Availability Egypt Rehabilitation services provided in an environment in which the state policy of systematic torture and impunity continues No domestic regulations that establish procedures for providing rehabilitation Lack of political will to address previous or current torture, and the spread of violence and political animosity threaten to increase society’s tolerance of torture The Code of Criminal Procedure, which allows redress for those who are unlawfully prosecuted, does not recognise torture victims as eligible for rehabilitation National legislation has not been changed — state agents who commit torture continue to be protected from criminal prosecution Appropriateness Funding of services is entirely from private sources Holistic rehabilitation, including psychological and psychopharmacological therapy, referrals to doctors and other medical professionals, forensic evaluations of torture, legal support, support to families of victims, campaigning and helping victims and their families to tell their story through the media Services provided according to victim’s needs Referrals to lawyers and the public health system as required Many victims prioritise redress through justice over rehabilitation, so providing legal support is an important service Helping victims to access other services reduces the stigma attached to seeking mental health support No discrimination in treatment offered by the centre Women can access specialised services for torture and other related violence; the centre takes referrals from refugee organisations Raising awareness of the centre’s services is a challenge, thus the centre has set up a hotline Accessibility Russian Federation Some field visits carried out to regions where torture has occurred, or if the victims are unable to travel to the centre Prohibited from accessing prisons or detention centres Victims fear reprisals, threats, arrests if they report torture and difficult to build trust High risk of retraumatisation — victims often return to the environment where the torture took place, making full rehabilitation difficult Difficult to access social support for victims who have lost their job, housing and enable those to meet basic needs Staff work in an insecure environment having faced personal attacks and attacks on the premises State does not implement or finance rehabilitation services, and the notion of “torture victim” is not recognised in the state healthcare system Free medical assistance for Russian citizens — any victim can rely on free basic somatic treatment Istanbul Protocol not implemented — healthcare professionals in state hospitals and clinics lack skills to diagnose and document torture-related injuries. This hampers investigation and treatment programmes for the victim More specialised and long-term treatment is not available free-of-charge NGOs fill the gap in the state healthcare system by providing medical, psychological and social rehabilitation through private donors and the UNVFVT. The treatment is tailored to the victim’s needs The centre provides a range of services: medical/psychological treatment and counselling, legal support (court representation and investigatory work) Protection gaps exist for victims not covered by medical insurance — the person is unable to access the state healthcare system. This mainly affects migrants, refugees, relocated persons or undocumented persons Safety and security of victims is not guaranteed. National law provides for the protection of witnesses and victims in criminal proceedings, but protection measures are rarely taken in relation to torture victims, even when there is irrefutable proof of intimidation Confidentiality of victims and families is not ensured, and they become easy targets for intimidation by state agents Human rights defenders work in a vulnerable situation with no protection offered by the state Ecuador Very few torture victims receive care directly from the state Only two centres provide rehabilitation services for torture victims Centres have limited financial and staffing resources Some dialogue with state institutions is possible, e.g. lobbying and advocacy work Services focus on rehabilitation, prevention, documentation and investigation of torture Services include psychological treatment and social assistance, encouraging the victim to restore links with his/her family and social network to aid the recovery process Many victims receive treatment in public hospitals where injuries are not documented properly, making it harder to prosecute Estimated 70% of torture is committed on persons deprived of their liberty Often victims are not aware of their rights and think torture is normal punishment (particularly in detention or police settings) Victims often fail to seek assistance from doctors, psychologists and social workers Stigma attached to seeking psychological help; offering multidisciplinary services can alleviate this obstacle Centre works in an insecure environment — threats have been made against staff and the internet has been hacked. A forensic doctor was killed Right to Rehabilitation for Torture Victims, Beirut, Lebanon – 27/28 June 2013 17