984). This important convention states in paragraph 10, that teaching and education of health care professionals among others have to be established to inform about the ban on torture.
A very important aim for RCT is to prevent torture and to help create and increase the general awareness about the existence of torture. Modestly, we hope that this book can be one of the means to achieve this.
The book has been written at the suggestions of and in co-operation with the Danish Nurses’ Organisation (DNO), which, with great understanding, over the years has supported the work against torture both in and outside Denmark. The DNO has supported financially and by publishing articles, and at the same time followed the work done with a stimulating interest. Thus in co-operation with RCT, the DNO has published the first textbook in Danish about torture survivors (.1987). I owe special thanks to Kirsten Stallknecht, President of the Danish Nurses’ Organisation.
A warm thank you to Inger Olesen, ward sister, and Maj-Britt Jo-hannessen, staff nurse, both from the neurological department, Rig-shospitalet in Copenhagen for writing the chapter “ When torture survivors are admitted to hospital “.
I must also thank my colleagues at RCT and all those attached to RCT and to the work against torture, who have helped with guidance, critique and artistic contributions to create this book. In particular I would like to thank the artist Nestor Guerrero for creating the beautiful cover for the book.
A special warm thank you to my colleague, Peter Vesti, M.D. specialist in psychiatry at RCT, who has participated in writing the book and who constantly has been an inspiring critic and support.
Bente Bach, senior nurse IT development, Barnet Health Authority, London, has translated the book into English, and I would like to thank her for her co-operation.
Lone Jacobsen
Februaiy 1990.
Chapter 1.
Introduction
To use the term torture victims is in a way misguiding. When we meet victims of torture we really meet people, who are broken body and soul, but who have survived torture. The victims themselves prefer the term “torture survivor" and this term will be used in the remaining part of this book. However, when describing torture and the methods it will be obvious to use the concept “victim".
A main theme throughout the book is that it is normal, healthy people who have been exposed to something abnormal, torture, who require professional help to overcome the sequelae. During that period the victims need the services of the Health Service and will in that context be described as patients.
We have chosen for practical purposes to use the term “he" about the torture survivor. This is solely a practical linguistic measure and does in no way refer to the reality, that a proportion of those seeking treatment are women, and that women also to a large degree are exposed to the most cruel torture.
This book is about torture, its survivors and how we as health care professionals can help this very severely distressed group of people. The sequelae of torture on the individual and his family require special treatment. That is the background for establishing the Rehabilitation and Research Centre for Torture Victims in Copenhagen (RCT). This book describes the treatment at the Centre and how it is organised by a multi-disciplinary team.
However, not all torture survivors need the combined efforts and many are treated by the RCT external treatment network consisting of private practising psychologists, psychiatrists, general practitioners, physiotherapists and relaxation therapists. The therapists, part of the external network, have been trained by RCT in the principles of treatment of the sequelae of torture, and there is a continuous contact between the external network and the Centre both for referral of torture survivors to the network and advice on treatment.
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