w w w . t o r t u r e c a r e . o r g . u k 2 5 y e a r s

Medical Foundation For the care oF victiMs oF tortureannual report 2009-2010

At the Medical Foundation we see daily the human cost of the torture that is carried out around the world. It happens in a wide range of circumstances, during conflict and in repressive regimes where torture is the tool of the police, military and prison officials. Torture is often shrouded in secrecy, and too frequently those who should act to prevent it turn a blind eye.

Through our work in centres across the UK, we work with survivors of torture to help them rehabilitate – that is core to our mission. We also document what the victims of torture tell us about what they have survived so that there is no impunity for torture. In this way, we do our part to ensure that international instruments of justice are being used to combat torture effectively; and promote the principle that governments, including our own, have a responsibility to protect those who are fleeing from torture and organised violence.

The vast majority of our clients at the MF are asylum seekers and refugees. Here in the UK, statutory bodies like the Border Agency need to accept the unique needs of survivors of torture, and to treat them accordingly. Torture is an incredibly traumatic experience; failing to take this into account in the way the UK’s asylum system treats survivors only compounds that trauma.

For many of the people we work with, any chance of rehabilitation is made impossible by the continuing isolation and uncertainty they face in their day-to-day lives here in the UK. Unable to move about freely, vilified by the media, forced to endure a complex and baffling bureaucratic system without proper legal representation - with all this, and above all with the constant fear of being returned to their home country to face torture, it is not surprising that some survivors have described their experiences in this country as ‘another kind of torture’.

As the Medical Foundation reaches its 25th anniversary, it is clear that we must work to bring about real and lasting change in the way the UK government treats survivors of torture. We must challenge the attitudes of policy-makers and of the public, campaigning for a system that recognises and takes into account the unique needs of torture survivors.

We are already committed to empowering our clients by helping them to make their voices heard, working with them to document the evidence of torture and argue the case for fairer treatment. In the next stage of the MF’s development, we will build on these achievements to ensure that media coverage tells the human stories behind the statistics, supporting anecdotal evidence with rigorous research. At the same time, we will continue to develop our work across the UK, sharing our expertise with statutory and voluntary sector service providers so that survivors have access to the support they need, no matter where they live.

Spreading the message that torture is not acceptable, identifying it and condemning it, is a moral obligation for an organisation like the Medical Foundation. Only by taking this message to the heart of government, to the streets of the UK’s towns and cities, and to the rest of the world, can we hope to end torture, and to give survivors the chance to rebuild their lives.

Keith Best, Chief Executive

A WOrd FrOM OUr CHIEF ExECUTIvESpeaking out against torture - in whatever form it arises - is a crucial part of the Medical Foundation’s mission. For 25 years, we have worked with survivors to help them overcome trauma and rebuild their lives. But in order to help our clients move towards recovery, it is essential that we address the wider issues underlying their individual experiences.

1 www.torturecare.org.uk 25 yearsIntroduction

“torture is an incredibly traumatic experience; failing to take this into account in the way the uK’s asylum system treats survivors only compounds that trauma”

Front cover photography: dylan Martinez/reuters. Aerial photograph of MF staff and client at the London Centre.

A WOrd FrOM OUr CHAIrTorture is an unequivocal wrong – a fact that has been recognised in international law for over 50 years. And yet a mass of evidence clearly shows that it continues unabated in many parts of the world.

2Annual review 2009/10Introduction

Best – and a new strategic plan promise to take our work even further.

None of this would be possible without the passionate support of our donors. remarkably, individual donations account for over 70% of our income every year; every one of these donations represents an act of deep compassion, as well as a statement of defiance against the perpetrators of torture. To all our supporters - whether current, past or prospective – the Medical Foundation is deeply grateful.

Thanks are also due to the current and former staff and trustees of the charity, including Simon Carruth, Betty Gordon, Gill Gorrell Barnes, david Walburn and Haji Jassim. Above all, I would like to pay tribute to the thousands of survivors of torture with whom the Medical Foundation has worked over the past 25 years. Their stories have been harrowing, deeply disturbing, but often inspirational – and they have pointed the way towards practical action in the face of an apparently insurmountable, global wrong.

Alison Wetherfield, Chair of the Board of Trustees

The actions of those who perpetrate torture go unchallenged all too often, protected from justice by governmental corruption and apathy. Meanwhile, the survivors of torture are left damaged, isolated and – frequently – with no access to the kind of support that would help them to rebuild their lives.

The Medical Foundation has been providing expert care to the survivors of torture for 25 years: treating them as full and equal human beings, and using our knowledge of the true consequences of torture to speak out against it. Our national centres act as a sanctuary and a place of healing for our clients, and as an important front-line in the fight against torture.

despite the challenges of the global recession, the last 12 months have presented the Medical Foundation with a huge opportunity to develop and grow our work, in terms of both scale and scope. With the opening of a new centre in the Midlands, and with the vital clinical outreach work our staff are undertaking across the UK, we have become a truly national organisation. As we enter our second quarter-century, a new Chief Executive – Keith

“our centres act as a sanctuary and a place of healing for our clients, and as an important front-line in the fight against torture”

[NB] The names of some of the Medical Foundation clients whose stories are shared in this document have been changed to protect their identities.

[>] The enclosed garden developed by the Medical Foundation’s Natural Growth Project.

OUr vISION ANd AIMS

3 www.torturecare.org.uk 25 yearsIntroduction

VISIon for the MedIcAL foundAtIonTo be a highly effective agency counteracting the inhuman practice of torture and its effects through:

• healing and empowering survivors;

• learning from and teaching others; and

• speaking and acting for human rights and dignity.

StrAtegIc AIMS

Aim 1: To ensure that survivors of torture and organised violence in the UK have access to the means of rehabilitation and receive quality services that meet their needs.

Aim 2: To ensure that the human rights of survivors of torture and organised violence are fully complied with and to contribute to worldwide efforts to stop torture.

Aim 3: To ensure that all our activities are informed by the experiences and voices of survivors of torture and organised violence and carried out in collaboration with them.

Aim 4: To be a highly effective organisation, one that learns and develops through the contributions of our clients, supporters, volunteers, trustees, staff and partners.

To achieve these aims, our five national centres provide clinical and other services to survivors across the UK. We also work with external organisations that provide health and social care services, supporting them with training, capacity building and promoting awareness of the unique needs of torture survivors. Finally, we campaign for change, gathering evidence to persuade the government of the need to take a new approach towards victims of torture in the asylum system and seeking to ensure accountability for torture in countries around the world.

We understand the importance of listening to the people we support. Our work is informed by the experiences and voices of survivors of torture, and we are committed to involving our clients and former clients at every level of our work.

Tim“I’m about to graduate from university. I simply can’t believe I’ve been able to reach this point. I remember vividly when I came here, I never thought that I’d be able to go to university and study, let alone survive all the difficulties. My counsellor at the Medical Foundation, Johanne, tried so hard to push me; week after week she’d say to me, “You must try and study, I believe you can do it.” ...But honestly I never had the confidence I could do it. I thought I’d lost my mind, I wasn’t intelligent any more, I’d lost a lot of my natural abilities with everything that had happened to me. And of course partly it was the new language, English. My fifth.

I told her this, but she told me, “You can do it.” But looking back I have mixed feelings - joy, but also sorrow, because of the hard times I had just to get here.”

“We are committed to involving our clients and former clients at every level of our work”

[>] dylan Martinez/reuters. Client working in theMF’s Open Art Studio.

4Annual review 2009/10clinical Services and national development

CLINICAL SErvICES ANd NATIONAL dEvELOPMENT

Torture is a global problem, but its devastating effects are intensely personal. The clients we work with come from a wide range of backgrounds; their experiences are sometimes strikingly similar, and often shockingly unique. For many, the ordeal is far from over on arrival in the UK. The shock and isolation of living in an unfamiliar cultural environment, along with the alienating complexities of the asylum system, can often compound the underlying trauma that torture survivors are forced to live with.

Helping survivors to overcome this trauma is at the heart of the Medical Foundation’s work. We provide holistic, therapeutic support from five national centres across the UK: offering survivors a chance to start rebuilding their shattered lives, regardless of the individual complexities of their case.

Client involvement in the work of the Medical Foundation is a key to ensuring that our services are tuned into the needs of survivors. At many of our centres we have client groups such as the Service Users Group in London and our Experts by Experience group in Manchester. These groups meet regularly to contribute to the work of the organisation, from the daily operations of a large clinical service to contributing to setting the strategy of the MF.

Our Audit and Evaluation team ensures that our clinical work remains at the forefront of working with survivors of torture. They issue an annual report that helps us to understand our clients’ clinical needs, and is an important source of information on how people are tortured and the circumstances in which they are tortured.

NatioNal ceNtresSince 2000, the UK government’s ‘no choice dispersal’ policy has rehoused large numbers of asylum seekers outside London and the South East – frequently in areas with high unemployment, social deprivation and a lack of the resources and specialist expertise needed to adequately support survivors of torture.

The Medical Foundation’s national centres in London, Manchester, Newcastle, Glasgow and Birmingham are a crucial part of our response to this problem. Each centre offers a range of therapeutic support services, as well as reaching out to local communities and statutory providers – sharing expertise and building capacity across the UK.

“For many torture survivors, the ordeal is far from over on arrival in the uK”

5 www.torturecare.org.uk 25 yearsclinical Services and national development

aazarAazar was arrested by the Afghan government in 1999 when his father – a member of the government intelligence service – fled the country following a regime change. Subjected to severe beatings and falaka (foot whipping), he was briefly released in 2001 before being assaulted by local militia forces and detained for a further five years.

Aazar arrived in the UK in April 2008. Suffering from chronic pain, insomnia, constant nightmares and severe anxiety, he was referred to the Medical Foundation by an NHS Community Mental Health Team later the same year. In his own words:

“What kind of life is it when you cannot sleep, have nightmares and wake up screaming, experience constant pain and feel disorientated and tearful?”

Aazar’s experiences mean that long-term therapeutic support is essential. Following almost two years of sessions with a clinical psychologist and a caseworker-counsellor, Aazar is beginning to respond positively, coming to create positive, trusting relationships with the people helping him move towards recovery.

Casework and CounsellingWe offer a combination of practical and psychological support to help survivors of torture deal with their trauma and rebuild their lives, working with them closely to ensure that we offer the right kind of support.

Caseworker-counsellors provide a culturally sensitive service that considers a client’s practical, medical and legal requirements. As well as individual counselling for adults, adolescents and children, we offer our clients group therapy – allowing them to interact in a protected social environment, and countering the isolation that can overwhelm their lives.

PsyChotheraPy, PsyChology and PsyChiatriC suPPortOur team of psychotherapists work with clients who have a history of psychological disturbance, and this may involve long-term therapeutic support. We offer our clients a range of therapy disciplines depending on their needs, including cognitive behavioural therapy and relaxation techniques.

The psychiatric team offers advice to other clinicians when the client may be suffering from a mental illness, assessing the client’s needs and referring them to external services if appropriate.

New referralsThe demand for our services far outweighs the supply. As an independent charity with limited resources, it’s crucial to ensure that we prioritise those who need our support the most and, through our outreach work, signpost where those we can’t directly assist can get help. We receive referrals from doctors, schools, community organisations, family members, community mental health teams and other statutory providers.

Those referred to the Medical Foundation are individually considered by an interdisciplinary intake panel, which assesses the client’s ability to cope psychologically and practically, and whether the MF can offer a timely, effective response.

Because the vast majority of our clients are asylum seekers and refugees, many of whom arrive in the UK speaking limited English, interpretation is an essential part of our work. For many of our clients, it may be the first time that they have had an opportunity since arriving in the UK to be heard in their own language. Our clinical staff are supported by some 80 interpreters speaking 65 languages. Where possible, we also ensure that interpreters’ background and gender match those of the client.

groupWorK Groupwork includes verbal and non-verbal forms of expression, such as art, music and horticulture, writing and drama, as well as psychotherapy groups facilitated by psychotherapists and counsellors.

Taking part in groups offers survivors the opportunity to meet others with similar experiences, enabling them to express feelings about torture, exile and loss. The group environment provides a transitional space that lessens feelings of isolation. Some groupwork is designed to support survivors as they progress through the journey of seeking refugee protection in the UK, and as their psychological, social and legal needs change over time.

The befriending scheme, holiday hosting and writing groups are very important programmes designed to ensure that a wide range of options are available to MF clients, according to their needs and aspirations.

docuMentAtIon of tortureA core part of the work done in clinical services is the provision of medico-legal reports (MLrs). MLrs can play a crucial role in a client’s application for refugee status, because they provide detailed evidence of the extent of a torture survivor’s injuries and trauma. A team of clinical staff, who are expertly trained in this area, follow an international standard for documenting torture to ensure that our MLrs are of a high standard.

6Annual review 2009/10clinical Services and national development

ferah A member of a minority ethnic and religious group in Turkey, Ferah was repeatedly detained, beaten, sexually assaulted and raped on several occasions between 2004 and 2008. She arrived in the UK in February 2009 and was immediately referred to the Medical Foundation by her solicitor. Experiencing nightmares, flashbacks, anxiety and depression, she was unable to wash due to a fear of bathrooms.

Ferah was diagnosed with severe post-traumatic stress disorder and hallucinatory phenomena. Her recovery is expected to take place in the long term; her caseworker-counsellor is currently working with her on multiple loss, shame, and symptom management.

“What kind of life is it when you cannot sleep, have nightmares and wake up screaming, experience constant pain and feel disorientated and tearful?”

[>] Artwork produced by MF client.

7 www.torturecare.org.uk 25 yearsclinical Services and national development

Growth and recoveryThe MF’s Natural Growth Project is an innovative way of helping torture survivors to come to terms with their experiences – combining horticulture and psychotherapy to address the difficulties that many survivors face with verbal communication. The project aims to facilitate growth and development for the individual, allowing nature to do its work, and creating space for reflection.

The last year has seen the expansion of the Natural Growth Project, with the London centre’s enclosed garden being developed into an invaluable space for all MF clients to meditate, work, and rebuild their lives through contact with the natural world.

Mary Raphaely, coordinator of the Natural Growth project says: “The new enclosed garden we’ve been able to develop this year, with grant funding from Edible Islington, has enabled us to create a safe and secure area where some of our most vulnerable clients feel able to express themselves whilst connecting with the natural world. For some, speaking about past traumatic experiences can be extremely challenging and so, for these clients, providing this outdoor space in which they feel comfortable adds much to the therapeutic process and facilitates their healing. The sense of ownership and shared responsibility for the success of the garden also gives clients a sense of empowerment that is often missing from their lives.”

outreAch And ShArIng our experIenceThe UK Government’s policy of dispersing asylum seekers, including survivors of torture, has created a nationwide demand for the Medical Foundation’s work. Whilst our national centres continue to provide vital front-line services to those in most need of our support, clinical outreach work – supporting service providers in the voluntary and statutory sectors through specialist training, supervision and consultancy – has become an equally important part of our mission.

By sharing our expertise, we can help to ensure that survivors of torture have the support they need to overcome their trauma, no matter where they are in the UK.

AMIrAAmira was repeatedly detained and tortured by the Ethiopian police between 2001 and 2003. Targeted because of her ethnic background, she was kept in a filthy, crowded cell, beaten, denied food and sleep, and raped. Fleeing the country with help from a cousin in the army, she arrived in the UK in September 2005.

referred to the Medical Foundation by a refugee agency in January 2007, Amira started working with a caseworker-counsellor around symptoms of severe depression, insomnia, nightmares and anxiety. The MF also liaised with Amira’s solicitor about her asylum claim, and with her GP about her medical problems. In January 2009 Amira began to reconnect with the outside world – making friends and attending college regularly. She also began talking openly about being raped for the first time. She continues to be seen by an MF caseworker-counsellor.

[>] Abbie Trayler-Smith/Panos. Torture survivor from Iran.

8Annual review 2009/10clinical Services and national development

ElisEElise is a member of a minority tribe in Kenya. After she moved in with a man from another tribe whose family disapproved of the relationship, she was subjected to years of attacks from her neighbours: on one occasion, she was raped by six men. On another, she was held down by men and women and subjected to female genital mutilation.

The police, members of the same tribe as her attackers, refused to take any action, and the assaults continued: Elise was raped on two further occasions, including once in the presence of her children.

On her arrival in the UK, she was haunted by memories of what happened to her and dreamt of being chased and strangled. She was fearful of leaving her accommodation and would only do so to attend church. Though overtaken by feelings of helplessness, Elise, now in her 50s, told her therapist: “I will smile again one day.”

Mf referrals by country 2009country AfghanistanAlbaniaAlgeriaAngolaArmeniaAzerbaijanBahrainBangladeshBelarusBoliviaBurmaBurundiCameroonChadChinaColombiaCongodrCEgyptEritreiaEthiopiaGambiaGeorgiaGuineaIndiaIranIraqIvory CoastJamaicaKenyaKosovoKuwaitLebanonLiberiaLibyaMalawiNepalNigeriaPakistanPalestinerussiarwandaSierra LeoneSomaliaSouth AfricaSri LankaSudanSyriaTanzaniaTogoTunisiaTurkeyUgandaUkraineUnited KingdomUzbekistanvietnamZimbabweUnknown

number of referrals1891417151811112112752192421127882759227327108208762174153254601679145571996816132105611153110953

9 www.torturecare.org.uk 25 years2009 referrals

2009 saw a huge influx in referrals to the Medical Foundation from survivors of torture from Iran. The disputed presidential elec-tion in June and the widespread protests that followed led to a brutal crackdown on civil rights and freedom of expression; large numbers of detainees were tortured, with some dying from their injuries. detainees were whipped and beaten; bound, tied up or handcuffed; kept in solitary confinement; kept suspended or hanging; and raped.

Iran 327 new referrals

Following the government’s declaration of victory over the Liberation Tigers of Tamil Eelam (LTTE) after more than 25 years of civil war, huge numbers of Tamil civilians were detained in government camps, many of them held secretly and without adequate food, shelter or water. A large number of refugees fleeing the violence were referred to the Medical Foundation, having been subjected to sexual assault and rape, being burnt, being whipped or beaten, and being suffocated.

Sri Lanka 199 new referrals

Conditions continued to deteriorate for many Afghan people, with widespread human rights violations against a background of escalating conflict. Anti-government groups including the Taleban continued to attack civilians, whilst the government refused to act against top officials responsible for human rights abuses. MF clients were detained and imprisoned, beaten, kicked and punched, whipped, and deprived of food.

Afghanistan 189 new referrals

Physical abuse and intimidation continued to damage lives in Zimbabwe, with Zanu-PF targeting political opponents for arrest and violence. MF clients suffered beating, whipping and rape, and were deprived of water.

Zimbabwe 109 new referrals

Iraq remains one of the world’s most violent countries, with human rights abuses perpetrated by government forces as well as armed groups. The US-led occupying forces and Iraqi forces continue to detain thousands of individuals without charge; torture is commonplace, and reports of disappearances and secret executions are widespread.

Iraq 108 new referrals

TOP TEN COUNTrIES OF OrIGIN FOr MF CLIENTSTorture: a global reality

10Annual review 2009/102009 referrals

The MF continued to receive large numbers of referrals from Turkey, where torture and other ill-treatment continued unabated. Human rights campaigners were obstructed in their work, and anti-terrorism legislation led to unfair trials for many, including minors. Torture victims came to the MF suffering wide-ranging traumas as the result of their experiences, including detention and imprisonment, sexual assault, being cut, electrical shocks, and sensory deprivation.

turkey 105 new referrals

Eritrea remained one of the MF’s main sources of client referrals, the result of endemic human rights violations and severe restrictions on freedom of expression. detainees were beaten, kicked and punched; bound and / or handcuffed; and deprived of food.

eritrea 88 new referrals

The drC is the site of some of the world’s worst human rights breaches, with paramilitary groups and the national army perpetrating serious violence against the civilian population. Arbitrary arrests and the use of torture were endemic, and MF clients were subjected to rape, sexual assault, being whipped or beaten, being deprived of fluid, and being bound, tied up or handcuffed.

democratic republic of congo 112 new referrals

The Cameroonian government has an appalling human rights track record, with multiple incidents of political opponents and journalists being arrested and held in brutal circumstances.

cameroon 75 new referrals

Human rights abuses continue en masse in Sudan: violence, torture and rape are widespread, and last year large numbers of people were executed following a government clampdown on human rights activists.

Sudan 68 new referrals

11 www.torturecare.org.uk 25 yearspolicy and external Affairs

Helping survivors of torture to rebuild their lives is at the core of the Medical Foundation’s work. But for many survivors, the day to day reality of life in the UK stands in the way of their rehabilitation: the complexities and inconsistencies of the UK government’s asylum policy, the threat of detention or removal, and the bias and hostility of much media reporting can compound their existing trauma. Our policy, campaigning and external affairs work is a crucial part of the MF’s mission – changing attitudes, and addressing the systemic problems that affect survivors’ lives.

poLIcy And AdVocAcyOne of the MF’s most crucial roles is speaking out for torture survivors seeking asylum in the UK. Our lawyers and caseworkers provide clarity and support within a legal system that is not sensitive to survivors’ needs – including ensuring that the UK Border Agency (UKBA) adheres to its own policies relating to survivors of torture.

It is abundantly clear that the UK asylum system does not adequately meet the needs of torture survivors. To address this, our policy and advocacy team reaches out to key policy-makers, working to ensure that survivors get the protection they need. We also work closely with other organisations across the voluntary and statutory sectors, helping to promote the human rights of survivors of torture.

POLICY ANd ExTErNAL AFFAIrS

AHMEDAhmed was referred to the MF’s North West centre in 2006. Tortured repeatedly in Iran between 2000 and 2002, he was experiencing severe trauma symptoms including nightmares, obsessive behaviours, and hearing voices. He had also recently made two suicide attempts.

Ahmed’s experiences made it extremely hard for him to talk to legal or health professionals outside the MF; answering questions reminded him strongly of interrogation, and following the rejection of his asylum claim in 2007 Ahmed was made homeless. He also lacked the funds he needed for legal representation.

The MF referred Ahmed to the Greater Manchester Immigration Aid Unit (GMIAU) in May 2007, giving him access to legal advice and representation in a supportive environment that recognised his needs. His appointments took place at the MF North West centre, with a counselling session following immediately after every meeting with his solicitor.

Ahmed was given accommodation following the submission of his fresh claim in December 2007, and granted indefinite leave to remain in 2009 – giving him the chance to address his trauma without the fear of being returned to Iran. Ahmed is clear that he would not have been able to access legal representation without the care and expertise shown by GMIAU and the MF in working with the most vulnerable survivors of torture.

“It is abundantly clear that the UK asylum system does not adequately meet the needs of torture survivors”

[>] Photograph: dylan Martinez/reuters

[>] Photograph: dylan Martinez/reuters

12Annual review 2009/10policy and external Affairs

The Medical Foundation plays an active role in working towards the fair treatment of torture survivors within the UK asylum system – alerting clients’ lawyers to UK Border Agency policy that exempts torture survivors from being detained, advocating against intrusive reporting procedures, and liaising with GPs and health workers to ensure that survivors’ needs don’t fall through the gaps in the system.

The MF has intervened on several occasions to protect torture survivors from removal when we were of the view that they would be returned to torture. We also help to ensure that survivors have access to adequate housing, as well as any other support they need whilst waiting for their claim to be processed. The threat of financial cuts to government-funded legal services – which are vital to torture survivors seeking asylum in the UK – leaves many MF clients vulnerable at this time.

cAMpAIgnIng

Community support is a crucial aspect of a torture survivor’s journey towards rehabilitation. recently, the MF has worked to develop its campaigning and communications work – engaging communities across the UK by exposing them to the harsh reality of day to day life for torture survivors in this country. At the same time, we are growing our presence in the media and online – giving survivors a voice, and ensuring that this voice builds support for their protection. The challenge now is to reach out to new communities which are not yet aware of the number of torture survivors in need of support and rehabilitation in the UK. In addition, we will be actively building awareness of the global problem of torture by working with other organisations and reaching out.

HAFIZOriginally from Azerbaijan, Hafiz was held at Harmondsworth Immigration Removal Centre between June and July 2010. He talked to the Medical Foundation about his experiences at the Centre.

“As soon as I arrived at Harmondsworth a nurse came to examine me. The nurse measured my blood pressure and imme-diately sent me to Hillingdon Hospital. The doctor (at Hillingdon Hospital) said that they could not keep me in hospital as ‘you have three officers with you’.

“On 20 June I fainted and was taken back to the hospital. I stayed there for three days. The same three officers were sent there to guard me. The officers would not let my daughter see me. They treated me like a criminal, as someone who is not allowed to be visited. On the third day the doctor said to me that I should stay, ideally for longer, but that he’d have to discharge me because it did not look good for the hospital to have the officers there.”

Hafiz was returned to Harmondsworth, where he says:

“No one understood how unwell I was. I was sat on the stairs with my head lean-ing on the banister. Two officers, one was taking me to my room and the other was the concierge, started kicking me saying ‘F*** you, stand up, get going’. The other just watched him. Three times he kicked me on the side of my leg with his boot. I was shrinking in the corner. I fainted again, it was because of fear and pain. I woke up in hospital.”

“They treated me like a criminal, as someone who is not allowed to be visited”

[>] Photograph: dylan Martinez/reuters. Aerial photograph of garden at the London Centre.

13 www.torturecare.org.uk 25 yearspolicy and external Affairs

SurvivorS Speak ouT! NeTwork

The Survivors Speak OUT! Network gives survivors a forum to actively speak out about their experiences – the torture they were subjected to in their home countries, and the ways they have sought to rebuild their lives in the UK. The Network also aims to help survivors to build their skills, aiding them to become experts in communication, advocacy, and human rights. As the Network expands, survivors will be increasingly involved in the campaigning work of the MF as a whole.

Survivors’ voices are clearly critical to bringing about change, and the MF is uniquely positioned to make these voices heard. We can work alongside survivors, open up spaces for them to be heard, and – ultimately – learn from their experience. At the same time, for many survivors speaking out is a crucial part of rebuilding their lives – identifying and resolving their own problems, and finding new resilience and power in the process.

One of the Network’s earliest achievements was contributing to a national inquiry on the UK’s asylum system, with a number of survivors’ recommendations being taken up as the basis for further action. Members of the Network have also met with the Chief Inspector of the UK Border Agency (UKBA), raising important concerns around the asylum application process (including inadequate housing, hostile interviewers and a lack of access to interpreters).

reSearch

The MF holds what is probably the world’s largest bank of information from torture survivors, gathered over the last 25 years and representing the testimony of tens of thousands of torture survivors from over a hundred countries. Bringing this information to light is one important way to give survivors a voice, as well as holding the perpetrators of torture to account. As our research team grows, the MF will be disseminating more information about torture and its consequences and placing this information strategically to join in the battle against impunity, to raise awareness and to prevent torture.

From local to global through networks

This year the MF has reached out to other organisations giving support to survivors of torture – creating new partnerships, and providing training on issues including assessing survivors, pain, vicarious traumatisation and medico-legal reports. Much of our work was with partners in the UK whom we are keen to support by building their capacity to work with torture survivors. Hundreds have benefited from our capacity building work and plans are underway to expand this area of our work. We participated in a conference of rehabilitation centres from across Europe, and delivered training in Moldova working with partners.

Our Director of Policy and External Af-fairs, Leanne MacMillan, was also elected to the International Rehabilitation Council for Torture Victims (IRCT) and met with rehabilitation centres from around the world to contribute to the development of the IRCT’s three-year strategy – giving organisations like the MF a crucial means of bringing pressure to bear on states that continue to torture their citizens, and on states in which survivors seek protection.

14Annual review 2009/10policy and external Affairs

Eva

“The journey from Albania to the UK was horrible. We were in a lorry and I thought we were going to die. It was so long I lost count of the days. We were crying, yet we were also trying to stay so quiet. We did not eat and just had some water. When we came out I felt dead - it was like how you see it in the movies. I never thought this would be me, but life had made me strong.

“If my family and I had not got help from the Medical Foundation, I don’t feel I could have done any of this. I’d be like my mum, the only place she feels good is here.”

InternatIonal Year of Youth

2010 marks the launch of the UN’s International Year of Youth (IYY). The MF is marking the IYY by focusing on the stories of young torture survivors who are rebuilding their lives in the UK.

read more about tim (p. 3) and eva’s stories at www.torturecare.org.uk/youth

ExtErnal training and capacity building

The MF’s external training and skills development function is designed to both improve access to and enhance the quality of relevant services for survivors of torture and organised violence. The MF’s varied training and capacity building programme, delivered by clinicians, lawyers and training professionals, aims to enhance the work and development of fellow professionals working with survivors in the UK and abroad. Founded on the strengths and experiences of the MF’s work and research, the training programme focuses particularly on health and legal rights and related issues for children, youth, families and adults.

Through our training work, the MF aims to bring about positive changes in government policies and frontline services affecting survivors of torture. Respecting diversity and equal opportunities, the methodology we use focuses on experiential learning, and is anchored in participatory and evaluative practices.

The MF provides training, supervision and internship opportunities to staff working in PCTs and other NHS agencies, university graduate students, local and international non-governmental and inter-governmental organisations and community based organisations. In 2009 over 2,544 individuals benefited from the MF’s capacity building programme.

Justice DenieD

In December 2009, the MF published a report called Justice Denied, focusing on the experiences of over 100 women from 20 countries – all of whom were denied access to justice following torture at the hands of the state. The report also emphasised the global prevalence of rape as a form of torture, and the devastating physical and psychological effects this has on women’s lives.

15 www.torturecare.org.uk 25 yearsMarketing

MArKETING

eVentS

Events strategy played a key role in supporting the MF’s mission this year, with high profile supporters including Sanjeev Bhaskar, robert Webb and Anish Kapoor helping to raise funds and - equally importantly - awareness across the UK. Michael Palin’s sold out show at London’s O2 - the single largest event ever staged by the MF - generated an incredible £51,000, whilst ‘Follow your Art’, the MF’s annual charity art auction, was another huge success, raising over £65,000 with the help of Sotheby’s and our Open Art Studio clients.

corporAte pArtnerShIpS

The MF continued to develop close partnerships with several private companies in 2009, all of which have provided incredibly valuable support - whether through donating funds or professional services, promoting us as Charity of the Year, hosting events, or promoting our work to employees and customers. Particular thanks go to the John Lewis Partnership, Triodos Bank and the Co-operative Group.

This year has been crucial for the Medical Foundation: developing new, wider-ranging clinical services across the UK, working with external organisations to share our expertise, and giving torture survivors a voice by campaigning for change. None of this would have been possible without the commitment and generosity of our supporters. Despite the challenges of the global recession, the year’s end saw our supporter base remain virtually level, with little or no decline in regular and one-off donations from individuals - a huge achievement in this vital area, representing roughly two-thirds of the MF’s income.

IndIvIduals and communIty gIvIng

Our supporters took part in a huge range of events and challenges throughout 2009 - from coffee mornings and sponsored dances to running marathons and shouting about the MF’s work from Trafalgar Square’s Fourth Plinth. Our Regional Supporters Groups continued to build crucial support in communities across the UK, with two new groups forming in Lancaster and Cornwall. Hundreds of faith groups also contributed vital funds. Looking forward, three new initiatives underpin our events and community fundraising work in 2010: Socials for Survivors (focusing on social events), Jam for Bread (focusing on music) and The Pomegranate Tree (focusing on food).

[>] Flowers grown by the MF’s Natural Growth Project.

[>] raffle prizes on a MF fundraising stall.

Legacies

During 2009 the MF was privileged to receive a total of 55 legacies from supporters, generating nearly £900,000. Every gift we receive is very important to us, and we would like to pay special tribute to the following:

Jane ElderJoan KirbyPeter LintonEdward and Pauline PaddonJane PowellJill Tinsley The Louth Charitable Trust

16Annual review 2009/10Marketing

truStS And foundAtIonS

2009 saw another year of generous support from a range of Trusts, Foundations and grant-makers, and the MF would like to express its gratitude to all those who have contributed. Whilst we are unable to name all of our supporters here, we would particularly like to acknowledge the following donors:A & S Burton Charitable TrustAllan & Nesta Ferguson Charitable SettlementBBC Children in NeedBig Lottery FundBreadsticks FoundationBryant TrustCecil and Hilda Lewis Charitable TrustCity Parochial FoundationComic reliefdepartment of Healthde Groot Charitable FoundationdG Charitable Settlement Economist TrustEleanor rathbone Charitable Trust Garfield Weston FoundationHenry Smith CharityMigration Impacts FundNorthern rock Charitable Foundation Persula FoundationPeter Stebbings Memorial Charityrobertson TrustSamuel Sebba Charitable TrustScotshill TrustScottish Government The Community development Foundation Hardship FundThornton Charitable TrustTolkien TrustTrusthouse Charitable Foundation Winnicott Trust

[>] Photograph: dylan Martinez/reuters. Young client receiving support from the MF’s Children, Young People and Familes team.

17 www.torturecare.org.uk 25 yearsfinancial overview

2009£’000

2008£’000

IncomIng ResouRces

Voluntary income from:

Individuals 4,821 4,785

Trusts & foundations 1,077 612

Government & public bodies 672 480

Legacies 891 1,027

Companies 82 39

Income from charitable activities 214 233

Activities for generating funds 198 138

Investment income 9 68

Total incoming resources 7,964 7,382

ResouRces used

Direct charitable expenditure:

Medical, therapeutic and casework 4,395 4,306

Education, training and information 790 723

Human rights work 431 371

Relief grants to individuals and families 116 125

Management and administration 28 25

Sub-total direct charitable expenditure 5,760 5,550

Cost of generating funds 1,919 1,975

Total resources used 7,679 7,525

net Income/(expenditure) 286 (143)

gains/(losses) on investments 2 (3)

net movement in funds - surplus/(deficit) 288 (146)

Balance brought forward 1 January 2009 6,156 6,302

Balance carried forward 31 december 2009 6,444 6,156

FINANCIAL OvErvIEW OF 2009conSoLIdAted IncoMe And expendIture Account for the yeAr ended 31 deceMBer

[NB] These are summary accounts prepared by our Finance director. For full audited accounts, showing the split between restricted and unrestricted funds and accompanied by detailed notes, call 020 7697 7752 or visit www.torturecare.org.uk

FINANCIAL OvErvIEW OF 2009conSoLIdAted BALAnce Sheet AS At 31 deceMBer

2009£’000

2008£’000

Fixed Assets

Tangible fixed assets 5,542 5,140

Investments 9 7

Current Assets:

Debtors and Prepayments 562 743

Cash at hand, in bank and short-term deposit 2,078 1,440

2,640 2,183

Creditors: amounts falling due within one year (492) (404)

Net current assets 2,148 1,780

Total assets less current liabilities 7,700 6,926

Creditors: amounts falling due within one year (1,255) (770)

Net assets 6,444 6,156

FuNds

unrestricted funds

Fixed Assets Reserve 4,472 4,079

General Reserve 1,225 1,493

5,697 5,572

Restricted funds 748 584

6,444 6,156

18Annual review 2009/10donate

the John MccArthy fund for the future

John McCarthy set up his ‘fund for the future’ in 2005 to mark the Medical Foundation’s 20th anniversary year. His own experience of kidnap in Beirut led him to set up the fund to appeal for legacy pledges, so that the Medical Foundation will be able to plan ahead, confident that the services so seriously needed by torture survivors will be there in years to come.

A gift for the Medical Foundation in your will is a powerful statement that torture is wrong and always will be.

A gift in your will demonstrates your belief that torture is never acceptable. It is a declaration of your values that will live beyond your own lifetime and give hope and care long into the future.

please complete the form and return it in an envelope addressed to:

Fund for the Future, The Medical Foundation, FrEEPOST Wd4196, London N7 7Br

I would like to receive more information about the work of the Medical Foundation and how I can help torture survivors.

I would like to receive more information about making or changing a will.

I have already included the Medical Foundation in my will.

Title

Name

Surname

Address

Postcode

Tel

Email

date

2 www.torturecare.org.uk 25 yearsSection title

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w w w . t o r t u r e c a r e . o r g . u k 2 5 y e a r s

I miss you, freedom...Once upon a time you came and emptied my soul of darknessand then you went away.You did not settle for long,Life is babble;we heard it on the other side of the wall.

Its colours, its voicesWhen you came, you broke all the rules.This is my freed voice: if you walk in the dark for too long, you will fall over and it’s difficult to get up.Even after freedom helps you to your feet,darkness can change things forever.

From Freed Voice by Aso (Medical Foundation client and Write to Life member)

The Write to Life and All Write groups run by the Medical Foundation give torture survivors an opportunity to express themselves and work towards rehabilitation through writing - an intensely personal experience that for many can be a crucial part of the recovery process.