Obituary

In recent months, during a year when organizations that provide services for survivors of torture faced new challenges during the global COVID-19 pandemic, some of the people who have been leading the anti-torture movement for years have passed. We would like to remember and pay tribute here to some of these figures. This list is by no means exhaustive. It is intended, through the names it contains, to serve as a tribute also to the many workers, survivors and friends who have left us.

“I just need to be with my family”: resettlement experiences of asylum seeker and refugee survivors of torture

A global migration of individuals fleeing persecution, violence and armed conflict reached almost 60 million world-wide in 2015. This world-wide crisis of displacement reflects people seeking safety across borders and oceans; dangerous journeys that compound the trauma endured by these women, men and children. Refugees/asylum seekers face barriers upon entry to the U.S. The Western New York Center for Survivors (WNYCST) provides care coordination/trauma-informed care to mitigate these challenges. The objective of this study was to explore the resettlement experiences of survivors of torture living in Western New York, who had received services from the WNYCST; identifying challenges, unmet needs, and services that were helpful. Secondarily, we describe the experiences of asylum seekers and legally resettled refugees, who due to their differing legal status, might be expected to have different experiences. Data were collected using semi-structured qualitative interviews. Results Three themes emerged: mental health challenges, relating to their experiences in their home country and their separation from family; unmet needs, including lack of a sense of purpose and meaning, difficulty navigating services, and missing connections to community; and coping strategies, including WNYCST assistance with connecting with sources of social support in their new community. WNYCST services were helpful, particularly the assistance and connection with care coordinators and local support groups. This care and outreach helped to mitigate feelings of separation and apartness from their home countries and families. Conclusions Some refugees/asylum seekers continue to struggle with unmet needs, issues of loss and isolation. If care providers recognize signs of stress early, appropriate interventions can be implemented. Care connections and trauma informed treatment with an emphasis on recreating ties with communities, may be one important factor in ensuring successful integration.

International survey of the utilisation in treatment centers for survivors of torture

Introduction: Literature about treatment of survivors of torture tends to focus on counseling and primary medical care. There are fewer published articles about the utilization of physiotherapy at treatment centers for survivors of torture and other forms of trauma. Methods: Lists were compiled of about 169 treatment centers receiving funding from the United National Voluntary Fund, 150 from the International Rehabilitation Council for Torture Victims, and another 40 treatment centers in the United States through the National Capacity Building Project. A survey about utilization of physiotherapy at treatment centers for survivors was created which included questions about the utilization of physiotherapy, treatment modalities provided by physiotherapists, other professionals working at the centers, perceived barriers to providing physiotherapy and interest in collaboration as a global physiotherapy community. Surveys were emailed to centers in French, Spanish and/or English. Results: 87 responses were received, for a response rate of 43% (87 of 200 emails sent). Approximately 30% of centers report that their clients have no access to physiotherapy, with one third of the centers having physiotherapy on staff (in contrast with 85% of survey respondents having psychotherapy/counseling on staff, 73% having social work on staff and 55% primary medicine). About one third of responding torture treatment programs reported being able to refer to physiotherapists outside of their centers. Therapeutic exercise, manual therapy, massage, and group activities and exercises were the most commonly reported treatment modalities provided by physiotherapists. Lack of funds or resources and shortage of physiotherapy personnel were perceived as being the biggest challenges limiting clients’ access to physiotherapy. Twenty-nine of the respondents (33%) were physiotherapists, and of these, 90% reported being interested in collaborative activities with other physiotherapists working with survivor of torture.

Looking for stability

Introduction: On-going conflict and political instability in the Democratic Republic of Congo (DRC) has led to increasing numbers of people fleeing their country for Europe. Many need rehabilitation services upon arrival in Greece after experiencing torture in DRC. The scarcity of state resources and the limited capacity of non-governmental organisations to assist survivors of torture means many needs remain unmet. This study explored the experiences of rehabilitation for male Congolese survivors of torture living in Athens, as well as the potential role of the wider Congolese community in Athens in supporting rehabilitation. Methods: This qualitative study included in-depth interviews with survivors of torture attending a rehabilitation clinic and key informant interviews with representatives of the wider Congolese community in Athens. Data was thematically analysed to construct and develop codes and themes. Results: 19 survivors and 10 key informants were interviewed. For many survivors, rehabilitation was an unclear concept. Despite the appreciation for services received at the clinic and the amelioration of physical and psychological symptoms, survivors felt rehabilitation was incomplete as it did not meet their accommodation needs nor provide stability through granting refugee status. Survivors were wary of trusting other Congolese people after experiencing torture and did not always associate themselves with the local Congolese community. The role of local Congolese leaders and organisations was not seen as replacing the clinical element of rehabilitation but aiding in practical issues such as information sharing and integration, especially in partnership with other organisations. Discussion: Systemic shortcomings in Greece, including poor access to accommodation and insecure asylum status, impeded processes of rehabilitation. Many participants found themselves navigating an unstable and unpredictable landscape in their journey towards “feeling whole again.” The role of the wider Congolese community in Athens in supporting rehabilitation remains complex and a lack of trust threatens social cohesion. Nonetheless, the willingness of the community to be more proactive should not be ignored by organisations and policy-makers.