THEMATIC REPORT 2017 SEXUAL TORTURE It is clear from the experience of these centres that rehabilitation for survivors of sexual torture is usually a long and complex process. Although it is difficult to categorise victims of different kinds of torture and draw generalisations on their distinctive needs, it can be said that survivors of sexual torture are confronted with a particular challenge: the stigmatisation of sexual torture. Shame, feelings of guilt and the fear of being judged and disgraced by society make it very difficult for them to approach rehabilitation centres and disclose their experiences of abuse. This delays their rehabilitative journey and as such their recovery. In addition, in many countries a lack of healthcare, which addresses the specific needs of survivors of sexual torture, a failure to prosecute perpetrators, and limited awareness of the issue further limit the rehabilitation process. This section sets out key actions to support a rehabilitation process that meets the needs of survivors of sexual torture. It recognises that their rehabilitation requires a holistic and multi-disciplinary approach. This may include medical care, gynaecological and urological treatment, physiotherapy, psychiatric treatment, family counselling and different kinds of psychotherapy in individual and in group sessions, as well as alternative approaches like acupuncture and homeopathy. In addition, educational, recreational and social activities are important for successful reintegration into society, and vocational training and income generation activities are important for entry or re-entry into the labour market. Finally, legal support and financial assistance are a crucial component in that they support efforts to bring perpetrators to justice and they help survivors build new lives. For similar reasons, KHIAM Lebanon offers home treatment. “Our social worker visits the victims and their families at home. For most of them it is difficult to talk about sexual abuse. It would take us much more time to win their confidence in the centre, in a strange environment for them. To make them feel safer, we sometimes suggest to transfer the treatment to their homes.” In many countries, anonymous telephone helplines or chat rooms enable victims to access an initial space to disclose what happened to them without any risk of exposure. Such helplines also provide them with information on local rehabilitation centres that can support them with different forms of assistance. With regard to safety and confidentiality in prisons, MATESO Kenya underlines how important it is that “medical examinations are conducted in private, under the exclusive control of the medical doctors, without presence of security agents and other government officials.” Each of these actions for rehabilitation will be discussed below, incorporating the experience and opinions from IRCT member centres. Obviously, many of the challenges and recommendations that follow apply to all survivors of torture. Key action 1 Ensure privacy & confidentiality Challenges: • To seek help and treatment without others becoming aware of it. • To access a variety of health services without client confidentiality being compromised. • To bring perpetrators to court whilst protecting the confidentiality of survivors. Recommendations: • Create or identify suitable locations for rehabilitation centres that do not compromise confidentiality. Key Action 1: Ensure privacy & confidentiality When working with victims of sexual torture, rehabilitation centres must ensure the highest standards of confidentiality possible. This encompasses pragmatic considerations such as the location of a rehabilitation centre. For example, CTV Bosnia & Herzegovina states: “Ideally, the premises are located in a city building that is used by many businesses and organisations, in order not to disclose the destination of victims when entering through the main door.” page 25 • Create or identify private rooms in prisons or hospitals where survivors can get medical treatment with only the medical staff and translators in attendance. • Set up free confidential telephone helplines or online help chat-rooms for survivors.