Effects of torture among Chechen refugees in Norway

Report by Amnesty International Danish Medical Group 2006 Effects of torture among Chechen refugees in Norway REPORT BY AMNESTY INTERNATIONAL DANISH MEDICAL GROUP 2006

THE DOCTORS BEHIND THE REPORT ARE: Tania Nicole Masmas MD Claes Kjær MD Lise Worm MD Morten Ekstrøm MD

© Amnesty International, Danish section Quoting the text is permitted when mentioning Amnesty International as the source

GRAPHIC DESIGN OG PHOTO: Michala Clante Bendixen

PRINT: Scanprint, November 2006

ISBN: 87-88252-16-7

Amnesty International Gammeltorv 8, 5. sal DK-1457 København K Denmark e-mail: [email protected] www.amnesty.dk CONTENTS

Introduction 5

Ethical Aspects 6

Material 6

Methods 6

Results 6

Medical examination 8

Discussion 8

Conclusion 9

Table 1: Background characteristics of Chechen examinees 10

Table II: Interview chart 11

Table III: Circumstances surrounding arrest and imprisonment 12

Table IV: Types of torture and other cruel inhuman or degrading treatment or punishment 14

Table V: Physical and psychological symptoms 15

Table VI: Physical findings of objective examination 16

Table VII: Anatomical distribution of all scars 16

Photos 17

Cases 18

References 25 Northern Caucasus and Georgia GIMU / PGDS Geographic Information and Mapping Unit As of March 2004 Population and Geographic Data Section

Email : [email protected] Shpakovskoye Termirgoyevskaya Blagodarnoyy R Novokubansk O W .

StavropoStavropolll C StavropoStavropolll L 3 A _ A I G R O E

Kurganinsk G Giaginskaya S Kalinovskoye U S A

Levokumskoye C U

Urozhaynoye A BelorechensBelorecensk Prikumsk C Sovetskaya N Proskoveya R E H

Aleksandrovskoye T Khanskaya R Kochubeyevskoye O Labinsk Nevinnomyssk N Yaroslavskaya STAVROPOLSTAVROPOL KRAII Voznesenskaya STAVROPOLSTAVROPOL KRAII Achikulak Sablinskoye ApsheronsApseronskk Mostovskoy Otradnaya Zelenokumsk DAGESTAN Neftegorsk Irgakly Kayasula Kamennomostskiy CChherkesserkesskk Stepnoye Caspian ADYGEA Suvorovskaya Mineralnyye Vody ?? Sea Georgiyevsk Psebay Ustdzhegutinskaya Lermontov RUSSIAN FEDERATION Ust'-Dzeguta Yessentuki Pyatigorsk

Uchkeken Novopavlovskaya Sary-Tyuz Zelencukskaja Marinskaya KARATCHAY-CHERKESSIA Kizlyar Karachayevsk Mozdok Prokhladnyy Kargalinskaya Krasnaya Polyana Baksan ZnZnameamennskskooyyee Mayskiy Aki-Yurt Naurskaya Nadterechnaya Dokshukino Malgobek Babayurt SochSochiii Chegem Pervyy Kalinovskaya Chervlennaya NalchiNalchikk Terek Teberda Bylym NalchiNalchikk Sovetskoye Tyrnyauz INGUSHETIINGUSHETIA INGUSHETIINGUSHETIA GGrrroznoznyy Gudermes Gagra KABARDINO-BALKARIA Sleptsovskaya KKhhazavyazavyuurrrttt Urukh Argun KKhhazavyazavyuurrrttt Kvemo-Kolkhida NazNazrrraann Nesterovskaia Kizilyurt Chikola Ardon Achkhay-Martan Lidzava Digora Urus-Martan Shali ABKHAZIA Alagir VladikavkazVladikavkaz SSukhumukhumiii CHECHNYA VedenVedenoo MakhachkalMakhachkalaa Kvemo-gulripsh NORTH OSSETIA VedenVedenoo Kaspiysk Nizhniy Unal ShatoShatoyy Tkvarcheli Buynaksk LarLarss Black Sea Ochamchira Itum-KalItum-KalItum-Kaliii Botlikh Tsageri ShShaatiltiltiliii GalGaliii ShShaatiltiltiliii

ZZugdidugdidiii 0 40 80 Levashi Sergokala SOUTHSOUTH OSSETIA Tkibuli kilometres Khoni Sachkhere Chiatura Senaki Kutaisi Abasha Tskhinvali Poti Samtredia Zestafoni Leningori Tianeti Vani Bagdadi Kareli Lanchkhuti AkhmetAkhmetaa Khashuri Kvareli Ozurgeti Kaspi Telavi LEGEND Borzhomi Mtskheta Kobuleti GEORGIA Lagodekhi Capital ELEVATION Bakuriani Sagaredzho Gurdzhaani (Above mean sea level) TBILISTBILISIII Belakan UNHCR Branch / Liaison office TBILISTBILISIII Office of Charge de Mission Below mean sea level BatumBatumiii ADJARIA ADJARIA Akhaltsikhe Tsnori Zaqatala UNHCR Sub office 0 to 250 metres Tsalka Tetri-Tskaro Rustavi UNHCR Field office 250 to 500 metres 500 to 750 metres Khryuk UNHCR presence Marneuli Tsiteli-Tskaro 750 to 1000 metres Bolnisi Akhalkalaki QAKH Town of interest 1000 to 1750 metres Hopa Shulaveri 1750 to 2500 metres Dmanisi International boundary 2500 to 3250 metres Bagdanovka Administrative boundary 3250 to 4000 metres Artvin Sheki Main road PazaOverr 4000 metres TURKEY Alaverdi Akstafa Secondary road Ardahan Kazakh Cayeli AZERBAIJAN Oghus Railway Rize AZERBAIJAN Tauz Printed: 18 March 2004 Tumanyan The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Sources: UNHCR. © INALCO / Laboratoire de cartographie de l'universite de Tbilissi. Global Insight digital mapping - © 1998 Europa Technologies Ltd. INTRODUCTION

One of Amnesty International Danish Medical The Danish Medical Group visited Norway twice. Group’s prime concerns is to document whether The first time was on 5th - 6th October 2005 and the torture has taken place. Medical documentation is second time on 11th -12th January 2006. A total of a crucial implement for preventing torture and ill 21 Chechen refugees were interviewed and exam- treatment. ined. The examinations took place in a secure and confidential setting where only the examinee, two During the recent conflicts in Chechnya a number physicians and an interpreter were present. of human rights organizations have reported seri- ous human rights violations including extrajudi- The report was drawn up in collaboration with cial killings, detention without charge or trial and Amnesty International Norway, the Norwegian torture. In the vast majority of cases the violations support association for Chechnya and the Norwe- were committed by Russian forces but it has re- gian Refugee Council. It contains a description of cently emerged that Chechen armed forces are also the torture methods used, their psychological and responsible for serious human rights abuses. physical impact on the Chechen refugees and an objective, medical description of the findings of the However, reports that include medical assessments examination. of Chechen torture victims (see references 1-3) are sparse. There are relatively few Chechens in Den- According to the UNHCR, European countries mark although several thousand Chechen refugees received slightly more than 20,000 asylum seek- are staying in Norway. A number of these were ers from Russia in 2005. The vast majority were previously interviewed by the Norwegian support Chechens (7). association for Chechnya (4) but were not exam- ined with a view to documenting the physical and The physicians of Amnesty International Danish psychological consequences of torture. Medical Group are unpaid and independent of po- litical interests. The examinations took place in a Four members of the Amnesty International Dan- different country from that in which the abuse oc- ish Medical Group consequently decided to go to curred and could consequently be carried out with- Norway in order to examine the Chechen refugees out interference from public authorities or others. and determine whether it can be medically docu- mented that torture of civilians has taken place in Chechnya over the past 10 to 15 years (1-6).

“On the last day they put a hood over my head and drove me out into the woods and shot me. They thought I was dead but a shepherd found me “I was blindfolded, my hands were tied behind my and brought me to the hospital where I spent two back and I was taken to an empty house where they months. While I was in hospital they had to remove interrogated me about the other inhabitants of my one of my kidneys, part of my intestine and my village. And then they started to torture me.” spleen. I never dared go home again.” 34 year old Chechen woman 22-year-old Chechen man

“During the interrogations I was blindfolded and “Two of the torturers raped me several times, they handcuffed. They kicked and beat me with clubs kicked me in the back and the loin and beat me all or rifle butts; my nose was broken, among other over. They also threatened to go after my children things, and several of my teeth were knocked out.” next time.” 40 year old Chechen man 34 year old Chechen woman

5 ETHICAL ASPECTS MATERIAL

The Danish Medical Group’s ethical considerations The study comprised a total of 21 adult ethnic are in accordance with the International Code of Chechens, 2 women and 19 men, between the ages Medical Ethics (World Medical Association 1959, of 22 and 59, who had either been granted asylum 1968, 1983) and the ethical conditions set forth in or had sought asylum in Norway. The reader is the UN Istanbul Protocol. (8). In documentation referred to Table 1 for further information on the work it is the physician’s responsibility never to background of the 21 Chechens. injure the individual regardless of the overall aim. According to their own statements the examine- It is therefore crucial to ensure that the individual es had all been subjected to extrajudicial detention, examinee does not suffer retraumatization by re- interrogation and torture or other cruel, inhuman telling the story of his or her torture. or degrading treatment or punishment. It is also the physician’s responsibility to ensure that those examined do not risk reprisals against themselves or their families. The stories have con- METHOD sequently been anonym zed. Subsequent talks with contact persons from the The Chechens were all examined by two physi- examined group have made no mention of any cians from Amnesty International Danish Medical psychological ill effects of the examinations. The Group and a professional interpreter was present at examinees were all offered treatment in the Norwe- all examinations. The interviews were structured gian healthcare system as needed. according to the categories in Table II. The exami- nees were questioned as to their general personal Everyone participating in the study signed a docu- background, the history of their torture, and types ment of informed consent concerning voluntary of torture used, physical and psychological symp- participation, anonymity, data confidentiality and toms and treatment. data publication by Amnesty International (9). The interviews did not touch upon the exami- nee’s escape from Chechnya but focused solely on The general rule of the patient-physician relation- the story of abuse. Subsequently all the examined ship is that the physician must help the sick person Chechens were medically examined with the aim including treatment and pain relief (10-11). How- of describing the objective psychological and phy- ever, when it comes to medical documentation sical findings (Table II). work treatment does not enter directly into the Each examination lasted between 1 ½ and 2 ½ picture. Nevertheless many torture survivors say hours and was carried out according to the princip- that they want to tell the story of their torture if les set forth in the UN Istanbul Protocol (8). it can help prevent others from being subjected to the same treatment. In addition telling the story of their torture may serve as a kind of relief in itself. RESULTS The examinees’ stories were written down without Arrest and imprisonment regard to political conviction, possible criminal The 21 Chechens had been subjected to a total of charges, religious affiliation or any other non-medi- 29 arrests, 56 of which resulted in imprisonment cal issues. or detention. Table III shows the arrest of each of the interviewed Chechens. The arrests took place between 1995 and 2005 although the vast majority took place between 2000 and 2005. The arresting authority was in all cases Russian military forces or police. In a few cases forces under the Chechen “The first day I was put in a hole in the ground president Akhmad Kadyrov were involved in both where the guards poured ice cold water over me, the arrest and the imprisonment itself. beat me with bottles and urinated on me.” 22 year old Chechen man Approximately one third of the arrests took place at night or very early in the morning. The arrests took place in the home or on the street and at ti- mes the selection of the person arrested seemed extremely arbitrary. One of the examinees was in

6 hospital in Chechnya when he and all the other Nine of the 21 Chechens had been subjected to patients and health workers were arrested. near asphyxiation with gas masks, bags over their Violence was used in more than half of the ar- heads or by hand. Approx. one third of the exami- rests, primarily in the form of blows inflicted by nees had been subjected to suspension, mock exe- hand or rifle butt as well as kicks. Between 3 and cution or isolation. 40 military personnel were present. The majority In addition, several of the examinees had been of the military personnel were armed and in some subjected to cigarette burns, sexual torture inclu- cases masked. The grounds for arrest varied gre- ding rape, being doused with water or petrol, being atly, see Table III. threatened with dogs, having their nails torn off, The detainees were primarily removed from their teeth filed down and being cut with a knife. the place of arrest by car or van. The detainees Ten out of the 21 examinees reported fainting du- were placed in prisons, military bases, holes in the ring torture. ground, warehouses, empty civilian houses which the Russian military forces had taken over or in Physical and psychological symptoms actual interrogation camps (the Chenokozovo in- Table V shows the physical and psychological terrogation camp among others was mentioned by symptoms suffered by the examinees at the time several examinees). of the examination. 16 of the 21 examinees stated The Chechens were detained from between one that they had been in good health prior to the day and approx. one year. Several of them were for- abuse. ced to sign confessions. Only one of the examined Chechens received legal counsel and was brought When questioned about the physical consequences to trial. He was released 4 days later. There were no of the torture the vast majority cited headaches official investigations of any of the other arrests. and joint pain. Six of the examinees complained of impaired hearing and/ or a buzzing in the ears. Methods of torture used and other When questioned as to psychological effects the degrading and inhuman treatment majority of the examinees stated they had diffi- The 21 Chechens all relate that they were subjec- culty sleeping, nightmares, impaired concentration ted to abuse and other degrading and inhuman and memory loss. A number of the examinees treatment. The torture methods are shown in Table additionally experienced recurrent memories of IV. torture in their everyday lives as well as heighte- ned irritability, feelings of dejection, anxiety and All the Chechens stated that they had been kicked nervousness. and beaten with rifle butts, iron poles or plastic Three subjects received pain medication or se- bottles. datives at the time of the examination due to the Most of them had also been subjected to electric effects of torture. None of the subjects were alcohol torture from a hand generator (described as an old- or drug abusers. fashioned telephone), degrading and humiliating treatment (including sexual violation, being called degrading names and being urinated on) or threats to their families and themselves. “I was also subjected to the “swallow”– that is, they suspended me from the ceiling with my hands tied More than half were handcuffed and blindfolded or behind my back while they beat me. That was how had a bag over their heads for a prolonged period my right shoulder was injured”. of time. In addition more than half had witnessed 40 year old Chechen man the severe torture of others.

“Sometimes they tied me to a chair during inter- rogation. They crushed my fingers, they burned my “They gave me electric shocks with a hand run hands with cigarettes and gave my fingers, toes and generator that looked like a telephone by attaching ears electric shocks. They tied a plastic bag around wires to my ears, nose and neck. But the worst part my head and put on an old gasmask with a tube and almost was being forced to watch my fellow prison- shut off the oxygen supply until I fainted.” ers being tortured”. 49 year old Chechen man 40 year old Chechen man

7 MEDICAL EXAMINATION DISCUSSION

Eleven of the 21 examinees were psychologically In all 21 cases the examinees’ reported case history powerfully affected by the interview particularly of torture was in accordance with the symptoms when it concerned their experiences during de- they are suffering from today and/or the objective tention and torture. They appeared extremely de- physical findings of the medical examination. Ty- jected, spoke in a low voice and had to stop several pically the torture methods used leave very few times during the interview. They generally avoided physical after-effects, for example psychological eye contact with the interviewer and at times wept torture, blows with plastic bottles full of water and profusely. near asphyxiation. There were very few reports of methods of torture that typically leave a scar such The physical findings of the examination are de- as cutting or slashing. scribed in Table VI. The findings were primarily Half the examinees had scars, which were all related to the musculoskeletal system. Five of the fully consistent with the described traumatization, examinees reported pain, loss of strength, sensory primarily blows and gunshot wounds. Similarly impairment or crookedly healed joints in the arms torture related musculoskeletal injuries were found and legs. Three had shoulder joint symptoms in in approx. half the examinees. the form of pain, loss of strength and impaired mo- bility. Two experienced pain during examination of Psychological symptoms were particularly pre- the back. valent among the Chechens including classical A total of 62 scars were registered distributed post traumatic stress disorder in more than half over 14 persons, 48 of which were alleged to be of them. The most frequent symptoms were sleep related to the abuse. 11 of the 21 examinees had disorders including nightmares, recurring painful scars that they stated had been caused by abuse memories of trauma and loss, impaired memory and which were in accordance with the abuse function, inability to concentrate and heightened described based on an objective assessment. The irritability. Several met all of WHO’s criteria for scars were caused by gun shot lesions (17), blows posttraumatic stress disorder, which is a typical with bludgeons or rifle butts (14), surgery (9), ciga- result of severe traumatization such as torture and rette burns (4), knife-cut lesions (4), vaccinations abuse. (4), shell splinters (2), burns (1), handcuffs (1) and On the whole the examined Chechens did not unknown causes (6). The scars’ primary location complain during the interviews. The vast majority was on the arms and legs (Table VII). Two persons of the 21 examinees were men who said that it is a had crooked noses and restricted nasal air passage taboo among Chechen men to discuss abuse and as a result of nasal fracture reportedly caused by an even greater taboo to mention the traumas fol- blows during torture. lowing in its wake. It is crucial to bear this in mind when examining Chechen refugees for the effects of torture. Five of the examinees reported having been “They put a metal helmet over my head and subjected to sexual torture including two who had hammered on the helmet with a sledge hammer. been raped. Sexual violation is often subject to ta- They gave me electric shock under my fingernails boo and is therefore presumably underreported in and under the nails on my little toes so later I had to this investigation (2). have the nails removed from my fingers and toes.” The 21 Chechens unanimously stated that torture “They threatened to go get my father and brother is extremely widespread in Chechnya and that it is and kill them” carried out almost without exception by Russian 22 year old Chechen man forces. A few stated that they had also seen ethnic Chechens among the prison guards/tormentors, for example in Chernokozovo interrogation camp. The investigation gave a clear picture of wide- spread arbitrary arrest, extensive use of torture and other inhuman and degrading treatment and forced confessions. Only one of the examinees reported having had access to a lawyer and being brought before a judge.

8 CONCLUSION

Amnesty International Danish Medical Group’s The examined Chechens are today visibly affected report documents that the extensive use of torture by their traumatization and several of them fulfill and other cruel, inhuman or degrading treatment WHO’s criteria for post traumatic stress disorder or punishment takes place in Chechnya. (PTSD), which is a typical result of severe trauma such as torture. The Danish medical assessment thereby confirms the numerous reports from organizations all over The report concludes that in all 21 cases the symp- the world, which for years have described the ex- toms and the medical findings were tent of torture and other human rights violations fully consistent with the torture the Chechens committed particularly by the Russian rulers – and stated they had been subjected to. to a lesser extent by ethnic Chechens – against Chechens in Chechnya. Torture is often approached as a political, socio- economic, legal or moral issue. The focus of the The abuse took place between 1995 and 2005 and present report, however, is restricted to a health the torturers typically used torture methods that angle. did not leave scars, such as psychological torture and near asphyxiation. Such a medical documentation is a crucial contri- bution to the total picture of human rights abu- All 21 Chechens that were examined had been ses committed against individuals or population beaten with rifle butts and plastic bottles, among groups. One of the primary aims of documentation other things. 15 witnessed the torture of their fel- is to prevent torture from taking place. low prisoners, 14 were threatened directly and indi- rectly, and 13 were handcuffed for prolonged peri- ods of time. 11 were subjected to electric torture. 9 experienced near asphyxiation whereby among other things a gasmask was placed over their heads and the oxygen supply shut off until they fainted. 7 had to undergo mock execution and 5 were sub- jected to sexual torture just to name a few of the “At first the torture was pretty much at random, most frequently used torture methods. then it got more systematic and it almost always took place at night. The torturers smoked hash and played loud music before starting in”.

“They constantly kicked and beat me all over my body with their bare fists, sticks and heavy hoses. I was beaten on the head with an iron pipe and on the mouth so I lost several teeth. They kicked me “They almost asphyxiated me with a plastic bag in the groin and told me I couldn’t have any more that they held over my head until I fainted” children”.

“We were given almost no food, really just what was “They gave me electric shocks with an old hand run brought to us from the outside, and among other generator that looked like a telephone; they at- things I had to completely go without food for nine tached electrodes to my neck, arms and loin.” days. I had to drink my own urine, partly because of 34 year old Chechen woman fluid loss and partly to prevent tuberculosis. But the worst thing of all was hearing my fellow prisoners being tortured.” 49 year old Chechen man

9 TABLE 1: BACKGROUND CHARACTERISTICS OF CHECHEN EXAMINEES

Characteristics Value

Age in years, average value (range) 37 (22-59)

Gender, men / women (%) 19 (90) / 2 (10)

Marital status, married / divorced / unmarried (%) 18 (86) / 1 (5) / 2 (10)

Number of children, average (range) 2.4 (0-5)

Education, none / medium-length1 / higher (%) 5 (24) / 9 (43) / 7 (33)

Occupation in Chechnya, employed / unemployed / unspec. (%) 13 (62) / 1 (5) / 7 (33)

Present occupation, employed / language course / unemployed / unspec. (%) 3 (14) / 3 (14) / 11 (52) / 4 (19)

Year of arrival in Norway 2001-2006

Health previous to abuse, healthy / chronic illness 2 (%) 16 (76) / 5 (24)

1) A medium-length course lasts about 3 years 2) Chronic illness in the form of cardiovascular disorders, surgery for benign tumors, fainting spells and congenital shoulder defects.

10 Objective observations General physical state General psychological state Skin, scars Head, face Eyes, ear, noseEyes, ear, Mouth, dental status Heart, lungs Abdomen Genitals Muscle-skeletal Peripheral nervous system Central nervous system Photos Treatment Medical journals Treatment for Treatment effects of torture Medication Psychological symptoms Sleeping disorders Nightmares Anxiety-nervousness Anxiety attacks Impaired concentration Impaired memory Depressed mood-sadness Flashbacks-reliving episodes Loss of self-confidence Affective lability-irritability Other symptoms Physical symptoms Headache Pain / ImpairedPain sensibility of the soles of the feet Neck or back pain Pain inPain the lower extremities Pain inPain the upper extremities Tinnitus, impaired hearing Dizziness Other symptoms Intestinal disorders Urinary incontinence Disorders of the urinary tract Sexual symptoms

Types of torture Falanga * Falanga Suspension Electric torture Forced positions Isolation Witness to the abuse of others Mock execution Humiliating treatment “The Elephant” ** “The Swallow” *** Other types of torture

Number of times arrested Torture history Circumstances surrounding arrest Cause of arrest Description of place of torture Threats (including to family) Court case INTERVIEW CHART Background Birthplace Place of residence Age Education Employment Previous health Examinations for effects of torture Informed consent TABLE II: * ”Falanga”: strokes* ”Falanga”: against foot and ball of foot ** ”The elephant”: use of a gas mask on the head of the tortured person and the oxygen supply is periodically cut. *** “The swallow”: the hands are fastened behind the back; the victim is suspended by the arms and is often beaten in this position.

11 4 days + 4 days - 3 days 1 day + weeks- months 3 days + 18 3 days + 18 days Hours to 1 week 1 week to several weeks Weeks to months 1 day + 8 days Length of detention “filtration camp” Thrown into the street unconscious. Not detained Empty house Military base, prison. “filtration camp” Hole in the ground. “filtration camp” Prison “filtration camp”. Basement Basement of unknown house. Military base. Placed in hole in the ground with bars over it for 4 days. Police station and basement of unknown house Detention facility Examinee was politically active No grounds known to the interviewee. Home was near the Russian military base Accused of being Chechen opposition fighter No grounds known to the interviewee Suspected of involvement in the Chechen guerrilla movement Accused of being Chechen opposition fighter No grounds known to the interviewee Was accusedWas of having worked with and helped Chechen opposition during the war Grounds for arrest arrest: nd arrest. 2 st No violence during 1 Hands tied behind back. Forced to lie on the ground. Beaten, kicked. Hood over the head. Circumstances of arrest At night, knock on the Beaten door. with rifle buts, kicked unconscious No violence reported Stood up against wall. Searched. Passport taken. Door-to-door action At night. Several family members killed. Attempted to escape. Hood away in van. over the head. Taken Knocked unconscious. Death threat to father. Handcuffs. Blindfolded. Gun against neck. Mock execution. Village surrounded Russian by military. Mass arrests. Handcuffs. Bag over the away in van. head. Taken Forced into a military van, hands tied behind the back. Forced to lie on ground Own home. On the street During a raid. At a checkpoint Own home On the street. Own and friends’ homes Own home Own home Own home. Stopped when driving Own home Place of arrest Own home Russian military, masked Russian military Russian military Arresting party/ tormenter Russian military, masked Russian military Russian military Russian military and Chechens Russian military and Kadyrov’s forces Russian military CIRCUMSTANCES SURROUNDING ARREST AND IMPRISONMENT (LISTED IN THE SAME ORDER AS THE CASE STUDIES PRESENTED). Time of arrest 2004 2000 & 2002 1996 & 1996 2000 2005 x 2 2005 2000- x 4 2001 1996 & 1996 1999 1999 x 3 1999 & 2002 1995 & 1995 2005 1996, 1996, & 2001 2003 TABLE III:

12 - 3 days + 1 week Several months 1 month 2 years + 1 week 4 days 5 days Days to months.Total of about 1 year Length of detention 19 days + 4 19 months+ 10 days 2 weeks 3 days + hours Hours to seve- to Hours ral months Detention facility Basement. “filtration camp” Prison. Hole in the ground Not detained Moved from prison to prison, to “filtration camps” and storage buildings Prison. Hole in the ground different16 prisons. Hole in the ground Basement of house House Prison. Military base. “filtration camp” Military base. Prison Basement of house House No grounds known to the interviewee Accused of political activities Didn’t report for military service Grounds for arrest No grounds known to the interviewee Perhaps mistake. Mistaken for neighbour Worked for Chechen politicians Undisclosed Worked for Chechen ministry Accused of helping Chechen soldiers No grounds known to the interviewee Suspected of being member of “bandit group” Military personnel in Accusedfamily. of being in possessionfalseof passport At night. No violence reported Circumstances of arrest No violence reported Blows with rifle butt, knocked unconscious Patients and hospital personnel arrested in hospital. Handcuffed At night. Beaten with rifle butt. Mother ill-treated. At night. Hood over head. Hands tied behind back. Beaten, kicked, stabbed At night. No violence reported Dragged out of car and taken away At night. Home surrounded. Blows No violence reported Took place at night.Took Mass arrests. Door broken down. Hood over head. Beaten House raided. Hands behind back. Hood over head. Own home On the street. Own home Own home Place of arrest Chechen hospital Own home Own home Own home Checkpoint Own home Checkpoint Home of friends Own home Russian military, masked Russian military Russian military Arresting party/ tormenter Russian military Russian military Russian military Russian military Russian military, masked Russian military Russian military Russian military Russian military 2000 x 7 Time of arrest & 1995 2003 2002 2000 2001 2000 & 2003, 2002 2001 2000- x 15 2003 2000 x 2 & 2002 2003 x 2 2003

13 TABLE IV: TYPES OF TORTURE AND OTHER CRUEL INHUMAN OR DEGRADING TREATMENT OR PUNISHMENT

Types Number of examined (%)

Random/Unsystematic blows, incl. with object 21 (100)

Witness to torture of fellow prisoners 15 (71)

Personal threats or threats to family 14 (67)

Prolonged handcuffing 13 (62)

Degrading treatment 11 (52)

Electric torture 11 (52)

Mock suffocation 9 (43)

including with gas mask, “the elephant”* 3 (14)

Unable to see: blindfolded/ bag over head 9 (43)

Mock execution 7 (33)

Suspension 6 (29)

including “the swallow” ** 2 (10)

Sexual abuse 5 (24)

including rape 2 (10)

Isolation 5 (24)

Shot 4 (19)

Ice-cold water poured on examinee 4 (19)

Burned with cigarettes 3 (14)

Nails torn off 3 (14)

Petrol poured on examinee 2 (10)

including igniting petrol 1 (5)

Cut with blunt knife 1 (5)

Fingers crushed 1 (5)

Beaten simultaneously on both ears 1 (5)

Threatened with dogs 1 (5)

Forced positions 1 (5)

Blows on metal helmet on head 1 (5)

Teeth filed down 1 (5)

Being kept in a hole 3 (14)

Denied water and food 1 (5)

*) “The elephant”: use of a gas mask on the head of the tortured person and the oxygen supply is periodically cut. **) “The swallow”: the hands are fastened behind the back; the victim is sus- pended by the arms and is often beaten in this position.

14 TABEL V: PHYSICAL AND PSYCHOLOGICAL SYMPTOMS

Symptoms Number of examined (%)

Physical symptoms

Headache 13 (62) Back pain 12 (57) Leg pain 10 (48) Pain in arms/shoulders 8 (38) Loss of hearing/ buzzing in ears 6 (29) Neck pain 5 (24) Chest pain 5 (24) Loss of feeling (arms, hands) 2 (10) Dental pain, difficulty chewing 2 (10) Dizziness 2 (10) Burning sensation in upper abdomen 2 (10) General loss of strength 1 (5) Weight loss 1 (5) Intermittent blurred vision 1 (5) Restricted nasal air passage 1 (5) Elevated blood pressure 1 (5) Frequent urination 1 (5) Intermittent red urine 1 (5) Haemorrhoids 1 (5) Psychological symptoms

Sleeping disorders 19 (90) Nightmares 17 (81) Recurring memories 14 (67) Loss of memory 13 (62)

Heightened irritability 13 (62) Loss of concentration 12 (57) Depressed mood 9 (43) Anxiety 8 (38) Nervousness, uneasiness, tension 7 (33) Feeling of hopelessness 3 (14) Isolates himself 2 (10) Hears voices 1 (5) Intermittent anxiety attacks 1 (5) Conflict averseness 1 (5)

15 TABLE VI: PHYSICAL FINDINGS OF OBJECTIVE EXAMINATION

Symptoms Number of examined(%)

Physical findings Crooked nose and restricted nasal air passage 2 (10) Tenderness of back 2 (10) Impaired mobility in musculoskeletal system 5 (24) Tenderness in musculoskeletal system 2 (10) Sensory impairment in musculoskeletal system 1 (5) Crookedly healed joints 1 (5) Effects of amputation of limbs 1 (5) Scars (torture related and non-torture related) 14 (67)

TABLE VII: ANATOMICAL DISTRIBUTION OF ALL SCARS

Anatomical location Number of scars

Head 10 Chest 1 Abdomen 8 Back 8 Arms 15 Legs 20

16 011 (CASE 15) The examinee states that he had been put in tight handcuffs. 2 cm X 2 mm transverse scar on upper side of right wrist furrow.

007 (CASE 7) Examinee told that he had been cut on his leg. 8 x 2 cm scar after cut wound on the outside of the right lower leg with small loss of substance.

008 (CASE 15) 019 (CASE 14) Examinee tells that he had been burned by cigarettes. There is an observable lower linear suture scar and an upper On his right lower arm a 1 x 1 cm. round scar can be irregular, circular scar. seen with central depigmentation and slight hyperpigmenta- The scars can be the result of a gunshot wound’s entry and tion at the outside of the scar. The appearance is typical for exit points. The lower scar could also be the result of inser- scars after cigaret burns. tion of a drainage tube during the following operation.

17 CASES

CASE 1 CASE 3

Torture history. 59-year-old Chechen man who was Torture history. 43-year-old Chechen man who was detained once in March 2004. He was arrested in his arrested in 2000 and 2002. On the second occasion own home and forced into a van by masked, armed he was kept in a basement for 8 days. He was inter- military personnel, allegedly from the Russian intel- rogated and received blows on the lumbar region and ligence services. The examinee was humiliated verbally legs. He was in isolation for the entire 8 days and was and subjected to blows and kicks until he lost con- forced to be present at an execution by firing squad. sciousness. He was thrown out of the van unconscious, He was threatened with harm to his family if he did not found and brought to hospital. No torture was used that cooperate. typically leaves scars. Symptoms. The examinee suffers from heightened ir- Symptoms. Psychologically the examinee sleeps poorly ritability, difficulty falling asleep, impaired memory and at night with occasional nightmares, recurrent memo- especially impaired concentration as well as a lack of ries of the most unpleasant and violent events and also confidence in the future. suffers from impaired concentration. He is fairly recov- Findings. No abnormal objective findings. ered today physically but suffers from intermittent pain Conclusion. The examination reveals that the medical in his foot. symptoms particularly the psychological symptom com- Findings. The examinee is visibly affected by the dis- plex is in accordance with the reported torture. cussion of abuse and loss in Chechnya and exhibits observable depressed mood with a tendency to weep. CASE 4 Impaired sensibility of the 4th and 5th fingers and the back of the right hand was observed. Torture history. 49-year-old Chechen man who was Conclusion. The examination reveals that the medical arrested 3 times, in 1996, 2001 and 2003. The ex- symptoms and findings particularly the psychological aminee was arrested on all occasions in his home and symptom complex is in accordance with the reported interrogated for periods lasting from weeks to months torture. by the Russian intelligence service. The examinee was subjected to abuse, particularly during the two first pe- CASE 2 riods of detention, in the form of unsystematic blows with fists all over his body and he lost consciousness Torture history. 48-year-old Chechen man arrested in due to the blows. Blows to the face. Cigarette burns. 1996 and 2000. On both occasions subjected to tor- “The elephant”, i.e. mock suffocation with a gas mask. ture including unsystematic kicks and blows, particularly Mock execution by shooting. Forced into uncomfortable blows to the genitals with a full water bottle, having ice positions with handcuffs. Placed in a hole in the ground cold water poured over him, subjected to threats to his with bars over it. Verbal humiliation and threats to his life and was forced to be present when his fellow pris- family. oners were tortured. He was not tortured with methods Symptoms. Psychologically, sleeping disorders includ- that typically leave scars. ing nightmares, but this has improved after arriving in Symptoms. Psychologically, he suffers from reliving his Norway. Fairly recovered physically today apart from traumas, while awake and during nightmares; he suf- intermittent pain in the right side of the back. fers other sleeping disorders, impaired memory and he Findings. Objectively two scars were observed in the is generally more anxious than he was prior to arrest. lumbar region, one of them circular about 1 cm in di- Complains of toothache, impaired hearing, and pain in ameter, the other uneven, about 1x2 cm. the right rib region, increased fatigability and markedly Conclusion. Sleeping disorders including nightmares impaired physical capacity. are common among severely traumatized persons. The Findings. Psychologically, he is clearly depressed and examinee today has limited after-effects of the torture affected by telling about of the traumas. He has tender- reported. The two scars on his back could be the re- ness of the abdomen and right kidney region sults of cigarette burns and the blow respectively. The Conclusion. The examination reveals that the medical occasional back pains could be the effects of blows or symptoms and findings particularly the psychological of being forced to remain in an unnatural position. The symptom complex is in accordance with the reported symptoms are in accordance with the reported torture. torture.

18 CASE 5 impairments, feels depressed and frequently relives his traumas. More conflict averse than previously. His jaw Torture history. 32-year-old Chechen man who was and some bones in the hand were broken and subse- arrested twice. In 1995 he was detained in prison for a quently treated in hospital. Currently, he suffers from month. He was subjected to electric torture and blows pain in the back and left shoulder and stiffness of the while suspended. He was beaten with plastic bottles joints in the upper arms. filled with water on the lumbar region, the calves and Findings. Observably dejected and occasional tendency the head until he lost consciousness. He and his family to weep. Tenderness of the back. On the left shin a received death threats. In 2005 he was detained for a dark, pigmented scar was observed and on the back of month. He was beaten while suspended by the arms. the right hand above the third metacarpal bone a 5 cm He was again threatened to be killed. He heard his fel- long scar was seen. low prisoners being tortured. Conclusion. The examination reveals that the medical Symptoms. Psychologically his sleep patterns are char- symptoms and findings are in accordance with the re- acterized by frequent waking, he dreams that he is be- ported torture. ing shot, is constantly worried about his family, has dif- ficulty concentrating, jumps from task to task, his short term memory is significantly impaired, and he is more CASE 7 short tempered than before his detention. The exami- nee complains of severe headaches especially at night, Torture history. 30-year-old Chechen man who was neck and back pain, impaired sensibility of the right arrested twice by Russian soldiers. The first time was in arm, loss of strength in the right thumb, buzzing and 1996 when for the following three days he was forced humming in the ears, and difficulty breathing at night. to remain in a hole in the ground together with other The breathing problems he attributes to asthma. prisoners, his clothes were taken away, he was beaten Findings. Minor loss of strength in the right arm and and shot in a toe on the right foot. The second time hand. In the middle of the right shoulder blade was ob- was in December 1999 when several family members served a circular scar 1 x 0.5 cm (allegedly after a gun were shot during the arrest. He was subsequently taken shot). On the front of the right shoulder was observed to an internment camp for 18 days. Here he was tor- a scar 1 x 0.5 cm (allegedly from a shell splinter) and tured daily with electric torture, blows with batons and on the front of the lower right leg was observed a linear having ice-cold water poured over him. scar 15 cm in length (origin unknown). Symptoms. Is today strongly affected by his experi- Conclusion. The examination reveals that the medical ences, suffers from pronounced sleeping disorders and symptoms particularly the psychological symptom com- is afraid to sleep owing to frequent nightmares. Suffers plex is in accordance with the reported torture. Loss from anxiety, impaired memory and concentration, of strength in the right arm and hand could be a result depressed mood, and re-lives his traumas. Physically of being suspended. The scars are not related to the he complains of loss of mobility of the right big toe, a torture. burning sensation in the top of the abdomen and pain in the neck musculature. Findings. Observably plagued by anxiety, looks down- CASE 6 wards all the time and speaks fairly indistinctly, seems dejected. Physically, tenderness of the neck muscula- Torture history. 32-year-old Chechen man who was ture, right big toe deformed and loss of mobility. On the detained briefly for interrogation 3 times in 1999 by right big toe there is an about 3 cm irregular scar, on Russian forces during which time he was beaten and the outer side of the lower right leg there is an about kicked. In June 2002 he was arrested and detained 8 x 2 cm scar and further up on the outer side of the for a week. He was arrested outside his home, a hood lower right leg there is a circular scar about 1 cm in was placed over his head and he was taken away in a diameter. van and put into a prison cell. Every day he was taken Conclusion. to interrogation and torture including mock suffocation, The symptomatology and the objective findings are in suspension, electric current to the nose, threats of be- full accordance with the torture. The reported scars are ing shot and blows and kicks. in accordance with the effects of gun shot lesions and Symptoms. Psychologically he suffers from sleeping knife cut lesions. The examinee meets the criteria for disorders including frequent waking and nightmares, oc- post-traumatic stress disorder. casionally hears voices, has memory and concentration

19 CASE 8 long scar with loss of tissue and several scars from 5 stitches directly beneath the left elbow flexion, two 0.5 Torture history. 40-year-old Chechen man who was x 0.5 cm round scars on the left upper arm, one 0.5 x arrested 4 times between 2000 and 2001. The exami- 8 cm crescent-shaped scar without substance loss on nee was imprisoned for a total of around 5 months, the right side of the lumbar region, several small scars the longest term being 4 months. The examinee was about 0.5 cm. long on the root of the nose, two 1x2 cm imprisoned in a Russian military camp/prison and the long scars beneath the chin and five about 1-2 cm long “filtration camp”, Chernokozovo. The arrests took place narrow scars without substance loss over the right knee. on the street or in his home. The examinee was sub- In addition an atrophied right shoulder and upper arm jected to torture in the form of random kicks and blows with loss of strength and impaired mobility consistent with batons and rifle butts (breaking his nose, among with a birth defect. other things, and knocking out several teeth), mock Conclusion. The examination reveals that the medi- suffocation with a plastic bag over his head until the cal symptoms and findings are in accordance with the examinee lost consciousness. The examinee was also reported torture. The examinee meets the criteria for subjected several times to the “swallow/lastochkha”, post-traumatic stress disorder. The scars reported are in which the examinee was suspended with his hands consistent with the after-effects of blows or knife cut tied behind his back and beaten, thereby sustaining lesions with the exception of two round scars on the further injury to his right shoulder. The examinee was upper left arm, which are the results of vaccination. The also subjected to electric torture with a hand generator effects of the nasal fracture are consistent with physical on several occasions and was cut in the arms and back violence such as blows with a rifle butt. with a blunt knife. In addition the examinee was present when fellow prisoners were tortured, received threats to CASE 9 his family and was treated in a degrading and humiliat- ing fashion. He was accused of being a Chechen soldier Torture history. 34-year-old Chechen woman who and forced to sign a document to that effect. During was arrested in her home in the spring of 2005 and interrogation he was blindfolded and handcuffed. detained for two days by Russian troops who were After each of his periods of detention he was released as masked during the arrest. The examinee was transport- a result of ransoms paid by his family. ed to an empty house, blindfolded and her hands were Symptoms. Psychologically the examinee experiences tied behind her back. The examinee was interrogated severe symptoms as a result of torture: sleeping disor- about the other inhabitants of her village, among other ders with frequent waking and nightmares of torture, is things, and was tortured during the interrogation. The generally anxious, nervous and depressed all the time, abuse consisted of electric shocks from an old hand suffers from frequent anxiety attacks when for example generator that looked like a telephone; the examinee he experiences a tightness in the throat and is unable was raped several times by two persons and kicked in to breathe, has difficulty remembering and concentrat- the chest and lumbar region of the back, and subjected ing, suffers from flashbacks and relives his torture. Loss to random blows. The examinee felt that she was “treat- of self-confidence after torture, easily irritable, feels on ed like a dog”. The examinee was further threatened guard all the time and isolates himself, spending a good that next time her children would be detained too. deal of time at home. The examinee has physical symp- Symptoms. Psychologically the examinee suffers from toms including headache, dizziness, buzzing in the left severe after-effects of the abuse and has been prescri- ear, tenderness of the neck, lumbar region and knees bed sedatives and sleeping medication. The examinee due to blows. The examinee has trouble chewing since has trouble sleeping, experiences nightmares, flash- several teeth have been knocked out. Suffers from backs, and suffers from severely impaired memory and urinary incontinence and at times stabbing pains in the loss of concentration. Also reports that she is afraid she chest. He said that he suffered damage to his right arm might do herself harm if it weren’t for her children. Is during birth. This had been further aggravated during generally depressed with a tendency to weep, is con- torture by blows and suspension. The examinee today stantly nervous and uneasy and is decidedly afraid that takes painkillers. someone will come and take her or her children. Since Findings. The examinee exhibits signs of mild to moder- the abuse the examinee has had physical symptoms in ate depression. The nose twists toward the left consist- the form of daily headaches and pain in the back and ent with previous fractures he described. Tenderness lower back. She experiences pain of the left knee and was found on the left temple. In the upper part of the right elbow, mild pain in the lower right side of the ab- mouth most of the teeth are missing and the dental domen. status is generally poor. On the skin there are a 0.5 Findings. Objectively the examinee appears depressed x 4 cm long scar above the right shoulder, a 1x7 cm and wept during the entire examination during which

20 she told the story of her torture for the first time. CASE 12 There is tenderness in both kidney regions. Conclusion. The examinee was not subjected to types Torture history. 49 year old Chechen man who in of torture that leave definite physical traces, but the 2000 was subjected to two periods of detention last- examinee’s psychological symptom complex is in ac- ing nine days and six months, followed by 5-6 further cordance with the reported sexual torture. brief periods of detention. On each occasion he was released following payment of a ransom by his family. CASE 10 Subjected to prolonged torture; food deprivation; had to drink his own urine partly due to fluid loss and partly Torture history. 42-year-old Chechen man who was because the prisoners believed this would prevent tu- arrested and tortured twice by Russian soldiers, in berculosis; was beaten and kicked constantly all over 1995 and in 2003. He was subjected to blows with his body with canes, heavy hoses, hands and boots; at truncheons and water bottles, blows to the ears, mock times tied to a chair; beaten on the head with an iron suffocation with a plastic bag and ice-cold water was pipe and on the mouth causing him to lose several poured over him, but not to any kind of physical torture teeth; kicked in the groin and told he wouldn’t be able which left scars or marks. He was subjected to men- to have more children; burnt on the hands with ciga- tal torture including witnessing the abuse of others, rettes; wires were placed on his fingers, toes and ears received threats to himself and his family and was and he was subjected to electric torture with an old subjected to a mock execution. On the occasion of his hand generator; fingers crushed; several times a plastic second detention he was additionally placed in a hole bag was pulled over his head or a gasmask with a tube in the ground for 3 days. (“the elephant”), the oxygen supply was cut off and he Symptoms. The examinee is particularly plagued by lost consciousness several times; forced to hear others the psychological effects of torture: sleeping disorders, being tortured (which the examinee feels was worst nightmares, flashbacks, anxiety, uneasiness and nerv- of all.) The examinee was subsequently in such critical ousness, heightened irritability and buzzing in the ears. condition that one physician said he only expected him Findings. Depressed mood. to live for another six months at the most. Subsequently Conclusion. The examinee’s psychological state is in ac- his family sent him to a neighbouring republic for treat- cordance with the reported torture. ment since there was no possibility of his receiving care in Chechnya. CASE 11 Symptoms. The examinee sleeps badly, has nightly an- xiety and nightmares, re-lives his torture, and has de- Ill-treatment. 48-year-old Chechen man who was not pressed mood, increased irritability and loss of memory. detained but ill-treated in 2002 when approached by He currently suffers from headache, pains in the neck Russian special forces in his own home for refusing to and shoulder as well as the face and left upper arm. join the Russian military. On one such occasion he was Findings. Examination shows that all the front teeth in struck hard in the rib cage and head with a rifle butt, the upper mouth are missing. A 4 cm long scar was lost consciousness and was subsequently hospitalised found on the scalp and two round scars on the left for a week. During the following 6 months his family hand. On the left shoulder, resistance and pain when was repeatedly threatened and severely harassed in raising the arm to more than 90 degrees and a slight their home, including an episode in which his daughter numbness of the left arm. was pushed to the floor, hitting her jaw and head result- Conclusion. The reported psychological symptoms are ing in a concussion. in accordance with the torture history. The missing Symptoms. The examinee suffers from reliving the teeth in the upper mouth and the impaired mobility events, nightmares, sleeping disorders, irritability, nerv- and sensibility of the left upper arm are consistent with ousness, depressed mood and memory loss. Further- the reported torture. The scar on the scalp is consist- more, the examinee at times suffers from headaches ent with the effects of blunt violence and the two scars and dizziness as well as sensitivity in the rib case when on the left hand consistent with the effects of cigarette lying on his stomach. burns. Findings. The examinee appears generally depressed. He has a 3.5 cm long scar on his scalp. Conclusion. The reported psychological symptom com- plex is in accordance with the ill-treatment and continu- ous harassment. The scar on the examinee’s scalp is fully consistent with the effects of blunt violence.

21 CASE 13 CASE 14

Torture history. 36-year-old Chechen man who ar- Torture history. 22-year-old Chechen man who was rived in Norway from Chechnya one week prior to the arrested and detained for about one month in 2001. examination. He was subjected to detention without At the time of his arrest his mother was ill-treated by charge or trial for about 6 months in 2000. While soldiers and subsequently died. He was subjected to hospitalised in a Chechen hospital he was detained severe humiliation, placed in a hole in the ground, had by Russian forces along with some 100 other patients ice-cold water poured over him, was urinated on, re- and hospital personnel. The examinee was hospitalised peatedly subjected to torture including tearing off his due to an injured right foot after stepping on a mine. nails, electric torture, blows to a metal helmet placed He was moved countless times during detention from on his head, threats to his life and that of his family. prisons or “filtration camps” to a Russian military hospi- He saw fellow prisoners being ill-treated. Finally taken tal and large storage buildings. During transport and in into a woods and shot by guards. He survived and was the detention facility the examinee was pushed, kicked, discovered by chance by a shepherd who took him beaten with rubber truncheons (including to the head) to hospital where he remained for 2 months. He was and forced into cold water. In addition transport condi- operated on, including removal of a section of his intes- tions were crowded and uncomfortable and the exami- tine, spleen and left kidney. nee lost consciousness several times. The examinee Symptoms. Psychologically he suffers from sleeping was infected with tuberculosis during his detention. He disorders, sleeping 3-4 hours a night at most, night- said that the prison guards placed prisoners that were mares of torture, feels anxious and nervous, cannot suspected of having tuberculosis next to healthy pris- relax, has difficulty remembering, cannot concentrate, oners in order to spread the disease. After about one becomes easily upset and often relives his traumas week of detention the examinee’s right leg was ampu- when awake. Furthermore, the examinee suffers from tated below the knee without anaesthetic in a Russian headaches several times a week, constant back pain, military hospital. The examinee does not believe that pains in the neck and arms particularly when there is a amputation was necessary and that the leg might have change in weather and pain in his left thigh and knee been saved by conservative treatment. During transport when touched. between detention facilities the examinee was beaten Findings. Objectively the examinee appears nervous, by three Russian soldiers who among other things also tense and depressed. Muscular tenderness of the back. kicked the examinee and placed their boots on his On his abdomen there are 2 irregular, 2 small stitched breastbone so that the examinee still experiences sen- and several larger typically surgical scars. In addition, on sitivity in the area; in addition they fired a shot at the the abdomen there are two irregular, round scars and a examinee’s left hand wounding his index finger. During similar irregular round scar on the back. detention the examinee was interrogated by Russian in- Conclusion. The examination reveals that the medical telligence officers and told to sign a declaration in which symptoms and findings are in accordance with the re- he admits having participated in “illegal groupings”. ported torture. Scars were observed that are fully con- Symptoms. The examinee is affected by sleeplessness, sistent with the effects of the reported surgery as well nightmares, anxiety, reliving his trauma, heightened as scars that are consistent with the effects of shotgun irritability and shortness of temper and loss of joy of lesion. life. He is today fairly recovered physically although he suffers from headache and intermittent pain in the right CASE 15 leg amputation stump. Findings. Psychologically the examinee appears de- Torture history. 30-year-old Chechen man who was pressed. There are observable effects after amputation placed in 16 different detention facilities’ in Chechnya of the right leg about 30 cm below the knee. Observ- and other parts of Russia over a two-year period start- able crooked healing of outer joint of left index finger ing in 2000. He doesn’t know whether Russian federal (allegedly after gun shot lesion). A 0.5 x 20 cm scar forces or Chechen security forces arrested him, but observable beneath right shoulder blade (which he they spoke Russian. He reports that he was constantly attributes to a tuberculosis operation) and a 2 x 2 cm moved to prevent him from being found by the Red scar on right flank (allegedly from surgical drainage Cross who would have wished to hear his story. He tube). Finally a narrow about 2.5 cm long scar on the was subjected to torture in the form of blows and kicks, left elbow is observed (from a fall). cigarette burns, a bag over his head that was ignited, Conclusion. The examination shows that the medical suspension, electric torture, gas mask over his head and symptoms and findings are in accordance with the re- the air shut off (“the elephant”), isolation, he was uri- ported torture. nated on and witnessed others having their tongues cut out so they couldn’t talk. 22 Symptoms. Psychologically he is plagued by sleep dis- and is afraid they will find out about her history. She orders, nightmares, reliving his torture scenes, anxiety feels worn down but tries to work a great deal in order and fear, depressed mood and heightened irritability. to prevent the recurrent thoughts of what happened. Currently he suffers pain in large areas of his body. Pe- Today she suffers from constant headache, neck pain, riodically red urine, tinnitus (buzzing in the ears), and pain in the back of the left foot and constant soreness headaches. and periodical stabbing pains in the chest. She is given Findings. Psychologically the examinee’s basic mood ap- sedatives and pain killing medication. pears depressed. Furthermore, there were observable Findings. Psychologically the examinee is observably scars on the bridge of the nose, right lower arm, wrist deeply affected when recalling her earlier traumatic and left knee. experiences. Furthermore, there is a chipped front tooth Conclusion. The examination reveals that the medical and considerable neck/shoulder tenderness. According symptoms and findings are in accordance with the re- to the examinee a CT brain scan was performed show- ported torture. The scars are consistent with the effects ing signs of previous bleeding. of burns (bridge of the nose), cigarette burns (right Conclusion. The examination reveals that the medical lower arm) and hand cuffs (right wrist). symptoms and findings particularly the psychological symptom complex is in accordance with the reported CASE 16 torture. The psychological symptoms she described are typical of torture survivors and she meets the criteria for Torture history. 29-year-old Chechen man who was post-traumatic stress disorder. arrested and tortured for 2-3 days in 2002. He doesn’t know whether Chechens or Russians arrested him, but CASE 18 they spoke Russian. He was kept in isolation in a dark cell, experienced threats to himself and his family, he Torture history. 32-year-old Chechen man who was could hear others being tortured and at times his hands arrested about 15 times between 2000 and 2003 were bound behind his back. Physically he was subject- by various Russian military units and militia under the ed to electric torture and unsystematic blows and kicks. control of Chechen president Akhmed Kadyrov. He was This resulted directly in bruises but no permanent scars. detained and imprisoned for periods lasting from days Symptoms. Psychologically he experiences difficulty to months, a total of about 1 year. He was detained in remembering and concentrating, sleeping disorders, different locations. The arrests took place by surround- nightmares and periodic depressed mood. Ever since ing the examinee’s house; the examinee was then ar- the abuse he has been plagued by back pain radiating rested and transported to prison. The examinee reports to the chest/abdominal region. This is currently being unsystematic blows during arrest and prison transport. investigated. The arrests allegedly took place primarily because the Findings: No abnormal findings. Russians believed the examinee and his family were Conclusion. The examination reveals that the medical hiding Chechen soldiers or helping them in some other symptoms and findings particularly the psychological way. The examinee was forced under torture to sign a symptom complex is in accordance with the reported document stating that he was a Chechen soldier. Dur- torture. ing arrest the examinee was subjected to unsystematic kicks and blows with rifle butts or truncheons. The CASE 17 examinee was subjected to electric shock treatment, filing his teeth down to the nerve, having needles stuck Torture history. 44-year-old Chechen woman who was under his nails and on one occasion petrol was poured detained for 5 days in 2001 in a Russian military build- over him. The examinee was subjected to mock execu- ing. She was subjected daily blows and kicks all over tion and “the swallow/lastochkha”, i.e. being suspended her body, her head was knocked against the wall, she from the ceiling with his hands tied behind his back. was dragged down the stairs in a prone position, made Threats were made that the Russians would bring in to go naked, received death threats to herself and her his brothers and he also witnessed the abuse of fellow family, was handcuffed and blindfolded and subjected prisoners. In addition the prisoners were lined up and to mock execution. She was ill in bed for two months subjected to humiliating insults. after the abuse. Symptoms. Psychologically the examinee suffers from Symptoms. Psychologically she generally feels anxi- sleep disorders, nightmares, relives his torture, is wor- ety that the abuse will repeat itself, she sleeps poorly ried and anxious and suffers from heightened irritability. and wakes often, has great trouble concentrating and During suspension his left shoulder was allegedly dislo- remembering what she has just read which makes it cated and was subsequently not set properly. Physically difficult for her to keep up at her language course. She the examinee’s primary after-effects today are in the tries to keep up a façade in relation to other people left shoulder in the form of pain and loss of mobility, 23 and pain in the lumbar region and buzzing in the ears. weeks the examinee was ransomed and released. Findings. Objectively the examinee appears depressed. Symptoms. The examinee today complains of intermit- Close to the left shoulder the collarbone is abnormally tent migraine-like headaches and double vision, for ex- prominent and there is observable loss of mobility ample if he watches television for a long period of time. and sensibility as well as discomfort when moving He attributes this to the effects of blows to the head. In the shoulder. In addition there are a number of scars, addition upper back pain when sitting still for too long. which, however, are not directly related to the abuse, Findings. The objective examination found mild tender- according to the examinee. One tooth missing. ness of the upper abdominal region and muscular sen- Conclusion. The examination reveals that the medical sitivity of the upper back. There are two visible scars on symptoms and findings are in accordance with the re- the left side of the back and in the left lumbar region, ported torture. The psychological symptom complex is one of which with loss of substance. Similarly on the typical of torture survivors and several criteria for post- right buttock there are two irregular scars, one signifi- traumatic stress disorder are met. The damage to the cantly larger than the other with loss of substance. left shoulder is fully consistent with the effects of hands Conclusion. The torture history is plausible. The exami- tied behind the back and subsequent suspension. nee today suffers from relatively few effects of torture, which might substantiate this. The four scars mentioned CASE 19 above are in full accordance with the effects of gun shot lesions which are not torture related. Torture history. 23-year-old Chechen man who was ar- rested 3 times by Russian forces in the period between CASE 21 2000 and 2002 and detained, for a total duration of around 5 months. Subjected humiliating and degrading Torture history. 41-year-old Chechen man who in the treatment, immobilized, subjected to kicks and blows spring of 2003 was arrested and tortured by Russian and forced to see fellow prisoners being tortured and federal forces He was bound and a hood was placed on shot. When trying to escape he was shot at, sustaining his head, he was forced to crawl on his knees, received wounds in the left foot. He was captured and brought heavy blows to the stomach, upper arms, legs and face to hospital. thereby fracturing his nose among other injuries. Threat- Symptoms. The examinee suffers today from head- ened with the death of his family if he refused to co- aches, which was sensitive to weather changes. In addi- operate. Ransomed after 3 days. Subsequently on two tion, pains in the left foot and impaired mobility of the occasions he narrowly avoided arrest again after which toes on the left side. he fled with his family. Findings. The objective examination found loss of mo- Symptoms. Psychologically he suffers from sleeping bility of the 2nd - 4th toe on the left foot and there were disorders including nightmares, distress and anxiety at- 3 round irregular scars on the back of the left foot and tacks, impaired concentration and memory, loss of spir- the left sole. its, heightened irritability with a tendency to react more Conclusion. The examination reveals that the medical violently, the need to be alone and loss of self-confi- symptoms and findings are in accordance with the re- dence. Today he suffers from elevated blood pressure, ported torture. The changes in the left foot are consist- pain in the left shoulder and left shinbone, headaches ent with the effects of gun shot lesions. and impaired air passage in the left nostril. Findings. He is observably depressed and has a ten- CASE 20 dency to weep. Blood pressure elevated, tenderness of the upper abdomen, tenderness of upper back, mas- Torture history. 29-year-old Chechen man who was sive muscular infiltrations of left shoulder, loss of feel- arrested in March 2003 by Russians and was detained ing when touched at left shinbone and loss of patellar for 2 weeks. The arrest took place at night. Russians reflex on the left side. Finally, the nose is crooked with surrounded the house, the door was broken down and restricted air passage on the left side. the examinee was taken from the house with a mask Conclusion. The examination reveals that the medical over his head. He was beaten with rifle butts during the symptoms and findings are in accordance with the re- arrest. He was taken to a house controlled by the FSB ported torture. The examinee’s psychological symptom (Federal Security Service). During arrest the examinee complex and general pattern of depressed mood and was put in a basement with very thin walls between tendency to weep are typical symptoms of persons that the cells and heard his fellow prisoners being tortured. have been subjected to abuse and he meets the criteria During the first 3 days the examinee was subjected for post-traumatic stress disorder. His physical problems to blows with rifle butts and truncheons while hand- and the objective findings including evidence of previ- cuffed to a radiator. The guards were masked during the ous nasal fracture are also in full accordance with the abuse. After 3 days the torture was reduced and after 2 reported torture. 24 REFERENCES

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