Torture survivors introduction to physiotherapy: Torture and sequelae after torture

Prip, K & Amris, K. (2003), Rehabilitation and Research Centre for Torture Victims, 45 pages.
 
This booklet was reviewed by Brittany Burton, doctoral physical therapy student at the University of Minnesota, 2014.
 
Link is to the article from the Dignity-Danish Institute Against Torture library. 
 
Introduction: Explanation of what the Rehabilitation and Research Centre for Torture Victims (RCT) is and the objectives of this organization which is based in Denmark. Illustrations and detailed descriptions of common types of torture and physical sequelae associated with them are made, with implications for physical therapy treatment.
 
Background: This item contains 24 illustrations with text explanations on the most common torture methods reported by clients at RCT. Although physically exhausting, torture also takes a severe toll on psychological state of the victim.  It is the aim of the torturer to breakdown the whole person, body and soul. Often victims are suffering from chronic pain or tissue dysfunctions as the result of acute injuries being left untreated.  These illustrations were collected from IRCT’s International Documentation Center.
 
Summary: Each illustration has text that goes into further detail about what occurs in each situation.  A brief summary is listed here but this is not the full text.  Arrest explains that families are attacked in their homes, suffer beatings and rape with others watching, often there is an imprisonment of one or both parents that follows, which includes further humiliation and brutality. Beating in a police station involves 24 hours of “unsystematic violence.” The victims are gathered, blindfolded and beat, then deprived of nourishment for days. The experience materializes as complete tension in the body and can become a particular muscular pattern. A haemoatoma in the gluteal muscles after beating can result in fibrous tissue which can press on nerves and vessels and inhibit muscle function. Staring eyes involves stripping a woman’s dignity with sexual humiliation. The operating table pictures a naked victim lying half off of a table being beaten. This form of torture results in significant soft tissue injury, pain everywhere, including tender points, and tension in muscles and fibrotic areas in fasciae. Falanga torture involves victim being beaten on soles of feet, usually with the victim tied up. Sequelae after falanga includes victim developing chronic pain and difficulty walking, also plantar fasciitis. Suspension involves victim being hung by a part of the body (legs, wrists) and being beaten, sometimes naked.  These victims sometimes have extensive complaints of neck and arms. “Palestinian suspension” with electrical torture consists of torturers attaching electrodes to sensitive areas of the body and is hung with arms behind back.  Often victims complain of pain in epigastric area.  Forced positions places victim in extreme position for long periods, sometimes cutting off blood supply and strangling nerves. Often have visceral symptoms.  The cage is an illustration of a victim kept naked in a cage.  Tissues start to decay and normal blood supply may never restore itself. “Submarino” is a form of torture where a victim’s head is forced underwater until almost drowned (contaminated water). The result of this is a changed respiratory pattern. Dry “submarino” is when a plastic bag is pulled over victims head and the victim is nearly suffocated.  Altered respiratory patterns need to be addressed with these clients. Dental torture results in issues at temporomandibular joint, leading to tension in cervical muscles and headaches. These survivors do not like to show their teeth.  Sexual torture (with bottle) results in muscular tightness and pain of low lumbar spine and pelvis. Sexual torture (with a trained dog) consists of multiple situations; however the aim is to make the victims fear telling anyone what has happened. Sequelae after chains include deep scars, pressure injuries (sometimes resembling tunnel syndrome), and irregular connective tissue. Scars after electrical torture may be small but if they do not originate from known source, suspect torture. Isolation is often used as torture and usually involves reduction in sensory input such as time, light and sound. These survivors are deprived of sleep, nutrition, hygiene.  This may lead to hallucinations, poor posture, pain and claustrophobia. People who have been subjected to waiting before torture are averse to waiting in later life. One description of torture is ordinary items reminding a person of torture. The final illustration listed shows and describes depressive posture which is often found in those who have been tortured, and another pattern of alternating hypertrophic and hypotrophic muscles.

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Gate Holloman's picture

Often victims are suffering from chronic pain or tissue dysfunctions as the result of acute injuries being left untreated. These illustrations were collected from IRCT’s International Documentation Center.

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