The Role of Physiotherapy in Direct Assistance to Victims of Torture: A Holistic Approach to Healing and Wellbeing

Abstract

Physiotherapy is considered a healthcare profession concerned with human function and movement, and maximising potential. It normally uses physical approaches to promote, maintain, and restore physical, psychological, and social well-being, taking account of the variations in health status. The human function is more than just a physical and movement issue. Physiotherapy plays a unique role in the rehabilitation of people who have been profoundly traumatised. Certain precautions are needed when handling survivors of torture, but sensitive physical techniques can relieve the legacies of severe pain, dysfunction, and stress. The physical medium is especially effective for people who are unable to speak of their experiences. (Hough, 1992) Trauma, especially those who have experienced torture and considerable life-threatening violence presents a very wide range of responses from an individual - responses that often include family members and close relationships. The Humane to Humane Transcultural Centre for Torture Victims in Manipur has been providing direct assistance to over 450 clients and their families in support with the UN Torture Fund since 2009.

Working with people who have been tortured has similarities to working with intensive care patients. There is a need for acute sensitivity to the client's responses, an extra awareness of the importance of autonomy, and an understanding of issues of power and helplessness. A multidisciplinary approach was adopted that included medical, psychological, creative movement therapy, social and financial assistance. Physiotherapy constituted an important component of the services provided by the centre, providing a vital link in rebuilding the personality of survivors of torture because trust can be fostered in the context of physical contact. Close liaison between the physiotherapist and other therapists is needed in this area of work. A combined approach is essential in the work and the support team also indulges in caring for each other and the luxury of co-working. The intimacy of our relationship with survivors of torture is matched by the perverted intimacy of their previous relationship with the torturer, and extra care is needed in this context.

This paper elaborates on the range of psychosocial, physical, and emotional responses to torture, the methodologies adopted, and the results obtained in our centre.