The Torture Doctors

Human Rights Crimes and the Road to Justice

Steven H. Miles, Steven H. Miles MD

• Publisher: Georgetown University Press
• Year: 2020
• Print ISBN: 9781626167520
• eBook ISBN: 9781626167544
• Topic: Politics & International Relations
• Subtopic: Ethics in Medicine
• Index: Politics & International Relations

Torture doctors invent and oversee techniques to inflict pain and suffering without leaving scars. Their knowledge of the body and its breaking points and their credible authority over death certificates and medical records make them powerful and elusive perpetrators of the crime of torture. In The Torture Doctors, Steven H. Miles fearlessly explores who these physicians are, what they do, how they escape justice, and what can be done to hold them accountable.

At least one hundred countries employ torture doctors, including both dictatorships and democracies. While torture doctors mostly act with impunity—protected by governments, medical associations, and licensing boards—Miles shows that a movement has begun to hold these doctors accountable and to return them to their proper role as promoters of health and human rights. Miles’s groundbreaking portrayal exposes the thinking and psychology of these doctors, and his investigation points to how the international human rights community and the medical community can come together to end these atrocities.

PART I

MEET THE TORTURE DOCTORS

1

DR. CHAND SEES A BURNED BOY

On October 29, 2009, at 5:30 p.m., police summoned Dr. Mahendra Chand to attend to an injured prisoner. The police had detained a fourteen-year-old boy, Twyon Thomas, and brought him to the La Grange Police Station in Guyana on the north coast of South America. The police then transferred Twyon to the Leonora Police Station. They tied him to a chair, put a sack over his head, and secured it with a string around his neck. They beat him on his head and body in an effort to get him to confess to a homicide. There was no reason to believe Twyon was connected to a homicide, and no such charges were ever brought. Twyon felt a cold liquid running between his legs and onto his genitals. A police officer set the alcohol on fire, badly burning the boy.¹ The police then took Twyon to Vreed-en-Hoop Police Station and sent for Dr. Chand, who had been contracted to serve as a police doctor for the previous twelve years.

Dr. Chand arrived at the station and saw two policemen standing near his “patient,” a boy with a bag over his head and wearing a shirt but with his burned genitals exposed for the physician to examine. Dr. Chand did not speak to the boy. He did not introduce himself. He did not ask the boy’s name. He did not remove the bag over the boy’s head. He focused on the burns as the police instructed. Dr. Chand saw what he later described as “first degree burns on the genital area, upper thighs and lower buttocks.”² Newspaper photographs of the burned child show extensive second- and possibly third-degree burns through the skin and baring the muscle.³ The doctor did not ask the police or his patient what had caused the burns. He did not look for other signs of torture, such as bruises from beatings under the boy’s clothes or beneath the bag that concealed his face, even though the circumstances gave ample reason to believe that other injuries were present. He told police to treat the boy with oral antibiotics, analgesics, and an antiseptic cream. He did not make a medical note for the police or for his own office records. He later claimed that he told the police to take the child to a hospital, but he did not record this instruction. The police denied that he made such a directive.⁴ He did not report the abuse.⁵ With no record of medical treatment, if the police had decided to disappear Twyon, the doctor would never have been connected to his death. Although the boy begged the police to take him to a doctor, the police detained him for four more days.

Finally, the police released the boy to his parents, who took him to a hospital for treatment. The Guyana Human Rights Association (GHRA) heard about the case, saw photographs of the burns, and learned of Dr. Chand’s involvement. The organization protested to the Guyana Medical Council. The Catholic Standard, a diocesan newspaper, published the GHRA’s point of view.⁶ In response, the furious Dr. Chand wrote to the local newspaper stating that the GHRA “mischievously resorted to capricious, spurious and slanderous allegations which I suspect were crafted to satisfy some sordid or malicious intent.” The rest of this letter deserves an unedited quotation:

On the said day, I was called out by the police administration to see a patient about ten kilometers away from my home at six PM, a time very much outside my normal working hours. I readily agreed to go and see the patient. I would like to ask the GHRA whether acting beyond the call of duty is an act of callous indifference.

On arrival at the Vreed-en-Hoop Police Station, I saw two ranks [police officers] in the inquiry area and introduced myself to them. After a short wait, I was presented with the said patient who was naked except for his head, which was covered with a bag. At this point, I must point out to the GHRA that the bag “was not tightened at the neck with a string” and that the patient was breathing comfortably.

The injured area was exposed and that was solely my concern and focus. On examining the area I concluded that the patient was suffering from 1st degree [superficial] burns of the genital area, upper thighs and lower buttocks (5–9%). I did not see any other “areas of brutality” as alleged by the GHRA, nor did I see any signs of dehydration as alleged by the GHRA. I did mention verbally that the patient should have been carried to the hospital. Again I ask the GHRA whether this is callous indifference.

I had a stamped prescription which I had walked with in anticipation of any medication that needed to be prescribed and I did prescribe antibiotics/analgesics and an antiseptic cream. This fact was misleadingly left out of the article based on a release from the GHRA. Again, I ask whether this is callous indifference or complicity to torture.

I never said that the patient was okay. In the given circumstances where no stationery was available and in a non-clinical setting, I did the best I could and acted with a clear conscience. I should like to make it clear that I have been practicing medicine in the Guyana Police Force for the past twelve years and I have always treated patients presented to me with care, sensitivity and concern, whether they be ranks from the Guyana Police Force, detainees from the lock-ups or prisoners.

I have never ever knowingly or unknowingly encouraged torture, neither have I ever participated in any cover-up or “down-play.” I left the Vreed-en-Hoop Police Station with the assumption that the patient would have been carried to the hospital as soon as it was possible to do so. To accuse me of a dereliction of duty and passive complicity with torture I consider to be most insulting and incorrect, and a sinister attempt to vilify and malign.

I refute the news article in the strongest possible terms and request that the GHRA stop forthwith associating me with direct, indirect, passive or active torture. I am not that kind of person, nor am I that kind of doctor. I urge that all of the unfounded and derisive remarks about me be retracted, and also that I be issued with an unconditional apology. Finally, I would suggest to the GHRA to cease casting aspersions in the media and to focus their energies more on some real humanitarian work in the prisons and underprivileged areas of the country.

Yours faithfully,

Mahendra Chand⁷

As has happened in many other torture doctoring cases, grateful patients wrote public testimonials attesting to Dr. Chand’s compassion and skill.⁸ Attesting to the fear of reprisals by the police in such situations, anonymous newspaper letters argued for censuring Dr. Chand.⁹

The Guyana Medical Council conducted an investigation, confidentially conveyed the results to Dr. Chand, and gave him one week to reply.¹⁰ When he did not respond, the council censured Chand and suspended his medical license for two months for passive, silent complicity in torture.¹¹ The minister of health unexpectedly intervened and asked the council to reconsider the suspension.¹² According to one article, quoted here with its original paraphrasing and capitalization, the minister explained,

“What is going through my head is one, the doctor was not part of any torture . . . the doctor was placed in a position that he had two options . . . One to walk away, remember the doctor took a Hippocratic oath of doing no harm because he did ask them to take off the bag [but the police refused],” the minister said.

The minister said one of the options the doctor had was to walk away and “in which case we would have all sacrificed him because we would have said he should have taken care of the boy because that is his job. ‘Do no harm’ that is his Hippocratic oath.”

The second option he had was to treat the patient, which he did and made a prescription and referred him, the minister said.

“So if those were his only two options he was damned if he did or damned if he didn’t,” the minister concluded.

“What I want to know from whomever, the medical council, I have asked them questions, what is any other possible options he had because maybe there was another option but right now I am only seeing two options and any doctor you would have put in the position would have ended up in trouble,” the minister said.

“Unless there is another option I can’t really blame the doctor, but I am not making the judgment I want somebody to tell me what other option . . . I am really at a point I am not certain anymore, you know when I first read the case I was as appalled as anybody else. I remain appalled but I am not quite sure if the doctor had a choice,” the minister said.¹³

The council then revoked the two-month license suspension and reverted to simply censuring Dr. Chand.¹⁴ The minister of health offered “no objection” to the council’s censure.¹⁵ The minister noted that Dr. Chand was loaned to the police by the Georgetown Public Hospital and suggested that the council “might want to consider any other action it might deem necessary.”¹⁶ The GHRA and several political parties characterized the censure as a “slap on the wrist.” They accused the minister of health of depriving the Guyana Medical Council of the ability to enforce professional standards.

Remarkably, the boy and his mother bravely sued for damages. Even more remarkably, they prevailed. A judge awarded the teenager 6.5 million Guyanese dollars (about US$3,000), one-fourth of what his attorney had asked. Two police officers were ordered to personally pay the family US$365, more than two months’ wages each.¹⁷ The judge identified Dr. Chand as “the Police Surgeon,” and her ruling stated that he “compounded the violations by what I consider to be a lack of sensitivity and professionalism.” Twyon, his mother, and his lawyer have all gone into hiding. Criminal charges were brought against the police officers, but because Twyon did not show up to testify, the criminal charges were dropped.¹⁸ The minority political party called for an investigation of police torture; the ruling party rebuffed that initiative. The department later promoted the two involved police officers, and the ensuing uproar led the vice president for public security to discharge the officers.¹⁹ Sadly, there is evidence of ongoing medical complicity with torture in Guyana.²⁰

This is a commonplace story of physician complicity with torture. The physician declined to enter a therapeutic relationship with the patient. Instead, his examination, treatment, record keeping, and reporting were confined to police requests rather than his patient’s needs. The physician minimized the injuries in his reporting and did not ask the police or his patient about the cause of the burns. He contemptuously responded to criticisms by a human rights group. Under pressure from the human rights groups, a medical licensing board took up the matter and imposed a minor punishment. The government intervened to protect the physician. Yet, because a new human rights movement—one that is this book’s subject—was under way, Dr. Chand was at least called to account.

2

WHO ARE THE TORTURE DOCTORS?

The idea of a “torture doctor” is so extraordinary, so obscene that it almost defies comprehension. When people learn that I study this topic, they often exclaim, “What did you say?” thinking that they have misheard. Incredulity must be broken in order to see and undo the partnership between torture and doctoring. Physicians must be firmly on the side of safeguarding prisoners’ health and monitoring for this most injurious of human rights violations. To demystify torture doctors, we must shift from a shocked, How could they? to more probing questions. Who are these people? What motivates them? Does being physicians psychologically insulate them from the horror of their work?

Such questions have no simple answers. There are a few biographical and autobiographical comments about torture doctors, but they are not compiled in a manner amenable to qualitative or quantitative analysis. There is scant research. We may not confidently generalize from the backgrounds, recruitment strategies, or political climates of small sets of torture doctors of one era or one national experience to those of other countries or other times. The results of...

Table of contents

• Cover
• Half title
• Title
• Copyright
• Contents
• Preface
• Introduction
• Part I: Meet the Torture Doctors
• Part II: A Time of Impunity
• Part III: Humanists and Healers
• Part IV: The Dawn of Accountability
• Appendix: Behavioral Examples of Torture Doctoring
• Notes
• Bibliographic Note
• Index
• About the Author