NATIONAL REPORT 2016 Dismantle the wheel of torture. Forum-Dialogue between civil society and the government to sign declaration to end torture in the Philippines. Signed on the occassion of the UN International Day in Support of Torture Victims, 26 June. © courtesy of MAG As to availability, the DoH has programs to decentralise health services but they are still mostly centered in urban areas. Torture victims who live in distant municipalities have to be accompanied by Balay or MAG to government hospitals in city centers as health facilities outside the urban areas have not yet been primed to provide rehabilitation services. Rural health units (RHUs) catering to those who live in remote areas are usually manned by volunteer health workers who are only able to give palliative management such as paracetamol. Lacking the diagnostic skills of a medical practitioner, they need to refer patients to larger centres. This may pose difficulties for victims in cases where a series of follow-ups are needed. However, despite these difficulties in availing medical services, infrastructure or set-up for the delivery of medicals services are better than the set-up for psychological services. Most of the psychiatrists or psychologists have their practices in highly urbanised areas, which makes it difficult to refer patients coming from rural areas. Unlike physicians, whose free services could be made available in government hospitals at municipal, provincial or regional levels, there is a lack of psychiatrists/psychologists/counsellors who could provide free assistance/help to patients. More so for patients, such as torture victims, who have been traumatised and need continuous support. Even the DSWD, which has an existing crisis intervention programme, recognises the lack of trained psychosocial therapists and case managers for torture victims and has entertained cooperation with NGOs, such as Balay, in assisting them on this area of intervention. Rehabilitation programmes are practically non-existent in areas other than in major cities and municipalities of the country. Environmental factors and lack of security or stability that impedes or prevents access will render available services inadequate. Many torture survivors do not feel safe and secure enough to approach and access rehabilitation services believing that the concerned government agencies will be biased against them. For example, in places where conflict or political instability is ongoing, torture survivors may run the risk of discrimination and further harassments from authorities. Independent service providersmay also face some security risks. In these situations, the availability of rehabilitation service providers such as NGOs is compromised, as NGOs are bridging the gap by providing the majority of torture rehabilitation services. One important question that have to be take into consideration by the government is what changes are needed in the torture victim’s environment to facilitate a full rehabilitation. In practice,the services will vary greatly in terms of the components, activities, availability of professionals and the page 9