the progress in implementing the Istanbul Protocol, with the encouragement and leadership of the Attorney-General’s Office. According to information provided by federal authorities, only three states in the country have not yet implemented the Protocol. The Subcommittee believes that effective and comprehensive implementation of the Istanbul Protocol, in addition to being a useful tool for demonstrating whether or not cases of torture are occurring, also helps prevent torture. The Subcommittee, while welcoming the efforts made thus far, therefore encourages the states to take appropriate steps to ensure full implementation of the Protocol. 85.Despite the progress made in this area, the Subcommittee delegation noted that in the states where the Istanbul Protocol is being implemented the objectives for which it was established are not being met. 86.There are several reasons for this lack of effective implementation of the Protocol, including insufficiency of specialized and/or trained personnel. Members of the delegation observed that the professionals involved, despite their willingness to effectively implement the Protocol, often lacked sufficient knowledge of its contents. The Subcommittee is of the opinion that the Istanbul Protocol provides guidelines for effectively investigating and documenting cases of torture and ill-treatment and that if these guidelines are properly followed, the Protocol’s standards will help forensic experts to evaluate the correlation between medical findings and allegations of abuse and to communicate their assessment of the situation to the entities responsible for prosecuting criminal offences. 87.The delegation noted that often the Istanbul Protocol was not being used for its true purpose as an instrument for proving torture, and instead was being used as a threat against the very people it was intended to protect: people who make complaints of torture. These people thus end up being accused of making false statements if medical and psychological findings do not indicate that methods of torture were used. This matter is of particular concern to the Subcommittee because of the vulnerable situation in which persons reporting acts of torture generally find themselves, a situation which is exacerbated by victims’ fear of reprisals if they lodge a complaint. That is why proof of torture cannot and should not rely solely on these findings. Moreover, many victims show no noticeable physical marks, even in cases of physical torture. The presence of physical symptoms that would prove that acts of torture have been committed depends on many factors, including the psychological status of the victim. The Subcommittee believes that medical examinations conducted in accordance with the Istanbul Protocol are rarely enough to prove torture. Complaints of torture or other ill-treatment cannot and should not be turned around and used against the complainants, employing forensic medical opinions issued in accordance with the Istanbul Protocol to charge them with making false accusations. 88.During the interviews that the delegation conducted in all the states visited, it noted that there had been no or very few complaints of torture in recent years. The Subcommittee is of the opinion that the number of complaints of torture is not a reliable indicator for evaluating the true extent of the problem. It cannot be argued that cases of torture have decreased simply because there have been few complaints. It must be recognized that both the complexity of the procedure for lodging complaints and the fear of retaliation can dramatically reduce the number of complaints (masking their true number). For example, many victims of torture do not have the mental stamina needed to deal with the bureaucratic red tape or undergo lengthy procedures, including interviews of several days’ duration. In addition, lack of confidence in the complaints system also tends to impact negatively on the number of complaints filed. If the medical-psychological examination fails to demonstrate exposure to a situation of torture, the complainant risks being prosecuted for defamation of the accused police or law enforcement officer. The Subcommittee considers such situations, in which the victim is rendered completely defenceless, wholly unacceptable and believes that the State party should ensure that persons who allege that they have been victims of torture or any other form of ill-treatment have complete freedom to report such incidents without fear of subsequent reprisals. 89.The Subcommittee wishes to recall that the principle of the Istanbul Protocol is to assess the degree of consistency between a history of torture or ill-treatment, health status and symptoms during and after the alleged torture or ill-treatment, and the findings of a medical and psychological examination. A case of torture can only rarely be fully documented on the basis of those parameters alone, however. 90.The delegation also wishes to note the importance of distinguishing between physicians working in facilities where people deprived of their liberty are held and the specialized experts who perform examinations in accordance with the Istanbul Protocol. 91.The members of the delegation also wish to express their concern about the confidential testimony received from the medical staff serving one attorney-general’s office where there were persons deprived of their liberty, who stated that often the medical reports did not reflect the truth of the findings of patient examinations. These individuals told the delegation that they frequently had to change the medical reports on express orders from staff of the attorney general’s office. The Subcommittee considers such situations totally unacceptable and wishes to remind the State party of its obligation to ensure that medical opinions in such institutions are rendered with a guarantee of complete independence. 92. The Subcommittee urges the State party, first, to promote and distribute widely among the professionals in charge of places of detention the content and information on best practices in the implementation of the Istanbul Protocol. In addition, the Subcommittee urges the State party to review current practice and training programmes with an eye to ensuring that medical and psychological opinions rendered in accordance with the Istanbul Protocol are used only for the purposes originally intended as clearly established under the Protocol itself, and are not used as grounds for asserting that victims have made false statements. The Subcommittee recommends strengthening the implementation of the Istanbul Protocol by ensuring independent, prompt and thorough investigations and by ensuring that the professionals who render medical and psychological opinions belong to forensic medicine institutes with demonstrated independence, and that independent expert testimony be admitted at relevant stages of legal proceedings in accordance with the applicable criteria for judicial examination. D.Training as a torture prevention mechanism 93.The Subcommittee is fully aware that to prevent torture and cruel, inhuman and degrading treatment it is necessary to ensure proper training in and awareness of human rights, due process and legal safeguards for public officials who have contact with potential victims of torture.