About Torture - Introduction

Torture is variously defined: the most widely used is that of the UN Conventional against Torture: "any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted by or at the instigation of a public official on a person for such purposes as obtaining from his or a third person a confession, punishing him for an act that he has committed or is suspected of having committed, or intimidating him or other persons ."

Using that definition, torture takes place in more than half of the countries in the world, whether or not they have ratified the convention; the International Rehabilitation Council for Torture Victims (IRCT) provides a rough estimate of the prevalence of primary torture victims worldwide between 10 and 100 millions. It is now most often used as an "oppressive instrument . in the preservation of power" (Maio 2001), aiming to destroy people physically and psychologically. Many people die under torture, so those we see are literally survivors. Since the end of the cold war, victims are not predominantly political prisoners but poor people, minorities, immigrants, criminals and suspects, often women and children, and many torturers are military or paramilitary personnel or police.
.: Recognition and Prevalence
Many torture survivors go unrecognised in health systems in their country of residence. There are few medical or psychological studies of the health consequences of torture and other forms of organised violence. Both physical and psychological methods can leave physical and psychological effects. What is written about the long lasting physical and psychological after effects of torture is often descriptive, based on selected populations and closely connected to the particular context and setting of that population; clinical studies are limited by lack of descriptive or diagnostic criteria applicable across populations and settings; and the choice of comparison populations and assessment instruments is complex.
.: Signs and Symptoms

The most important point to make is that very few methods of torture leave long-term signs which could not have arisen from injury without torture. All that the clinician can do is comment on the likelihood that any observable signs and symptoms are consistent with the effects of torture. However, this is complicated by a number of factors. In many countries, torturers aim to leave as little evidence as possible on the body of the victim to confound attempts to document torture. Further, we know very little about what some of these abuses, particularly when prolonged, do to the human body, as it is beyond any analog research, even with cadavers. In some cases the victim cannot bee clear what was done to him or her or to recall it, particularly when s/he was unconscious at the time or sustained head injuries. Most often, years have elapsed since torture was inflicted, although the survivor may have undergone other privations and health insults in the interim. The commonest complaints are headache, musculoskeletal pain, and abdominal pain

There are two major reasons for medical and psychological examination of the torture survivor: for documentation of torture and its effects, and for delivery of health care. It is therefore helpful for clinicians to be cognizant of torture methods.

What does international law say about the meaning of torture?
The basic definition of torture is that contained in the UN Convention Against Torture (1984) . According to Article 1(1), the term means :

"any act by which severe pain or suffering , whether physical or mental , is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession , punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity . It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions."

From this definition, it is possible to extract three essential elements which constitute torture :

•  The infliction of severe mental or physical pain or suffering
•  By or with the consent or acquiescence of the state authorities
•  For a specific purpose , such as gaining information, punishment or intimidation

Cruel treatment , and inhuman or degrading treatment or punishment are also legal terms which refer to ill-treatment causing varying degrees of suffering less severe than in the case of torture. Forms of ill-treatment other than torture do not have to be inflicted for a specific purpose, but there does have to be an intent to expose individuals to the conditions which amount to or result in the ill-treatment. The essential elements which constitute ill-treatment not amounting to torture would therefore be reduced to:

•  Intentional exposure to significant mental or physical pain or suffering
•  By or with the consent or acquiescence of the state authorities

In order for the international bodies to make a distinction between the different forms of ill-treatment and assess the degree of suffering involved,

Torture may include:

  • systematic beatings
  • being deprived of sleep for several days
  • being subjected to electric shock
  • being submerged head first in foul water
  • being confined to mental hospital on other than medical grounds
  • being given sophisticated drugs
  • starvation
  • exposure to extreme temperatures
  • electric shock treatment
  • live burials ...

Victims of torture are often caught up in government suppression of dissent, they are not charged with any criminal offence and they may be the wives or young children of suspects. They suffer, physically and mentally, long after release.

Effects of torture may include:

  • serious injury and/or paralyses
  • destroyed minds
  • emotional scars
  • death
  • disappearance - a terrible form of torture for those left behind ...

Torture is not just an expression of sadism, practiced by those who deal with prisoners. It becomes an institution, part of the system, authorised by governments, connived by officials at every level, and accepted as a "necessary evil".

There are, however, also many 'grey areas' which do not clearly amount to torture, or about which there is still disagreement, but which are of great concern to the international community. Examples include:

•  Corporal punishment imposed as a judicial penalty
•  Some forms of capital punishment and the death-row phenomenon
•  Solitary confinement
•  Certain aspects of poor prison conditions , particularly if combined
•  Disappearances , including their effect on the close relatives of the disappeared person

Treatment inflicted on a child which might not be considered torture if inflicted on an adult.

Who are the perpetrators?

As is emphasised in the section describing what is torture, it is necessary that the behaviour in question be carried out by, or with the approval of, a representative of the authority in power. This means that any state official could potentially be involved in torture or ill-treatment. However, considering the common purposes of torture, which may be to obtain information during an interrogation , or, increasingly, to intimidate the population as a whole in the face of insurrection or disturbance, it is unsurprising that the principal perpetrators are those officials involved in the criminal investigation process, and those responsible for the security of the state.

This means that those most likely to be involved in torture and other forms of ill-treatment include :

•  The police
•  The military
•  Paramilitary forces acting in connection with official forces

But could also include :

•  Prison officers
•  Death squads (torture following disappearance and preceding killing)
•  Any Government official
•  Health professionals - doctors , psychiatrists or nurses may participate in torture either by act (direct involvement which may include certifying someone fit for interrogation ) or by omission (falsifying medical reports or failure to give appropriate treatment)
•  Co-detainees acting with the approval or on the orders of public officials

Who are the victims?

Anybody can be a victim of torture - man or woman , young or old, religious or atheist, intellectual or farmer. Very often the determining factor may be membership of a particular political, religious, or ethnic group or minority . However, no-one should be considered immune.

The identity of the victim is important because:

•  Specific groups, such as children , women , the elderly , or religious persons , may be more vulnerable to the effects of ill-treatment, making it easier to consider that the degree of suffering is severe enough to amount to torture.

Where is torture most likely to occur?

While the majority of such places will be familiar to those in the local area and are official places of detention, it is fairly common for other, unacknowledged places of detention to exist also. These could range from installations which are regularly used for such purposes, (e.g. a disused factory or Government buildings), to those which are used in a particular case because they are convenient on that occasion. (e.g. a school building used as a holding area, or even open land).

Remember that torture does not have to be confined to a place of detention and may occur in the victim's own home or during transportation to an official place of detention.

When is torture most likely to occur?

•  The greatest risk of torture and other forms of ill-treatment to individuals is in the first phase of arrest and detention, before they have access to a lawyer or court. This risk persists as long as the investigation lasts, irrespective of where a suspect is being held.

•  Incommunicado detention (i.e. detaining somebody either without acknowledgement or without allowing them access to anyone, such as their lawyer or family) is probably the single highest risk factor for torture because it means that there is no external