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Abstract
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Objective
This desk study intends to update and complement the desk study review of the torture rehabilitation literature completed in 1998 (Gurr and Quiroga, 2001), emphasizing areas not covered by the original study but updating the torture rehabilitation literature from the publication of the original desk study. Some selected earlier references have been retained, but the focus remains primarily on the published literature from 1998 through mid-2004. This paper intends to stand alone but will refer back to original study. The target audience is those working in or interested in the field of rehabilitation of politically motivated torture survivors.
Findings since 1998
Perhaps the most important finding is that either torture has increased worldwide or the exposure of torture events has improved.
Publications: Much has been written about trauma and torture, especially since the terrorist attacks on New York City and Washington, D.C. on September 11, 2001 (9/11) and the Abu Ghraib prison abuses in Iraq. The print and visual media has fostered a virtual explosion of information about torture and terrorism. Even in the professional literature, the relevant books are too numerous to catalogue here and beyond our scope. Research on PTSD and on the prevalence of torture has been notable. In addition, much information is more readily available with the increased access and availability of internet resources and publications.
Changing Nature of Torture: After 9/11, terrorism and its relationship to torture became an issue.The use of torture methods to extract information from suspected terrorists became controversial. Evidence of torture by "civilized" western countries was uncovered. Worldwide, the context of torture has broadened to include many aspects of organized violence, often occurring during war. Antiimmigrant sentiment has not improved and, if anything, has worsened in the US Europe, and in many other Western countries.
METHODS: The Abu Ghraib prison abuses and alleged torture by coalition forces in Iraq has fueled an international discussion about what methods constitute torture.
Assessment: Progress has been made on the legal and forensic evaluation of torture survivors, notably publication of the Istanbul Protocol. Questions raised regarding the validity of memory recall have implications for assessment of torture survivors.
Prevention: Passage of the UN Optional Protocol and formation of the International Criminal Court are significant advances in the effort to prevent and eradicate torture.
Gaps in the literature since 1998
After a quarter of a century and dramatic expansion of rehabilitation efforts worldwide, there is still no consensus about the efficacy of treatment interventions for torture survivors.
There is little additional literature about treatment outcome, models and structure of rehabilitation services, design of services, cost-effectiveness, or sustainability of services. General principles of assessment and treatment remain virtually unchanged. Controversies over PTSD applicability for torture survivors persist.
Restructuring of the desk study
New Structure: In order to focus the desk study on health issues, the sections with this emphasis will be presented as chapters while the remaining topics, which are more political, research, or prevention oriented will be included as appendices.
Language: en |