Activities within the Global Project
Training and awareness raising
The training sessions were given at different levels:
It was conducted through group sessions, lectures, trainings, workshops and conferences for a total of 148 hours, with the support of 9 expert trainers during the two years of the project. The main topics of the training were the following:
Introduction to the topic of torture and Human Rights
Physical and psychological sequels of torture
Medical documentation of torture, based on the Istanbul Protocol
Medical-psychotherapeutic treatment of torture victims
Alternative therapies for treatment of torture victims (floral essences, management of energies, visualisation etc.)
Techniques for self-care
Basic guidelines for mental and behavioural treatment of prisoners, victims of torture
Sexual violence: causes, consequences, treatment methods
Gender and Human Rights approach
Epistemology of research on the topic of torture
Training of trainers
This training took place in December 2008, and lasted for 10 hours during which 10 people were trained. The aim of the training was to strengthen their abilities to train other professionals. The training started by giving participants a theoretical knowledge of different training processes followed by practical work with essential methodological tools for training as well as group techniques to apply to the target groups.
Training of para-healt professionals
The training took place with the participation of 30 persons and consisted of a awareness session on the topic of torture addressed at doctors, psychologists, social workers, lawyers from different institutions/organisations working within the filed of human rights defence.
Two seminars were held in which professionals from different organisations in Latin America working with the subject of torture participated. The first seminar took place in Tegucigalpa in June 2008, which saw the participation of 33 professionals from 14 countries in this 5 day training, addressing the topics of sexual violence and the transgenerational effects of torture. The second seminar took place in Mexico in March 2009, again with the participation of professionals from Latin America, addressing the topics of interview techniques and care for caregivers.
The training materials used in the different trainings in Mexico as well as during the regional trainings in the Latin America region are gathered in the electronic library.
The public symposium took place at the end of the project period, informing about the subject of torture to a wider audience. A report on torture, covering the violations of human rights that took place after the military coup in Honduras was presented to members of different organisations and the local and international press.
For the purpose of knowledge dissemination two folders were produced: one for para-health professionals entitled “The role of health personnel on the subject of torture” and one for the population at risk of suffering from torture (farmers, indigenous people, men, women etc.) entitled “Torture: Methods and Consequences”. Furthermore, a 15 minute video entitled “Healing Scars”, with testimonies of rehabilitation processes and treatment that took place under the project (see Other materials).
Treatment of torture survivors
In Honduras, the violations of human rights has turned into acts of routine with various forms of expression, including repression, torture, cruel, inhuman and degrading treatment, organised violence, forced eviction of lands, imprisonment, persecution, social exclusion and the violation of the right to life. These practices have been historically used as mechanisms of domination and social control which in turn have serious effects on the mental health of the affected population which includes indigenous people, farmers, youngsters, women, human rights and environmental defenders and popular leaders. Day by day violence is legitimized from the highest levels of economic and political power, and this legitimacy of repressive and abusive power generates prototypes of violent models, easily transferable to the behaviour of the popular community. The kinds of abuse and torture reported by victims and found during examination of the survivors include: blows, threats and verbal abuse, mock executions, food deprivation, suffocation, sleep deprivation, isolation, burns, shots, sexual abuse and electric torture.
In 2007, 110 victims were registered and in 2008, 288 cases of which 123 were women, 165 men and 28 minors, totalling 378 torture survivors. These people were treated in different settings: prisons, headquarters of the CPTRT and in the community (Comayaga, La Paz, Siguatepeque, Santa Barbara, Trujillo, Valle, Atlántida, Choluteca and Fransisco Morazán).
Treatment in prisons
As part of the Global Project, 54 people were treated in prisons, 40 men and 14 women. The treatment was provided both on the individual and group level (prison of Nacaome, Valle, Granja Penal de Comayagua, National Prison Marco Aurelio Soto, Fransisco Morazán). The major challenges were to provide training on topics of personal growth and psychological accompaniment, as well as to conduct the two studies “Research on factors related to violent behaviour in prisoners convicted of murder” (sponsored by the RCT) and “The relationship of domestic violence in the crime of parricide in women prisoners of the national female prison of social adaptation”.
Treatment at headquarters
A total of 45 people were treated at the centre’s premises: 18 men, 20 women and 7 minors. The main challenges of the treatment in the office were related to the distance and economic means for mobilisation of patients, which in turn made it difficult for them to continue attending their treatment sessions. Nevertheless, and despite the obstacles we managed to create good links and provide patients with efficient treatment in a short time.
Treatment in communities
Treatment was provided to patients in the communities of Palillos, Ojo de Agua and San Sebastián (Comayagua), El Rincón (Siguatepeque), El Guantillo, El Porvenir (Fransisco Morazán), Seis de Mayo and El Pital (Santa Bárbara) and Trujillo.
48 people were treated during visits to those communities. The main challenges were: the difficulty of access due to the long distances and the access roads, as well as the security risks both for the members of the different communities and for the project workers. In addition, the project had no budget covering expenses for travel to the communities, which were therefore covered by RCT and other organisations.
A key element of the treatment was the case supervision, which was both internal and external. The supervision took the shape of individual interviews, therapeutic sessions, team sessions for analysis of complicated cases and accompaniment of the team in various treatment activities. The internal supervision was conducted by Dr. Eliomara Lavaire from CPTRT and the external supervision by Dr. Mauricio Rovelo, General practitioner and psychiatrist and member of the Honduran Institute of Mental Health and the Department of Forensic Medicine. He provided a total of 25 hours of supervision to the team.
A research project with the aim of evaluating results of treatment of patients was designed and used by the five partners in the project. The data on user services (torture survivors), the use and effectiveness of the intervention were generated by the use of the following clinical questionnaires:
A medical and social questionnaire
Harvard Trauma Questionnaire (HTQ)
Beck Depression Inventory (BDI)
Camberwell Assessment of Needs (CANSAS)
A questionnaires for medical and social follow-up
The research in Honduras shows the work done to find health alternatives for torture victims through comprehensive medical treatment (homeopathic and allopathic) and psychological accompaniment through short therapy and counselling processes.
One of the most revealing aspects analyzed in this research is the management of the population sample, which due to the object of the study is a complex factor; in the profile of the subjects that participated in the study we found serious obstacles, from socioeconomic, geographical, logistic, technical and personal security problems, which complicated their participation in the work with holistic health. Due to this, the samples cannot be static and rigid; on the contrary they are characterized as dynamic and flexible (and fluctuating) samples, and therefore the initial sample consisted of 79 persons and the process was finalized with 17 persons. This shows us the need to approach the analysis of the studies from different epistemological perspectives, for example by putting more emphasis on the qualitative analyses that can more precisely explain the reasons for these situations; the positivist approach, even though it allows us to classify and generalise, does not go into the nature of these phenomena in depth.
The socio-demographic data as well as the data shown in the proposed psychometric tests were plotted into a spreadsheet in order to create a baseline, and this was done again after 3 and 6 months respectively. The quantitative data were analysed with the Statistical Package for the Social Sciences (SPSS – Version 10), thus obtaining descriptive and inferential statistics for the variables and scales. Finally, the changes in numbers of symptoms, depression and posttraumatic stress disorder were studied using repeated measures for variance analysis.
In this way, the responses to holistic treatment were satisfactory for the majority of patients. During the months after the end of the project, the clinical care for these persons was continued, and the organic illnesses continued to be treated within the possibilities of our centre. Some of the positive responses were due to the premorbid personality characteristics of those who showed up for their medical visits, psychological therapy and with whom there was a good treatment alliance.
Finally, the initial results of the centres in Honduras and Mexico were presented at the ISHHR conference in Lima, Peru at the end of October 2008. The results of the Honduran research will also be presented in different national and regional conferences during the autumn of 2009.