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How do we heal and prevent the worldwide epidemic of torture? Currently there are 27 treatment programs in the United States serving an international population of torture survivors. The National Consortium of Torture Treatment Programs (NCTTP) conservatively estimates that there are approximately 500,000 torture survivors from more than 70 countries living in the United States. On the other side of this social situation, however, hundreds, perhaps thousands, of torturers live in the United States. These perpetrators are responsible for torture and other human rights atrocities committed in their homelands through commanding or directing execution of heinous acts.

In countries where conflicts have raged, peace accords have been signed and truth and reconciliation committees have been formed but without punishment for the crimes committed. The effects of torture are compounded by impunity. Impunity for human rights atrocities contributes to the ongoing state of fear that survivors live with day to day. The unpunished crimes of the perpetrators continue to violate survivors' personal sense of integrity and freedom. Survivors of human rights abuses are potent advocates for a movement toward justice.

Under United States law, the U.S. courts have jurisdiction to decide civil cases for serious human rights violations, including those against non-Americans, wherever they are committed. Victims have sued 13 perpetrators in civil court under this law. In October 2001, four Bosnian Muslim plaintiffs presented their testimonies before a federal judge in Atlanta, Georgia. They brought charges against a former Bosnian Serb soldier living in the Atlanta area. The plaintiffs presented evidence implicating the defendant in the systematic violation of their human rights in Bosnia-Herzegovina, while acting under the auspices of the Bosnian Serb military and political authorities. Other cases pending trial involve perpetrators from El Salvador, Chile and Indonesia.

This legal recourse presents the opportunity for torture survivors living in the United States to seek justice and confront impunity. The few who are able to take their cases to court create a collective voice for all torture victims, bringing the issue of human rights atrocities into the public eye. This opportunity also presents a means for psychological healing of torture's wounds by breaking the silence, confronting perpetrators and refuting impunity.

These lawsuits filed by torture survivors living in the United States provide the torture rehabilitation community with new terrain to explore. In the forefront are concerns about the impact of the legal process on the plaintiffs. Significant stressors include the need to provide detailed information about the torture experience, to testify under adversarial conditions, and to tolerate the delays within the legal system. Having appropriate psychological support in place is critical.

Few clinicians have engaged in this important work. Guidelines for plaintiffs, attorneys and mental health professionals are being developed in collaboration between the Marjorie Kovler Center for the Treatment of Survivors of Torture, in Chicago, Ill., and the Center for Justice and Accountability, in San Francisco, Calif. The Kovler Center, a health care program of Heartland Alliance, has been coordinating comprehensive services for torture survivors since 1987, including collaboration with attorneys and human rights advocates.

The Center for Justice and Accountability began its work to hold perpetrators accountable and seek redress for survivors in 1998. This collaboration is the result of the recognition of the need to be psychologically sensitive in the documentation of information and to promote an opportunity for healing the wounds of torture.

For additional information, contact Sandra Coliver, executive director, Center for Justice and Accountability, 415/544-0444, or Dr. Mary Fabri, director, The Kovler Center, 773/751-4090.