IRCT- RESTART

1. IRCT- RESTART Scientific Conference Beirut, Lebanon 27-28 June 2013

2. Workshop A: State led -vs- NGO Lecture by: Psychologist Miguel Scapusio SERPAJ- Uruguay (Peace and Justice Service)

3. “Our North is the South”, claimed in 1936 Uruguayan painter Joaquín Torres García when he was illustrating the inverted map of South America. With this phrase we has highlighting the latin americanist vocation of Uruguay. On the map, on a small rectangle he locates Uruguay, a small country of 170.000 square kilometers and 3, 5 million inhabitants, enclosed between Brazil, Argentina and the River Plate.

4. Uruguay and Latin America in the 60´s and 70´s • Because of the huge social and economic differences, the exploitation that different sectors of the population were submitted to and the interference of countries from outside the region, Latin America became the scenery for big social and political movementswhich were searching for the transformation of their societies. • Armed movements also emerged (“the guerrilla”), inspired in the model of the Cuban Revolution, as an answer to despotic governments which submitted their countries to injustice.

5. The answer came promptly. The governments started a repressive rise, making use of the police and military repression of popular demonstrations. • When the situation overflowed legal frameworks, these governments were rapidly replaced by military dictatorships which, resorting to the excuse of “the fight against comunism”, started the persecution and the extermination of the leaders and militants of diverse social and political organizations, aiming at eliminating every kind of opposition. • The basis of these repressive way of acting was “the Doctrine of the National Security”, designed and transferred to the Armed Forces of the region by USA, through the School of the Americas.

6. At the beginning of the 70`s, coup d´états are executed in Bolivia, Uruguay and Chile, these last two happen with a difference of a few Months. (precisely today, 27th June, it´s the 40th Anniversary of the coup d`ètat in Uruguay). • Brazil and Paraguay already had their own dictatorships installed since the previous decades. The Southern Cone of Latin America was thus standarized into one terror regime which, developed genocide policies targeted towards vast sectors of its population. • The repressive coordination that the Armed Forces of these Countries took forward within the framework of the so called “Cóndor Plan” has been documented and there are enough proofs of it. This Plan consisted on the exchange and transference of prisoners from one country to the other for their physical elimination. • The stage of “State Terrorism” was thus installed.

7. The dictatorship in Uruguay.- • On the middle of the 60`s, the actions of the MLN – Tupamaros guerrilla movement and the big popular agitation because of an unprecedented social and economic crisis in the whole Uruguayan history received as an answer an increase of state violence exercised by the Armed Forces and para - military groups. • These groups, -called “death squads” – acted before the coup d´état and received the guidance and logistic support from the Central Intelligence Agency of the US, and the Anti-comunist Alliance of Argentina (called the “Triple A”). • Once on the hands of the Armed Forces, the MLN Guerrilla was defeated. The repression was then focused on the Communist Party and other left – wing political parties, disseminating at the same time to the all the popular sectors: the Central of Workers, the University and social and cultural organizations. • The institutional breakage caused the suppression of all political activity and the instalment of acivic – military dictatorship during 12 years (1973-1985).

8. The methodology used was State Terrorism: summary executions, murders and forced disappearances. • Torture and long imprisonment were the distinctive characteristics of the Uruguayan dictatorship. • Thousands of people were put into jail for years(Uruguay had the highest rate of imprisonment of South America, with a rate of 31 political prisoners for every 1.000 inhabitants) • Torture was systematically practiced aiming at destroying the personality of the militants; its body, its psyche, its relations, its ideals. But their goal went further: through torture they wanted to install fear, censorship and disinformation to all the society. • They wanted to ban the capacity to produce sense, of expression and of thinking of the entire society.

9. The end of the dictatorship. • The defeat on a plebiscite about a project which assured the continuance of the de facto regime, international pressures and popular resistance marked the fall of the dictatorship process. • In 1984 elections were held (in which the main political movements and figures of the opposition were banned from participating). • In March 1985 a transition democratic regime was reinstalled, “guarded” by the Armed Forces. • Thousands of political prisoners were released and the people who were exiled returned. • At the same time and because of the pressure of the militaries, the Parliament approved a lay - “impunity law” – by which the State resigned to prosecute the violations of Human Rights which had been committed during the dictatorship.

10. Post – dictatorship governments systematically denied the existence of forced disappearances and political assassinations and invoked the impunity law to avoid the judgement of the militaries and policemen accused of others severs human rights violations: torture, violation and arbitrary imprisonment decided by the “military justice” of the dictatorship regime. During almost two decades these governments promoted oblivion and silence policies about what had happened, falsified the history of the recent past and, what is even more serious, consecrated impunity, a situation that, without exceptions, is still suffered in Uruguay until today.

11. The “marks” from that period (1985-2004) were present in the clinical work with the affected population. All of them had to undergo situations in which they were damaged and also suffered the prolongation of the traumatic experience caused bythe impact of impunity and the absolute absence of reparation from the State. • Apart from all they had to suffer, there was also the • absence of Justice. On top of that, the State aimed • at the stigmatization of the victims, accusing them of • being responsible of the advent of the dictatorship.

12. Only in 2005, with the arrival of “Frente Amplio” (left wing political party) to the government, the first trials to well known repressors and torturers started. • The de facto president and his chancellor (civilians) and several militaries and policeman were convicted in 2008 for having committed severe violations to human rights. • Also, the search for the remaining of detained-disappeared • people in military areas started in this period. • In October 2006, a law grants a special reparatory pension for the people who were imprisoned during the dictatorship. • In June 2008, a presidential decree assures the lifelong and free assistance for the victims, their children and their grandchildren, although this is only provided by the health services of the State.

13. The work of Sersoc • The Service of Social Rehabilitation (SERSOC) was founded in August 1984 and its mission was to provide assistance to all the people affected by State Terrorism: relatives of detained – disappeared and people who were murdered because of political reasons, political prisoners and their families, and people who came back to Uruguay after having been exiled and their families. • Its main areas of work were psychiatric, psychological and social assistance of the people affected. • Since its foundation until its closure in February 2009, it provided attention to more than 4.500 people.

14. The organizational chart of the assitance contemplated: • a reception team composed by a psychiatrist and a social worker which, after the first diagnostic interviews, oriented the users to the diverse modalities of assistance: • Individual psychotherapy • Group psychotherapy • Family and couples psychotherapy • Psychiatric attention • Psychosocial assistance and monitoring • Interdisciplinary work carried out in clinical diagnosis sessions and diverse • spaces of theoretical and technical exchange made the combination of • these modalities possible when the cases required it.

15. A survey on "users’ satisfaction" , conducted ​​in SERSOC in 2008, • showed that a significant portion of the assisted population • demanded to obtain a full Reparation Programme set by the • government, including physical and mental health care as • part of that reparation. • Once the negotiation started with the State through State actors, • the State committed to take over these issues and resolve them • promptly and effectively. • Also, the organization pointed out the need of a specialized attention • for this specific universe of people which were affected by this • situation and we obtained the commitment of the Ministry of Public • Health to elaborate a mental health attention programme that • could take into consideration the characteristics of this population • and how many years they suffered because of the actions carried out by • the State.

16. In 2009, SERSOC defined that its institutional mission had reach its completion. An extraordinary assembly unanimously decided to close it down. Auto-critically, I now think that there was some Ingenuousness in thinking that the State would fully comply with its obligations and promises in terms of reparation and rehabilitation.

17. Peace and Justice Service (SERPAJ) • SERPAJ is the first organization dedicated to the promotion and • defense of human rights created in Uruguay (1981). • It collaborates actively with diverse groups, networks and organizations of human rights from all over the country. • It organizes and coordinates actions to promote Memory, Truth and Justice. • It carries out the psychological counselling of the group of affectedpeople from “Operation Morgan”.

18. SERPAJ Axes or strategic guidelines: • Education for Peace and Human Rights • Memory and Fight against Torture and Impunity • Promotion and Defence of Civil and Political Rights • Promotion of the rights of people deprived of liberty • Promotion of economic, social and cultural rights • Relations with other organizations of the civil society

19. The current legal situation in URUGUAY • In February 2011 the Interamerican Court of Human Rights (CIDH) condemned the Uruguayan State (Gelman Case) and urged it to leave the Expiry Law without effect. • In October 2011 the Parliament passed a law which establishes that there is no deadline to judgecrimes against humanity, neither procedural, prescriptive or expiration. • As of that moment, numerous causes have started to be presented to the justice.

20. The law was impugnated by the militaries and in February of 2013 the Supreme Court of Justice declared this law unconstitutional. The Supreme Court of Justice also transferred the judges which were more committed to the judging of crimes against humanity. • At the same time, the Interamerican Court of Human Rights • established that the ruling of the Supreme Court of Justice of • Uruguay is contrary to international humanitarian law and • warned that the ruling “is not in compliance with the evolution • of Interamerican Law and Universal Human Rights Law, nor with • The internationalresponsibility of the Uruguayan State. • Also, the High Commissioner for Human Rights of the UN, • Navi Pilay, expressed her serious concern about this decision. • “The States are forced to investigate and the victims have the • right to receive the truth, justice and reparation”, she pointed out.

21. Uruguay, by continuing to support impunity, is exposed to international rejection and also keeps causing diverse type of damage to the people affected by State Terrorism. This is expressed in the disbelief in the Justice System and how much their life plans are affected (uncertainty, hopelessness). It also affects the family and the relationships of these people. But, above all, it affects the whole society because of the absence of Truth and Justice.

22. The current situation of URUGUAY in matters of • Rehabilitation. • Though some achievements were completed (especially in relation to physical health), health rehabilitation policies show major shortcomings due to the fact that there are no concrete Rehabilitation Programmes that take into account the different levels of affectation existing in victims’ universe. • Since full reparation processes are interfered with for political • reasons, trying to quantify how these variables influence policies • in our understanding of rehabilitation is risky and can lead to • mistakes.

23. With the above, we will try to approach the status of rehabilitation • following the lines previously suggested for its evaluation. • Availability: • Health assistance is restricted to state services and does not • consider other levels of assistance (health insurance, • complementary health insurance, etc.) • Initially, there was only one reference centre: the Maciel Hospital, located in Montevideo. • Over the last months, other hospitals and services depending on the Ministry of Public Health have been incorporated, though this process presents serious difficulties (location, bureaucracy, • and financial resources), which are characteristics of public • systems in Uruguay.

24. Thus, many times the work turns out to be inappropriate • because of: • A lack of training and knowledge of the serious damage and • sequelae caused by torture and other human rights violations. • An absence, in many cases, of the necessary sensitivity • required from professionals to work with those affected. • The referral to the various medical specialities is performed • Impersonally and bureaucratically regardless the TRUST • patients must have towards professionals who will assist them. • Therefore, a human rights NGO is often consulted first, in order to find out about the reliability level of assistance mechanisms.

25. This is even more visible when it comes to psychiatric, • psychological and psychosocial assistance. • Initially, health authorities committed - following proposals from • SERSOC and organisations for those affected - to design a Mental • Health Programme, selecting the most adequate persons to work • on this programme through a competitive exam. • Then, it was left aside invoking situations of “political opportunity” and budgetary and regulatory issues. • As a result, mental health care has been “tercerised” and • the cooperative of professionals that offer this service nowadays • (in which specialists that have integrated Sersoc’s staff work) • have serious integration, location and budgetary difficulties • to fulfil their missions.

26. Accessibility: • Formally, there is no sort of discrimination to access state services. • There is a Citizen Service Office for those affected by State terrorism • that orients them on medical care brought by the State in the context • of the Integrated National Health System. • The obstacles are apparent in practice and in the functioning • of this system: • High level of bureaucracy • Dependency on decisions of political incentive • Lack of staff and space • Delays and waiting lists, sometimes for months, to be attended

27. There are no oficial programs in Uruguay for the protection • and counselling to witnesses and complainants who are • undergoing legal processes regarding their imprisonment and • the violation of human rights they suffered. • The counselling which is being done currently is done by • Organizations of the civil society (such as SERPAJ), the • University of the Republic (State University of Uruguay) and • solidary teams of professionals. • The intimate relation between Health and Justice is • omitted, most of the times, exposing the • complainants and their families to the cyclic • reactivation of their conditions, pains and symptoms.

28. CONCLUSIONS: • Absence of real public policies in relation to the recent past. • Some achievements were concessions in response to international claims or the claims of the organizations of affected people, without a true commitment from the State. • Rehabilitation cannot be separated from Integral Reparation. • We need to move forward in terms of Truth, • Justice and Memory, areas in which the State • is still negligent.

29. When we talk about Rehabilitation, we think about • Health highlighting that it is important not only as an • individual asset but also as a public one, a social asset • and therefore as a fundamental human right. • Rehabilitation, such as reparation, are processes • which cannot be separated from the finding of truth • and justice for the people which were victims of State • Terrorism. The work in Rehabilitation is a • clinical-political work. • “We fight against all diseases, even against injustice” • (Slogan of Doctors of the World Argentina, WHO Conference • on Social Determinants of Health, Río de Janeiro, 2011).