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Torture

Torture methods
and its Health Consequences
Jens Modvig, MD PhD
DIGNITY - Danish Institute against Torture
Chair, UN Committee against Torture
www.dignity.dk
Twitter @Modvig
Credit: East Timor Human Rights Centre
Credit: https://www.pri.org/stories/2014-12-10/graphic-shows-torture-global-problem
http://www.payam-aftab.com/en/doc/report/40961/the-road-to-guantanamo-using-terror-fight
Electricity Chemicals and bio agents

Cuts and stabs Unsystematic beatings

Physical
Cold and heat Torture Systematic beatings
Methods

Asphyxiation Forced positions

Suspension
Tramline bruises

Credit: https://www.alayyam.info/news/3GO62O00-GQ7AQ9
Bruise
A bruise or
contusion is a
type of
hematoma of
tissue in which
capillaries and
sometimes
venules are
damaged by
trauma,
allowing blood
to seep into the
surrounding
interstitial
tissues
Credit: http://howihurtmyselfthistime.blogspot.com/2012/04/inner-thigh-bruise.html
Abrasion
Abrasion is a
wound
consisting of
superficial
damage to the
skin

Credit: Gettyimages
Laceration
Laceration is a
wound that is
produced by
the tearing of
soft body
tissue. This
type of wound
is often
irregular and
jagged and
leads to a scar

Credit: https://www.reddit.com/r/MedicalGore/comments/aw859g/my_friend_somehow_cut_his_arm_while_holding_a/
Credit: https://www.osce.org/pc/233896?download=true
Credit: https://www.novayagazeta.ru/articles/2018/07/20/77222-10-minut-v-klasse-vospitatelnoy-raboty
Credit: Human Rights Watch
Credit: Al Jazeera https://www.aljazeera.com/humanrights/2013/05/201358152317954140.html
Credit: Mogens Flindt /Scanpix
Credit: https://freeomar.ca/pics/photo-timeline-omar-khadr-detention-2015-2002/
Credit: Daily Monitor https://www.monitor.co.ug/artsculture/Reviews/A-call-to-end-torture-using-the-law/691232-2763732-aiga0i/index.html
Strappado – Palestinian hanging

Credit: © Хьюман Райтс Вотч 1999


Credit: http://www.memoiresdeguerre.com/article-deputy-commandant-of-treblinka-released-from-prison-by-germany-104370084.html
Waterboarding

ATTRIBUTED TO CORPORAL GEORGE J. VENNAGE/OHIO STATE UNIVERSITY RARE BOOKS AND MANUSCRIPTS LIBRARY
Credit: Vanity Fair https://video.vanityfair.com/watch/watch-christopher-hitchens-get-waterboarded
https://www.gomanzanillo.com/features/museo/bag.jpg
Credit: https://www.aljazeera.com/news/americas/2012/07/201272523357443353.html
Cigarette burns (2,3,4,16 days)
Cigarette burn scars
Amputations

Credit BBC http://news.bbc.co.uk/2/hi/africa/3046426.stm


Credit: ISIS’ twitter profile
Abu Ghraib public domain
Credit: https://www.wikidoc.org/index.php/File:Burn9.jpg
Credit: https://loevy.com/blog/doubling-down-with-police-tasers/taser-works/
Credit: Reuters
Exposure for
phobic objects Threats
Humiliations

Solitary confinement
Psycho-
Mock executions logical
Enforced violation
Torture of cultural taboos
Sleep deprivation
Methods
Sensory deprivation

Witnessing torture of others


Abu Ghraib public domain
Credit: https://www.denverpost.com/2005/11/16/5-marines-killed-in-iraq-house-blast/
Abu Ghraib public domain
Credit: https://www.metropolisweb.it/metropolisweb/2016/05/19/blitz-nel-bordello-prostitute-e-clienti-nudi-in-strada-foto/
General physical health consequences
• Chronic pain
• Unspecific complaints from heart, stomach,
intestines, genitals
• Specific pains and functional limitations (e.g.
walking difficulties after falanga, impaired
shoulder function after strappado)
PTSD
• Posttraumatic stress disorder (PTSD) is an
anxiety disorder which may develop after
– Exposure to a life-threatening event
– With intense fear and helplessness
• The cardinal symptoms of posttraumatic stress
disorder are
– Intrusion (re-experiencing the trauma)
– Avoidance
– Hyperarousal
General mental health consequences
• PTSD
• Depression
• Anxiety
• Sleep disorders
• Social isolation
• Feelings of guilt and shame
• Substance abuse
What to document?

Who did what to whom?


When? Where? Why?
Challenges in medico-legal
documentation of torture
• Ethical aspects (whose interest? Reprisals?)
• Traumatization (blurs memory and account)
• Get facts but avoid retraumatisation
• Torture that leaves no marks
• Complicated reality
– Many arrests, Many interrogations, Many torture
sessions, Many torture methods
• Limited time for the interview
• Long time has passed – signs and memories
disappear
Photo taken by wife Photo taken by JM

04.05.13 03.06.13
Istanbul Protocol
• UN Standard
• 75 experts in law, health
and human rights
• 40 organizations from
15 countries
• Content
– Legal Investigations
– Medical Evaluations
– “Istanbul Principles”
In conclusion
• Documentation puts cases on the table
• Medico-legal documentation crucial part of
investigation (justice and redress),
rehabilitation and advocacy
• Istanbul protocol provides the golden
standard
• Strong professional collaboration between
skillful doctors and lawyers required