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Raising Awareness and Strengthening the Capacity of Doctors: Training on Documenting Injuries Caused by Torture and Ill-Treatment

In the period from February 28 to 29, the Civil Alliance organized training for doctors entitled “Documentation of injuries caused by torture, inhumane treatment and punishment of persons deprived of their liberty”, attended by doctors from the Emergency Department, Emergency Center, Administration for Execution of Criminal Sanctions (UIKS) and health centers.

The training was opened by Aleksandar Tomčuk, a member of the CPT (European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment), who introduced doctors to the legal aspect, psychological and somatic signs of torture and abuse. Speaking from many years of experience, he stated that victims are not always willing to talk about their experiences and that physical signs do not have to be visible at the time when a case is initiated regarding allegations of torture. The doctor’s important role, which has been highlighted, is to determine the health capacity for detention, to document the immediate physical (somatic) signs of abuse, and also the late physical and psychological consequences of abuse while respecting medical secrecy.

Jovo Đedović, Head of the Department for Forensic-Judicial Psychiatry, spoke about the most common manifestations of torture, namely the chronic pain syndrome, as well as the appearance of anxiety, depression, PTSD, and social and financial difficulties. Physical examinations in the case of complaints about the behavior of the police are important for the prevention of inhumane behavior and cruel punishment. This is also a measure of protection of the individual and the police.

What can be concluded is that healthcare workers lack awareness of these topics and lack knowledge about torture techniques/methods, and that is why it is important to work on the development and improvement of forensic medicine skills.

The training continued with lectures by representatives of the Ombudsman Institution – Deputy Ombudsman Mirjana Radović and advisor and member of NPM (National Preventive Mechanism) Mensur Bošnjak, who spoke about the role of doctors in the prevention of abuse.

They pointed out that if the UIKS (Administration for the Execution of Criminal Sanctions) doctor fails to examine all those injuries that the emergency physician fails to examine, the possibility of that person proving torture is reduced to a minimum. Doctors’ reports are mostly short and insufficiently clear, and as such they can lead to criminal liability. They also stated the guarantees of procedural protection measures against abuse: the right to a lawyer and the right to be instructed about their rights, the right to call the family, i.e. the notification of deprivation of liberty, and the right to a medical examination. There is a wide range of abuses that have been declared a violation of the prohibition of torture, such as severe beatings, hitting with hands, inflicting wounds or injuries, cigarette burns, electric shocks, rape, or other sexual violence or abuse.

The training was completed by forensic medicine specialist Nemanja Radojević with the topic of forensic medical characteristics of police torture and abuse. In a large number of cases that were formed during the last six months based on reports of torture, the existence of no injuries from a medical point of view has not been established.

Through a series of practical examples and photos, he showed some of the injuries that doctors may encounter in their work and how they can recognize injuries caused by blunt or sharp objects, stabbing, slapping, and similar. He also pointed out the importance of a forensic medical examination in cases of suspected abuse (lack of and non-criticality in medical documentation, forensic medical examination, photography, and additional diagnostic procedures). He told them that as important as it is to take photos of injuries, it is just as important to take photos if there are no injuries, because they never know if their report will be part of the proceedings in a year. Victims of poor medical documentation are patients, suspects, the doctor who keeps the medical documentation, and finally the judge.

He concluded that each medical report must have anamnestic data, subjective symptoms, clinical signs, and additional diagnostic procedures and that each patient’s condition must be described in as much detail as possible.

The activity was carried out within the framework of the project “No Impunity for Breach and Violations of Human Rights in Montenegro”, which has been implemented by the Civic Alliance with the financial support of the European Union, and which is co-financed by the Ministry of Public Administration.

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