HPC Fellow: Jose Miguel Guzman, IRCT
Jose Miguel Guzman is the Executive Director of the Centre for Mental Health and Human Rights (CINTRAS), based in Santiago, Chile. He is also a Hilton Prize Coalition Fellow with IRCT (International Rehabilitation Council for Torture Victims) in which CINTRAS is part of the network. For over 30 years, CINTRAS, has worked to provide holistic psychosocial support and medical treatment to survivors of torture and their families in Chile, helping rebuild lives and communities. In his blog, Jose overviews the history of torture in Chile, informs us of where Chile stands today in regard to rehabilitation of torture victims, and shares how he played a role in delivering recommendations to the UN Committee against Torture in Geneva, Switzerland.
Caring for Survivors: Chile Can Do Better
In July 2018, Jose Miguel traveled to Geneva to brief the UN Committee against Torture on the obstacles survivors face to creating a life after torture in Chile. His testimony significantly influenced the Committee’s recommendations to the Chilean government. Jose’s full think piece can be downloaded here. An excerpt from his research, work, and experience as a Hilton Prize Coalition Fellow follows.
Rehabilitation in Chile Today
To its credit, the Chilean state has implemented one of the world’s few nationally mandated torture rehabilitation programs. Popularly known by its Spanish acronym, PRAIS, it consists of multidisciplinary teams of medical doctors, psychologists and social workers whose task ostensibly is to design a holistic health intervention to address the trauma caused by torture. Anyone who is a family member of a disappeared or summarily executed person as well as to those registered under the National Commission on Political Imprisonment and Torture has access to its services.
Despite these laudable efforts, there are currently serious practical impediments that prevents PRAIS from accomplishing its stated aims. First, waiting lists can often be extremely long. Second, the multidisciplinary teams that provide the services vary widely in professional formation, with some being very knowledgeable in the field of torture rehabilitation, and others with almost no training or knowledge. As there is no continuous or standardized training provided by the State, access to quality services can therefore often be down to pure luck as treatment varies significantly depending on the training and knowledge of the service provider. Third, the multidisciplinary teams constantly rotate meaning that healthcare professionals work in a PRAIS team, before being sent to another department. Fourth, with existing resources, the program cannot meet the current demand for its services.
These issues have very practical ramifications. Many of CINTRAS’ clients wait for years to access services and some recount with bitter disappointment the treatment they received under PRAIS. Repeatedly having to recount traumatic experiences to potentially untrained staff who lack the expertise to treat them, is not only a failure to provide care, but also potentially retraumatizing. Torture rehabilitation is a specialized medical field requiring not only specific medical training in the sequelae of torture, but also a considerable degree of empathy and commitment on behalf of the clinician. Without this, the process can potentially retraumatize the victim and cause damage to their well-being and to their families.
In July 2018, the UN Committee against Torture scrutinized Chile’s record on supporting victims of torture. During a comprehensive review, the Committee recommended that Chile enact concrete measures to increase funding and services of PRAIS as well as to avoid excessive staff rotation and to provide specialized training in torture trauma to all PRAIS staff.
The government should heed these recommendations and work with local partners to implement them. Resolving these problems must be an urgent priority as, on average, victims of torture from the dictatorship are on average 67 years old. Worryingly, preliminary results from a recent study by the School of Health of the University of Chile shows that life expectancy of victims of the dictatorship is reduced by an average of 17 years for men and 20 years for women when compared to the rest of the population.
To continue reading, download Jose’s full piece.
(Photos courtesy of Carlos Candia via CINTRAS)
About The Hilton Prize Coalition
The Hilton Prize Coalition is an independent alliance of the 23 winners of the Conrad N. Hilton Humanitarian Prize, working together to achieve collective impact. Through three signature programs—the Fellows Program, the Collaborative Models Program and the Storytelling Program—the Coalition leverages the resources, talents and expertise of each of its members to innovate and establish best practices that can be shared with the global NGO and donor communities. Working in more than 170 countries, the Coalition is governed by a board comprised of the leaders of the Prize-winning organizations led by an Executive Committee and a Secretariat, Global Impact.
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