Draft:Survivors of Torture, International

Survivors of Torture, International (“SURVIVORS”) is a nonprofit organization headquartered in San Diego, California, that offers multidisciplinary services to survivors of politically-motivated and other forms of torture. It also extends its services to survivors’ families. The organization is the only accredited torture treatment center in San Diego and Imperial Counties and serves an estimated 35,000 survivors of torture in the region.

Founded in 1997, SURVIVORS provides medical and psychological evaluations to torture survivors that can be used in the survivor’s asylum application. SURVIVORS also facilitates long-term healing by providing a “Journey to Healing” process for its clients. In addition to directly treating and assisting survivors, the organization educates the broader community on trauma-informed responses to interacting with torture survivors and advocates for the abolition of torture. Annual Report 2021

To reach these survivors, SURVIVORS advocates for them and partners with various organizations, including the Center for Victims of Torture (“CVT”), health professional organizations, interpreting organizations, intergovernmental organizations, and governments. Annual Report 2021 SURVIVORS also celebrates and recognizes June 26th, which is the UN International Day in Support of Victims of Torture. SURVIVORS has also gained international recognition for its work. As one of the 160 members of the International Rehabilitation Council for Torture Victims (IRCT), SURVIVORS has met the IRCT's criteria for treating at least a hundred torture survivors annually. SURVIVORS is a member of the National Consortium of Torture Treatment Programs.

The organization has received numerous awards and recognitions for its efforts, including Distinguished Organization of the Year Award from the San Diego County Bar Association and the Eleanor Roosevelt Human Rights Award from the United Nations Association San Diego Chapter. Annual UN Day Awardee SURVIVORS' founder, Kathi Anderson, has received several individual awards for her role in forwarding justice for torture survivors nationwide.

Background and history
Torture treatment worldwide

The treatment of torture survivors has its roots in the aftermath of World War II following the revelation of the horrors of the Holocaust survivors experienced in concentration camps. The field further developed after the world learned about the human rights abuses occurring within Augusto Pinochet's regime. The first global response to torture came when the United Nations explicitly prohibited torture in the 1948 Universal Declaration of Human Rights and the 1949 Geneva Conventions. In 1966, the international community further condemned torture when enacting the International Covenant on Civil and Political Rights. Numerous regional treaties also ban the act, including treaties in Europe, the Americas, and Africa. In 1984, the United Nations created the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (“CAT”), which solidified the international community’s position on eliminating torture.

Defining and treating torture has been complex for the international community. Within CAT, the United Nations defined torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.” This definition does not include “pain or suffering arising only from, inherent or incidental to lawful sanctions.”

Torture treatment in the United States
In the United States, torture treatment centers did not emerge until the 1980s. The International Rehabilitation Council for Torture Victims (IRCT) was formed in response to the growing need for helping torture survivors. Its founder, Dr. Inge Geneke, soon launched the Rehabilitation and Research Centre for Torture Victims (RCT) in 1982, which was the first torture treatment program in Europe. In the United States, the first organizations to focus on torture survivors were the Program for Torture Victims (PVT) in Los Angeles, California, and the Center for Victims of Torture (CVT) in St. Paul, Minnesota.

The United States ratified the CAT in 1994, but submitted a declaration reserving Articles 1 through 16 of the CAT as non-self-executing. Congress enacted the Torture Victim Protection Act (TVPA) in 1992 to allow redress for torture survivors residing in the country. The U.S. has a similar definition of torture in the TVPA that aligns with the definition provided in the CAT, but provides modified language. This is the governing definition of torture in the U.S.

Torture treatment experts noted that the definition of torture included in the TVPA deviates in several areas from the U.N. definition of torture. First, it heightens the threshold of government involvement from acquiescence (as required under the CAT) to “under the color of law”. PDF Link The definition also requires a specific intent to commit torture rather than the general intent required by the CAT.PDF Link The TVPA definition includes an additional element of “custody or physical control” over the victim, which is absent from the U.N. definition.PDF Link Finally, the TVPA definition does not require that torture be carried out for one of the enumerated purposes in the U.N. definition. Acknowledging these differences, organizations such as SURVIVORS continue to advocate for the U.S. to align the TVPA’s definition to internationally recognized elements of torture.PDF Link

SURVIVORS contribution to torture treatment
SURVIVORS was co-founded by Kathi Anderson, Rev. George Falk, and Rev. William Radatz on February 27, 1997. Headquartered in San Diego, SURVIVORS’s role is significant in developing torture treatment as it is located in a border city that serves as the first location for many torture survivors entering the US. The organization has also been actively involved in advocacy efforts to clarify the definition of torture, which forms the bedrock of all torture survivor services both in the United States and internationally. Kathi Anderson has testified before the U.S. Congress, and the organization was instrumental in the passage of the Torture Victims Reliefs Act. SURVIVORS continues to advocate for further advancements in torture treatment through its policy and advocacy initiatives.

Kathi Anderson, the founder of SURVIVORS, first learned about working with torture survivors from Cosette Thompson while working at Grossmont Hospital and shortly thereafter began the process of establishing San Diego’s torture treatment program. Kathi went on to become a leader in the torture treatment field, holding positions on the committee for the Barbara Chester Award, the State of California’s Refugee Programs Bureau, and the State Advisory Council. In 2022, Kathi retired from her position as Executive Director of SURVIVORS and is succeeded by Etleva Bejko, who previously served as the Director of Refugee Services at Jewish Family Services.

The organization itself has been recognized by various torture treatment institutions, including: the International Rehabilitation Council for Torture Treatment (IRCT), the National Consortium of Torture Treatment Programs, the San Diego Refugee Forum, the San Diego Immigrant Rights Consortium, and the San Diego Rapid Response Network. It has also won numerous regional and national awards for its work in the San Diego community.

Mission & values
SURVIVORS’s stated goal is to end torture worldwide by providing torture survivors access to the care they need to heal and thrive. To achieve its mission, SURVIVORS facilitates the healing of torture survivors and their families, educates professionals and the public about torture and its consequences, and advocates for the abolition of torture. SURVIVORS expressed values include celebrating the human spirit by rejoicing in survivors’ triumphs in the face of unimaginable adversity and celebrating their courage, tenacity, and resilience.

The organization specifically respects the worth and dignity of individuals by intentionally creating an inclusive culture focused on respect and equity. SURVIVORS states that it is committed to the highest standard of professionalism by incorporating honest and ethical practices in its client services and organizational operations, including responsible stewardship of resources entrusted to it.

Services
SURVIVORS is an organization that offers a variety of services to torture survivors and their families. The main avenue through which clients connect with SURVIVORS is through referrals from their attorneys for forensic evaluations. These forensic evaluations are provided to both detained and non-detained clients. Once the forensic evaluations are completed, the client is left with the aftermath of reliving through their trauma in these evaluations. One of SURVIVORS unique aspects is that it provides ongoing mental health support after clients receive their forensic evaluations in addition to being connected to case managers and social services to address all aspects of their trauma treatment.

Although the initial service SURVIVORS provided was forensic evaluations, SURVIVORS recognized the need for ongoing mental health care for its clients. Through a contract with San Diego County, SURVIVORS expanded its mental health services to provide individual therapy, group therapy, and healing clubs to its clients to help them in their long-term trauma recovery and torture treatment.

Among the mental health services provided by SURVIVORS are psychiatric services hosted by contracted MD psychiatrists from the University of California San Diego (UCSD). The organization provides diagnoses, treatment, and monitors client’s mental health improvement. In addition, SURVIVORS has agreements with UCSD psychiatric residents to complete psychiatric work and contracts with psychiatrists to conduct psychological evaluations, including in immigration detention centers. SURVIVORS is also building the capacity to conduct medical evaluations of clients within immigration detention centers. To ensure effective communication with client, SURVIVORS contracts with two professional interpreting companies to provide linguistically and culturally appropriate services.

SURVIVORS also offers an internship program with both San Diego State University (SDSU) and Cal State University of San Marcos masters in social work (MSW) programs. Furthermore, it maintains agreements with interns from the International Security and Conflict Resolution (ISCOR) and the Joan Crock Center, as well as the SDSU Board Fellows Program, which is nested in the Social Policy Institute of SDSU’s School of Social Work and is directed by Steven Hornberger. SURVIVORS decentralizes its services by contracting with skilled professionals on demand to meet clients where they are, both physically and psychologically.

Under social services, SURVIVORS provides case management services. The organization offers food through Feeding America, hygiene items, and connects people to educational resources such as ESL classes. It also helps asylees and refugees obtain citizenship in partnership with a wide network of legal service providers, including Casa Cornelia, International Rescue Committee (IRC), Jewish Family Services, and Catholic Charities. SURVIVORS refers clients to pre-existing local organizations for social services to help clients integrate into the community. The organization receives additional funding from the United Nations High Commissioner for Refugees (UNHCR).

While SURVIVORS does not offer direct legal services, the organization provides legal support to immigration attorneys and their clients in the San Diego and Imperial County regions. SURVIVORS is also the largest organization in the area to provide medical affidavits and psychological evaluations verifying torture experiences. The organization works closely with immigration attorneys, and its services help to corroborate torture conditions in other countries through its reports documenting client experiences.

SURVIVORS also works with pro bono physicians to conduct medical affidavits as part of its services. The organization's medical case manager helps connect clients to eye care and dental work. SURVIVORS will also have MD students from UCSD to perform pro bono medical evaluations. SURVIVORS also recognizes the retraumatizing effects of medical services on survivors of torture and aims to improve training for medical providers to bring awareness of these issues.

George Longstreth and Lydia Grypma, physicians who had worked with SURVIVORS pro bono, published notable research on falanga (foot torture) through their work with SURVIVORS. Falanga is a torture that is often not known or recognized by physicians. Furthermore, SURVIVORS trains its staff and providers on the international requirements enumerated in the Istanbul Protocol to help promote a uniformed standard of torture recognition and treatment. Overall, SURVIVORS is committed to its mission in providing clients services that are not widely available in their communities while ensuring that services are available to more members of the refugee and asylee community.