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.
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Throughout this article the term torture will be used to cover a range of practices involving the use of violence against people in detention, including lesser forms of force that may not constitute torture. The United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) (1987) defines torture as severe physical or mental pain or suffering inflicted intentionally at the instigation or with the consent or acquiescence of a public official to obtain information or a confession, inflict punishment, intimidate or coerce or for any reason based on discrimination. Of the acts condemned by the convention, torture is the most severe.
The terms structural and systemic both point to causal factors that lie within institutional practices, discourses, and cultures. Given the historical use of the term, systemic approaches in public health in general and analyses of institutional violence in particular, this term is used throughout the article but with an understanding that it is pointing to causal structures.
Ethics approval for all aspects of the empirical research, including interviews, surveys, focus groups, and participant observation, and attending to issues concerning subject and researcher safety and confidentiality was obtained from the University of Sydney Human Research Ethics Committee.
While police participation was voluntary and confidential, it is noted that access to subjects was facilitated by the Associates and as such, the material communicated needed to be interpreted within this context of direct or indirect oversight of superiors. Access to the unmediated views of police personnel, as with access to other empirical material in the security sector, is always constrained in this manner.
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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.
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Celermajer, D.D., Saul, J. Preventing Torture in Nepal: A Public Health and Human Rights Intervention. Bioethical Inquiry 13, 223–237 (2016). https://doi.org/10.1007/s11673-016-9712-6
- Public health
- Primary prevention
- Systemic approaches