Human Rights
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Duncan Forrest, FRCS. Excerpted from Lives Under Threat, Medical Foundation for Care of Victims by Torture (1999)
Introduction
As a result of the violence in the Punjab there has
been an increase in the numbers of Sikhs coming to the UK from the
Punjab to escape harassment. Some of these have come to the Medical
Foundation for treatment or for examination by a doctor who may then
write a medical report to assist their asylum application. Doctors and
other health workers at the Foundation see a large number of clients who
allege torture from over 90 countries. Those from the Punjab, like
clients from many other countries or districts, show a consistent
pattern in their histories, pointing to a systematic abuse of power on
the part of the security forces.
Subjects And Method
Between November 1991 and March, 1999, 341 Sikhs
attended the Medical Foundation. Of these, only five were women. This
imbalance between the sexes perhaps indicates a cultural difference :
more men than women arrive in the UK as refugees; perhaps fewer women
have been detained and tortured, though it is reportedly not uncommon
for women to be raped in the home at the time of their male relatives’
arrest.
I personally interviewed and examined 95 men, who are
the subjects of this chapter. This represents an unknown but certainly
small percentage of all the Sikhs applying for asylum in the UK. All but
three, who were fluent in English, were interviewed with the aid of
Punjabi-speaking interpreters to ensure accurate communication.
Three of them were seen in detention, one each in
Bedford Prison, Pentonville Prison and Haslar Detention Centre. All the
others came to the Medical Foundation in London, one after having been
recently released from Pentonville Prison. All were asylum seekers.
At interview, documents relating to their asylum
applications were available, in all cases the Home Office Political
Asylum Questionnaire or Interview, completed when they first claimed
asylum, and in most cases, also the statement given to their solicitor.
Three brought medical reports, or affidavits from India, but none of
these were of sufficient quality to assist the application for asylum.
The examination of clients seeking asylum has some
distinctive features. The need to obtain a complete picture of the
detentions means that every possible detail about the circumstances and
methods of interrogation and the weapons used for beating has to be
elicited, but this often conflicts with the patient’s real fear of
talking about his experiences. Consequently, the interviews have to be
conducted with extreme patience and are accordingly often very
time-consuming. Occasionally, recalling certain details causes the
subject extreme distress, and on several occasions these interviews were
interrupted by weeping.
Similarly, physical examination is likely to induce
painful reminders of torture and has to be conducted gently.
Occasionally the physical examination could not be carried out fully at
the first interview because it caused undue distress.
Findings
The 95 men studied were aged from 17 to 58 years when
seen, but had been aged between 14 and 53 when first arrested.
The subjects came from a rather narrow social
spectrum. All but eight (who had left school by the age of 12) were
educated at least to secondary level, and nine were graduates. Thirty
nine came from farming families and, after finishing their education,
had worked on the family farm, while six others had jobs related to
farming such as cattle dealing or milk delivery. Nine were employed in
professions, eight were skilled workers, while 15 were still students.
Thirty-eight of them had joined the All India Sikh
Students’ Federation (AISSF) while at school or college, and many worked
actively for the organisation. Thirty belonged to other political
organisations, while 27 admitted to no political affiliation at all and
claimed that their detentions were arbitrary, due to mistaken identity
or else were caused by the political activities of relatives or friends.
Three of these claimed they had been arrested simply because they were
strangers in hiding in the locality.
All the men except one claimed that before their
first arrest they were fit and had not suffered from serious disease or
injury. One of them was a full-time athlete (a middle-distance runner),
one was a professional hockey player who had played for India, one had
played volleyball for the Punjab and one was a professional kabbadi
player. Others had played active sports at school or college, one
playing football for his university. Several displayed scars sustained
at sports, in childhood or at work but only one had been disabled by
injury (a leg fractured at kabbadi)
They reported detentions between the years 1978 and
July 1998 : the longest interval between release from the last detention
and interview at the Medical Foundation was 8 years 3 months and the
shortest 6 months.
The man who reported 35 detentions might not have
been believed had he not produced police records detailing them.
Detention was usually for a comparatively short time on each occasion,
ranging from one to 10 days, but totals ranged from two days to eight
months in police custody. Four of the earlier arrests (in 1984) were by
the Indian Army, and the detainees were held in army barracks, but the
rest (since the withdrawal of the army from the area) were all taken by
police and held in police stations, often in their own village. Eighteen
were later transferred to a special investigation unit of the Central
Investigation Agency (CIA). Of the 95 only 18 were charged and tried;
two were convicted. The large majority were never charged with any
offense. In addition to the detentions listed, several stated that they
had many times been held, questioned and threatened but not detained
overnight.
Methods Of Ill-Treatment
All reported severe ill-treatment, usually worst in
the first few days of detention. An indication of the severity of their
beating was the statement by 82 of them that one or more occasions they
had been beaten unconscious. One man said that he was beaten only with
truncheons, but the others all claimed to have been beaten with an
assortment of weapons, including fists, boots, blows with lathis (long
stout bamboo canes), leather belts with metal buckles, pattas (leather
straps with wooden handles) or rifle butts. One was beaten with a branch
torn bush, five with metal rods and one with a metal chain. In addition,
57 reported being suspended by the wrists, ankles or hair and then
beaten.
A particularly painful method of suspension, which
was suffered by 20 men, is to tie the wrists or arms behind the back and
then suspend the whole body weight by them. Most survivors of this
treatment have permanent damage to the shoulder joints. Eleven men had
their arms twisted behind the back, 22 had their hands trodden on, or
hammered, and ten were repeatedly thrown against a wall or onto the
floor. Thirty five were given electric shocks, either by a magneto or
from a mains socket. One man was forced to pass urine into a bucket and
another passed urine into an electric fire, giving painful electric
shocks in the penis. One was given shocks while in a water tank.
Fourteen suffered burns, and seven had their nails pulled out by pliers.
While these methods of torture are found in many
countries, there are some which appear to be peculiar to the Indian
police, using local items of equipment. The lathi is the standard weapon
issued to the Indian police. Being long and stout it delivers punishing
blows which often cause unconsciousness. However, it tends not to cause
an open wound except over a bony point. There is often a metal knob on
the end which in one case was claimed to be sharpened to a point and
used to poke the victim painfully.
One method we have not seen practised in other
countries (though it has been reported in neighbouring Kashmir) is given
the nickname of cheers ("tearing" in Punjabi). It consists of forcing
the hips strongly apart, often to 180o, sometimes repeatedly and at
other times continuously for 30 minutes or more. This is often done with
the victim sitting on the floor with a policeman behind him pulling the
head back by the hair while pressing a knee into the back, but in three
cases was achieved when the victim was strapped to a manja or charpoi (a
wooden bed frame). Forty eight men reported this torture, four of them
stating that they heard and felt the muscles tearing while others
reported that extensive bruising appeared in their groins immediately
afterwards. Two men, on examination, had severe scarring in the groin
which could have been caused only by excessive stretching of the skin.
Another method, alleged by 69 men, involves the use
of a thick wooden roller. The police sometimes have a thick log of wood
or a steel tube kept for the purpose, but they often use a ghotna, the
pestle about four feet long and four inches in diameter which is used
locally for grinding corn or spices. One man reported being beaten on
the back with a ghotna, one had the ghotna placed between the thighs and
then the ankles tied forcibly together, 19 had the ghotna placed behind
the knees and then the legs flexed over it, but the commonest method,
applied in 63 cases, was for the ghotna to be rolled slowly down the
things or calves with one or more of the heaviest policemen standing on
it. Fourteen men suffered both of the last two methods. Usually the
roller was said to be smooth and caused no break in the skin, though the
pain was unbearable. One man, however, stated that the surface was rough
and cut the skin, while another said that a square-section table leg was
used. Sometimes the roller was made of stone or metal and clearly made
specially for the purpose. One had "Welcome" written on it had another
was labeled "75kg".
Much of the abuse took place during interrogation
sessions, but police also beat detainees randomly at other times.
Twenty-seven men reported having been beaten late at night when the
officers were drunk.
Some forms of torture which are common in other
countries were rarely found, emphasising the fact that torture methods
are a geographically selective phenomenon. Whereas in Sri Lanka, for
example, burning with cigarettes in extremely common, in this group it
was seen only twice. Burns were inflicted with a hot iron rod in eight
cases, an electric iron in one, hot candle wax in four, caustic liquid
in one and, in one case, the victim was suspended, head down, over an
electric fire. Similarly, sexual abuse, usual in Algeria or the former
Zaire,[6] for example, was uncommon in this group though five men had
hot chillies or petrol pushed into the rectum.
Sites Of Injury
The majority were beaten principally on the back, the
legs or the buttocks, while 20 said they had been beaten all over and 20
had been beaten over the head. Nine had been beaten about the ears,
resulting in bleeding and deafness. Beating the soles of the feet was
used on 37 victims. It is an extremely painful method widely used in the
Middle East, where it is known as falaka or falanga. It does not appear
to have a special name in India. Six men described having their ankles
fixed in a wooden frame (khaath or sakanga) so that their soles could be
beaten. Forty-two men said that their heads had been forcibly pulled
back by the hair while a knee was held in the back. One man had chilli
powder thrown into the eyes, one had salt rubbed in the eyes and one
other lost an eye as a result of a blow from a sharp implement.
Psychological Abuse
Forty-nine men reported being threatened with further
punishment, death or harm to family. Six experienced mock executions,
and others were told that the police could easily make it appear that
the detainee had been shot in a gun battle or when attempting to escape
("false encounter"). Twenty suffered extreme humiliation, often with
removal of the five sacred objects (the five Ks) which baptised Sikhs
wear at all times. One particularly devout man had cigarette smoke and
ash blown in his face, alcohol poured into his mouth and threats of
having his beard and hair cut off. He remembered this as worse than his
(very severe) physical abuse.
Release
Most men were released without charge, usually after
representations by the village elders (the panchayat), a politician or
lawyer, but in 44 cases, only after the payment of a large bribe. One
man estimated that, after his five detentions, his family had paid out 4
lakh of rupees, equivalent to about £7,400. Five men were forced to sign
statements before release, exonerating the police from blame for injury.
On release, 61 were unable to walk. Three were thrown out of a police
car close to their village. In several cases the relatives had to hire a
taxi to take the victim home from the police station and one man was
twice sent home in a rickshaw. Twenty-two were hospitalised but some
were refused admission to a government hospital on the grounds that they
were "police cases". Most stayed in bed at home for up to two months and
were treated by a private doctor or received traditional treatment.
Present Condition
Most of the Medical Foundation examinations were
conducted long after the last detention, the shortest interval being six
months and the longest eight years, but nevertheless, all subjects had
physical symptoms and signs which they attributed to the ill-treatment
they had received and which they claimed had not been present prior to
detention.
The most common complaints were of back pain and pain on walking,
principally but not only, by those who had suffered beating on the soles
of the feet, cheera of the hips and/or crushing by the ghotna. Permanent
damage to the shoulder girdle was common among those who had suffered
suspension, especially with the arms tied behind the back, or
arm-twisting - or both. Eight men had visual disturbance that they
attributed to blows on the head with rifle butts. The man who had had
chilli powder thrown in the eyes still had severe lachrymation, while
the man who had lost an eye through injury with a sharp implement had an
unsatisfactory prosthesis which caused pain. Eight had deafness or
discharging ears attributed to blows. Four had sensory loss and one had
vascular impairment in the lower limbs attributed to application of the
ghotna.
Psychological damage was obvious in all cases, with elements of post
traumatic stress disorder, such as loss of concentration (65 cases),
memory loss (34), confusion (11), intrusive thoughts (37), flashbacks
(eight), panic attacks (20), and especially, recurrent nightmares
reproducing events experienced during detention (56). Thirteen men
claimed to be depressed (though only two were receiving treatment for
clinical depression), and five confessed to suicidal thoughts (strongly
condemned by their religion). On the other hand 15 stated that they were
strongly supported during detention and afterwards by prayer and
religious observance.
Discussion
The first problem in interviewing alleged torture
victims is the great difficulty many have in talking of their
experiences. Some have never before seen a doctor who seemed sympathetic
or who was not the employee of the authorities. Immigration offices, HM
prisons or detention centres are not the most reassuring environments
for an interview. Confidence is much more easily gained in a friendly
and welcoming environment. The importance of a knowledgeable and
sympathetic interpreter cannot be over-emphasised.
A great deal of time needs to be spent in slowly
eliciting the account of detention and torture. Many subjects experience
great distress at the recollection, and in several of the present cases
the interview had to be temporarily halted while the man wept bitterly.
Many had not previously described the most painful, and perhaps
humiliating, events to a living soul, not even their wives. In almost
every case, relevant material that did not appear in the original
interview record or questionnaire was elicited by patient questioning.
With one exception all these men gave a history of
abuse with a variety of techniques that show a pattern peculiar to the
region, partly due to the use of materials easily available to the
police, such as the lathi and the ghotna. Several factors are evident:
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Severe physical and psychological ill-treatment is
routinely employed during interrogation in police stations and
interrogation centres.
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Clearly, torture is at least a semi-official policy
since several detainees affirmed that the torture occurred during
questioning by senior officers, some of whom were named by the victim.
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Ill-treatment was clearly aimed at obtaining
information about dissident groups.
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An additional purpose seems to be to terrorise the
supposedly disaffected population.
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Forty-two subjects stated that they were released
without charge only after a substantial bribe was paid. It has been
alleged that this is sometimes the sole motive for the repeated arrest
of the sons of well-to-do parents.
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The beating was often very severe, as shown by the
fact that 82 of the 95 reported having lost consciousness on one or more
occasions during interrogation.
The visible scars months or years after the
detentions were often few. This could be explained partly by the passage
of time, but more particularly by the fact that much of the physical
injury was superficial. Many men described how they were covered in
bruises that faded and disappeared after a few weeks, but had few open
wounds that would leave scars. Others described how their arms or legs
and been wrapped in towels before suspension, which could only have been
with the intention of avoiding abrasion and scarring.
The police seemed to be aware of the need to avoid
gross visible injury in detainees who may have to be presented in court,
hence the common finding that suspension had left no visible scars round
wrists or ankles. Several men advanced the information voluntarily that
soft cotton ropes or turban cloth were used, or ordinary rope was bound
with cotton cloths when suspending detainees, clearly with the specific
purpose of avoiding permanent scarring to the wrists or ankles. One man
described having his back covered with a wet towel before the police
beat him. However, though the police are cautious about causing visible
scarring, they often do not avoid more insidious damage. A recent paper
from neighbouring Kashmir [7], reports 10 cases of kidney failure due to
products of muscle breakdown escaping into the bloodstream following
police beating. In addition to official interrogations, 26 detainees
reported beating, apparently random, by drunken police, usually late at
night. There is often clear evidence of long-lasting damage to the
joints or muscles of the shoulders, hips and knees as a result of the
techniques of suspension and crushing used by the Indian police.
In taking a history from torture victims, it is
sometimes difficult to decide if the description is accurate and
credible. In any medical interview it is, of course, imperative to make
an estimate of the patient’s credibility. An important feature is that
the history obtained at a medical examination often brings out features
that have not been mentioned in previous statements. This should not
cause surprise, because the doctor seeking specific information (while
attempting to avoid leading questions) about the methods of torture and
their effects, elicits descriptions which have not been asked for by
solicitors or immigration officers. Many studies have documented the
fact that when giving a medical history, a patient will often not reveal
quite important facts until a second or subsequent interview [9]. It is
hardly to be expected that a man who has suffered horrific treatment
will be able to recall and reproduce every detail at once to a stranger.
One who has suffered many detentions will naturally have difficulty in
recalling accurately what happened on each separate occasion. Indeed, it
might be suspicious if he did so.
It is often alleged that asylum seekers embroider or
invent their experiences. If this were so, one would expect them to
attribute every scar or deformity to their torture. In fact 70 of the 95
men in the present study pointed out scars that they said were due to
childhood injury or accidents at work and were often at pains to dismiss
them as unimportant. Only two of the present group gave the impression
that they were embroidering the truth, and consequently no report was
written for them. The subjects normally have a strong impression of
transparent honesty and, if anything, belittled their injuries. The
longer the interviews went on and the more details of their
ill-treatment came to light, the more credible their stories sounded. In
addition, some gave details so bizarre that they could hardly have been
invented. One man recounted how the police, before beating him with a
patta, showed him the flat wooden handle upon which was written
"Welcome", and at the end of the session, showed him the other side with
the legend "See you again". Another told how the police brought in an
electrical apparatus, evidently new, which they experimented with at
first achieving only gentle shocks, but after testing, were able to
deliver graduated shocks of greater severity.
A common finding of those who see a variety of
torture victims is that asylum seekers from a particular region tend to
produce very similar histories of torture. This is sometimes taken to
indicate that they are colluding with one another to fabricate a story
they hope will further their cases. In the present study it appears that
there is a pattern of abuse in a region and that police have a limited
repertoire of techniques, some of which are traditional and some
developed using locally available materials. Indeed, the only subjects
whose credibility was in doubt were those who described conditions of
detention and methods of torture which had not been heard before. The
descriptions of ill-treatment given by all the other men closely
corresponded to descriptions previously collected in the Punjab and
described independently by Dr. Pettigrew in her book and by Amnesty
International [4]. By contrast, other methods of torture found in any
countries around the world, such as burning with cigarettes or sexual
abuse, were found only occasionally in this group.
In all but one of the men there was physical
evidence, such as scars or damage to joints and muscles, to support
their allegations. In no case was there categorical proof of torture,
though in 32 cases there were scars that appeared highly suggestive that
they had been caused as described, and unlike any accidental wound.
Concrete proof, often expected by solicitors or asylum officials, is
almost never available unless, as is seldom the case, the victim can be
examined within a few days or weeks after the injury. Even apart from
the fact that there is often conscious effort on the part of
interrogators to avoid any permanent visible evidence, there is no way
after a lapse of years to prove that a scar or deformity could have been
caused only in the manner and at the time alleged. Whereas in many
countries that practice torture, interrogators are not restrained by any
attempt to hide it, in India the possibility that the victim may have to
appear in court makes them go to some lengths to avoid causing severe
external injury.
Nevertheless, the ghotna and cheera, routinely used
by the Indian police, do leave long-standing changes in the joints and
muscles which are characteristic and quite unlike signs caused by
natural disease or other forms of trauma.
X-ray or other imaging, biochemical tests or muscle
biopsy may supplement clinical examination but are unlikely to provide
proof that cannot be elicited by physical examination.
Consequently, in the present group, it was not
considered justified to subject anxious subject to an additional burden.
Psychological changes, though very real, were even
less specific than the physical. All the subjects showed clearly that
they were suffering from the long-term effects of trauma, but in none
could it be causally related with any certainty to their history of
torture. It is inevitable that at least some of the psychological damage
must be due to the harmful effects of exile, separation from family,
social deprivation and uncertainty about the future.
Conclusions
It must be admitted that this group of asylum seekers
who came to the Medical Foundation for medical reports are a highly
selected sample of all the refugees who find their way to the UK: they
all allege that they have suffered torture; their lawyers have decided
that documentation of their alleged torture is relevant to their asylum
claim and that the torture has left some residual evidence; their
application for a medical report was accepted by the Medical Foundation;
and in all but two cases the examining doctor decided that their history
and examination gave sufficient support to their allegation of torture
to justify the submission of a medical report.
The total number of refugees arriving in the UK is in
turn a tiny minority of all those have suffered gross police harassment.
The vast majority remain in their own country. Dr. Pettigrew’s study
suggests that many of those detained by the police in the Punjab, often
on trumped-up charges, "disappear" or are killed in "false encounters".
Only those with considerable financial means are able to obtain release
from detention (the family of one of my patients had to sell a plot of
land in order to pay the bribe for the release of their son), and it may
taken several months to find the money to pay an agent for false
documents and transport to the country of refuge. It is no surprise,
therefore, that all the men included in this study came from families of
substantial farming, business or professional stock. None of them showed
evidence of having come to this country as "economic migrants". They all
had well established life-styles before their peace was shattered by
police harassment and persecution. Many of them were politically active
or had given food, shelter or assistance to rebel groups and thus were
at risk of detention, but a significant number had no political or
criminal history and were caught up by accident or by a friend or
relative giving their name under torture. Some were arrested simply for
being young Sikhs. One young man who had moved to another part of India
for safety was once more arrested, simply, he claimed, for being a
stranger and therefore suspect. Two others had similar experiences while
visiting a distant village.
There are many reasons why an applicant, having
arrived in the UK, may not present his case for asylum to the best
advantage. The initial interview or questionnaire is the key document
which is used throughout the asylum process, and any subsequent
amendment or addition is viewed with mistrust. It is often conducted at
the port of entry, when the applicant has just arrived in the UK, often
still suffering physically and psychologically from recent experiences
of detention, torture and flight into exile. The victim of torture may
suffer from confusion or loss of memory because of the trauma he has
suffered, as exhibited by 45 men in the present study. He often suffers
from cultural inhibitions that induce deep shame for any transgression
he may have committed or felt he has committed against the mores of the
community. This is particularly true of sexual attacks which victims
from many countries never reveal even to their spouse. The agent who has
sold him false documents, wishing to cover his own tracks, may have
instructed his client to destroy all documents before landing and warned
him not to mention torture or imprisonment, one reason being that the UK
authorities might take this as a sign that he is a criminal and
therefore undesirable. He may have deep distrust of the interviewer or
interpreter, having learnt by bitter experience that it is safest to
reveal as little as possible to those in authority. With all these
inhibitory factors, is it any wonder that many initial interviews
produce errors, omissions and apparent discrepancies?
The uncomfortable conclusion is unavoidable - that at
least some asylum applicants are being unjustly labelled as "economic
migrants", "bogus refugees" or "abusive claimants" and refused asylum to
which, by any humane or legal standards, they are fully entitled. They
are in danger of being sent back to an environment they rightly fear, of
summary detention, torture, "disappearance" or execution in a "false
encounter".
All the evidence provided by human rights agencies as
well as the continuing number of clients at the Medical Foundation who
claim that they have been tortured in the late 1990s suggests that,
although terrorist activity has largely died out, police brutality is
still rife. Fresh examples of torture are still surfacing in the Punjab
as well as other parts of India. The traditional methods that the Indian
police have employed from time immemorial appear still to be in common
use. Seven of the cases I have seen recently have reported severe
torture, including all the methods described here, during detentions
between May 1997 and July 1998. The fears that these Punjabi Sikh asylum
seekers entertain are both real and justified.
References
1. Amnesty International, Human rights violations in
Punjab : use and abuse of the law, May 1991. AI Index: ASA 20/11/91.
2. British Medical Association. Medicine Betrayed.
London : Zed Books Ltd., 1992.
3. Amnesty International. A Glimpse of Hell: reports
of torture worldwide. Ed. Forrest D. London : Cassell, 1996.
4. Amnesty International. India : torture, rape and
deaths in custody, 1992. All Index: ASA 20/06/92
5. Human Rights Watch/Asia with Physicians for Human
Rights. Dead Silence : the legacy of abuses in Punjab. New York : Human
Rights Watch/Asia, 1994.
6. Medical Foundation. Zairian Asylum Seekers in the
UK: their experiences in two countries. London: Medical Foundation,
1995.
7. Malik G. H. et. al. Acute renal failure following
physical torture, Nephron 1993; 63:434-437.
8. Ramsey P G et al. History-taking and preventive
medicine skills among primary care physicians: an assessment using
standardized patients. American Journal of Medicine. 1998; 104:152-8.
9. Callahan E.J. et al, The impact of recent
emotional distress and diagnosis of depression or anxiety on the
physician-patient encounter in family practice. Journal of Family
Practice. 1998;46:410-8.
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