There is a global consensus, whitout exceptions, that torture and cruel,
inhuman and degrading treatment and punishment are intolerable and should
be forbidden. Prohibition of torture is regulated by many UN and regional
treaties. However, torture and other forms of cruel, inhuman and degrading
treatment still remains as a problem in many parts of the world. There
are alarming records on human rights violation, including torture, coming
from different parts of the world. The frequency of human rights violation
and torture is extremely high especially in the regions of armed clashes.
Forensic experts play a key role for documentation of torture signs
in survivors of torture, as well as in the casualties associated with torture.
It is of extreme importance for forensic experts dealing with the subject
to know which signs to look after, which pitfalls and dilemmas exist. Also,
appropriate documentation and evidence preservation in torture survivors
is essential for further litigation. However, there can be large difference
between the complaints and the visible damage based largely upon the used
method for torture, as well as in the function of elapsed time since the
ending of torture treatment. Aside of sings of major trauma (e.g. bone
fractures, scars, mutilations, etc.) there might be a plenty of discrete
sings, revealed particularly upon neurological examination.
In the cases of long run natural psychological mechanisms may form
a certain balance in torture victims. Thus, the careful examination and
interviewing must be convey especially in the case of expertise, since
there is no previous confidence and therapeutic relationship between torture
victims and examiner/expert.
Due to psychical consequences of torture, either isolated or in the
presence of different physical consequences, expertise in the cases of
torture survivors must be multidisciplinary, i.e. there must be a team
of experts. The team must include a specialist in forensic pathology and/or
clinical forensic medicine, and at least a specialist in forensic psychiatry.
Participation of other medical specialists (neurologists, ophthalmologists,
etc.) may be sometimes indispensable, mostly due to the particular cases.
Our team perform an examination of 185 torture victims during the five-year
period (1994-1998), on different sites. Examinations were performed in
Belgrade, as well as throughout different places in the Republika Srpska
- a part of Bosnia and Herzegovina. All of the reviewed cases, except 4,
were of Serbian origin, and were released on different occasions from detention
camps in Bosnia and Herzegovina held by Muslims and Croatians. In all the
cases we have the same approach based on standard examination protocol.
In some cases medical records were available, too. Evidence of torture
were documented by means of medical records, photography, and in few cases
by video recording of entire examination process. There were 91% of male
victims and 9% of female, age ranging from 18 to 80 years (mean 44 year).
All victims were captured in the different detention camps and/or prisons
for variable period of time - from one day (7%) up to more than 2 years
(2%) with the prevalence of imprisonment from 3 to 6 months (29%). During
the interview victims described in details different methods of sustained
torture including physical and psychical ways, or both. Degrading, severe
beating, forcing to be present during the torturing of other detained persons,
lack of food and/or water supply, cutting and/or stubbing were among the
most applied methods, as reported by 94% to 31% of victims. The other methods
of torture, including gun shooting, sleep deprivation, repeated sexual
abuse, burning, and applying of electricity were reported, too. It should
be stressed that 6 victims (3%) reported on the participation of medical
professionals (physicians) in torture.
Performed examination failed in proving of the physical consequences
in 14% of victims. Documented sings of sustained torture were in the form
of scars (76%), healed fractures (52%), lack of tooth (26%) and different
deformities of upper and lower limbs or severe mutilation (36%). Torture
effects were lOcalised on head (51%), upper limbs (46%), lower limbs (42%),
chest (41%), abdomen (17%), neck (9%) and over genital region (1%). Noticeable
neurological sings as a consequence of torture were proved in 43% of examined
victims. There were different forms of sensory disturbances, paralysis,
paresis and other sort of neurological signs. Psychiatric evaluation failed
to prove psychical consequences in 36%, while in the remainder 64% cases
PTSD, psycho organic syndrome, depression, psychosomatic disturbances,
personality changes, and other forms of disturbances were documented.
Key terms: Forensic Expertise, Torture, Physical Consequences,
Psychical Consequences