Pioneering Centers : New Care for Torture’s Old Wounds

A nightmare steals sleep from Gebyhu.

Something heavy is crushing his body. “I try to call for help. I want someone to push the weight off. I try myself but I can’t. I try to call to somebody. But I can’t.”

Panicked, Gebyhu awakens: “I am sweating . . . breathing hard. I am scared.”

The same dream interrupts his sleep several times a week now. That is an improvement. It used to happen every night. It began during the five years he spent in an Ethiopian prison where, though never tried for a crime and only a teen-ager, he was tortured.

Other Reminders

Gebyhu is haunted by other reminders of prison. His shoulders are dislocated. He experiences frequent pain. His concentration is poor. His ability to trust has eroded. He knows about man’s inhumanity to man.

“Sometimes they held burning newspaper to our backs.” Gebyhu recalls. “Sometimes they poured hot oil on our heads. Sometimes,” he adds, “they would pull out (finger)nails with pliers.”

For Gebyhu (he asked that his real name not be used), the scars remain vivid but the healing has begun. He is more fortunate than most.

At 29, he belongs to a huge but largely invisible population of refugees who settled in the United States after being tortured--psychologically and physically, and often gruesomely--in their home countries. But unlike the vast majority of victimized refugees, Gebyhu is among the early beneficiaries of a budding treatment specialty that recognizes that torture survivors have special problems that make it difficult for them to function free of their own personal nightmares.

Few Centers Exist

So far, these victims far outnumber society’s ability to aid them. Gebyhu, for instance, is a patient at Chicago’s Marjorie Kovler Center for the Treatment of Survivors of Torture. Along with the Center for Victims of Torture in Minneapolis, it is one of only two full-service centers in the United States designed to help this uniquely burdened group of refugees.

More critically, perhaps, medical knowledge of how best to treat the survivors is only in the pioneering stage. Surprisingly little is known about them, and for now professionals must rely mostly on what has been learned about victims of other kinds of psychological traumas.

“We believe their needs to be something unique,” says Douglas A. Johnson, executive director of the Minneapolis center. “We need to do outcome research to find out whether or not we are having impact.”

In Minnesota, 80% of the state’s 2,000 Ethiopian refugees are victims of torture. “It’s the most severely abused refugee population in the state,” Johnson says. “We believe that we have a minimum of 2,000 and as many as 8,000 torture victims living in Minnesota.”

In Chicago there are an estimated 20,000 survivors, reports Antonio Martinez, coordinator of the Kovler center, where 79 clients have been accepted in the facility’s initial 18 months.

In Southern California, which has the country’s highest concentration of torture survivors among its huge refugee population, the Walter Briehl Human Rights Foundation in Los Angeles is treating refugees and hopes to open a full-service center later this year.

Social workers estimate the majority of victims in Southern California are Salvadorans. Psychiatrist Harvey Weintraub, president of the Briehl Foundation, says that there are also large numbers of people at risk among refugees from Southeast Asia, Ethiopia, Iran, Iraq and Armenians emigrating from Turkey.

“Everybody seems to be torturing everybody all over the world,” says Weintraub, who is treating survivors.

The first clinic dedicated to helping torture victims opened in Copenhagen in 1982. Others operate in Toronto and Paris. Assistance is also available in San Francisco and Newark, N.J. But, given the amount of torture in the world, there are surprisingly few centers overall. Amnesty International has documented torture and ill treatment of prisoners in at least 98 countries.

Governor Helped

The Minneapolis facility, launched with help from Minnesota Gov. Rudy Perpich, opened in 1985. The Chicago center--operated under the auspices of Travelers & Immigrants Aid--received a boost from entrepreneur Peter Kovler and opened in mid-1987.

Because the organized treatment of torture survivors is a relatively new field for medicine and social work, specialists are in the early stages of finding the best forms of therapy. Meanwhile, they rely mainly on techniques used to treat other post-traumatic syndromes resulting from rape, Vietnam experiences, family sexual abuse and natural disasters.

“What makes the torture victim different is that they are targets of a strategic manipulation of their personalities,” says Johnson. “With other kinds of victimization there is always the hope for rescue by some third party. The child can be rescued by another parent. The crime victim can be rescued--even if they aren’t--by the police. There is the hope of some kind of rescue.

“When you’re being tortured it’s being done by your government, by your police department, it’s all been bureaucratized to great banality in terms of the methodology used and in the sense there is no hope of rescue,” says Johnson. “You are the ultimate target with life and death completely in the hands of not only a person, but a government.”

At the Minneapolis Center, site of American threshold research on how to best help torture survivors, refugees accepted for treatment receive a physical examination and a psychiatric assessment and are then assigned to a long-term therapist. Simultaneously they work with a social worker who coordinates their overall treatment. Many also receive physical therapy.

“Almost everybody who has been tortured suffers from chronic pain of one sort or another--neck problems, back problems,” says Thomas M. Dixon, clinical supervisor of Chicago’s Kovler center.

“Torture victims tend to relive the experience because it is often triggered by a common everyday object or occurrence,” says Johnson. “For example, waiting is a very critical part of the torture experience. We schedule people so they do not have to wait. So that when they come in they are given attention immediately.

“We try to avoid the use of a lot of electronic equipment in the examination procedures because people are often tortured with electricity or by rather formal, medical-looking equipment,” adds Johnson, whose Minneapolis outpatient clinic is located in a two-story house to avoid an institutional appearance.

“The goal of torture is to destroy a person’s personality so that they will forever be subjugated to the torturer, to the power source.” says Dixon. “It is the complete destruction of trust at all levels.”

The official international definition of torture is spelled out by the United Nations. “Torture . . . means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted by or at the instigation of a public official,” to obtain “from him or a third person information or confession, punishing him for an act he has committed, or intimidating him or other persons.” The United Nations adds that, “Torture constitutes an aggravated and deliberate form of cruel, inhuman or degrading treatment or punishment.”

Torture is something much more personal to Gebyhu.

He was just 17 when he was taken off to prison along with his father and his older brother. They were arrested in 1977, in the aftermath of a communist military coup that deposed the late Emperor Haile Selassie. Their crime: Gebyhu’s father was a security guard for the deposed royal family and his mother was a land owner.

Sometimes, Gebyhu says softly, slowly, the police came at night. “When they came after nine o’clock we knew they wanted someone to kill. Everybody sat very still. Everybody tried not to look at the eyes of the police. Nobody. . . . It is hard to talk,” he apologizes.

His brother was taken away during one of these visits. Later the brother’s clothes were returned to the family. “Only his clothes.”

Gebyhu was one of 9,000 in the prison. “We would sleep in crowded rooms. There was no place to turn. We would sleep holding the feet of someone who was lying the other way. And someone would hold your feet.”

But it was the hanging that still causes him pain.

One day the guards came and told him to put his arms over a pole they held behind his back. They tied his hands. They raised the pole until Gebyhu’s feet were off the ground. His upper arms carried the entire weight of his body. And while he was helplessly hanging . . . .

“They beat my feet. They left me there. On the second day they cut the rope. I fell to the ground. They tell me I was unconscious.”

Experiences Not Unusual

Now Gebyhu’s shoulders regularly dislocate. He is often in pain. And awful as they may seem, his experiences are not unusual.

It is common in Africa for torture victims to have the bottoms of their feet beaten, in Latin America to be forced to eat decomposed food and excrement and to have body parts mutilated, and in Vietnam to be subjected to isolation and other forms of psychological torture, reports Martinez, coordinator of Chicago’s Kovler clinic.

Social worker Holbrook Teter, coordinator of the San Francisco-based Coalition to Aid Refugee Survivors of Torture and War Trauma, says: “I’ve worked with Salvadorans, both men and women, who have been subjected to electroshock treatment, who were hung by their thumbs, beaten, sexually abused. They had their heads submerged in water, they had hoods filled with lye put over their heads burning their scalps.”

“There are survivors who have had cattle prods inserted into their vaginas and men and women who had electricity applied to their genitals,” says Dixon of the Chicago center. “One survivor was pregnant and guards put a dead fetus in her urine can. Husbands are forced to watch their wives being tortured and wives are forced to watch their husbands being abused and parents their children tortured.”

Of 34 patients who received long-term treatment at the Minneapolis clinic, all were beaten and subjected to isolation and overcrowding and threatened with death, forced to watch others killed or tortured or were taunted with mock execution. More than half were kept in uncomfortable positions or had their bodies suspended in painful positions for long periods of time and more than a third were burned with either boiling liquid, chemicals, cigarettes or electricity. A third also had their feet beaten.

One outrageous aspect of torture is the frequent “complicity of the medical profession,” says Martinez, a psychologist.

“There are a lot of doctors who are accomplices in these situations. . . . The torturer has a doctor by his side so he knows where to put the electrodes, where to go so not to kill the person . . . where to cut so not to kill the person,” says Martinez.

A range of symptoms commonly found among refugees who were subjected to torture include: An inability to sleep, flashbacks to instances of torture, nervousness, an inability to trust, hyper-activity, recurrent nightmares, robotic behavior, anger, an inability to enjoy normal life experiences, sexual dysfunction and tendencies toward suicide and violence.

“If they are pulled over by police they think they are going to be tortured again, they panic and they lose control of themselves,” says Dixon. “We had one client who was going for a (medical) exam and he freaked out. He was strapped to the machine and he ripped off the belts and ran from the hospital. Later he said he thought he was going to be tortured again.”

Children who have either been subjected directly to torture or forced to watch a sibling or parent tortured have difficulty in school. Both their performance and their behavior suffers, doctors say.

“We emphasize calling them ‘survivors’ rather than victims,” says Dixon, “so people don’t carry this idea of being victimized, that that was the focal experience of their lives. They want to go on to more positive experiences.”

Going on is very much on Gebyhu’s agenda.

Attends College

In the United States for the last 18 months, he is a student at Chicago’s Truman College where his grades are good and he excels at mathematics. However, his constantly dislocating arms currently make it impossible for him to find a job and his prison experience is hurting his studies.

“It is difficult,” he says. “I don’t have any concentration.”

And even here the terror continues for Gebyhu.

Last November, his roommate, also an Ethiopian refugee, was murdered in a $70 robbery at a downtown parking lot where he was working.

“Please don’t use my real name,” Gebhyu pleads with a reporter. “I am scared.”