Kyrgyzstan Enlists Hundreds of Doctors in Its Fight against Torture

Open Society Foundations

Kyrgyzstan Enlists Hundreds of Doctors in Its Fight against Torture

by Nuriana Kartanbaeva

When the UN Special Rapporteur on Torture visited Kyrgyzstan in 2011, he found widespread evidence of torture in our country. Law enforcement officials regularly used beatings, asphyxiation, and electric shock applications during interrogations, often within the first few hours after taking someone into custody.

For many years—including in response to allegations of torture during and following ethnic violence in June 2010—the Kyrgyz government denied any of this took place. Officials did not take a strong stance against torture and did not adopt systemic measures to prevent it or fight impunity for those responsible for it.

Following the report of the UN Special Rapporteur, however, the Ministry of Health not only recognized torture as a pervasive problem, but it also embraced the United Nations’ Istanbul Protocol, which spells out how to properly investigate and medically document instances of torture.

In 2014, we launched a comprehensive collaboration with the Ministry of Health to proactively address the issue, convening a multidisciplinary team of experts to develop national clinical guidance for doctors based on the Istanbul Protocol’s principles.

What we have been able to achieve since then is remarkable. Working together with civil society partners, the Kyrgyzstan Ministry of Health, other relevant state entities, and Open Society grantees such as Physicians for Human Rights, we’ve instituted new standards for medical professionals.

Now, doctors must read patients their rights, telling them what they can expect from the health care system and what they can do within it. Before any treatment takes place or any private medical information is shared with others, patients must give informed consent. And doctors must report potential cases of violence or torture to the relevant authorities within 24 hours. This reporting mechanism will allow us to keep national statistics on torture, which could eventually lead to new prevention policies.

We’ve paid particular attention in our efforts to the role of forensic doctors. Medical documentation is crucial in torture investigations, especially for physical wounds that heal over time. As part of the collaborative process, we introduced new, standardized medical forms that forensic medical doctors, psychologists, and psychiatrists fill in during their examinations.

The required forms protect patients, who may later need proof of their claims, and doctors, who have historically faced undue pressure from law enforcement agencies to ignore evidence of torture. Jointly with the Ministry of Health, we also offered trainings to forensic doctors, in part to deconstruct long-held beliefs and perceptions they developed in a system that previously encouraged them to put—or coerced them into putting—the interests of the state above the interests of any individual patient.

To ensure that the next generation of medical professionals gets things right from the start, we worked with the Kyrgyzstan State Medical Academy to develop a curriculum based on the Istanbul Protocol. In addition, we began joint trainings for practicing doctors and supported their efforts to develop their own new curriculum. Altogether, we trained 600 medical professionals on the new standards in 2015.

Torture is still a problem in our country. By some estimates, 90 percent of reported incidents are not fully investigated or prosecuted. And although the Ministry of Health has been at the forefront of efforts to improve the situation, it does not have the power to adjudicate cases or even to ensure they are properly vetted. In 2016, we are launching a new project with the government and local NGO Coalition against Torture to bolster the capacity of other important players in the investigation process, including defense attorneys, prosecutors, and judges.

It takes time to bring about tangible results, but we are encouraged to see that things have dramatically changed in our country, and we are committed to working with the government to make freedom from torture a reality.

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