3. Are rehabilitation services appropriate, including by meeting the specific needs of the victims? Are
they provided according to medical ethics and with special processes and approaches in place for
vulnerable clients and gender specific forms of torture? Are there training opportunities for healthcare and legal professionals?
The working group discussion on the delivery of rehabilitation services was framed around the
following key questions: when delivering rehabilitation services or monitoring and evaluating current
services, are rehabilitation services sufficiently accessible to torture victims? For example, who is
eligible to access services, how and when are victims able to access services, are services free to access
and do they guarantee the safety of victims? How is information about the services disseminated to
ensure that they reach target groups? Are gender specific forms of torture recognized as such and
addressed in the scope of services offered? How is the sustainability and continued development of
rehabilitation services ensured by the state? Is specialized training provided to professional bodies
(medical, psychological, legal, public-sector professionals) that may have first contact with torture
victims? Is the state providing adequate funding in its regular budgets to allow torture rehabilitation
services to function in a stable manner?
It was suggested that formal referral mechanisms should be put in place in order to ensure, as a first
step, that torture survivors have access to rehabilitation services. One example mentioned was a
referral mechanism established in close coordination between the public and private sector resulting
in a strategic partnership with civil society that provided an effective way to refer survivors to
rehabilitation services. During the discussion, experts explained that an effective referral mechanism
relies on appropriate allocation of human and financial resources, trained personnel and relevant
contacts. A range of support services and resources (i.e. GOs, NGOs, IOs, law enforcement officials
and representatives of the judiciary) should be identified at the local level to obtain sufficient local
coverage for victim support. Furthermore, international resources and contact points are an essential
part of this network (i.e. resettlement). The referral mechanism resources should be identified and
secured as early as possible.
Regarding the actual delivery of rehabilitation services, the discussion once again underlined the need
for multidisciplinary approaches (social service, medical assistance, mental health, legal assistance,
cultural mediator). It became clear that psychosocial approaches should be favoured over trauma
focused approaches. Through the multidisciplinary approach and the constant communication
between the different experts, all dimensions of a victims’ torture trauma are discussed and the
rehabilitation plan becomes more realistic and self-oriented. It is crucial to include cultural mediators
in the program in order to address the gender and cultural characteristics of each torture trauma.
Ways to build trust between the experts and the survivors during the rehabilitation process were also
discussed. In this regard, it is crucial to give the survivor absolute control at all times over every
session, because it is precisely the absolute lack of control that always goes along with acts of torture.
Therefore, participation of the survivor in the decision-making process, the possibility to ask questions
and to express concerns at any stage throughout the delivery of rehabilitation services, was found to
be a crucial step towards the empowerment of a survivor.
Key principles for the delivery of rehabilitation services:
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