the United States: Torture Treatment Centers in National Consortiumn The South American Roots of a Michael Nutkiewicz the Universal Assembly adopted and proclaimed The United Nations General 10, 1948. Article 5 states, "No one or shall be subjected to torture ofHuman Rights on December inhuman or degrading treatment or punishment." Amnesty to cruel, 1961, and decade later it launched a a Declaration International was founded in of torture. It focused on campaign for the abolition the countries that were involved. recording incidents of torture and "naming and shaming'" language used by NGOs to speak about torture was legalistic, blatant violation of human rights. The consequences of torture survivors not addressed. The rehabilitation of victims and torture was was indeed on not was appropriate for the survivor, however, a were possible in countries where and they certainly were practiced. Dictatorships denied that they employed torture, heal the bodies that not going to and refugees who had The vision for victims started in they had broken. Rehabilitation physicians did not specialized centers in the large part for identifying victims. in Chicago, who had been tortured I thought they were only possible for dissidents United States for the rehabilitation of torture with South American torture survivors, tools yet have the conceptual or even was fled to safer countries. and 1970s. At this who fled to this country in the 1960s survivors- as The as a refugees, and asylum seekers time, mental health professionals and to understand the clinical Irene profile of torture Martinez, a physician in Cook County Hospital political prisoner during Argentina's Dirty Wars, torture survivors because they reminded me of me." noted: Another pioneer in this field was Dr. José Quiroga, a cardiologist who had been Allende. He worked pro bono personal physician of Salvador Southern California, at the time the patients from the Los Angeles physical problems survivors Quiroga recognized that psychological and by the horrors countries. He asked Ana Deutsch, experienced in their home the United States during Argentina's Dirty Wars, take about ways in which survivors could care Family Clinic in clinic in the country. The Clinic had many Latino community. Dr. triggered in were largest free at the Venice a of war, persecution, and the torture a clinical psychologist who fled to talks at the Clinic if she could offer informal of themselves and create some semblance of psychological well being In 1980 Quiroga and Deutsch established Angeles (PTVLA) - the first years, it was a volunteer in Los the Program for Torture Victims United States. For torture treatment program in the organization. Its mission was to provide medical torture. The Venice Free Clinic to victims of state-sponsored medical served assessment. as Deutsch PTVLA then offered social services to expert witnesses in asylum cases before federal for working with began to establish protocols both physicians and mental health professionals beginning to address the particular needs 1985 the and psychological aid provided the space needed for asylum seekers, and the clinical staff immigration courts. torture survivors. in the United States and Quiroga and They linked with other Europe who were also for rehabilitation. On the East coast, psychiatrist established Richard Mollica and social worker Jim Lavelle 1981, and in the first fourteen a center at Harvard University in Minneapolis-St. Paul-based Center for Victims of Torture (CVT) was founded in the Midwest. Outside of the offices of organizations such as Amnesty International and Human Rights Watch, torture was a relatively invisible human rights issue in the United States in the 1980s. Several high-profile cases in US courts, however, These cases revived the Act of nearly forgotten Alien Tort Statute, also known primarily include the with crimes such as piracy. in the Alien Tort Claims violation of international law. In the protection of human rights. Tort Statute. Dr. Joel rights case involving the Alien Filártiga and Dolly Filártiga sued and sought Norberto Peña-Irala, for the 1976 torture and death of within 45 minutes. Joelito's abduction and torture damages from Américo agank" ne 6r Joelito (Joel's son and Dolly's sister) in ol Paraguay. Peña-Irala was then the Inspector General of whippings, beatings, and high levels of electrical Originally, the law twentieth century, however, it was expanded to Filártigav. Peña (1980) is the most well-known human human as Police in Asunción. Subjected to shock, the seventeen-year-old Joelito died were no doubt in retaliation for his father's rights work, including helping torture victims, and his criticism of General Alfredo Stroessner's regime. Dr. Filártiga had himself been arrested and tortured several times. Dolly fled to the United States and asked for political asylum. She soon discovered that Peña-Irala had entered the United States illegally. She reported him to the Immigration and Naturalization Service, and he was arrested. In 1979, Dolly and her father filed a suit against him in the U.S. District Court for the Eastern District Cnecrkiy ? 1789, which allows non-U.S. citizens to bring lawsuits in district federal courts for torts (civil wrongs that result in injury) committed dealt brought the subject to the general public. U.s:'Cov o Irala asked the court to dismiss the of New York for the murder of Joelito. Peña- complaint and allow him to return to Paraguay. The court agreed with him because it did not see the law as pertaining to suits between individual people. Peña-Irala was deported to Paraguay and was granted immunity by its government. After an appeal, the case was heard without the presence of Peña-Irala. During the trial Dr.Quiroga testified on the physiological consequences oftorture on Joelito, and Ana Deutsch so testified on the psychological effects of Joelito's torture o n health professionals doctors and mental important role what compensation for w" constrained, however, happened is by the terms entirely inadequate Filártiga and Dolly a to response which $10 million judgment. highlighted the rights legal proceedings Filártiga's loss. It only allows for monetary medical costs, in addition to and lost work incurred Dr. Filártiga and Dolly. Unsurprisingly, the Filártiga family never received of the summed up the importance District court, however, that plaintiffs in expectation of money can, in a symbolic way, vindicate pursue court-ordered award. the case was Dr. The Court awarded damages, million each in punitive approximately $5 which included funeral costs, compensatory damages case that Court siressed several times Statute, of the Alien Torts asked for The family had compensation. family. The have in human the In its decision, family. the of favor The Court found in an the by The U.S. decree: in its concluding "It is not Court conviction that this this suit, but out of the torture and take of the victims of the enduring personal anguish in the fulfillment of the another 'small but important step ageless dream to free all people from brutal violence."Another Héctor high-profile Gramajo, American nun Minister police engaged in had military. a of Defense in 1989, she At the time she full-throated assault kidnapped that of Sister Dianna Ortiz (1958-2021) Guatemala between 1987 against General and 1990. Ortiz was an communities in the northwestern who worked among Maya-Akateko Guatemala. In November and case was on was was kidnapped, tortured, and raped kidnapped, the by the Guatemalan Guatemalan government dissidents. Just two months before her ten Guatemalan student leaders executed, and many of their bodies showed from San Carlos signs of torture. highlands of was already abduction, the police University. They were all Several days after her abduction and ordeal, a man with an American accent intervened in her interrogation and took Sister Ortiz out of the prison. destination when she escaped from his car. Within He was driving her to an unknown forty-eight hours, she was back in the United States. Sister Ortiz filed a case which determined that when in 1990 with the Inter-American Commission on Human Rights, military and security personnel acting on behalf of the government abducted her, Guatemala had violated the American Convention on Human Rights. The Commission "recommended" that the Guatemalan government investigate and take measures against individuals who had violated Sister Ortiz's human rights. In addition, it recommended that adequate monetary compensation should be given to her. In 1991, Sister Ortiz utilized another piece ofU.S. Victims Protection Act of 1991 to pursue her legislation, namely, The Torture claim in the U.S. District Court for the District of Massachusetts against Gramajo, who was studying for an advanced degree University. This Act allows plaintiffs to bring civil suits in U.S. courts Ortiz won the case, and the court awarded her $47.5 million in able to collect. Harvard against individuals. Sister damages, which she was never Gramajo had completed his degree and returned to Guatemala. During the trial, Sister Ortiz shed arm at light on the role that the American government had taken to support, train, and the Guatemalan military." Most notorious was the School of the Americas, a military training facility in Fort Benning, Georgia. Established in 1946, it is estimated that the School of the Americas trained 63,000 military personnel from twenty-one countries. Gramajo had trained there in 1967. In the 1990s, the Pentagon revealed that torture, among other interrogation methods, was part and parcel of the training at the School of the Americas. Like cases involving TULu was Posk the Alien Tort Statute, however, plaintiffs using the Torture Victims Protection Act have been unsuccessful in suing the United States government for its role in torture. The Refugce Act of 1980 created the U.S. Federal Refugee Resettlement Program whose mission was the resettlement of refugees. Torture, however, was not considered a subject or M o r problem in and of itself. Eventually, in 1998, Congress passed the Torture Victims Relief Act, acknowledging that many refugees and asylees entering the country had experienced torture. At the time, the United States Department of Health and Human Services estimated that 35 percent of all that had been tortured. More recent research indicates political refugees percent of refugees appropriated funds are "either primary to centers that worked Funding has been appropriated terror" when it was made or secondary survivors of torture."" Congress torture. specifically with victims of state-sponsored every year since the bill public that the the Ana Deutsch's first small step into the centers are there funded are by the thirty-four Most programs offer refugees and area who fled to this of rehabilitation in even asylum during the "war on seekers States is are seeking entry to directly related to country. From Dr. Quiroga and 1980, the movement has grown. torture treatment programs in Office of Refugee Resettlement Administration for Children passed, origin of these centers in the United experience of South American professionals Currently (2021) was United States itself was party to torture. The funds limited to victims of state-sponsored torture among the United States. As noted, the many as 44 as (ORR), a twenty-two states. The division of the and Families in the U.S. Department of Health and Human Services. evaluation and treatment, psychological evaluation and counseling, medical short-term assistance with food and other essential needs, expert witness services for asylum cases, public education and training of health care providers, and advocacy and legislative work. The National Capacity Building Project, hosted by the Center for Victims of Torture in St. Paul, hu? Minnesota, is a rich resource that promotes understanding among health professionals greater concerning the problems refugees and immigrants may suffer as a result of prior traumatic experiences. Survivors have described the human rights abuses. And physicians who work with survivors have documented their findings, which have been utilized in positions, the shocking array of torture methods for agencies that monitor asylum cases as proof of torture. Abuses such as beatings, long rape and sexual humiliation, and variations of the medieval "rack" 1970s, a relatively new phenomena called "stealth are Stres still used. But in torture," emerged in Central and South America. These methods also result in terror and pain but do not to leave marks, making it more difficult for human rights monitors to gather evidence. Political scientist Darius Rejali, one of the world's experts on the history of torture, explains the importance of knowing about these horrific methods: "If global monitoring of torture is to succeed in eliminating these clean tortures, citizens need to understand clearly what these techniques are, where they come from, and what they do. Being able to talk intelligently about these techniques is not simply a cognitive ability that promotes better research on torture but a necessary civic skill. Citizens who cannot speak competently about cruelty are unable to protect themselves against tyranny and injustice." The psychological symptoms exhibited by torture survivors include those associated with other traumas: PTSD, depression, anxiety disorders, and often physical pain. But the torture survivor- especially if the victim was a political activist - is a victim in a deeply existential way. Although torture is unreliable as a method of eliciting information, it is successful in tearing down basic human relationships, especially those that depend upon trust. The torturer knows that activists on whether unwillingly the the outside will wonder whether their compatriot "broke;" or toda prisoner said something that might help the police or military. The helplessness and powerlessness of the victims is complete. "T will take you to the verge of death as many times as IWant to. But here you are going to talk and if it means that you will die. that is OK." said South African secunty officer Jeftrey Benzien to prisoner PeterJacobs. Thus, the torture survivor lives with deep shame and guilt in addition to fear. Torture survivor Héctor Aristizabal from Medellin, Colombia., describes the twisted relationship of "dependence" and the dynamic between prisoner and torturer: "When you're in that room, that isolated place where no help can reach you, where you can no with longer count on family or friends or human decency, one person is entirely focused on me, you. He was controlling me, watching me, listening to my breath, keeping me alive while holding over me the power of life and death. And I had never in my life paid such close attention to anyone. I was alert to him and to his every response, trying to predict his every move with all my senses, until pain overwhelmed everything, and I lost my very identity. In that moment of utter surrender, when everyone else had abandoned me, when my own body and mind betrayed me, only he was there." Further. the torture victim is betrayed by the very institution that was established to protect him: the nation state and its representatives. "Torture challenges the very idea of law itself." write Winston Nagan and Lucie Atkins, because it violates the fundamental expectations we have about civil society and the state, namely, that transparency, accountability, and responsibility are the cornerstones of a working nation-state." Trust in a basic human institution is broken. Thus, superimposed on the expected psychological and medical consequences of torture, there is a political dimension that is invisible when torture is regarded mainly as a psychiatric problem. Some clinicians who work with survivors have suggested that in light of the existential and political dimensions of torture, a new diagnosis termed "torture syndrome" be added to the Diagnostic and Statistical Manual of Mental Disorders (the DSM). " 10 The political dimension, which is intertwined with of the "torture syndrome," is hidden o from the general public for many reasons and in many ways. The State that tortures is interested in deniability, and often describes torture as "a localized set of events," removed from policy This is how the 2014 U.S. Senate Report documenting CIA torture of alleged terrorists during the "war against terror" characterized accusations that the United States was engaged in torture. The Committee agreed that torture did not work; it accused the CIA of false claims about the Loo efficacy of torture; it agreed that the CIA underplayed the brutality of the interrogation methods it used, and it acknowledged that the CIA hid information from Congress. As groundbreaking and useful as the Report is, however, there were serious limits on how it characterized the United States's role in torture. For example, it did not examine the complicity of officials in the executive and judicial branches of government, placing the blame on officers in the field. Further, the Report did not make any policy recommendations to reform the ClA to ensure that torture will not remain part of the agency's playbook." Ana Deutsch, co-founder of the Program for Torture Victims has noted: "The wounds inflicted by the dictatorships upon the societies of those countries have remained open. Years later, there are still incidents that reopen the wounds and lead to new investigations and trials that seek to punish the perpetrators and persons responsible for human rights violations. This is how cases were opened against Pinochet in Chile [1998], as well as the Trials for Historic Truth in Argentina |2005). They prevented forgetfulness and even ifthey did not necessarily lead to the punshinent ofthose held responsible, they opened a path that resulted in the repeal ofthe afurectioned laws and pemmitted trying those who violated human rights during the dictatorship."l3 The Inter-American Court of Human Rights was established in 1978 to examine human rights abuses and redress through reparations the suffering of survivors. At this point, most pending cases do not have their origin in the brutal period of 1970s - 1990s. The cases of Garcia Lucero and Others v. Chile was not adjudicated until 2013, and it was the first judgement from the Pinochet era.4 The effort to bring states and their representatives to justice continues, although the process is very slow. There is no doubt that individuals who participated in torture must be held criminally accountable. Further, states that order or enable their official representatives or proxies to torture must be named, have their shamed, and brought day in court. But to domestic and/or international courts. Victims must for survivors, torture and subsequent flight forever disrupted An Angolan destroyed the complex network of friends, family, and community. statement to me arriving in a in 2004 safe knows me." The encapsulates the utter sense of being alone that remains country: "Where I come from, nobody wants me. Where I also and survivor's even came after to, nobody for their cases uncertainty about their future (especially asylum seekers waiting to be adjudicated), the stress of adjusting to a new society, and the focus on their traumatic past adds to their feelings of inadequacy, victims often have a helplessness, and depression. significantly greater rate of symptomatology than other groups traumatized individuals. significant low self-esteem, Although number fall into a many survivors work and continue normal Torture of activities, a cyclical pattern of pain, anxiety, depression, and withdrawal from normal activities. These problems are not alleviated in courts of law. They require a deep understanding of the centers. consequences of torture. This need is the raison d'etre of torture treatment Torture is one of the most difficult subjects to talk about. Kate Millett has written: "The knowledge of torture itsclf is a political act, just as silence or ignorance of it have political COnsequence. To speak of the unspcakable is the beginning of action." For survivors of torture, the physical and emotional wounds will never heal completely. But as Ana Deutsch has explained: "Although we cannot remove the memories, we can ensure that they do not crush the Survivors. As long as survivors believe in hope, they can move forward with their lives." Log Fabri, M. Joyce, M., Black, M., & González, M. (2009). "Caring for torture survivors: The Marjorie Kovler Center," n C. E. Stout (Ed.), The new humanitarians: inspiration, innovations. Cand blucprints for visionaries, Vol. 1. Changing global health inequities (pp. 157-187). See the judgement of the United States Court of Appeals, Second Circuit (1980) Dolly M.E. Filártiga and Joel Filártiga v. Américo Norberto Peña-Irala htps://hrp.law.harvard.edu/wpcontent/uploads/2011/04/filartiga-v-pena-irala.pdf. For an analysis of the continuing relevance of Filártiga in human rights cases, see Karen Holt, "Filártiga v. Peña-Irala After Ten Years: Major Breakthrough or Legal Oddity?" in https:/digitalcommons.law.uga.edu/cgilviewcontent.cgi?referer=https:/www.google.com/&https redir=1&article=16271&context=giC Dianna Ortiz and Patricia Davis, The Blindfold's Eyes: My Journey from Torture to Truth (Maryknol1, NY: Orbis Books, 2002). See the judgement of the United States Court of Appeals for the District of Columbia (2015) Amir Meshal v. Chris Higgenbotham, et. al. https://www.cadc.uscourts.gov/internet/opinions.nsf/E8CAF3B08FAA9E8185257EE7004E2DO 2/Sfile/14-5194.pdf Center for Victims of Torture,"Updating the Estimate of Refugees Resettled in the United States who have Suffered Torture," (Sept. 2015). hitp: ww.cvt.org/sites/cvt.org/files/SurvivorNumberMetaAnalysis_Sept2015_0.pdf. Darius Rejali, Torture and Democracy (Princeton: Princeton University Press, 2007), p. 3. See Benzien's testimony to the Amnesty Committee of South Africa's Truth and Reconciliation Conmission at https://www.justice.gov.za/trc/decisions/1999/99 benzien.html.He was granted amnesty in 1987.