IRCT REGIONAL REPORT 2016 This report is based on information collected with nine IRCT torture rehabilitation centres from eight countries in the EU. Their experiences indicate that despite the introduction of clear region-wide obligations, torture victims continue to fall through shortcomings in implementation at the national and local level, combined with flaws in the design of the current system.4 The IRCT member centres in this report state that procedures by asylum authorities to identify torture victims are either highly flawed or do not exist at all. The only screening that is systematically carried out focuses on identifying communicable diseases, rather than assessing the broader health needs of the individual person. Identification is the key that unlocks the door to a set of special support measures, which torture victims are entitled to and need. Without systematic identification, victims depend on the goodwill and awareness of individual case workers and support from non-governmental organisations (NGOs) to access rehabilitation and have a fair determination of their asylum claim. The member centres also reported that in their countries many torture victims are left to deal with their trauma alone. Torture trauma can make it extremely difficult to function in society, with victims suffering from panic attacks, mistrust, flashbacks, chronic depression and paranoia. Torture victims therefore struggle throughout the asylum process. They are unable to work and find it difficult to maintain and develop relationships with others because they cannot trust them or prefer to be alone. This trauma has a knock on effect, as it is passed on to their immediate family, affecting their children’s education and ability to integrate socially. Torture trauma rarely fades over time and is actually often exacerbated if left untreated, especially when the victim lives in a state of uncertainty and in poor asylum conditions. Barriers to rehabilitation Rehabilitation services do exist throughout the EU but victims often do not receive support due to: • Legislative or administrative barriers to access such as legal restrictions on the type of health care provided to refugees and asylum seekers or requirements to obtain permits for medical treatment • Insufficient capacity of specialised rehabilitation services due to lack of funding and insufficient numbers of health professionals with specialised knowledge about rehabilitation of torture victims Several IRCT members report that their governments restrict the type of medical treatment available to asylum seekers to emergency medical needs, a category which often does not cover the type of rehabilitation interventions torture victims need. IRCT member centres have experienced a significant increase in victims seeking rehabilitation, but because funding has decreased or stagnated, victims have to wait for long periods – 12 months in some countries – before they are able to access treatment. Obtaining refugee status can provide victims with the safety and stability, which is key to successful rehabilitation. However, member centres reported that again due to the lack of identification, victims are often put at a double disadvantage in their pursuit of international protection. Firstly, they cannot access a medico-legal assessment of their torture claims, which can be a crucial piece of evidence in the asylum process. page 6 © Swedish Red Cross, Ola Torkelsson