“Physicians for Human Rights”: We believe in positive changes in Tajikistan

International experts from “Physicians for Human Rights” international organization, Vincent Iacopino (USA) and Rusudan Beriashvili (Georgia), who visited Tajikistan last week with a team of other experts, dedicated their visit to training primary care physicians, psychologists, forensic medical examiners and lawyers on the issues of proper and efficient medical documentation of torture facts by medical personnel at the stage of criminal prosecution of detainees and convicts.

A four-day training organized by PO “Human Rights Center - Tajikistan” with support by the Tajik branch of Open Society Institution - Assistance Fund in Tajikistan, was aimed at presenting the materials of practical nature and teaching the main procedures and principles of efficiently investigating and documenting reports on the facts of torture.

“Tajikistan has been taking measures, including legislative ones, to address the issue of torture and cruel treatment, however, human rights are still violated, both from the moment of actual detention and while serving sentence in penitentiary institutions”, says Parvina Navruzova, Coordinator of the project “Assistance in implementing Istanbul principles in the operation of forensic medical examiners”.

According to Ms. Navruzova, the practice of investigation activity of law enforcement agencies shows that confessionary statements of the detainees remain the main evidence in solving crimes, even though some of them have been received by means of torture and cruel treatment.

Ms. Navruzova is certain that the legislation must provide legal guarantees from the moment of actual detention, including fast and efficient measures to pass medical examination and access to independent doctors at the detainee’s request, without the need for any additional permissions or requests from the officials. In order to guarantee the detainees’ rights and ensure timely recording and evaluation of physical and psychological evidence of torture, it is vital to conduct a medical examination of the detainees or convicted persons by the state forensic medical examiners or hospital doctors, based on an official statement by prosecution officials and judges.

“At the same time, lack of legislative norms regulating the procedure for establishing and conducting private forensic medical examination, as well as the absence of skilled doctors experienced in evaluating physical evidence of torture, makes it impossible to establish the institution of private forensic medical examination”, Ms. Navruzova laments.

This is the reason, experts say, why more training is needed for medical personnel, particularly primary care physicians and trauma specialists, so they can properly perform initial medical examination of the detainees following the Istanbul Protocol standards, in all parts of the country, which will give detainees and their lawyers an opportunity to choose doctors or medical institutions to perform medical examination.

Istanbul Protocol is a manual on efficient investigation and documentation of facts of torture and other inhumane types of treatment and punishment. It contains international governing principles on evaluating the condition of alleged victims of torture and cruel treatment, and on providing the results of such evaluation to judicial or other government authorities responsible for investigating facts of torture.

Istanbul Protocol is a result of three years of analytical work by more than 75 experts in the area of medicine and human rights, representing 40 organizations and institutions from 15 countries. The document has been adopted by the UN in 1999, with the aim of giving governments a practical manual on efficient documentation of facts of torture. It allows identifying and making public evidence of torture and inhumane treatment with the aim of exercising justice.

The principles of Istanbul Protocol (also known as Istanbul Principles) include development of minimum standards and are normally used by medical specialists in domestic and international court proceedings to evaluate physical and psychological evidence of torture and inhumane treatment.

Another issue, pointed out by psychologist Jamilya Muhitdinova, is the absence of trained professional psychologists, who could conduct psychological examination of torture victims in accordance with the principles of Istanbul Protocol, and lack of legislative norms regulating the procedures for performing psychological examination.

“Forensic examiners are not sufficiently trained on the methods of conducting psychological assessment. Comprehensive forensic medical examination, particularly involving psychologists, is vital for cases related to torture”, says the psychologist.

Yahyo Odinaev, director of the National Forensic Medicine Center, believes that observance of Istanbul Protocol provisions in Tajikistan is becoming a reality. “Together with Human Rights Center we are working on a plan of events to implement the Istanbul Protocol principles in the forensic medical practice, with a view on revising the entire range of regulatory documents and adapting it to international standards”, he says.

Mr. Odinaev is certain that acknowledgement of this document by the Government of Tajikistan already is a sign of political goodwill – a major condition for establishing the foundation and implementing the project in general. “The rest is just a matter of time, and I think together our country will achieve significant results in implementing the Istanbul Protocol requirements”, says the Head of National Forensic Medicine Center.

AP reporter talked to the international experts from “Physicians for Human Rights” international organization, to find out their vision of the situation with torture in Tajikistan, the Government’s actions in this direction and the experience of other countries.

Doctor of Medicine, Senior Medical Consultant at the US Branch of “Physicians for Human Rights”, Vincent Iakopino:

- The main goal of training in Dushanbe is to help end the practice of torture in this country and create conditions to make torture impossible from now on. Our organization, “Physicians for Human Rights”, is located in the USA, and we’ve been working in this area for almost 25 years. We put a lot of effort into establishing an international standard on efficient documentation of torture, and then we worked a lot in many countries of the world to ensure its effective operation in documenting such cases. It’s the third year of our operation in Tajikistan, Kyrgyzstan and Kazakhstan with the aim of implementing this international document called “Istanbul Protocol” and its main principles into the practice of these Central Asian countries.

The main directions of operation in Tajikistan include establishment of new opportunities, including technical ones, for forensic medical experts and other specialists to work in compliance with the Istanbul Protocol and amend the domestic legislation accordingly.

We have partnered with Human Rights Center, local branch of Open Society Institute - Assistance Fund in Tajikistan, Ministry of Healthcare, General Prosecution Office, National Center for Forensic Medicine in order to create favorable conditions and train the specialists to work in compliance with the international standards.

- As an international expert who spent several years in Tajikistan, how would you evaluate the Government’s actions in this direction?

- I should say, right now Tajikistan is going through an historic moment, when major changes can be made to eliminate torture. The government has made a lot of positive steps, and most importantly - acknowledged its dedication to fighting this phenomenon. International documents that have been recognized are very important for positive changes in the country. I see important signs of positive cooperation between the government and public organizations in this direction.

However, I must admit there are still issues and challenges which require some more work. It is one thing to hold a manual; it is quite another thing to actually implement it, so that the culprits are prosecuted, the malpractice is prevented, and situation is monitored to avoid regression. This is why we are here, because we believe in positive changes; otherwise we would never come to Tajikistan. And we are working here because we are confident about changes we bring.

- What are, in your opinion, the key problems obstructing the application of Istanbul protocol in our country?

- The biggest problem is the lack of efficient mechanisms for investigating facts of torture, which prevents efficient investigation of these factors. The thing is, our system is based on confessionary evidence, which encourages torture.

At the same time, even though the prosecution office is very powerful, torture victims do not have an opportunity to contact attorneys, pass medical examination in a timely manner; the experts do not have adequate qualifications meeting international standards. In other words, there are several different factors that result in the system being generally not prepared to investigate such torture cases. Besides, the situation of impunity is a signal to those who practice torture that they can get along with their actions, no one is watching. So, the first priority for us is to ensure that the law is binding on everyone, and all the people can say they are equal to the law and equally protected by the law. Of course, this is a difficult process.

- Do you have any data on the frequency of torture in Tajikistan?

- Such data was collected by the UN Special Rapporteur during her last year visit to Tajikistan, based on the data provided by the General Prosecution office. That is the data we use in our activities. The authorities say such cases are numbered in dozens, no more than a hundred cases in the worst case. Meanwhile, I think the actual number is much higher, probably thousands of cases. Most torture victims do not complain, as they do not trust in the justice system, they are afraid to be subjected to even more torture. If I were there, I probably wouldn’t file a complaint either, out of fear of this system.

Rusudan Beriashvili, associate professor, Chair of Forensic Medicine, Tbilisi State University, expert at international organization “Physicians for Human Rights”:

- Georgia implemented Istanbul Protocol more than ten years ago, but this document is so dynamic it takes regular monitoring to make sure we are going in the right direction.

- Certainly some progress has been achieved in more than ten years?

- Progress is definitely visible. Speaking about the Georgian practice of implementing Istanbul protocol, we tried to work in several areas – this affected changes in the legislation, in the day-to-day practice of doctors, forensic experts, psychologists, and psychiatrists. We’ve got some major improvements. In fact, changes to the legislation already allow us to apply IP principles when investigating cases and preparing documents. We have precedents of cases investigated following the Istanbul Protocol principles and then sent to the European Court and won.

We can proudly say there is no torture at all in our police; however, prisons remain a big issue. All the international community knows that last year some very disturbing footage was published from a prison in Tbilisi, which led to major changes in the government and a number of resignations. On the other hand, just a few years ago we did not speak about torture at all, and whatever was happening in prisons was a sealed book. Currently there are no taboos in Georgia, particularly in the area of torture. People talk about this freely, they have a clear understanding of what torture is. Today it is one of the most commonly discussed topics in Georgia, and the people are very open about it - both the society and the government. This is probably the most positive and important effect of implementing Istanbul Protocol.

- During your stay in Dushanbe, you had meetings at the Ministry of Healthcare, General Prosecution Office, National Center for Forensic Medicine. What is your impression of these meetings?

- Impressions are only positive. For many years, since the collapse of the Soviet Union, we did not have any contacts with our Tajik colleagues. The main documents regulating forensic medical examiners’ work here are very similar to ours. This allows me, as an expert, to consult and share my experience. I was impressed by the new forensic medicine building, which meets all modern standards. A lot can be done here, as long as there’s money for purchasing equipment, etc.