Torture and its consequences
Extract from TORTURE, Volume 5, Number 4, 72-76 p., 1995

An ICRC viewpoint

Hernan Reyes, MD*, is a trained obstetrician/gynaecologist from Geneva University, the author subsequently specialized in the medical aspects of detention. He has
been a medical coordinator for the ICRC's detention-related activities since 1984 and is now based in Geneva. His work includes visiting prisoners, together with ICRC
teams in the field, and medical coordination at headquarters level, as well as liaising and exchanging experiences with many medical groups around the world.

* Medical Division, International Committee of the Red Cross, ICRC, Geneva, Switzerland

During the Seminar on Torture and Organized Violence held in Moscow by COMPASSION in September 1994, the International Committee of the Red Cross (ICRC)
gave an outline of its main activities in the field of visits to prisoners, stressing the work being done in connection with the Nagorny-Karabakh conflict. Since then the
conflict in Chechnya has taken on a new dimension. The principles stated at that time for visits to prisoners from all sides hold just as true in the more recent conflict
as they do for all areas in which the ICRC works.

In writing this summary, the author has deliberately decided to specify certain general principles concerning torture and its consequences, as they are relevant to the
work performed by ICRC delegates and physicians in the field.


On definitions of torture

The reasons for torture are many. They have been discussed at length in countless publications and papers, and particularly in medical studies and documents by the
IRCT in Copenhagen and other such rehabilitation centres. While it is not the purpose of this paper to reopen this issue, a number of comments based on the author's
experience with the ICRC would seem necessary and useful.

"State torture", as a designated government policy intended to break any or all political opposition and, as such, applied to anyone suspected of being an "enemy" of
those in power, is unfortunately still a very real occurrence. Torture of "political prisoners", and particularly of their leaders, is clearly still going on in various
countries. (The term "political prisoner" is used here for the sake of convenience to designate opponents, real or seen as such by the government. Few if any
governments admit to having "political prisoners".) It is this use of torture that best fits the description of "the most efficient weapon against democracy" as used by
the Danish IRCT (quoted from Dr. Inge Genefke) [4]. Unfortunately, this rather restrictive definition tends to make people forget that torture can be and is used in
many other contexts.

There are indeed many other aspects to this issue. The ICRC does not have its own definition of torture and uses, when necessary, those already established - or
none at all - as it sees fit in a given situation. Definitions of torture have become more complex, and not necessarily clearer, over the years. (See the Amnesty
International and World Medical Association definitions, both formulated in 1975, and the 1984 definition by the United Nations in its Convention against Torture.) The
one generally accepted today is that of the UN, which defines torture as being an aggravated form of cruel, inhuman and degrading treatment.

It is interesting to note that definitions of torture have tried to set out the possible intents of those who practise torture. (Earlier definitions, as for example the
definition by Professor Chet Scrignar of Tulane University, New Orleans, do not attempt to define the purpose of the torturer, but only describe the effect of torture on
the victim. Prof. Scrignar defines torture as "An intentional trauma deliberately conceived by vile men to systematically cause pain and suffering to a selected
individual, and ultimately ending with the physical and psychological collapse of the victim.") The old notion that the main purpose of torture was to make people "talk"
(and give information) was rightly countered in the 1970s by the opposite notion, namely that the intent of torture was, in fact, to make the general population keep
silent ... It is this targeted type of torture that indeed attempts to curb democracy.

Without getting into a detailed analysis of torture as it stands in the mid-1990s, it must be said, however, that the purpose of torture is not as clear-cut as it was, for
instance, in the mid-1970s or early 1980s. In those years, the "torture versus democracy" formula was, if not the rule, arguably the most visible and widespread
form of systematic state torture. This was the kind of torture that had been applied to the victims (or "survivors", as they are called today) who managed to reach
the various centres in Europe and North America, where they were received and tended by concerned health professionals and human rights workers. These people
were the sources of information for many of the publications on torture.

But as it did even then, the true purpose of torture spans a much broader spectrum of reasons today in the mid-1990s than "merely" the dissuasion of political
dissidents. Torture has always been, and still is, used for many other reasons. One of the most perverse forms of torture is its use to elicit compliance and
collaboration from people not actually involved in a given conflict, but who are tortured and blackmailed so that they will infiltrate or testify against suspected
"enemies" of the government.

Forced collaboration, with all its implications, is arguably one of the most tragic aspects of the use of torture. The victims who have been forced to collaborate are
shunned and rejected by all, and are at immense risk of being killed or tortured by their own people.

Torture and other forms of violence perpetrated to induce what is now called "ethnic cleansing" are another case in point. Innocent civilians without any political
stance or ideology have been brutally tortured - and many massacred - only to force them to leave their lands. These people are victims of a policy that has little to
do with repressing democracy.

A third example of torture that does not fit the "antidemocracy" definition could also be mentioned, namely the incredibly cruel and inhuman beatings and other forms
of violence - that cannot be called anything else but torture - inflicted on prisoners in some countries. Those people are common law prisoners, and not dissidents or
opponents of any kind, and they are tortured so as to dissuade them from escaping. Prison guards, when told that their already miserable wages will be slashed by
50% if a prisoner escapes, do not hesitate to use incredibly violent forms of repression.

The list could go on. The point being made here is that the fight against torture has to be seen to encompass all these forms of torture, and not just the torture of real
or imagined political dissidents. It is in this light that the 1984 UN Convention's definition of torture very rightly states as the bottom line, when defining the possible
intents of torture: "... or for any other purpose".

The term organized violence itself is perhaps rightly championed by many human rights groups. Such violence has been and is used for the same purposes as torture,
and in some cases there has been a government policy to implement it. In other cases the motive behind the use of organized violence may be less clear ... The term
certainly includes the notion of torture, whatever the definition, and its use may in many cases be preferable to the always controversial term 'torture". (What is
meant here by "controversial" is that the purpose of intervening against torture is to have it cease, no to beat around the bush by dissecting definitions. This is one of
the reasons why the ICRC does not use any specific definition, but prefers instead to describe what is going on.)

The effects on the victims of torture or organized violence (and what about "unorganized" violence?) are obviously very different depending on the group that is
targeted. When subjected to state torture, political activists, who are arguable "prepared" for torture - in some cases even "trained" to expect it - have coping
mechanisms that men, women and children who are tortured because they happen to be in the wrong place or belong to the wrong ethnic group, or both but who are
not militants in any particular cause, obviously do not have. Civilians caught up in the various forms "ethnic cleansing" in various countries are examples of persons
who are in no way "prepared" for the frightful violence perpetrated against them.

It is certainly not the objective here either to comment on the diverging parameters of those professional medical groups who favour what can be summarized as the
"torture syndrome" approach, and of those other professionals who believe that the effects of one and the same form of torture will vary immensely according to the
inner strength, personality and coping mechanisms of those to whom it is applied.

Suffice it to say that there is still an immense amount of work to be done in this field. The main point to be stressed here would be that torture must not only be seen
as a form of repression of potential political prisoners, but as a far more extensive evil.