RCT Annual Report 2007

RCT07 Rehabilitation and Research Centre For Torture Victims

Annual Report 2007

THEME

RESEARCHING TORTURE IN A CHANGING WORLD

CONTENTS Editorial

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THEME: Researching torture in a changing world The relationship between RCT’s research clusters The changing face of torture Common ground between development and research The RCT Field Manual of Rehabilitation New knowledge of pain in the feet after falanga When does a war end?

The victims’ stories Confinement, survival and justice from below Rehabilitation is also about good living conditions Largest knowledge resource in the world Praise for research

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Reorganising rehabilitation New opportunities and challenges for international work Denmark called before the UN Anti-torture Committee Highlights of the year Publications Donations Annual Accounts

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Annual Report 2007 Rehabilitation and Research Centre for Torture Victims, RCT Borgergade 13 P.O. Box 2107 DK-1014 Copenhagen K Phone: +45 33 76 06 00 Fax: +45 33 76 05 10 e-mail: rct@rct.dk www.rct.dk SE-nr. 69 73 51 18 Giro BG Bank nr. 1199-0007383940 Dansk Bank nr. 3001 4310821209 Editors Bengt H. Sjölund (Editor-in-chief) Signe Trier Tue Magnussen Heidi Koch Tokle Edith Montgomery Ann Persson Graphic design Eckardt ApS Production Sangill Grafisk ISBN: 978-87-90878-24-5 ISSN: 1396-2418 Printed in Denmark 2008

Printed on Cyklus Offset

Editorial The Rehabilitation and Research Centre for Torture Victims celebrated its 25 year anniversary in October 2007 in the presence of the early pioneers, our dedicated, multiprofessional staff, NGO partners from many countries in the South as well as invited prominent guests, notably the Danish secretary of foreign affairs, mr Per Stig Møller. A time for joy in the stately environment of the city hall in downtown Copenhagen, but also a time for reflection – why are organizations like ours needed more than ever – why was not torture and organized violence eradicated long ago?

Many reports by observers all over the globe, directed to the media, to the Committee Against Torture, to the High Commissioner for Human Rights of the United Nations and to the blogosphere, demonstrate that torture is still abundant, occurring in more than half of the world’s countries, not only in the South, but also in countries in the North, sadly even in some of those that have traditionally stood up for personal freedom and human rights.

A scientific foundation for torture prevention In 2007, our organization has taken further significant steps as evident from the present yearly report with the theme on research. Our present focus on intensifying research by systematic high level capacity building, including the development of research programs, is a significant ongoing achievement, where data generation in previously ignored or insufficiently penetrated areas now becomes possible. Historically, much of the writings in the field have been marred by superficial and repetitious descriptions, often reflecting opinions rather than evidence. The evaluations of interventions have often been subjective and lacking in substance.

This, we hope, will now be replaced by a situation where reliable data based on sound observations are collected in properly designed projects and trials. When designing a research project, it is important to consider quality, i. e. that we can be sure that the data is reliably showing what we want to examine. The ultimate proof of scientific quality is to get a study published in an international, independently peer reviewed publication, whether a journal or a book. Here, RCT nowadays performs very well.

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Integrating research and interventions However, for RCT research this is not enough. Our research must also have clear relevance for our stake holders, i. e. the results must have strong value and meaning in the fight against torture and organized violence (TOV) and to assist TOV survivors. Such relevance can be more or less immediate, either by providing practical advice on interventions on individual, community or state levels or by developing theoretical models and principles for TOV related problems. This work also demands contextual knowledge from the researchers on community and individual levels, either on prevention or on rehabilitation, and RCT is fortunate to have been able to recruit researchers with such contextual profiles.

In an ongoing process, the RCT International department is simultaneously developing new projects as well as carrying out established projects to support local NGOs to produce change and impact in their countries. Here, fruitful collaborations between RCT program managers and researchers have been initiated and provide a unique opportunity to use RCT’s multiple strengths for its overriding cause.

Strengthening communication At the same time, the new information must be communicated to users all over the world. This will mainly occur via our English web page on the internet, where documents from the RCT documentation centre can already be downloaded in full text versions. So, for the issues you cannot find in this booklet, visit our homepage: www.rct.dk ! It is our ambition to use this type of communication also for more detailed project reports, for lessons learnt and for the new Field manual on Rehabilitation in different language versions.

Last but definitely not least we will maintain our Danish-speaking web page for easy access for the Danes at large, for persons in need of treatment, for colleagues from other centers and referring physicians and for our lively advocacy in Denmark including the important dialogue with our Danish supporters.

Professor Bengt H. Sjölund, Director of the RCT 1

THEME: RESEARCHING TORTURE IN A CHANGING WORLD

The relationship between RCT’s research clusters Steffen Jensen, senior researcher

RCT has played a leading role in the global anti-torture movement for a quarter of a century. The organisation and its partners have succeeded in placing torture high on the international agenda, and in pioneering rehabilitation and documentation work. The Research Department’s capacity has increased year on year since it was established in 1999, and has been organised in the clusters Rehabilitation and Prevention since 2005. A third research cluster, Populations and Communities, was introduced in 2006.

RCT and its Research Department are unique in many ways, both in Denmark and globally. Few organisations of this kind have been so focused on building up a strong, relatively autonomous internal research unit, and it is rare for medical research to be combined with public health, psychology and social studies research. The integration of knowledge generation, rehabilitation and prevention work with a worldwide network of partner organisations and research institutions affords RCT a singular perspective. However, it also presents a multitude of challenges, and demands hard work, plenty of reflection and strong collegiate bonds that transcend departments.

Old truths and new challenges This work will continue in 2008, but new challenges will also be taken up. Following pressure from our partners, RCT has expanded its focus from dealing only with torture in the original sense to also addressing the concept of “organised violence”. At the same time, RCT and others in the anti-torture movement also have to address the fact that although torture is widely condemned, it is also considered by many to be a legitimate tool in the fight against society’s “enemies”: the terrorist, the criminal, the drug dealer, etc. The challenge is to retain our original focus and energy while simultaneously expanding our slightly narrow mandate to make room for new types of violation.

Prevention and rehabilitation – individual victims, communities and perpetrators The expansion of RCT’s research focus to include organised 2

violence has also resulted in an expansion of the groups and individuals included as research subjects. Whereas previously the focus was solely on torture victims and their persecutors, research now focuses on four different groups: victims of civil and international conflict; persecuted groups and individuals; tortured and traumatised refugees and migrants; and interned individuals and groups. The range of groups of persecutors has also been expanded, from the state official in the police or prison service to also encompass militias, vigilantes and paramilitary groups. Again, the challenge is to keep both new and old balls in the air.

RCT and the Research Department deal with both rehabilitation and prevention. This entails testing and improving upon methods of treatment and prevention initiatives that originate anywhere in the world. This differentiation between prevention and rehabilitation is a key aspect of RCT’s research. It is also vital to differentiate between individual survivors of torture and organised violence, vulnerable communities and populations subjected to violence, and the perpetrators of violence at state and/or non-state level.

RCT and the Research Department set ambitious targets. We aim to integrate rehabilitation and prevention, and to think in an integrated manner about the relationship between perpetrators, communities and individual victims, in terms of both research and intervention.

The Research Department has grown significantly since its modest beginnings seven years ago. In 2005, it employed four more researchers and got a new director with a strong research background. The Department expanded with the help of external research funds, comprising six PhD students, three researchers and six senior researchers at the end of 2007. It also secured funding for four more PhD students from the beginning of 2008. In addition, three other employees (two librarians and a documentalist) are engaged in building up the world’s largest and most authoritative collection of torture documentation.

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The changing face of torture Henrik Rønsbo, senior researcher

The story of RCT is inextricably intertwined with shifting cultural perceptions of torture,which are also reflected in and challenged by scientific studies of the subject.

Torture today is a multi-faceted phenomenon, and so now, more than ever, it demands close scientific scrutiny.

James Bond is stretched out on a table. Goldfinger, the archetypal baddie, wants him to reveal what the British Secret Service knows about his gold-smuggling operation. Bond remains calm as laser beams approach his undercarriage. By means of cunning and subterfuge, he manages to save his own life.

Scenes like this are part and parcel of our cultural baggage, and serve to define our concept of torture. For decades, our thinking was focused on the torturer – usually an SS officer or KGB agent who used violence against heroic opponents. As the USA and the Soviet Union sought military allies all over the world, the number of domestic conflicts grew, and so did the number of refugees. Between 1975 and the end of the 1980s, the numbers grew from 2.8 million to almost 15 million. Many felt that humanity was being crushed by this conflict between the superpowers, so supporting refugees who had survived torture seemed to be a natural response.

and better understand the types of torture to which the victim had been subjected, the consequences of their ordeal were described. New methods were developed of analysing and assessing the physical consequences of torture such as burn marks and damaged joints. As early as 1988, neurological scanning technology was also used to document comprehensive changes to the brains of our clients.

A world in dissolution The end of the Cold War in the early 1990s, and the subsequent bipolar world order breakdown, heralded a period of major change. While many areas found themselves at peace for the first time in years, new wars broke out elsewhere – e.g. in Iraq and Yugoslavia. RCT now moved increasingly towards international work, backing up NGOs as a part of the UN’s work on rehabilitation, democratisation and the construction of modern legal systems. But it was an unavoidable fact that, even though many of the proxy wars had ceased, a new era of instability had begun. The UN’s limitations had become all too clear. The Yugoslavian wars could not be stopped, and large tracts of the African continent found themselves mired in low-intensity conflict. Much of Central and Western Africa, Transcaucasia and parts of Afghanistan were taken over by warlords and militias.

National cause During the Cold War years, the prevailing image of the torture victim was that of the heroic survivor – a person who, simply by remaining alive, had achieved some measure of triumph over a murderous nation state. Many Danes reached out to these victims when refugees started to arrive from Greece, Chile, Argentina, the Soviet Union and Poland in the 1970s. This image was also at the core of the 1984 Torture Convention, which railed against the brutal treatment meted out to individuals by states.

In the early 1990s, the RCT clients in Copenhagen – Somalis, Afghanis, Palestinians, Iraqis and former-Yugoslavians – came to reflect the new conflicts. The focus shifted from the individual survivor’s torture syndrome to traumatised refugee families fleeing from war, burdened by psycho-social problems and often post-traumatic stress disorder. Torture survivors were no longer heroic individuals, but persecuted and often absolutely ordinary families.

It was against this background that opposing torture became something of a national cause in Denmark and the RCT was founded. From the outset, the collation of knowledge was therefore focused on the survivor, the individual who came to the clinic. As might be expected, the clinical research tradition prevailed at RCT at that time. In order to improve diagnosis

In the name of terror With the 2001 attack on the World Trade Center in New York, this picture of the world changed abruptly. Less than two months after 11 September, military action was instigated in Afghanistan, followed shortly afterwards by the invasion of Iraq. The concept of torture took on new nuances. The ques-

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THEME: RESEARCHING TORTURE IN A CHANGING WORLD

The changing face ... tion of who you could torture and whether it could be justified suddenly became topical for many Danes. What would you do if you could save 1,000 people from dying in a terror attack by torturing a single terrorist?

Time after time, we are now presented with torture as a solution to angst and fear. In attempting to prevent a terror attack, Jack Bauer, the main character in the hit TV series 24, made the method of torture known as “waterboarding” known far and wide. It is now no longer the baddie who is the torturer – it is our hero, who uses torture to safeguard democracy and freedom. Many of our preconceptions have been turned upside down. It is hardly surprising that people are confused.

Wide-ranging research Fear of terror has taken over where compassion for victims used to hold sway. Therefore, more than ever, there is a need for a comprehensive, research-based understanding of torture.

We need to understand every aspect – from neurological studies of brain damage in victims, to anthropological studies of torturers and armed groups. And in the middle, between these two research dimensions, RCT must strive to understand the lives of the persecuted. Whether individuals or groups, they inhabit the same society and the same world that we do. The solid foundation of a wide-ranging research tradition represents the best possible way of beginning not only to remedy the effects of torture and violence, but also to prevent them.

Common ground between development and research Heidi Koch Tokle, science writer

RCT has received a number of new grants for development research in recent years. The research is designed to improve the quality and effectiveness of interventions in the rehabilitation of torture survivors and the prevention of torture and organised violence (TOV). This means that practitionens and researchers must continually evaluate and renew their working methods – a process that is in full swing at RCT. Privileged co-existence RCT is one of the few NGOs privileged enough to have an international intervention department and a research department under the same roof.

“It is a great advantage to have researchers around you,” says Jan Ole Haagensen, Head of International Work. “You regularly get challenged by people who have the time to take an indepth look at your work. The presence of a separate research area makes it possible to critically assess some of the conditions upon which interventions are based, and identify those practices that turn out to be ineffective.”

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Senior researcher Steffen Jensen is in no doubt that co-existence has a clear advantage.

“As RCT researchers, we are subject to the realities of intervention. When the two otherwise separate areas of research and intervention come together, then the ethical dilemmas and questions become clearer.”

Challenges Both agree that this mutual benefit also brings with it a number of challenges and structural problems. Firstly, the approaches of practitioners and researchers are fundamentally different. Where the researcher seeks reliable data in order to increase their understanding of an issue, the practitioner’s focus is directed towards social change. The researcher’s demand for long-term relationships can conflict with the practitioner’s ongoing evaluation of a partnership’s value. The practitioner has to trust that the researcher’s analysis will not destroy fruitful relationships that it has taken many years to establish.

Most importantly, both researchers and practitioners have to respect each other’s and the partners’ integrity.

RCT ANNUAL REPORT 2007

Independent or commissioned research “You cannot conduct your research as if it was being done at a university,” Jan Ole Haagensen says. “A different approach is required. RCT is a normative organisation, and even our name is controversial. We have a mission – freedom from torture and relief for the victims.”

Ways part quite easily when it comes to discussing research priorities. Where practitioners and partners demand applied knowledge in the form of expert advice, studies and evaluations (e.g. of the effectiveness of different forms of therapy), researchers want to prioritise long-term basic research. The issue of who determines the scope of research is another area fraught with danger – and on top of that come questions of how to involve the partners and who owns the data.

“The researcher’s independence is enormously important,” says Steffen Jensen. “For example, data has to be controlled in order to avoid manipulation.

However, the way in which the results are subsequently presented and used is beyond the control of researchers.”

The value of the research results depends upon your point of view. For many researchers, the focus is on new insights into complex issues; they have less interest in the study’s conclusion and the messages that can be extrapolated from it. For practitioners, the message and its effect on individuals, relationships and organisations is the Alpha and Omega. The question of perspective is also crucial as far as advocacy is concerned – although research-based messages are often more convincing than claims and assumptions, this does not mean that practice-generated knowledge has no validity.

Partnerships that work In South Africa, torture disappeared along with apartheid – or did it? The project “Profiling Torture in South Africa” is an example of successful co-operation between researchers and development staff. The objective of this intervention by RCT and its South African partners is to criminalise torture and get the government to take the police’s actions seriously. Officially, torture is disowned, but in practice it is tolerated. Much of WWW.RCT.DK

what takes place in the country’s prisons, closed institutions and police stations can be categorised as torture.

“If people are asked whether the police have permission to torture, then the answer is no,” explains Steffen Jensen. “If they are asked whether the police have permission to beat a suspect, then the answer is yes. We often hear about beatings, mock executions, and police officers who place prisoners in a particular department knowing full well they’ll be raped. There is a need to establish a knowledge base. The mere fact of clarifying that this is indeed torture, the act of defining it as such, makes a political difference.”

By way of example, a media-monitoring project has been launched in order to draw attention to news stories that reveal the use of torture. At the same time, work is currently being done to document and evaluate the rehabilitation methods used by our South African partner.

Transcending disciplines One outcome of this project is that RCT’s practitioners and researchers, along with those of our South African partner, have become better at working together. It has been difficult, and has placed great demands on resources, but the participants report that it has all been worth it. A new way forward has emerged.

From the outset, social-science researchers, lawyers and medical researchers have helped to define the project and provide a clear common goal. The different academic microscopes have come together to focus on the same area, which has generated commitments – both to the project and to a great extent also to one another – that transcend traditions, disciplines and languages.

“It is not merely a matter of commissioning consultancy services,” says Steffen Jensen. “I don’t just contribute one single piece of input, I’m there for the duration of the project. The bonds between the participants gradually become closer along the way – how we use each other’s knowledge and competencies is far more important than whether you are a practitioner or a researcher.”

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THEME: RESEARCHING TORTURE IN A CHANGING WORLD

The Rehabilitation Cluster The Rehabilitation Cluster focuses on chronic pain and pain management, as well as chronic stress and higher brain functions. Work continues on the consequences of torture by falanga, and on the development of process indicators in pain rehabilitation. In the light of research into methods for quantifying the consequences of torture, indicators have been developed that can be used both in the systematic monitoring of clients at RCT and in the supervised clinical experiments currently planned by RCT.

The RCT Field Manual of Rehabilitation Bengt H. SjĂślund, Director of the RCT and Edith Montgomery, Director of the Research Department

Since many years, RCT representatives in the field have received numerous questions about specific health advice regarding torture survivors and their rehabilitation. The new RCT Field Manual on Rehabilitation is intended to meet that need for evidence-based or consensus-based advice in attempts to rehabilitate survivors of TOV in regions lacking specialized medical care.

The manual is not a textbook of traumatology; rather it is specifically directed towards the rehabilitation of survivors of TOV, from 3 months after the trauma and onwards. It is an attempt to provide practical recommendations for health workers at different skill levels.

Rehabilitation approach The organization and emphasis of the manual is one of its kind. It is problem-oriented, not professionally oriented, since the survivor presents with one or several problems and does not usually have access to multi-professional healthcare. It uses the globally developed concepts of the International Classification of Functioning & Disability (ICF; WHO, 2001) rather than diagnoses from Western medicine. This serves to emphasize the rehabilitation approach, which is focused on a person’s ability to be active and to participate, rather than on disease or on remaining injury. Thus the problems are listed in the three sections: Body Functions; Activities & Participation and Context.

Interdisciplinary and integrated approach Each entry word defines a problem that a survivor may experience and the advice given is presented at three levels: 1) for a healthcare assistant or layman with some training); 2) for a healthcare professional; and 3) for a physician with the 6

relevant specialization. A separate section details commonly employed therapies in TOV survivor rehabilitation, followed by selected references. The compilation has an interdisciplinary and integrated approach and contains physical, physiological, pharmacological, psychological, social, psychiatric and therapeutic aspects.

Emphasizing cultural perspectives At RCT, we are very much aware that the general knowledge and cultural traditions in a local community are extremely important for the satisfactory outcome of rehabilitation efforts.

Therefore, the manual is by no means an attempt to impose a Western model of health care without acknowledging local customs and practices. Only by acknowledging and integrating local concepts of health, disease and healing can rehabilitation, group cohesiveness and empowerment be successfully promoted. RCT therefore recommends that the advice given should be combined with such contextual inputs.

Evidence base and experience Hopefully, the manual will constitute a valuable tool and guide in therapy, not only for survivors of TOV, but also those of other psychosocial traumas. The authors have been assembled from present and past staff from the RCT rehabilitation, research and international departments, using up-to-date systematic reviews of controlled clinical trials as well as their extensive experience in rehabilitation for the advice given. The text is also the result of active and open exchange via workshops and the RCT’s joint work with partners. It is through this open and integrated approach between science, practice and contextual experience that RCT may contribute significantly as a knowledge center.

The manual will be made available in several languages via www.rct.dk. It will be regularly updated, thus the present version should be seen as a first attempt, and suggestions for improvements are invited, to be sent to: rct@rct.dk.

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New knowledge of pain in the feet after falanga Karen Prip, PhD student

The falanga method of torture involves systematic repeated blows to the soles of the feet with clubs, iron bars, cables or other blunt objects. The pain is reported to be so intense that it is conveyed from the feet up through the body to the brain.

Immediately after the blows, the feet begin to bleed and a build-up of fluids causes swelling that spreads from the lower legs to the knees. The bleeding and the excess fluids disappear after a few weeks provided the torture is not repeated.

The long-term effects of falanga are often severely disabling and lead to significant deterioration in the quality of life. Physical activity in which the feet are put under pressure, such as going up or down stairs, walking to the shops or playing football with one’s children, becomes extremely difficult and excruciatingly painful. Burning and stabbing sensations in the soles of the feet can arise spontaneously or be triggered by walking.

A group of male falanga-torture victims, who had previously completed an interdisciplinary rehabilitation model at RCT, participated in the study. The control group consisted of men of the same ethnic background and age, but without a history of torture. The purpose was to examine their feet in detail in order to try to understand the underlying pain mechanisms.

Impaired sensitivity The results show that torture victims suffered from chronic pain in their feet and the lower part of their legs. This adversely affected their gait, which subsequently caused tension and muscle pain. Typically, this pain was exacerbated by time. Another symptom was impaired sensitivity in the painful areas, the most common being reduced sensitivity to light contact WWW.RCT.DK

and a deterioration in their ability to differentiate between hot and cold. We also encountered dysesthesia, an unpleasant and abnormal feeling produced by physical contact, and allodynia, i.e. pain induced by something that would not normally do so.

These clinical findings did not exist, or were rare, in the control group. Observations of pain in the falanga group’s feet could then be divided up into two different chronic states of pain: one in which pain arises absolutely spontaneously without any outside influence; and one in which pain arises from physical activity, such as walking.

Nerve malfunction Finally, we observed obvious clinical signs of nerve malfunction in the feet of torture victims. The sensory findings point towards two neuropathic pain mechanisms: one is dominated by a peripheral pain generator as a result of permanent nerve malfunction in the sole of the foot; the other is an irritative phenomenon that suggests oversensitivity of the central nervous system. These changes must be ascribed to the falanga torture, as no other explanation could be found in the victims’ medical histories.

The study showed that physical contact with an oversensitive area of skin often exacerbates pain. This was the case in two-thirds of the torture victims’ feet and lower legs. This may explain why a gradual increase in physical activity, as often prescribed for chronic pain patients by physiotherapists, is inappropriate for victims of falanga. Tests should be conducted on special footwear that can alleviate the strain on the sole of the foot.

We also recommend an individual diagnostic analysis in order to produce indications regarding specific medicinal treatment.

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Photo: Andrew M. Jefferson

THEME: RESEARCHING TORTURE IN A CHANGING WORLD

The Populations and Communities cluster The work in the Populations and Communities cluster combines research and intervention programmes, as well as research into the consequences of torture and organised violence (TOV) among particularly vulnerable groups. It focuses on the inter-generational repercussions of TOV, in both the short and long term, as well as on the development of knowledge about the culturally conditioned coping strategies employed by those affected by TOV. The articles on this page are just two examples of research in these fields.

When does a war end?

Sven Arvid Birkeland, senior researcher

The arrest and torture of members of the Danish resistance movement left its mark on up to three generations, as documented in the book Captured by the Germans: Danes in World War II. The project interviewed resistance fighters, their children and grandchildren, and gave the victims the opportunity to acknowledge that they not were alone in carrying their trauma within them for up to 60 years. Many expressed a desire to meet their “own kind”, which became possible with the establishment of an informal network for children of the resistance movement. The network’s members have now met several times, gathering to reflect upon their experiences and unravel their painfully tangled recollections.

A daughter explains: “As a kid I was extremely lonely, as my dad was a man whom the war had scarred deeply, both physically and mentally. He was a communist and resistance fighter, and filled me with nightly horror stories about his wartime experiences, especially as a prisoner of the Germans. This was not something I could share with my mother, my sisters or my friends. By knowing something that they didn’t, I felt sullied, that I had an insight into something terrible that I was almost incapable of putting into words. It was just such a big thing.”

“It is still very difficult to think about it even now, because it is so painful. It brings back memories of eternal sleepless nights when, after listening to my father’s accounts, I would lie there horrified and alone in the dark.”

“My sisters and I didn’t play with Barbie dolls or read Donald Duck comics, but we knew the names of all the torture methods and we could make the perfect molotov cocktail. All three of us probably felt different from the other children and young people. The war was with us all the time when I was young – if I came home late, I’d find Dad crumpled, crying on the floor, because my heels on the parquet floors sounded to him like the boots of German officers, and his mind was instantly transported back to the camps. But on the outside he was this strong, charismatic person who made things happen. I loved him deeply and hated him fervently at the same time. He died when I was 23.”

“I am interested in whether others felt the same loneliness, and maybe also a duty to read everything about the war and watch every TV documentary on the subject. While the other kids wrote about their pets or their summer holidays, all my essays at school were about World War II. Right from when I was really small up until my father’s death, I carried with me the name of the commandant from the camp he was in, so that I would know him if I met him – and I fully intended to kill him.”

“I feel soiled, infected or worse, as if certain themes have been inflicted on me against my will. It is very difficult, as it is not something you can simply share with anybody else, certainly not with your peers.”

“I have used my father’s story in various artistic projects, but have never really spoken with anybody about it. In some ways I feel that perhaps I am now betraying him. My father was greatly admired by many people. By explaining how I knew him, I feel as if I am taking some of the shine off of his halo.

We talk about him often, my sisters, my mother and I, and we are always very careful about what we say. It is extremely seldom that anything really negative ever comes out. He is still the hero.”

A war never ends.

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The Victims’ Stories – insight into an international research programme Lotte Buch, PhD student

The participants in “The Victims’ Stories” workshop held in 2007 in Antigua, Guatemala, demonstrated great commitment to the research programme. Among the subjects of lively discussion were participants’ experiences of research methods and the programme’s implications for practices that transcend academic and cultural boundaries. The workshop culminated in the drafting of a protocol designed to guarantee better links between research and practice, and to ensure that research results are used to determine practice in global TOV work, specifically in the fields of rehabilitation and advocacy.

Torture has changed greatly in the last 30 years, and so, therefore, has global anti-torture work. Research is now also directed at the context in which TOV takes place, instead of just focusing on individual survivors. The context also takes into account the social reality in which NGOs (e.g. RCT and its partner organisations) are required to act in their work against TOV and for the rehabilitation of victims.

Victim categories The research programme looks at how victim categories are created within the international health and development system, and how these make their mark on politics and policy.

“Victim categories” refers to target groups for intervention, and also to the subdivision of these groups into primary and secondary victims for the purpose of assessing whose need for systematic intervention is the greatest, and what form that intervention should take. The categories are regular subjects of political and economic negotiation within regional and local development and health organisations.

The project also explores how the affected social groups overcome and cope with suffering in their daily lives. This is sometimes done in conjunction with the intervening organisations, but on other occasions is independent of them or runs counter to their wishes. Overall, the programme’s aim is to help make RCT’s and the partner’s efforts more result-oriented, and therefore strike a chord among the target populations.

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Results for the time being The interaction between research and practice was of central importance throughout the research process. This is a far from unproblematic area, as research seeks to generate knowledge, whereas the purpose of practice is to generate change.

Nevertheless, ongoing discussions held throughout the research period helped to ensure a synergy effect, thereby avoiding parallel and unrelated paths being taken by the researchers and the practitioners.

One of the research programme’s outcomes is the revision of the way in which the South African project partner Masisukumeni conducts preliminary studies of clients and their needs.

Their new method looks at the client’s overall circumstances, rather than merely defining the person in question as a victim of violence. The Guatemalan organisation ECAP (Equipo de Estudios Comunitarios y Acción Psicosocial) has utilised the knowledge from the research programme in their lobbying work at policy level, as well as in setting up the national inquiry commission for the victims of the civil war (1966–1996).

What these results have in common is that they have emerged through sustained co-operation and discussion between the programme’s participants, including psychologists, researchers and administrators at all levels. Continued dialogue between all stakeholders in anti-TOV work is necessary if research results are to be translated into improved practice and better research methods.

Facts about the research programme “The Victims’ Stories” was financed by the Danish Research Council on Society and Business. The programme was launched in South Africa in 2005, when participants from RCT, the Masisukumeni Women’s Crisis Centre in South Africa, and ECAP in Guatemala met for the first time to discuss methodological strategies for data acquisition in South Africa, Guatemala, Colombia and the occupied Palestinian territories. The field work in Colombia and on the West Bank is in full swing, and a South African PhD student is being funded by RCT. The research programme is expected to conclude with a conference in Copenhagen in autumn 2009.

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THEME: RESEARCHING TORTURE IN A CHANGING WORLD

The Prevention Cluster The Prevention Cluster works thematically with research into the use of torture by state and non-state institutions and networks. The “War on Terror� and the democratisation wave that has swept over large parts of the non-Western world have necessitated research into the relationship between these political processes and TOV. The focus has expanded from the traditional torturer to cover vigilante groups, militias and political groupings. The article on this page underlines the importance of understanding the lives of those involved in TOV as a precondition for effective intervention.

Confinement, survival and justice from below Andrew Jefferson, researcher

Confinement and survival are the two dominant themes emerging from analysis of data conducted during seven months fieldwork in Sierra Leone as part of a research project on detention and violence. The project featured data collection via participant observation and interviews amongst former combatants, former prisoners and prison officers across sites as diverse as the state prisons, the courts, police stations, the urban ghetto and former rebel bases in the jungle. In December 2007, the dominant themes of survival and confinement were presented and discussed by a group of stakeholders at a seminar in Freetown which marked the culmination of the project.

These stakeholders represented eight organisations actively involved in justice sector reform issues; the seminar was entitled Justice from Below.

Approaching issues of justice sector reform from below, through long term ethnographic research creates opportunities to think differently about the justice sector, its institutions and its practices. This was one of the aims of the project and is a characteristic of prevention research more generally at RCT. The Ghetto or the Prison Confinement is a rather obvious theme in the context of prison studies. What is interesting however, is the degree to which confinement is a cross cutting theme in a state as fragile as Sierra Leone in at least two respects. For the first, our examination of the social life of the prison reveals that prison officers experience almost as much confinement as prisoners. For the second, confinement is not limited to judicial institutions; it is also a characteristic of the everyday lives of ghetto dwellers, refugees, former combatants and former prisoners. As much as these groups of people struggle and manoeuvre to make a living more or less legally, possibilities to establish sustainable livelihoods and live lives free of violence are severely limited.

Freedom is a relative concept. As the sociologist Loic Wacquant has pointed out in relation to the USA, the prison and the ghetto are actually homologous and perform similar func10

tions. Our data from Freetown reinforce this point. Examining instances of societal suffering through the lens of confinement has proved a productive point of departure for the analysis, and it certainly resonated with participants in the stakeholders’ seminar.

Making Sense of Violence Survival is clearly related to confinement. When prisoners, prison officers, ghetto dwellers and others experience their lives as confined and their possibilities limited, then their choices, motives and rationales become increasingly oriented towards everyday survival. To put it another way, the moral imperative is survival! This was illustrated by the case of 43 Liberians refugees in Sierra Leone arrested and tortured after violently protesting outside a local office of a humanitarian agency. When examined carefully in relation to this case, the violence of refugees can be understood in its own terms as a rational response to decades of accumulated suffering and unmet expectations. We do not want to justify violence but seek an understanding of how it makes sense to those who perpetrate it. This is what is involved with studying violence and justice from below.

Volatility and Change in Fortunes The ethnographic approach of the project focused on studying people in situ as they moved across what we now can call sites of relative confinement. Contemporary and retrospective data was collected via participant observation and interviews which clearly showed how many of the particularly young people simply move from one form of confinement to another. Some former junior combatants for example have moved via forced recruitment into militias to prison to the ghetto. The dynamics of these institutions are similar. It is little surprise that they are open to violent remobilization, if the resources offered outweigh the travails of everyday life and offer hope for a different future. Other more senior combatants, whom the study encountered just out of prison, RCT ANNUAL REPORT 2007

have recently shifted position radically as a result of the opposition party winning elections. No longer outcast political prisoners, they now form the inner core of the new president’s security entourage, illustrating the volatility of politics in fragile states.

Justice from Below The perspective of justice from below seeks to illuminate the dynamics of everyday life of those for whom access to justice is a rarity. A focus on the demand for justice and experiences of injustice provides an alternative lens through which to un-

derstand the post-war world, different from that utilized by traditional intervention and justice reform agencies which tend to focus more on the supply side of justice that is on institutional and legal infrastructure and training. The stakeholders’ seminar presented an opportunity for the two worlds to meet.

As results from the study enter the public domain in the form of publications, it is hoped that they can be taken up by a wider array of practitioners and policy makers. One significant lesson of this study is that the prevention of TOV demands both understandings of everyday practice and interventions which take these understandings into account.

Overview: Research projects 2007 Rehabilitation

Populations and communities

Prevention

Ann L. Persson and Bengt H. Sjölund: Mechanisms for pain after TOV

Edith Montgomery: The mental conditions and integration of young refugees from the Middle East

Andrew Jefferson: State and non-state detention practices in Sierra Leone

Karen Prip: Falanga torture: Reduced functions, pain mechanisms and behavioural consequences

Henrik Rønsbo: The influence of violence on social and gender identity in Latin America and psycho-social initiatives in communities

Andrew Jefferson and Steffen Jensen: The reformation of justice institutions in transitional societies

Kamilla Portala: Post-traumatic biological changes in the brain

Henrik Rønsbo, Steffen Jensen: The victims’ stories: Building communities, context, trust and social inclusion

Steffen Jensen: State and non-state police practice in South Africa

Bengt H. Sjölund: Instruments and principles for the evaluation of rehabilitation in an ICF perspective

Shr-Jie Wang: Epidemiological study of torture and political violence in areas of conflict

Daniel Merrick: Monitoring of the rehabilitation programme in respect of function loss due to chronic pain

Sven Arvid Birkeland: The long-term consequences of German torture during the occupation

Ann L. Persson: Symptom-monitoring instruments

Lotte Buch: Sexual violence and gender definitions on the West Bank

Bengt H. Sjölund: The rehabilitation field manual

Stine Finne Jacobsen: Social misery, livelihood and networks among the internally displaced in Colombia

Henrik Vigh: Youth, mobilisation and social navigation in Guinea Bissau Anton Petrenko: Torture in ex-Soviet republics

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Helene Risør: Security patrols in El Alto, Bolivia

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THEME: RESEARCHING TORTURE IN A CHANGING WORLD

Rehabilitation is also about good living conditions Signe Trier, communications officer

Although many refugee children are traumatised by war and organised violence, it is not the experiences they carry with them that determine their long-term development. Rather, it is the conditions in which they live in their new country. The rehabilitation of torture-victim families is therefore not simply about ameliorating trauma, but is to just as great an extent about creating frameworks that support the children’s development.

This principle was the starting point for the network project “Towards a Joint Approach”, the intention of which is to strengthen preventative efforts among the most vulnerable children and reduce the likelihood of them getting involved in crime. Karlebo Council tested the concept with particularly positive results, and it will be introduced by several other Danish local authorities in 2008.

Stressful living conditions “Towards a Joint Approach” is partially inspired by Director of Research at RCT, Lic. Psycologist Edith Montgomery’s longterm research on refugee children, which highlighted the specific problems faced by vulnerable families.

“In addition to the trauma the families must overcome, they must also face a number of other stressful factors, such as language barriers, difficulties in finding work, isolation from the rest of society and dependence on social-support systems,” explains Edith Montgomery. “The mother, who may be traumatised herself, often has to take care of many tasks on her own because the father is suffering from the consequences of torture. It can therefore be difficult for her to cope with the children’s problems too.”

Images of the enemy There are usually many different professionals involved with vulnerable families, including case-workers, school psychologists, teachers and doctors. Because of poor communication between the different stakeholders and a lack of knowledge of one another, it is often the case that they pull in very different directions. Edith Montgomery mentions as an example a mother whose son had problems in school. She was encouraged to play an active role in her son’s schooling, but at the same time the local authority sent her on a welfare-to-work programme. The authorities in this case constituted an obstruction.

Misunderstandings are not uncommon. They can originate in a lack of knowledge of, for example, cultural behavioural norms 12

and practice, and can cause those involved to develop an image of the other parties as “the enemy”. As well as impeding intervention, this generates a certain distance between the stakeholders, and has a destructive effect on co-operation.

Ultimately, it impacts upon the kids and influences their opinion of the authorities in a negative direction.

A common goal “’Towards a Joint Approach’ is about strengthening co-operation between all those involved in the children’s day-to-day life,” explains Montgomery. “The work has to be synchronised, so that everyone works towards a common goal – that is creating frameworks that underpin the children’s development.”

In practice, this happens via what are known as network meetings, at which all the relevant players gather around a table. Facilitated by a specially trained chairperson, the meetings enable the professionals to gain a more holistic insight into the families’ issues and the children’s backgrounds. In the example of the mother cited above, the solution was to make her participation in the son’s schooling a part of her welfareto-work programme.

For parents, the meetings provide an opportunity to air their concerns and influence the decision-making process. The faceto-face meetings and mutual dialogue also help put a human face on both a family who are otherwise just another case, and a local authority that is an otherwise hostile system. The meetings are not just about solving specific questions and coordinating initiatives. They are also about changing attitudes and demystifying images of the enemy.

International perspectives The project uses a community-based method in which the rehabilitation work takes place both in the local environment and in close interaction with it. “It is the way many of our partners work,” says Edith Montgomery, who therefore feels it is only natural to try it here in Denmark. She also thinks that the idea of getting the different bodies involved in intervention to collaborate could be applicable elsewhere in the world, even though it would be different stakeholders around the table. The aim is to refine the idea in collaboration with RCT’s partners – and to this end a report describing the project’s method and experiences was published in both Danish and English in 2007.

RCT ANNUAL REPORT 2007

Photo: Willi Hansen

Largest knowledge resource in the world Heidi Koch Tokle, web editor/science writer

designed ‘Reindex’, for use by RCT’s external and internal users. The result is a modern, flexible system and a website that provides ample opportunity to add further tools and online user services in the future.”

The manager of the Documentation Centre Sven-Erik Baun provides easy access to knowledge on torture. Photo: Signe Trier

RCT’s Documentation Centre and Library collates literature and information about torture and organised violence. In 2007, it provided materials to users from 29 countries around the world. An ever-growing number of external users visit the website to gain direct access to the centre’s online documents and information-retrieval services. The website also offers a number of invaluable online tools.

The physical library is visited every year by researchers, students, journalists, authors, etc., several of whom stay for prolonged periods as part of their research. Sven-Erik Baun, the manager of the centre, recalls its inception: “When RCT was set up in 1982, it was clear to the organisation’s founder, Inge Genefke, that Danish and international work to prevent torture and help victims would be greatly assisted if all of the available knowledge of torture and its repercussions were gathered in one place, registered, and made available to RCT and other organisations and individuals. The development of the library commenced a couple of years later, and a publicly accessible library and archive opened in 1987.”

Rapid development Since then, the RCT Documentation Centre and Library has expanded, and is today an absolutely central national and international torture information resource.

“The Documentation Centre collates, registers and makes accessible all published scientific information about torture, irrespective of language and where it is published,” Baun explains.

“We are also continually developing our online systems. In 2007 we worked on adapting a new library system, the DanishWWW.RCT.DK

Tailor-made online tools One such online tool is the “Thesaurus of Torture Terminology”, which was developed by Documentation Centre staff in 2007. The first edition of the thesaurus consists of an Englishlanguage list of technical terms associated with torture and the rehabilitation of torture victims, and includes short definitions of the central technical terms in this field. In 2008, the thesaurus will gradually be incorporated into the database system, and ultimately will also be put at the disposal of other organisations in order to collate subject indices of documents referring to torture.

“We expect to face many challenges in the near future,” says Baun. “We have an ever-growing number of users, both internal and external, who have ever-higher expectations and requirements for up-to-date, effective forms of communication in terms of literature and information provision. As far as possible, we will attempt to continue to fulfil our support functions for RCT and act as a central knowledge resource for global research, prevention and rehabilitation work on torture and its victims.”

About the collection At the end of 2007, the library contained approximately 7,000 books and reports, as well as 14,000 articles about torture, organised violence and other relevant subjects. These are all registered in the library’s database, which is freely accessible on the Internet. The collection also contains images (e.g film, photographs, drawings and watercolours) and comprehensive archive material about individual countries, collated from both printed and online sources. An ever-growing number of bibliographic databases and online magazines are available for RCT staff and visitors to the library. The library makes an active contribution to increasing the volume of reliable, freely accessible information about torture on the Internet. We do this by requesting that people and organisations make documents that are only available in hard copy available to us for digitalisation and conversion into full-text versions in the library’s database.

The Documentation Centre website is at: http://www.reindex.org/RCT/rss/Portal.php

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THEME: RESEARCHING TORTURE IN A CHANGING WORLD

Praise for research Tue Magnussen, advocacy co-ordinator

RCT’s Scientific Committee described research performance in 2007 as “highly satisfactory” in its evaluation and presentation to the RCT board in March 2008.

The report to the Board also stresses that the content, relevance and themes of RCT’s research are all relevant and deserve to be developed. The Committee points out that the “perpetrator question” ought to receive more attention, and that greater consideration ought to be given to the potential inherent in geographical and thematic approaches. Finally, the Committee stresses that “the planning of scientific studies to assess the effects of the development of rehabilitation efforts is particularly relevant”.

The work of the committee Established in 1983, the Scientific Committee is only a year younger than RCT itself. Its task from the outset has been to advise the Board on questions of research, a role that became more and more important as RCT began to conduct its own research in extension of its therapy and teaching work.

The importance of the Scientific Committee continued to grow as a result of RCT’s increasing emphasis on research. In early 2002, actual terms of reference were drawn up that describe the purpose and duties of the Committee, which comprises five or six people appointed by the Board. The members of the interdisciplinary Scientific Committee, have expertise in health sciences, social sciences and the humanities, which reflects RCT’s fields of research. All are qualified to at least associateprofessor level, and are employed by either a university or a research institution. The members serve for a maximum of six years.

with international developments in relevant research methods and results, and to help set up and provide input to relevant research networks. Once a year, a joint meeting is held with the RCT Research Department, which in 2007 consisted of nine researchers, plus PhD students and research assistants.

First and foremost, the Scientific Committee monitors and evaluates the quality of RCT research projects, including their methods, results, presentation and ethics. The findings are collated in the form of an annual report, which is presented to the RCT board.

Evaluation of research in 2007 In the Scientific Committee’s March 2008 report to the Board, Professor Anders Foldspang of the Institute for Public Health at the University of Aarhus, the chairperson since 2002, wrote that RCT’s research performance in 2007 “must be considered highly satisfactory”. He described the research’s academic level as “internationally competitive” and that “productivity, assessed as the number of publications per research year, is on at least the same level as general university quantifications and must be considered highly satisfactory”. It is stressed that “all academic articles are published in international, peer-reviewed magazines”. Professor Foldspang also mentions that RCT research appears in “a number of other types of publication, including several weighty books”. A total of 19 academic publications are included in the list of publications in this annual report (see page 22-23).

The Committee advises the Board on RCT’s research policy, and advises the director and research manager on strategies and methods for systematically collating and documenting instances of torture and organised violence. In addition, two or three meetings are held per year in order to keep up to date 14

RCT ANNUAL REPORT 2007

REHABILITATION

Reorganising Rehabilitation Lise Worm,, MD, acting head of the Rehabilitation Department

The Rehabilitation Department has undergone major changes since it came under the Hospital Act in 2006.

Torture survivors in need of treatment are referred to RCT by their general practitioner or another specialist.

The treatment is mainly provided in house at RCT, but sometimes also takes the form of home visits, training with a physiotherapist, or of case-workers assigned to accompany clients to meetings with local authorities or to prosthetics consultations.

The clients are individually assessed in terms of their need for three potential forms of treatment. A key aspect of this part of the process is that four therapists are allocated to each client – a psychologist, a social worker, a physiotherapist and a doctor – to make sure that the client’s issues are addressed in an interdisciplinary manner. RCT evaluates the client’s needs on the basis of interviews with the four therapists. If clients are deemed to belong to our target group, they are referred to one of our three teams. In the past, most were offered individual treatment, but the range of available treatments was changed in 2006, when three teams were set up to offer individual, family or group therapy.

Challenges faced - shown in waiting list The Hospital Act led to changes in administrative procedures, as per the operational agreement with the Regions. A waiting list was also introduced, rendering visible the status of the treatment needs of torture survivors. As per 31/12 2007, there were 142 clients on the external waiting list and 24 clients on the internal list. Waiting times depend on the type of treatment required, but can be as long as two years. Long waiting times will be one of the challenges faced by the treatment system in the future.

2007 in brief In 2007, the Rehabilitation Department focused on implementing, developing and improving the new structure. Of the 185 people referred to RCT last year, 129 were undergoing treatWWW.RCT.DK

ment as of 31/12 2007. The Individual Team had 27 clients in treatment as of 31/12 2007. The Family Team was treating 97 people from 25 families. The Group Team continued to develop group therapy, which started in the current form in 2005.

Greater emphasis was therefore placed upon providing individual consultations parallel with group therapy in 2007. Groups are assembled from the waiting list on the basis of gender and language. Two groups (Farsi speakers and Bosnian men) completed their therapy last year, and two Arabic-speaking men’s groups were set up. A pain school for Arab women is also due to begin in February 2008.

The vast majority of clients at RCT need interpreters for the duration of their therapy, and good interpreters are the key to successful treatment. In 2007, the Department again recruited and retained a well-qualified staff of interpreters who are offered supervision and time off for in-service training.

WHO project In addition to its clinical work, the Department participated in various other activities in 2007. A national project involving seven rehabilitation centres for torture victims has been launched in order to implement the WHO’s ICF monitoring programme (International Classification of Functioning, Disability and Health). As part of this project, RCT helped define relevant classification codes, which will be tested on six clients in the Rehabilitation Department in 2008. In the longer term, RCT aims to introduce the ICF codes into its monitoring work as a means of describing the client population and the effects of the treatment.

Open house One of RCT’s aims is to disseminate information about the effects of torture and the treatment of torture victims. Several therapists are currently training students and graduates in torture-specific aspects of health care. The Rehabilitation Department also organised an “open house” event on International Day in Support of Torture Victims (26 June), which was very successful.

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INTERNATIONAL WORK

Kissi Town, Sierra Leone. Photo: Andrew M. Jefferson

Children in Gaza

New opportunities and challenges for international work Jan Ole Haagensen, head of the International Department

These days, it can be difficult to spot positive global trends in the struggle against torture. However, the work of RCT’s International Department in 2007 revealed several rays of hope.

For a start, preventative work has been strengthened with the passing of the UN’s Optional Protocol to the Torture Convention. This is designed to help states improve their supervision of conditions in prisons and other forms of custody, as the risk of torture is particularly great in closed institutions. Under the protocol, the signatory states are committed to accepting control visits from UN experts and establishing effective national preventative mechanisms.

The protocol paves the way For RCT, this means increased demand for our knowledge of torture prevention. The protocol is now a central element in our partnerships with the Philippines, Cambodia, Bangladesh, South Africa, Albania, Honduras and Guatemala. We have already harvested many valuable experiences that will be applicable elsewhere. This provides us with new opportunities, but also poses new challenges. On the one hand, it entails closer co-operation with state institutions, which can be vital to our work on curbing the use of torture. On the other, it is crucial that we retain our integrity and continue to act as an independent critical player.

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New foothold in the Middle East 2007 also saw constructive dialogue with official state bodies in other contexts. Good progress was made in RCT’s partnership with the Jordanian government under the Danish Ministry of Foreign Affairs’ programme “The Arab Initiative”, which is aimed at preventing torture in prisons and custodial institutions. In the autumn we held the first regional seminar in the Middle East on this subject. NGOs from 13 countries in the region met to exchange their experiences of prison supervision.

The meeting revealed significant differences between the countries in the region. However, the interest shown by the Arab media bears witness to the fact that initiatives such as the Optional Protocol have enabled NGOs and others to legitimately discuss the conditions of those whose liberty has been taken from them, even in countries that have not yet signed up to it.

After the conflict Other regions face different issues. The poorest parts of Africa are often bogged down in wars and conflicts, as a result of which absolutely fundamental material and organisational resources are scarce and the social structure is fragile. This is certainly the case in Sierra Leone, where the majority of the educated population have fled and the infrastructure has broken down. In 2007, we started a pilot project designed to help heal the wounds inflicted on the country by 12 years of civil war. Our biggest challenges here involve examining and RCT ANNUAL REPORT 2007

One man’s fate

by Erik Wendt, programme manager for Asia Giving torture victims a name and a face is one way in which RCT encourages decision-makers to take action. In 2007, we succeeded in drawing attention to the case of journalist and human-rights activist Jahangir Alam Akash from Bangladesh.

Akash’s critical reports on the Rapid Action Battalion (RAB), Bangladesh’s infamous police corps, led to three weeks’ imprisonment, during which he was severely tortured. Although he was eventually released on bail, he is still not safe from prosecution. He has been subjected to false accusations, and the RAB even threatened to kill him if he went public with his story. As a result, he went underground and has not been able to return home to his wife and six-month-old son.

Routine use of torture Akash’s story is not unique. Since the 1971 war of independence with Pakistan, Bangladesh has suffered several periods of martial law. The legal system, police and security forces routinely use violence and severe torture as weapons against civilians and political activists. The victims are powerless and seldom dare submit complaints or act as witnesses in court cases.

Seminar on violenceprevention in Guatemala. Photo: Rodrigo Barahona

Along with our partner BRCT, RCT has employed active advocacy as a means of exerting pressure on the Bangladeshi government to guarantee Akash’s safety. We contacted the Danish Minister for International Development Co-operation, Ulla Tørnæs, in advance of her visit to Bangladesh. She met with the head of BRCT and expressed grave concern about the many reports of human-rights violations. She also promised that Denmark, along with the other EU countries, will bring the case up with the authorities in Bangladesh.

A step towards better prevention in the Middle East

by Søs Nissen, programme manager the Middle East

understanding the dynamics in place both during and after the conflict, and applying this knowledge to local and national reconciliation programmes. We also need to facilitate treatment for victims of war by ensuring the necessary preconditions are in place for a smoothly functioning and viable organisation.

Multiple paths to change RCT’s preventative and development-oriented work is predominantly based on the long, hard slog. Torture will not be abolished in a month, a year or a decade. However, RCT and our partners can, both together and separately, employ active advocacy to influence political decision-makers and create positive openings right now. This can happen at national level, where we change policies and rules to restrict torture, or on an individual level, where a single person receives the attention and protection they sorely need. Personal histories can play a vital role in influencing decision-makers. The case of Jahangir Alam Akash, a Bangladeshi journalist and human-rights activist mentioned elsewhere on these pages, is a case in point.

RCT and its partners’ anti-torture work is important because it means that official bodies are continually confronted with torture and its consequences. Making issues topical and newsworthy prevents the problem from growing in secret. This means that all of RCT’s work towards its over-arching goal – freedom from torture – contributes, in large ways or small, to limiting the scope of torture.

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Torture is a widespread problem in the majority of Arab states – both as a means of preserving political power and as part of ordinary police investigations. Although prison supervision is not a new phenomenon in the Middle East, access is restricted and granted only by the grace of the authorities. In September 2007, RCT organised the region’s firstever seminar on prison monitoring, in which NGOs from 13 countries gathered to exchange experiences.

For several national NGOs, the seminar was principally about establishing formal agreements with the states in question and gain access to the prisons. In order to promote such agreements, NGOs refer to international resolutions and the Torture Convention, as well as to positive experiences from Eastern European states.

Where agreements already exist, or where the national human-rights institutions have a statutory supervisory mandate, the issue is all about the difficult balancing act between maintaining a critical monitoring role and at the same time being able to continue dialogue with the authorities.

Following the seminar, RCT received regular progress reports from the participants. In the Lebanon, Jordan and Palestine, national monitoring seminars are planned for 2008. In Morocco, the Bar Association wants to include a special session on monitoring at its annual conference.

Both RCT and our partner APT provided input into these activities.

It’s just the beginning, but the subject is now on the agenda. It is hoped that a regular regional forum will be established in order to continue the exchange of experiences but this will be dependent on funding and resources.

The seminar was held in collaboration with the Association for the Prevention of Torture (APT), the Jordanian Human Rights Society and the Mizan Law Group for Human Rights, and is funded by the Ministry of Foreign Affairs/Danida (the Danish International Development Agency) under The Arab Initiative.

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PREVENTION

Denmark called before the UN Anti-torture Committee Dorrit Rée Iversen, legal advisor

“Torture has to be forced out into the light, and combating torture must therefore continue to be an important issue for Denmark,” said the Minister for Foreign Affairs, Per Stig Møller, at an event to mark the 25th anniversary of the RCT on 30 October 2007. The minister is right when he says that torture is still a key Danish issue.

Indeed, successive Danish governments have utilised the corridors of power, e.g. in the UN, the EU and the European Parliament, to speak up on behalf of torture survivors and work to guarantee compliance with the ban on torture.

Shadow reports and watchdogs International standards on torture were laid down by the UN’s Torture Convention, which came into force in 1987 – the same year that Denmark ratified it. It demands that torture is made punishable, that torturers are brought to book and that survivors receive treatment and restitution. The UN’s anti-torture committee was established to guarantee that these obligations are met.

Denmark has been right at the forefront of this work, and in international circles we are considered a pioneering country.

We are one of the nations others look to as an example of how to ensure compliance with basic human rights, such as the ban on torture. But with recognition comes responsibility – we must be absolutely sure that the fulfilment of our international duties is beyond question.

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RCT ANNUAL REPORT 2007

On 2–3 May 2007, Denmark came before the committee for the fifth time. The hearing was based on a report from the Danish state and so-called “shadow reports” from watchdogs such as RCT and Amnesty International. The Danish state’s report outlined the steps that had been taken to comply with the Torture Convention. On the other side of the coin, the shadow reports focused on cases that provide cause for concern about Danish compliance.

The committee’s conclusion was basically positive, and praised the Danish state for the depth of its commitment to international anti-torture work and its close co-operation with civic society.

The committee also recognised the Danish state’s continued efforts to improve conditions in prisons and other forms of detention. However, Denmark was not given an entirely clean bill of health. Partly based on RCT’s shadow report, the committee had some harsh words of criticism too – although Denmark’s status as a pioneer in this area did provide some measure of mitigation.

Familiar concerns The committee looked at a whole series of concerns, some very familiar. One question in particular revolves around the need for a regulation on torture to be incorporated into the Danish penal code. This has been the subject of much discussion in the domestic debate, especially in the period leading up to the hearing, when the Ministry of Justice asked a panel of criminal-law experts to look into the issue. A bill may be submitted in 2008.

Without a specific regulation on torture in criminal law, the usual rules about the statute of limitations apply, and torture crimes become exempt from prosecution after a period of 10 years. The committee highlighted the fact that torture is such a serious crime that there should be no statute of limitation. Denmark must not run the risk of becoming a refuge for torturers.

Solitary confinement Denmark’s use of solitary confinement was once again the subject of criticism. The committee was troubled by the widespread use of isolation among prisoners on remand, particularly in the case of the indefinite isolation of terror suspects.

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The initiatives taken by Denmark in this area were judged to be inadequate. The committee stated that Denmark ought to consider using isolation only as a last resort – and even then only for as short a period as possible.

Extradition to torture In response to the case where Danish forces transferred prisoners in Afghanistan to the Americans, as depicted in the documentary The Secret War, the committee emphasised that the ban on extraditing people to countries where they risk torture is absolute, and is not one that can be waived or watered down. If there is any risk of torture, the detainee cannot be handed over.

The committee also once again drew attention to the necessity of having an independent tribunal in place to study complaints against the police. Doubts were raised about the existing system and about the degree to which the Danish Police Complaints Commission is truly independent from the organisation it is set up to monitor.

In addition, the committee highlighted the fact that it still takes too long to process asylum-seekers through Danish refugee centres, which can result in long-term psychological damage.

Nobody is immune from criticism From the watchdog’s perspective, the committee’s conclusions show that the system works – at least in the Danish case.

Namely, the conclusions demonstrate how important it is for all stakeholders to play a part in the process. Without the state’s report there would be no assessment; without shadow reports from the national watchdogs, the extremely topical and sensitive cases would perhaps go unnoticed. The conclusions also illustrate that nobody is beyond the committee’s reach, and that even countries like Denmark can have difficulty living up to their international commitments.

It is hoped that Denmark will try to do something about some of these criticisms before it is once again called before the committee in June 2011. RCT and the other watchdogs will do their best to keep the Danish state’s eye on the ball.

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Highlights of the year...

20 March, The Premiere of the Multimedia Story Network for Rami RCT made use of new media to raise awareness of a research project on the subject of networking. The multimedia narrative Network for Rami presents a method and a number of practical tools for the prevention of crime among children of torture survivors. It is available on the RCT website at www.rct.dk

26 June, Open House on Torture Victims Day The 2007 United Nations International Day in Support of Victims of Torture was marked with an open-house event in the Rehabilitation Department. The event was of particular interest to case-workers and health-care professionals in the public sector, who regularly come into contact with torture survivors.

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RCT ANNUAL REPORT 2007

Foto: RCT

30 October, Challenges for Rehabilitation and Prevention Topical challenges in rehabilitation and prevention work were the subject of a conference held to coincide with RCT’s 25th anniversary. The event was attended by speakers from both sectors, both from Denmark and abroad. The “rehabilitation” part of the conference consisted of three insightful lectures about the latest research into neurobiology and PTSD, effective treatment, and developmental psychology. “Prevention” focused on developments in international defence and security policy, and their consequences for both theoretical and practical preventative work.

30 October, Anniversary Party Copenhagen City Hall provided a beautiful setting in which to mark RCT’s 25th anniversary, complete with musical performances and speeches. The Minister of Foreign Affairs, Per Stig Møller, drew attention to RCT’s professional approach and described the organisation as a “solid sparring partner”. In a special video message, Archbishop Desmond Tutu said, “Torture is a global phenomenon, and the struggle against it must be global”. He praised RCT’s pioneering work in rehabilitation and research, and was particularly pleased that RCT had in recent years strengthened reciprocal exchanges of knowledge and practical experience with its partners.

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10 December, “Break the Silence” Concert The winners of RCT’s essay competition aimed at high school students were announced at the “Break the Silence” benefit gig at Copenhagen JazzHouse, which saw performances by some of the best up-and-coming young bands: Lily Electric, Ali Kazim and We Go Ego. The prizes were awarded by a panel of judges consisting of documentarymaker Christoffer Guldbrandsen, musician and songwriter BlæsBukki (also known as Lasse Baungaard), and journalist Anita Bay Bundegaard.

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PUBLICATIONS

International peer-reviewed articles

International books and book chapters

Other books and book chapters

Andersson E, Persson AL, Carlsson CPO: Are auricular maps reliable for chronic musculoskeletal pain disorders?: a double-blind evaluation.

Acupuncture in Medicine, 2007, 25 (3): 72-79

Buur L, Jensen S, Stepputat F (eds.): The Security-Development Nexus: Expressions of Sovereignty and Securitization in Southern Africa.

Uppsala: Nordic Africa Institute, 2007

Birkeland SA: Taget af tyskerne: danskere i 2.

Verdenskrig. København: Gyldendal, 2007

Dersh J, Mayer T, Gatchel RJ, Towns B, Theodore B, Polatin P: Psychiatric comorbidity in chronic disabling occupational spinal disorders has minimal impact on functional restoration socioeconomic outcomes. Spine, 2007, 32 (17): 1917-1925

Buur L, Jensen S, Stepputat F: The securitydevelopment nexus: introduction. In: Buur L, Jensen S, Stepputat F (eds.): The SecurityDevelopment Nexus: Expressions of Sovereignty and Securitization in Southern Africa. Uppsala: Nordic Africa Institute, 2007: 9-33

Dersh J, Mayer T, Theodore BR, Polatin P, Gatchel RJ: Do psychiatric disorders first appear preinjury or postinjury in chronic disabling occupational spinal disorders? Spine, 2007, 32 (9): 1045-1051

Jacobsen L, Montgomery E: Treating torture victims. In: Schulz WF (ed.): The phenomenon of torture: readings and commentary. Philadelphia: University of Pennsylvania Press, 2007: 285-296

Dorr LD, Thomas D, Long WT, Polatin PB, Sirianni LE: Psychologic reasons for patients preferring minimally invasive total hip arthroplasty.

Clinical Orthopedics and Related Research, 2007, 458 (May): 94-100

Jensen S: Security and violence on the frontier of the state: vigilant citizens in Nkomazi, South Africa. In: Ahluwalia DPS, Bethlehem L, Ginio R (eds.): Violence and non-violence in Africa. New York: Routledge, 2007: 105-123

Furlan AD, Sjölund BH: Igniting the spark?: editorial. Pain, 2007, 130 (1-2): 1-3

Jensen S: Through the lens of crime: land claims and contestations of citizenship on the frontier of the South African State. In: Buur L, Jensen S, Stepputat F (eds.): The Security-Development Nexus: Expressions of Sovereignty and Securitization in Southern Africa. Uppsala: Nordic Africa Institute, 2007: 193-211

Hauggaard A, Persson AL: Specific spinal stabilisation exercises in patients with low back pain: a systematic review. Physical Therapy Reviews, 2007, 12 (3): 233-248 Jefferson AM: Prison officer training and practice in Nigeria: contention, contradiction and re-imagining reform strategies. Punishment and Society, 2007, 9 (3): 253-269 Mandel L, Worm L: Documentation of torture victims, assessment of the start procedure for medico-legal documentation. Torture: journal on rehabilitation of torture victims and prevention of torture, 2007, 17 (3): 196-202 Montgomery E, Foldspang A: Discrimination, mental problems and social adaptation in young refugees. European Journal of Public Health, 2007 [Electronic prepublication] Qouta S, Punamäki R-L, Montgomery E, El Sarraj E: Predictors of psychological distress and positive resources among Palestinian adolescents: trauma, child, and mothering characteristics. Child Abuse & Neglect, 2007, 31 (7): 699-717 Sjölund BH, Persson AL: Pressure pain threshold changes after repeated mechano-nociceptive stimulation of the trapezius muscle: possible influence of previous pain experience. Journal of Pain, 2007, 8 (4): 355-362

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Jensen S, Buur L: The nationalist imperative: South Africanisation, regional integration and mobile livelihoods. In: Buur L, Jensen S, Stepputat F (eds.): The Security-Development Nexus: Expressions of Sovereignty and Securitization in Southern Africa. Uppsala: Nordic Africa Institute, 2007: 63-84 Johansen ML, Mouritsen T, Montgomery E: Towards a concerted effort: networking to prevent youth crime in traumatized refugee families. 2.ed.

[1st ed. in Danish only]. Copenhagen: RCT, [2007].

Petersen HD, Rønsbo H: Documenting interventions in prisons: studying the PRIVARCT project 1999-2003. (Praxis Paper, no. 4).

Copenhagen: RCT, 2007.

Sjölund BH (ed.): Contrib. Authors. Harlacher U, Jansen GB, Kastrup M, Madsen A-G, Montgomery E, Prip K, Sjölund BH: RCT Field Manual on Rehabilitation, Ver. 1:1, Copenhagen: RCT, 2007 Vigh H: Youth soldiers. In: Middleton J, Miller J (eds.): New Encyclopedia of Africa, 2.ed. Chicago: Charles Scribner’s Sons, 2007

Iversen DR, Rytter TM: Forbuddet mod tortur i dansk ret. In: Plum L, Laursen A (eds.): Enhver stats pligt...: international strafferet og dansk ret.

København: Jurist- og Økonomforbundets Forlag, 2007: 357-389 Johansen ML, Mouritsen T, Montgomery E: Mod en fælles indsats: netværksarbejde til forebyggelse af ungdomskriminalitet i traumatiserede flygtningefamilier. 2.udg. København: RCT, [2007].

Kessing PV, Rytter T: Den humanitære folkeret og Danmark. København: Dansk Røde Kors’ Folkeretsudvalg, 2007.

Magnussen T: Torturens historie. In: Bjerg J (ed.): Gads Psykologi Leksikon. 2. udg. København: Gad, 2007: 664 Montgomery E: Epidemiologi. In: Bjerg J (ed.): Gads Psykologi Leksikon. 2. udg. København: Gad, 2007: 151-152 Montgomery E: Flygtningebørn. In: Bjerg J (ed.): Gads Psykologi Leksikon. 2. udg. København: Gad, 2007: 177-178 Montgomery E: Tortur. In: Bjerg J (ed.): Gads Psykologi Leksikon. 2. udg. København: Gad, 2007: 663 Vigh H: Et barn på 34: om krig og social reintegration i Guinea Bissau. In: Valentin K, Christiansen C (eds.): Unge liv i Syd: beretninger om børn og unge i udviklingslande. København: Danmarks Pædagogiske Universitets Forlag, 2007: 195-210

Articles in professional journals and specialist magazines Haagensen JO: The role of the Istanbul-Protocol in the uphill battle for torture survivors being granted asylum in Europe and ensuring the perpetrators pay.

Torture: journal on rehabilitation of torture victims and prevention of torture, 2007, 17 (3): 236-239 Jefferson AM: The political economy of rights: exporting penal norms to Africa. CJM: Criminal Justice Matters, Winter 2007/08 (no.70): 33-34 Jensen S, Sikhauli E: Sundhedspraksisser og sundhedssystemer i Nkomazi. Den Ny Verden, 2006 [udg. 2007], 39 (3): 69-77

RCT ANNUAL REPORT 2007

Nissen S: Besættelse og tortur. Palæstinaorientering, 2007, 29 (4): 4-7 Nissen S: Stadig tortur. Palæstina-orientering, 2007, 29 (4): 8-9 Pedersen HJ: Fysioterapeuten skal passe på sig selv. [Interview with Lone Tived]. Fysioterapeuten, 2007, 89 (12): 24-27.

Risør H: Mellem hyperrealitet og usynlighed: ’den kriminelle’ i Santiago, Chile. Den Ny Verden, 2007, 40 (2): 15-26 Turner S, Vigh H (eds.): Den Ny Verden, 40 (2): Usynlighed: globaliseringens blinde vinkler.

København: DIIS. Dansk Institut for Internationale Studier, 2007

Magnussen T: Tvangsforsvindinger skal stoppes.

Kristeligt Dagblad [daily newspaper], 2007, October 9: 9

Contributions to subject gateways and other electronic media Jacobsen L: Handlerum - undersøgelser og behandling. traume.dk, [2007]. http://www.traume. dk/sundhed/sygeplejersker/Handlerum/ Jacobsen L: Screening - for traumer og tortur. traume.dk, [2007]. http://www.traume.dk/sundhed/sygeplejersker/Screening_for_traumer/ Jacobsen L: Søvnbesvær og mareridt. traume.dk, [2007]. http://www.traume.dk/sundhed/sygeplejersker/Hvile_og_sxvn/

Vigh H: Er konflikter noget særligt afrikansk?

[Book review: Violence, political culture and development in Africa / Preben Kaarsholm m.fl.].

Udvikling, 2007, 33 (2): 22

Master’s theses, student dissertations, etc.

Vigh H, Turner S: Usynlighed. Den Ny Verden, 2007, 40 (2): 7-14

Klahr A: Rehabilitering af torturramte flygtninge: et kvalitativt studie af fysioterapeuters kliniske resonnering. Syddansk Universitet, 2007.

Kandidatspeciale.

Feature articles etc.

Andersen MK: 286.000 forklaringer på forandring i Bangladesh. Information [daily newspaper], 2007, July 24: 20 Andersen MK: Politisk krise i Bangladesh.

Information [daily newspaper], 2007, January 25: 24 Birkeland SA: Læger og tortur. Politiken [daily newspaper], 2007, June 26 (section 2): 5-6 Iversen DR: Sri Lanka og det glemte folk.

Jyllands-Posten [daily newspaper], 2007, October 4 (section 1): 11 Magnussen T: Danmarks særlige ansvar: kommentar. Information [daily newspaper], 2007, January 16 Magnussen T: Strid om ny præsident kan udløse Albansk nyvalg. Information [daily newspaper], 2007, July 23: 7 Magnussen T: Kampen mod tortur fortsætter.

Kristeligt Dagblad [daily newspaper], 2007, June 26: 9 Magnussen T: Tag kritikken alvorligt: menneskerettigheder. Information [daily newspaper], 2007, May 31

WWW.RCT.DK

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DONATIONS

RCT is extremely grateful for the following donations from Danish foundations and trusts.

Unless otherwise stated, the money was allocated to RCT’s general work.

Forskningsrådet for Kultur og Kommunikation (The Danish Research Council for the Humanities) DKK 3,777,000 for the research project The Violent Organisation of Political Youth. An ethnographic comparison of mobilization and radicalization processes Novo Nordisk Fonden DKK 700,000 for research projects in 2008 Foundation Jochum DKK 91,060 for the PhD research project Falanga torture: Reduced functions, pain mechanisms and behavioural consequences Danske Fysioterapeuters Forsknings-fond DKK 23,000 for the PhD research project Falanga torture: Reduced functions, pain mechanisms and behavioural consequences Kong Christian den Tiendes Fond DKK 20,000 for the PhD research project Falanga torture: Reduced functions, pain mechanisms and behavioural consequences

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Lippmann Fonden DKK 20,000 for the PhD research project Falanga torture: Reduced functions, pain mechanisms and behavioural consequences Civiling. Frode V. Nyegaard og hustrus Fond DKK 17,000 for the research project German torture of members of the Danish resistance during the occupation Egmont Fonden DKK 150,000 for translation and printing of the report “Towards a Joint Effort” Tømmerhandler Johannes Fogs Foundation DKK. 15,000 for the writing and distribution to Danish upper-secondary schools of materials about the essay competition Fabrikant Mads Clausens Fond DKK 10,000 Grosserer Andreas Collstrops og søn Rudolf Collstops Mindelegat DKK 50,000 Aase og Ejnar Danielsens Fond DKK 100,000 Gerda Lautsens Fond DKK 20,000

Fabrikant Kaj E. Nielsen og Gudrun E. Nielsens Fond DKK 5,000 Det Obelske Familiefond DKK 25,000 Scandinavian Tobakskompagnis Gavefond DKK 30,000 Private donations DKK 415,342 Other support Copenhagen Catering

Although a great deal of the RCT’s national and international activity in 2007 was funded by the Royal Danish Ministry of Foreign Affairs and the Ministry of Health, one of the criteria for the allocation of public funding is that other RCT activities must be privately funded. The donations listed above have therefore been invaluable to the work of the RCT, and the Centre would like to express its gratitude for both the financial support and all the other support it received in 2007.

It is of great importance to our clients, the torture victims, that the RCT enjoys financial support from the Danish people.

RCT ANNUAL REPORT 2007

ANNUAL ACCOUNTS

Annual Accounts, RCT

January 1 - December 31, 2007

Income The Danish Ministry of Foreign Affairs, Framework Agreement Additional expenditures, Framework Agreement

RCT’s project expenses in the South

Amounts in 1,000 DKK 42,000 -585

Rehabilitation (financed by the Regions)

13,834

DANIDA-financed Projects in the South

2,146

Contributions, other

3,001

Amounts in 1,000 DKK DANIDA Legal assistance, Zimbabwean Human Rights Defenders, South Africa MENA, Jordan

1,391 205 1,596

Pools Revenue

384

The Danish Ministry of Foreign Affairs, Framework Agreement

Other Income

304

CSVR, South Africa

1,442

Total Income

61,084

Zimbabwean TOV Survivors, South Africa

1,841

Expenditures

Amounts in 1,000 DKK

CEDSA, Sierra Leone

1,115

CPTRT, Honduras

2,162

ODHAG, Guatemala

2,945

GCMHP, Gaza

2,692

MENA, Jordan

722

TRC, Palestine

196

F1: RCT’s Policy and Organisational Development F2: Rehabilitation

534 13,607

F3: Prevention and Advocacy

1,604

F4: Information and Communication

2,099

F5: Research and Documentation

13,290

F6: TOV and Development Projects in the South

24,776

F7: Planning and Support

1,670

Audit

208

Total Expenditures

61,432

Total Income

61,084

Total Expenditures

61,432

Result of Operations

-348

Income financing

573

Expenditures financing

322

Result financing

251

Net Result of the Year

-97

BRCT, Bangladesh

1,653

AHRC, Hong Kong/Sri Lanka

1,769

BALAY, Philippines

1,004

OPCAT, Asia

271 17,812

Total expenses for projects in the South

Asia 4.697

19,408

Africa 4.398

Middle East 3.610 Latinamerica 5.107

Expenditures

WWW.RCT.DK

Regional Distribution of Project Expenditures

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Rehabilitation and Research Centre for Torture Victims, RCT Borgergade 13 P.O. Box 2107 DK-1014 Copenhagen K Phone: +45 33 76 06 00 Fax: +45 33 76 05 10 e-mail: rct@rct.dk www.rct.dk