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MODULE 4 Prevention through Documentation Project. Torture Methods and Medical Consequences CONTRIBUTORS: Vincent Iacopino, MD, PhD, Physicians for Human Rights Önder Özkalıpçı MD, International Rehabilitation Council for Torture Victims
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MODULE 4Prevention through Documentation Project Torture Methods and Medical Consequences CONTRIBUTORS:Vincent Iacopino, MD, PhD, Physicians for Human Rights Önder Özkalıpçı MD, International Rehabilitation Council for Torture Victims Alejandro Moreno, MD, JD, Boston Center for Refugee Health and Human Rights Ole Vedel Rasmussen, MD, DMSc, International Rehabilitation Council for Torture Victims Türkcan Baykal MD, Human Rights Foundation of Turkey Caroline Schlar, PhD, Human Rights Foundation of Turkey, Emre Kapnın, Human Rights Foundation of Turkey Kathleen Allden, MD, Indochinese Psychiatric Clinic PtD Project (IRCT, HRFT, REDRESS, PHR)
Module 4 Outline • Subjective element of suffering • Torture methods • Psychological consequences of torture PtD Project (IRCT, HRFT, REDRESS, PHR)
The Subjective Element of Suffering • Take into consideration individual factors: • Gender • Religion • Physical and psychological condition • Age • Meaning of experiences affects degree of suffering PtD Project (IRCT, HRFT, REDRESS, PHR)
Beating • Most common method of physical torture • Practiced with or without instruments • Impacts may cause • Abrasions • Lacerations • Contusions • Hematoma • Internal bleeding • Perpetrators may: • wait for signs to resolve prior to remanding to judicial custody • Attempt to limit evidence using barriers (ie blanket) PtD Project (IRCT, HRFT, REDRESS, PHR)
Beating PtD Project (IRCT, HRFT, REDRESS, PHR)
Falanga PtD Project (IRCT, HRFT, REDRESS, PHR)
Falanga PtD Project (IRCT, HRFT, REDRESS, PHR)
Ear Trauma PtD Project (IRCT, HRFT, REDRESS, PHR)
Eye Trauma PtD Project (IRCT, HRFT, REDRESS, PHR)
Restraint, Shackling and Positional Torture • Characteristically, these forms of torture leave fewexternal marks or radiological findings, despite subsequent chronic disability. • Handcuffs, wrist or ankle ties leave no mark if applied properly • The use ofleg irons is widespread in police stations and prisons • Many forms of positional torture, all of which tie or restrain the victim in contorted, hyperextended or other unnatural positions PtD Project (IRCT, HRFT, REDRESS, PHR)
Abu Ghraib PtD Project (IRCT, HRFT, REDRESS, PHR)
Suspension • Common form of torture • produces extreme pain • leaves littlevisible evidence of injury • Examples: • Cross suspension or “crusifixion” • Butchery suspension • Reverse butchery suspension • “Palestinian” suspension • “Parrot perch” suspension PtD Project (IRCT, HRFT, REDRESS, PHR)
Winged Scapula PtD Project (IRCT, HRFT, REDRESS, PHR)
Crushing and Stretch Injuries PtD Project (IRCT, HRFT, REDRESS, PHR)
Crushing and Stretch Injuries PtD Project (IRCT, HRFT, REDRESS, PHR)
Crushing and Stretch Injuries PtD Project (IRCT, HRFT, REDRESS, PHR)
Burning PtD Project (IRCT, HRFT, REDRESS, PHR)
Electrical Injuries PtD Project (IRCT, HRFT, REDRESS, PHR)
Asphyxiation PtD Project (IRCT, HRFT, REDRESS, PHR)
Asphyxiation PtD Project (IRCT, HRFT, REDRESS, PHR)
Asphyxiation PtD Project (IRCT, HRFT, REDRESS, PHR)
Violent Shaking • Acute symptoms • headache • disorientation, • altered mental state • If severe: • cerebral oedema • haematoma • retinal haemorrhage • death • Chronic symptoms of non-fatal brain trauma: • recurrent headaches • cognitive impairment • cervical spine fracture/cord injury/paralysis PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Assault • Nudity • Verbal threats • Humiliating acts • Molestation/groping • Assault • Injury to genitals • Forced sexual acts • Insertion of objects (vagina, urethra, anus) • Rape: Penis inserted in to vagina, mouth, anus PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Assault PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Assault PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Humiliation – Abu Ghraib PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Humiliation – Abu Ghraib PtD Project (IRCT, HRFT, REDRESS, PHR)
Sexual Humiliation PtD Project (IRCT, HRFT, REDRESS, PHR)
Prolonged Isolation and Sensory Deprivation PtD Project (IRCT, HRFT, REDRESS, PHR)
Sleep Deprivation • achieved through the use of • stress positions • sensory overload • temperature manipulation • other techniques • causes cognitive impairments including deficits in memory, learning, logical reasoning, complex verbal processing, and decision-making • Symptoms of torture • independently affects clinical outcome • Affects course of disorder • associated with independent increase in of suicidal ideation and action PtD Project (IRCT, HRFT, REDRESS, PHR)
Temperature Manipulation PtD Project (IRCT, HRFT, REDRESS, PHR)