Journal of Bioethical Inquiry

, Volume 13, Issue 2, pp 223–237 | Cite as

Preventing Torture in Nepal: A Public Health and Human Rights Intervention

  • Danielle D. CelermajerEmail author
  • Jack Saul
Symposium: Structural Competency


In this article we address torture in military and police organizations as a public health and human rights challenge that needs to be addressed through multiple levels of intervention. While most mental health approaches focus on treating the harmful effects of such violence on individuals and communities, the goal of the project described here was to develop a primary prevention strategy at the institutional level to prevent torture from occurring in the first place. Such an approach requires understanding and altering the conditions that cause and sustain “atrocity producing situations” (Lifton 2000, 2004). Given the persistence of torture across the world and its profound health consequences, this is an increasingly important issue in global health and human rights.


Torture Public health Primary prevention Systemic approaches Nepal 



We would like to acknowledge Aastha Dahal, Kiran Grewal, Rohit Karki, Anna Noonan, and Pradeep Pathak for the research and project work in Nepal that is discussed in this article.


  1. Advocacy Forum and Human Rights Watch. 2008. Waiting for justice: Unpunished crimes from Nepal’s armed conflict. New York: Advocacy Forum and Human Rights Watch, ISBN: 1-56432-319-6. Accessed March 2, 2016.
  2. Advocacy Forum and Human Rights Watch. 2009. Still waiting for justice: No end to impunity in Nepal. New York: Advocacy Forum and Human Rights Watch, ISBN 1-56432-550-4. Accessed March 2, 2016.
  3. Advocacy Forum and Human Rights Watch. 2010. Indifference to duty: Impunity for crimes committed in Nepal. New York: Advocacy Forum and Human Rights Watch, ISBN 1-56432-727-2. Accessed March 2, 2016.
  4. Advocacy Forum—Nepal. 2014. Promising developments persistent problems: Trends and patterns in torture in Nepal during 2013. Nepal: Advocacy Forum—Nepal. Accessed September 9, 2015.
  5. Agamben, G. 1998. Homo Sacer: Sovereignty and bare life. Translated by D. Heller-Roazen. Stanford: Stanford University Press.Google Scholar
  6. Austin, M., and J. Claassen. 2008. Impact of organizational change on organizational culture: Implications for introducing evidence-based practice. Journal of Evidence-Based Social Work 5(1–2): 321–359.CrossRefPubMedGoogle Scholar
  7. Baker, J. 2012. The rise of Polri: Democratisation and the political economy of security in Indonesia. PhD dissertation, London School of Economics and Political Science.Google Scholar
  8. Bandura, A. 1973. Aggression: A social learning analysis. Oxford: Prentice Hall.Google Scholar
  9. Banerjee, A.V., and E. Duflo. 2008. The experimental approach to development economics. National Bureau of Economic Research, working paper no. w14467.
  10. Basoglu, M., J.M. Jaranson, R. Mollica, and M. Kastrup. 2001. Torture and mental health. In The mental health consequences of torture, edited by E. Gerrity, T. Keane, and F. Tuma, 35–62. New York: Plenum Publishers.Google Scholar
  11. Basoglu, M., M. Paker, O. Paker, et al. 1994. Psychological effects of torture: A comparison of tortured with nontortured political activists in Turkey. American Journal of Psychiatry 151(1): 76–81.CrossRefPubMedGoogle Scholar
  12. Bayley, D.H. 2001. Democratizing the police abroad: What to do and how to do it. Washington, DC: National Institute of Justice. Accessed February 29, 2016.Google Scholar
  13. Bronfenbrenner, U. 1992. Ecological systems theory. London: Jessica Kingsley Publishers.Google Scholar
  14. Brown, W. 2004. The most we can hope for … : Human rights and the politics of fatalism. The South Atlantic Quarterly 103(2): 451–463.CrossRefGoogle Scholar
  15. Bullock, K., and P. Johnson. 2011. The impact of the Human Rights Act 1998 on policing in England and Wales. British Journal of Criminology 52(3): 630–650.CrossRefGoogle Scholar
  16. Bunch, C. 1995. Transforming human rights from a feminist perspective. In Women’s rights, human rights: International feminist perspectives, edited by J. Peters and A. Wolper, 11–17. New York and London: Routledge.Google Scholar
  17. Celermajer, D. 2015a. Issues paper 1: International legal frameworks and traditional approaches to preventing the use of torture. University of Sydney.
  18. Celermajer, D. 2015b. Issues paper 2: Exploring the root causes of torture. University of Sydney.
  19. Celermajer, D. 2015c. Issues paper 7: Case studies from Nepal and Sri Lanka: Human rights protection facilitator projects. University of Sydney.
  20. Celermajer, D. 2015d. International review: Current approaches to human rights training in the law enforcement and security sectors. University of Sydney.
  21. Celermajer, D. 2015e. Project overview: Enhancing human rights protections in the security sector in the Asia Pacific project. University of Sydney.
  22. Celermajer, D., and K. Grewal. 2013. Preventing human rights violations “from the inside”: Enhancing the role of human rights education in security sector reform. Journal of Human Rights Practice 5(2): 1–24.CrossRefGoogle Scholar
  23. Celermajer, D., and A. Noonan. 2015. Issues paper 8: Measuring change; evaluating a torture prevention project. University of Sydney. Scholar
  24. Center for Legal Research and Resource Development (CeLRRd). 1999. Analysis and reform of the criminal justice system in Nepal. Kathmandu: CeLRRd.Google Scholar
  25. Chan, J. 1997. Changing police culture: Policing in a multicultural society. Melbourne: Cambridge University Press.CrossRefGoogle Scholar
  26. Chan, J. 2003. Organizational socialization and professionalism. In Fair cop: Learning the art of policing, edited by J. Chan, C. Devery, and S. Doran, 3–40. Toronto: University of Toronto Press.Google Scholar
  27. Chan, J., and D. Dixon. 2007. The politics of police reform: Ten years after the royal commission into the New South Wales police service. Criminology and Criminal Justice 7(4): 443–468.CrossRefGoogle Scholar
  28. Clarke, R.V., and R. Homel. 1997. A revised classification of situational crime prevention techniques. In Crime prevention at a crossroads, edited by S.P. Lab, 17–27. Cincinnati, OH: Anderson.Google Scholar
  29. Committee Against Torture. 2011. Report on Nepal adopted by the Committee against Torture under article 20 of the Convention and comments and observations by the State party. Accessed March 2, 2016.
  30. Copelon, R. 1993. Recognizing the egregious in the everyday: Domestic violence as torture. Columbia Human Rights Law Review 25: 291–367.Google Scholar
  31. Davis, R.C., and P. Mateu-Gelabert. 1999. Respectful and effective policing: Two examples in the south Bronx. New York: Vera Institute of Justice.Google Scholar
  32. Dishion, T.J., and E.A. Stormshak. 2007. Intervening in children’s lives: An ecological, family-centered approach to mental health care. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  33. Drescher, K.D., D.W. Foy, C. Kelly, A. Leshner, K. Schutz, and B. Litz. 2011. An exploration of the viability and usefulness of the construct of moral injury in war veterans. Traumatology 17(1): 8–13.CrossRefGoogle Scholar
  34. Ede, A.J. 2000. The prevention of police corruption and misconduct: A criminological analysis of complaints against police. PhD thesis, Griffith University.Google Scholar
  35. Evans, C., A. Ehlers, G. Mezey, and D.M. Clark. 2007. Intrusive memories in perpetrators of violent crime: Emotions and cognitions. Journal of Consulting and Clinical Psychology 75(1): 134–144.CrossRefPubMedGoogle Scholar
  36. Evans, M.D., and R. Morgan. 1998. Preventing torture: A study of the European convention for the prevention of torture and inhuman or degrading treatment or punishment. Oxford: Oxford University Press.Google Scholar
  37. Gendreau, P., C. Goggin, and P. Smith. 2002. Implementation guidelines for correctional programs in the “real world.” In Offender rehabilitation in practice: Implementing and evaluating effective programs, edited by G.A. Bernfeld, D.P. Farrington, and A.W. Leschied, 247–268. New York: John Wiley & Sons Ltd.Google Scholar
  38. Goldfeld, A.E., R.F. Mollica, B.H. Pesavento, and S.V. Faraone. 1988. The physical and psychological sequelae of torture: Symptomatology and diagnosis. The Journal of American Medical Association 259(18): 2725–2729.CrossRefGoogle Scholar
  39. Grewal, K., and D. Celermajer. 2015. Issues paper 4: Human rights in the Nepali law enforcement and security sector. University of Sydney. Scholar
  40. Hafner-Burton, E. 2008. Sticks and stones: Naming and shaming the human rights enforcement problem. International Organization 62(Fall): 689–716.CrossRefGoogle Scholar
  41. Hamber, B. 2009. Transforming societies after political violence: Truth, reconciliation and mental health. London: Springer.CrossRefGoogle Scholar
  42. Hamber, B., and E. Gallagher. 2014. Psychosocial perspectives on peace-building. London: Springer.Google Scholar
  43. Hayner, P. 2002. Unspeakable truths: Confronting state terror and atrocity. New York: Routledge.Google Scholar
  44. Herman, J. 1992. Trauma and recovery. New York: Basic Books.Google Scholar
  45. Informal Sector Service Centre (INSEC). 2000. Human rights yearbook 1999. Kathmandu: INSEC.Google Scholar
  46. Informal Sector Service Centre (INSEC). 2001. Human rights yearbook 2000. Kathmandu: INSEC.Google Scholar
  47. Janis, I.L. 1971. Groupthink among policy makers. In Sanctions for evil: Sources of social destructiveness, edited by N. Sanford, C. Comstock, and Associates, 71–89. San Francisco: Jossey-Bass.Google Scholar
  48. Jauregui, B. 2013. Beatings, beacons, and big men: Police disempowerment and delegitimation in India. Law & Social Inquiry 38(3): 643–669.CrossRefGoogle Scholar
  49. Jensen, S., and A. Jefferson, eds. 2009. State violence and human rights: State officials in the south. Oxon and New York: Routledge-Cavendish.Google Scholar
  50. Kelman, H.C. 1989. Crimes of obedience: Toward a social psychology of authority and responsibility. New Haven: Yale University Press.Google Scholar
  51. Kennedy, D. 2002. International human rights movement: Part of the problem? Harvard Human Rights Journal 15: 101–125.Google Scholar
  52. King, N. 1992. Modeling the innovation process: An empirical comparison of approaches. Journal of Occupational and Organizational Psychology 65(2): 89–100.CrossRefGoogle Scholar
  53. Kohrt, B.A., M.J.D. Jordans, W.A. Tol, et al. 2008. Comparison of mental health between former child soldiers and children never conscripted by armed groups in Nepal. The Journal of the American Medical Association 300(6): 691–702.CrossRefPubMedGoogle Scholar
  54. Kothari, M. 2005. Report of the special rapporteur on adequate housing as a component of the right to an adequate standard of living. Geneva: United Nations, E/CN.4/2005/48.Google Scholar
  55. Kotter, J.P. 1996. Leading change. Cambridge: Harvard Business Press.Google Scholar
  56. Krug, E.G., J.A. Mercy, L.L. Dahlberg, and A.B. Zwi. 2002. The world report on violence and health. The Lancet 360(9339): 1083–1088.CrossRefGoogle Scholar
  57. Landau, J., and J. Saul. 2004. Facilitating family and community resilience in response to major disaster. In Living beyond loss, edited by F. Walsh and M. McGoldrick, 285–319. New York: Norton.Google Scholar
  58. Lifton, R.J. 2000. The Nazi doctors: Medical killing and the psychology of genocide. New York: Basic Books.Google Scholar
  59. Lifton, R.J. 2004. Conditions of atrocity. The Nation, May 13.Google Scholar
  60. MacNair, R. 2001. Psychological reverberations for the killers: Preliminary historical evidence for perpetration-induced traumatic stress. Journal of Genocide Research 3(2): 273–282.CrossRefPubMedGoogle Scholar
  61. Marks, S. 2011. Human rights and root causes. The Modern Law Review 74(1): 57–78.CrossRefGoogle Scholar
  62. Mayne, J. 2012. Contribution analysis: Coming of age? Evaluation: The International Journal of Theory, Research and Practice 18(3): 270–280.CrossRefGoogle Scholar
  63. McCarthy, T.E., ed. 2006. Attacking the root causes of torture: Poverty, inequality and violence. Geneva: World Organisations Against Torture.Google Scholar
  64. Meckled-García, S., and B. Cali, eds. 2006. The legalization of human rights: Multidisciplinary perspectives on human rights and human rights law. London and New York: Routledge.Google Scholar
  65. Mertens, D.M., and A.T. Wilson. 2012. Program evaluation theory and practice: A comprehensive guide. New York: Guildford Press.Google Scholar
  66. Milgram, S. 1974. Obedience to authority: An experimental view, 1st ed. New York: Harper & Row.Google Scholar
  67. Miller, K., and L. Rasco. 2004. An ecological framework for addressing the mental health needs of refugee communities. In The mental health of refugees: Ecological approaches to healing and adaptation, edited by K. Miller and L. Rasco, 1–66. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  68. Moscardino, U., S. Scrimin, F. Cadei, and G. Altoe. 2012. Mental health among former child soldiers and never-abducted children in northern Uganda. The Scientific World Journal 2012. doi:10.1100/2012/367545.Google Scholar
  69. Nation, M., C. Crusto, A. Wandersman, et al. 2003. What works in prevention: Principles of effective prevention programs. American Psychologist 58(6–7): 449–456.CrossRefPubMedGoogle Scholar
  70. Noonan, A., and D. Celermajer. 2015. Issues paper 6: From structural analysis to structural intervention. University of Sydney. Scholar
  71. Norris, F., S. Stevens, B. Pfefferbaum, K. Wyche, and R. Pfefferbaum. 2008. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. American Journal of Community Psychology 41(1–2): 127–150.CrossRefPubMedGoogle Scholar
  72. Nowak, M. 2006. Civil and political rights, including: The questions of torture and detention. Report by the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment. Geneva: United Nations Economic and Social Council, publication no. E/CN.4/2006/6/Add.5.Google Scholar
  73. Nowak, M. 2012. What’s in a name? The prohibitions on torture and ill-treatment today. In Cambridge companion to human rights law, edited by C. Gearty and C. Douzinas, 307–328. Cambridge: Cambridge University Press.Google Scholar
  74. Office of the High Commissioner for Human Rights. 2012. Nepal conflict report: An analysis of conflict-related violations of international human rights law and international humanitarian law between February 1996 and 21 November 2006. Geneva: United Nations Office of the High Commissioner for Human Rights. Accessed September 9, 2015.Google Scholar
  75. Ortiz, S.D. 2001. The survivors’ perspective. In The mental health consequences of torture, edited by E. Gerrity, T.M. Keane, and F. Tuma, 13–34. New York: Springer US.Google Scholar
  76. Rejali, D. 2007. Torture and democracy. Princeton, NJ: Princeton University Press.Google Scholar
  77. Rieff, D. 2003. A bed for the night: Humanitarianism in crisis. Simon and Schuster.Google Scholar
  78. Ritterman, M. 1987. Torture: The counter-therapy of the state. The Family Therapy Networker 11(1): 43–47.Google Scholar
  79. Ritterman, M. 1990. Hope under siege: Terror and family support in Chile. Norwood, NJ: Ablex.Google Scholar
  80. Rodley, N. 2009. Reflections on working for the prevention of torture. Essex Human Rights Review 6(1): 15–21.Google Scholar
  81. Saferworld. 2007. Policing in Nepal: A collection of essays. Accessed March 1, 2016.
  82. Sallis, J.F., N. Owen, N., and E.B. Fisher. 2008. Ecological models of health behavior. In Health behavior and health education: Theory, research, and practice, 4th ed., edited by K. Glanz, B.K. Rimer, and K. Viswanath, 465–485. San Francisco: Jossey-Bass.Google Scholar
  83. Saul, J. 2013. Collective trauma, collective healing: Promoting community resilience in the aftermath of disaster. New York: Routledge.Google Scholar
  84. Saul, J., S. Ukshini, A. Blyta, and S. Statovci. 2003. Strengths based treatment of trauma in the aging: An Albanian Kosovar case study. In Mental wellness in aging: Strength based approaches, edited by J. Ronch and J. Goldfield, 299–314. London: Health Professions Press.Google Scholar
  85. Schachter, S. 1959. The psychology of affiliation: Experimental studies of the sources of gregariousness. Stanford, CA: Stanford University Press.Google Scholar
  86. Shahinian, G. 2011. Report of the special rapporteur on contemporary forms of slavery, including its causes and consequences. Geneva: United Nations, A/HRC/18/30/Add.2.Google Scholar
  87. Sharma, B., and M. Van Ommeren. 1998. Preventing torture and rehabilitating survivors in Nepal. Transcultural Psychiatry 35(1): 85–97.CrossRefGoogle Scholar
  88. Sharma, M. 2014. Making laws work: Advocacy forum’s experiences in prevention of torture in Nepal. SUR-International Journal on Human Rights 11(20): 201–212. Scholar
  89. Shin, J., and G.E. McClomb. 1998. Top executive leadership and organizational innovation: An empirical investigation of nonprofit human services organizations (HSOs). Administration in Social Work 22(3): 1–21.CrossRefGoogle Scholar
  90. Shrestha, N.M., B. Sharma, M. Van Ommeren, et al. 1998. Impact of torture on refugees displaced within the developing world: Symptomatology among Bhutanese refugees in Nepal. The Journal of the American Medical Association 280(5): 443–448.CrossRefPubMedGoogle Scholar
  91. Simmons, B. 2009. Mobilizing for human rights: International law in domestic politics. New York: Cambridge University Press.CrossRefGoogle Scholar
  92. Somasundaram, D. 2010. Collective trauma in the Vanni-a qualitative inquiry into the mental health of the internally displaced due to the civil war in Sri Lanka. International Journal of Mental Health Systems 4(22): 1–31.Google Scholar
  93. Somasundaram, D. 2014. Addressing collective trauma: Conceptualisations and interventions. Intervention 12(1): 43–60.CrossRefGoogle Scholar
  94. Terai Human Rights Defenders’ Alliance (THRD). 2015. Report on torture in the Terai. Kathmandu: Terai Human Rights Defenders’ Alliance.Google Scholar
  95. Tol, W.A., I.H. Komproe, S.B. Thapa, M.J.D. Jordans, B. Sharma, and J.T.V.M. de Jong. 2007. Disability associated with psychiatric symptoms among torture survivors in rural Nepal. The Journal of Nervous and Mental Disease 195(6): 463–469.CrossRefPubMedGoogle Scholar
  96. United Nations. 2014. Summary report on the panel discussion on preventing and eliminating child, early and forced marriage. Geneva: United Nations, A/HRC/27/34.
  97. United States Department of State. 2013. 2012 human rights report: Nepal. Washington, DC: U.S. Department of State. Accessed February 29, 2016.Google Scholar
  98. Wahl, R. 2013a. Doing without believing: The tension between internal socialization and compliance with human rights norms among law enforcement officers in India. Paper presented at the annual International Studies Association conference, April 3–6, in San Francisco, CA.Google Scholar
  99. Wahl, R. 2013b. Learning norms or changing them? State violence, state actors, and human rights education in India. Paper presented at the Comparative and International Education Society annual conference, March 10–15, in New Orleans, LA.Google Scholar
  100. Wahl, R. 2013c. Policing, values, and violence: Human rights education with law enforcers in India. Journal of Human Rights Practice 5(2): 220–242.Google Scholar
  101. Weine, S., S. Feetham, Y. Kulanzovic, et al. 2004. Bosnian and Kosovar refugees in the United States: Family interventions in a services framework. In The mental health of refugees: Ecological approaches to healing and adaptation, edited by K. Miller and L. Rasco, 263–294. Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  102. Witkin, B.R., and J.W. Altschuld. 1995. Planning and conducting needs assessment: A practical guide. Thousand Oaks, CA: Sage Publications, Inc.Google Scholar
  103. Woodcock, J. 1995. Healing rituals with families in exile. Journal of Family Therapy 17(4): 397–409.CrossRefGoogle Scholar
  104. Zimbardo, P.G. 2005. A situationist perspective on the psychology of the evil. In The social psychology of good and evil, edited by A.G. Miller, 21–50. New York: Guilford Press.Google Scholar
  105. Žižek, S. 1999. Human rights and its discontents. Lecture at the Bard College, November 16. Accessed February 29, 2016.Google Scholar
  106. Zukoski, A., and M. Luluquisen. 2002. Participatory evaluation. What is it? Why do it? What are the challenges? Community-Based Public Health Policy and Practice/Partnership for the Public’s Health 5(April): 1–6.Google Scholar

Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2016

Authors and Affiliations

  1. 1.Department of Sociology and Social PolicyUniversity of SydneySydneyAustralia
  2. 2.Department of PsychologyThe New School for Social ResearchNew YorkUSA

Personalised recommendations