What is torture?
Article 5 of the UN’s Universal Declaration of Human Rights says: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.”

A child’s plastic train set lies on the waiting room floor. Above a squashy red sofa hangs a poster made of colourful postcards from well-wishers saying “Welcome” in different languages. One card reads: “You are safe and precious.”
Reassuring words. And they need to be because the people waiting their turn have been raped, beaten, hanged, mutilated or had electric current passed through them, writes Anabel Unity Sale.

Welcome to Star House, a grey brick building on a grey north London street in Kentish Town. Behind its glass front doors lies the UK’s only dedicated treatment centre for torture victims. It is run by the Medical Foundation for the Care of the Victims of Torture, which helps about 3,000 new asylum seekers and refugees a year pick up the pieces of their lives.

Torture, including rape, has an enormous effect on an individual’s personality and their emotional response to the world, says Petra Clarke, an examining physician and gynaecologist at the Medical Foundation. “They lack confidence and feel guilty that they have allowed themselves to be raped,” she says.

Although usually associated with women, men are often victims of rape. Clarke interviews and examines women who have been raped and writes medical legal reports to support their asylum claim. Women claim asylum as a result of rape because in some cultures they are ostracised and their husband might leave them, taking their children. “If a woman is beaten in her home country she’ll often accept it and lead a quieter life. But the culture in somewhere like Kosovo views the rape of a woman as a symbol of shame for the whole community,” Clarke says.
Some women who have been raped internalise feelings of shame, and rarely speak to other female rape victims. Clarke says: “I saw one 17-year-old African woman who told me she understood why boys would think nothing of her because she has been raped.”

Half of male clients sexually assaulted

The Medical Foundation’s health and human rights adviser, Michael Peel, says that about 50 per cent of the Medical Foundation’s male clients say they have been sexually assaulted and 5 per cent admit to being raped. He has worked with Tamil men who were raped and tortured while in detention in Sri Lanka in the 1990s, and reports that the men internalised the stigma of being raped and asked themselves why the guards chose them. “It made them doubt their sexuality and the perpetrators played on this,” he says.
Peel says that at least half of the men he referred on to therapy did not attend more than one session. “They simply did not want to address it,” he says.

Wondimu Yohannes, director of development and integration at Refugee Action, says tortured asylum seekers may be too traumatised to give a full account of what happened to them in their initial asylum interview. Also, he says, many do not know that rape constitutes persecution and do not refer to it in their asylum claim. “Such omissions are held against them by the Home Office and used to discredit their claims.” Peel says the psychological impact on a person can depend on their expectations. He says: “Research in the 1970s in South America showed that people could prepare themselves for torture and contextualise it as suffering for their cause.”

People who are forced to watch the torture and rape of others suffer terribly because they were powerless to stop it. “It is an image that comes back to haunt them again and again,” says Andy Keefe, the Refugee Council’s acting specialist team manager.

"National disgrace"

There is not enough specialist provision to meet the needs of victims of torture, says Clarke, who describes it as a “national disgrace”. Men who have been raped find it difficult to access appropriate help, especially outside London. Keefe believes the dispersal of asylum seekers to cities such as Birmingham, Glasgow and Sheffield has resulted in the development of more services, but says torture is such a serious issue it should be addressed wherever an asylum seeker or refugee lives.

Tortured asylum seekers and refugees often find it difficult to trust anybody in a position of authority. Rachel Witkin, a refugee case worker at Amnesty International, says many traumatised asylum seekers fear lawyers and immigration officials, and find it difficult to differentiate between the meaning of “authority” in the UK and in their native country.
Social care professionals can help their asylum seeker or refugee clients who disclose torture and rape by believing them and not responding in a shocked way, Keefe says. “We need to reassure them that they are not going mad, but that terrible experiences do happen and we can help them deal with it.”

It is vital to use professionally qualified interpreters experienced at dealing with asylum seekers, so that they feel safe confiding in them. Significantly, social care staff need to reassure clients they are there to help them. As Witkin says: “People come from paranoid regimes where talk costs lives and you need to explain to asylum seekers and refugees that you are working on their behalf.”

Case study of Iraqi woman:

Hind Salman (not her real name) is a 43-year-old refugee who fled Iraq after being repeatedly raped by a security officer. After receiving a first class university degree in accountancy the Iraqi government agreed to let her study to become a chartered accountant in England. They withdrew the offer when they found she and her family were not members of the ruling Ba’ath party. She says their Catholicism was also a factor.

Instead the government forced Hind to be an accountant at Iraqi Airways, where she worked for 11 years until the Gulf War in 1991. After the war the government told her she would be the new accountant at Saddam Hussein’s private hospital. Two days later four security officers went to Hind’s house and told her that if she refused the job she would be executed. She protested, saying she had to nurse her diabetic mother as her father had died and her siblings lived with their own families.

“The guards said I had four days to decide or they would destroy our lives.” On hearing this, Hind’s mother collapsed and later died in hospital. 

Hind worked at Saddam’s hospital for several years and was responsible for the medical equipment supplies.
One day a store room manager told her £4 million worth of equipment had disappeared overnight. Hind called the hospital’s general manager and head of security, who accused the store room manager of stealing. When Hind defended the woman they insisted she sign a document ordering the woman’s hand be cut off. She refused but they went ahead anyway. For three days Hind was detained and raped by the head of security. On two further occasions he detained and raped her.

Hind did not tell her brothers or sister about being raped. One brother arranged her marriage to a much older Iraqi man, a British citizen, so she could escape. She flew to Manchester in 1997. Her husband was violent and abusive so she fled to London.

She claimed asylum and learned English by watching EastEnders. In June 2001, she was granted leave to remain for four years. She says: “I cannot forget what has happened to me, it has injured my heart.”
She receives regular counselling from the Medical Foundation and has taken anti-depressants for six years. Hind dreams of visiting Italy: “I want to go to the Vatican with my family, it would mean a lot to them.”