Skip to main content


Log in

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

  • Symposium: Structural Competency
  • Published:
Journal of Bioethical Inquiry Aims and scope Submit manuscript


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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2

Similar content being viewed by others


  1. 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.

  2. 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.

  3. 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.

  4. 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.


  • 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.

  • 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.

  • 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.

  • 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.

  • Agamben, G. 1998. Homo Sacer: Sovereignty and bare life. Translated by D. Heller-Roazen. Stanford: Stanford University Press.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

  • Bandura, A. 1973. Aggression: A social learning analysis. Oxford: Prentice Hall.

    Google Scholar 

  • Banerjee, A.V., and E. Duflo. 2008. The experimental approach to development economics. National Bureau of Economic Research, working paper no. w14467.

  • 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.

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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 

  • Bronfenbrenner, U. 1992. Ecological systems theory. London: Jessica Kingsley Publishers.

  • Brown, W. 2004. The most we can hope for … : Human rights and the politics of fatalism. The South Atlantic Quarterly 103(2): 451–463.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • Celermajer, D. 2015a. Issues paper 1: International legal frameworks and traditional approaches to preventing the use of torture. University of Sydney.

  • Celermajer, D. 2015b. Issues paper 2: Exploring the root causes of torture. University of Sydney.

  • Celermajer, D. 2015c. Issues paper 7: Case studies from Nepal and Sri Lanka: Human rights protection facilitator projects. University of Sydney.

  • Celermajer, D. 2015d. International review: Current approaches to human rights training in the law enforcement and security sectors. University of Sydney.

  • Celermajer, D. 2015e. Project overview: Enhancing human rights protections in the security sector in the Asia Pacific project. University of Sydney.

  • 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.

    Article  Google Scholar 

  • Celermajer, D., and A. Noonan. 2015. Issues paper 8: Measuring change; evaluating a torture prevention project. University of Sydney.

  • Center for Legal Research and Resource Development (CeLRRd). 1999. Analysis and reform of the criminal justice system in Nepal. Kathmandu: CeLRRd.

  • Chan, J. 1997. Changing police culture: Policing in a multicultural society. Melbourne: Cambridge University Press.

    Book  Google Scholar 

  • 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.

  • 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.

    Article  Google Scholar 

  • 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.

  • 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.

  • Copelon, R. 1993. Recognizing the egregious in the everyday: Domestic violence as torture. Columbia Human Rights Law Review 25: 291–367.

    Google Scholar 

  • 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 

  • 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.

    Book  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Ede, A.J. 2000. The prevention of police corruption and misconduct: A criminological analysis of complaints against police. PhD thesis, Griffith University.

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

  • 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.

    Article  CAS  Google Scholar 

  • Grewal, K., and D. Celermajer. 2015. Issues paper 4: Human rights in the Nepali law enforcement and security sector. University of Sydney.

  • Hafner-Burton, E. 2008. Sticks and stones: Naming and shaming the human rights enforcement problem. International Organization 62(Fall): 689–716.

    Article  Google Scholar 

  • Hamber, B. 2009. Transforming societies after political violence: Truth, reconciliation and mental health. London: Springer.

    Book  Google Scholar 

  • Hamber, B., and E. Gallagher. 2014. Psychosocial perspectives on peace-building. London: Springer.

    Google Scholar 

  • Hayner, P. 2002. Unspeakable truths: Confronting state terror and atrocity. New York: Routledge.

    Google Scholar 

  • Herman, J. 1992. Trauma and recovery. New York: Basic Books.

    Google Scholar 

  • Informal Sector Service Centre (INSEC). 2000. Human rights yearbook 1999. Kathmandu: INSEC.

  • Informal Sector Service Centre (INSEC). 2001. Human rights yearbook 2000. Kathmandu: INSEC.

  • 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.

  • Jauregui, B. 2013. Beatings, beacons, and big men: Police disempowerment and delegitimation in India. Law & Social Inquiry 38(3): 643–669.

    Article  Google Scholar 

  • Jensen, S., and A. Jefferson, eds. 2009. State violence and human rights: State officials in the south. Oxon and New York: Routledge-Cavendish.

  • Kelman, H.C. 1989. Crimes of obedience: Toward a social psychology of authority and responsibility. New Haven: Yale University Press.

    Google Scholar 

  • Kennedy, D. 2002. International human rights movement: Part of the problem? Harvard Human Rights Journal 15: 101–125.

    Google Scholar 

  • King, N. 1992. Modeling the innovation process: An empirical comparison of approaches. Journal of Occupational and Organizational Psychology 65(2): 89–100.

    Article  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • 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.

  • Kotter, J.P. 1996. Leading change. Cambridge: Harvard Business Press.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

  • Lifton, R.J. 2000. The Nazi doctors: Medical killing and the psychology of genocide. New York: Basic Books.

  • Lifton, R.J. 2004. Conditions of atrocity. The Nation, May 13.

  • MacNair, R. 2001. Psychological reverberations for the killers: Preliminary historical evidence for perpetration-induced traumatic stress. Journal of Genocide Research 3(2): 273–282.

    Article  CAS  PubMed  Google Scholar 

  • Marks, S. 2011. Human rights and root causes. The Modern Law Review 74(1): 57–78.

    Article  Google Scholar 

  • Mayne, J. 2012. Contribution analysis: Coming of age? Evaluation: The International Journal of Theory, Research and Practice 18(3): 270–280.

    Article  Google Scholar 

  • McCarthy, T.E., ed. 2006. Attacking the root causes of torture: Poverty, inequality and violence. Geneva: World Organisations Against Torture.

  • 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.

  • Mertens, D.M., and A.T. Wilson. 2012. Program evaluation theory and practice: A comprehensive guide. New York: Guildford Press.

    Google Scholar 

  • Milgram, S. 1974. Obedience to authority: An experimental view, 1st ed. New York: Harper & Row.

    Google Scholar 

  • 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.

  • 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.

  • 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.

    Article  PubMed  Google Scholar 

  • Noonan, A., and D. Celermajer. 2015. Issues paper 6: From structural analysis to structural intervention. University of Sydney.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

  • 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.

  • 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 

  • 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.

  • Rejali, D. 2007. Torture and democracy. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Rieff, D. 2003. A bed for the night: Humanitarianism in crisis. Simon and Schuster.

  • Ritterman, M. 1987. Torture: The counter-therapy of the state. The Family Therapy Networker 11(1): 43–47.

    Google Scholar 

  • Ritterman, M. 1990. Hope under siege: Terror and family support in Chile. Norwood, NJ: Ablex.

    Google Scholar 

  • Rodley, N. 2009. Reflections on working for the prevention of torture. Essex Human Rights Review 6(1): 15–21.

    Google Scholar 

  • Saferworld. 2007. Policing in Nepal: A collection of essays. Accessed March 1, 2016.

  • 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.

  • Saul, J. 2013. Collective trauma, collective healing: Promoting community resilience in the aftermath of disaster. New York: Routledge.

    Google Scholar 

  • 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.

  • Schachter, S. 1959. The psychology of affiliation: Experimental studies of the sources of gregariousness. Stanford, CA: Stanford University Press.

    Google Scholar 

  • 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.

  • Sharma, B., and M. Van Ommeren. 1998. Preventing torture and rehabilitating survivors in Nepal. Transcultural Psychiatry 35(1): 85–97.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  CAS  PubMed  Google Scholar 

  • Simmons, B. 2009. Mobilizing for human rights: International law in domestic politics. New York: Cambridge University Press.

    Book  Google Scholar 

  • 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 

  • Somasundaram, D. 2014. Addressing collective trauma: Conceptualisations and interventions. Intervention 12(1): 43–60.

    Article  Google Scholar 

  • Terai Human Rights Defenders’ Alliance (THRD). 2015. Report on torture in the Terai. Kathmandu: Terai Human Rights Defenders’ Alliance.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

  • United States Department of State. 2013. 2012 human rights report: Nepal. Washington, DC: U.S. Department of State. Accessed February 29, 2016.

    Google Scholar 

  • 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.

  • 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.

  • Wahl, R. 2013c. Policing, values, and violence: Human rights education with law enforcers in India. Journal of Human Rights Practice 5(2): 220–242.

  • 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.

  • Witkin, B.R., and J.W. Altschuld. 1995. Planning and conducting needs assessment: A practical guide. Thousand Oaks, CA: Sage Publications, Inc.

    Google Scholar 

  • Woodcock, J. 1995. Healing rituals with families in exile. Journal of Family Therapy 17(4): 397–409.

    Article  Google Scholar 

  • 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.

  • Žižek, S. 1999. Human rights and its discontents. Lecture at the Bard College, November 16. Accessed February 29, 2016.

  • 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.

Download references


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.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Danielle D. Celermajer.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Celermajer, D.D., Saul, J. Preventing Torture in Nepal: A Public Health and Human Rights Intervention. Bioethical Inquiry 13, 223–237 (2016).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: