Guantanamo detainees to require special therapy

The length of ex-detainees' imprisonment and trauma experienced in Guantanamo raises particular problems Keystone

The three Guantanamo detainees that Switzerland has accepted to resettle will need special therapy to help them integrate after years in prison.

A Swiss Red Cross expert on torture tells swissinfo.ch that the men most likely will suffer from symptoms of post-traumatic stress disorder as a result of the treatment handed out at the United States prison camp.

Brigitte Ambühl is in charge of medicine and therapy at the Red Cross outpatients clinic for victims of torture and war where the former inmates may undergo a first assessment.

The Swiss cabinet announced on Wednesday that it would admit two Uighur brothers from the Chinese province of Xinjiang into Switzerland on humanitarian grounds. Bahtiyar and Arkin Mahnut will receive a permit to live in canton Jura, in northwestern Switzerland.

An Uzbek was the first ex-detainee to arrive in Switzerland and was settled in the canton Geneva last month.

swissinfo.ch: What would people who have been housed in Guantanamo for several years need in terms of counselling and therapy?

Brigitte Ambühl: I think these people have been badly tortured and they have symptoms of post-traumatic stress disorder, which means they have an overactive brain. They can’t sleep, they have nightmares. They have hyper irritation. And it is very important that these people know that these symptoms may be the result of torture. So they have the information and control it cognitively. They can understand: what happened to me goes with these symptoms.

The second step would be to know what their coping strategies are. Have they kept their sense of survival during torture or isolation? What are the physical symptoms?

They have a double problem because they aren’t going back to their families. They are going to an unknown world and will continue to be separated.

swissinfo.ch: So how do they survive when they arrive in a new place? How would you help?

B.A.: I think the first step is to get translation [help]. The second step is medical help, psychological help. You can’t solve traumatisation just by speaking about it. You first have to help them recognise that they are strong and have survived. We discuss it with the patient as a first step. We strengthen his autonomy. He isn’t only a victim. He is also a fighter. He has survived. He can be very proud. He is even stronger than me.

And then we just add our therapeutical coping strategies. We don’t know if they will benefit from imagining a safe place. Some people [try to] avoid talking about it. There is a huge variety of coping strategies.

[How well they integrate] depends on if they have family, friends or people from their country [of origin], and friendly surroundings. Swiss people should support them, help them and not be afraid of them.

swissinfo.ch: If a canton takes on former detainees, would they be responsible for their psychological care? What facilities are there in the cantons?

B.A.: In the cantons there is a normal psychiatry service, but they are not specialised in victims of torture and extreme traumatisation. We [the Red Cross] have four centres in Switzerland. I think they will be sent to one of them to get an assessment or for treatment.

swissinfo.ch: Surely people like this who have been wrongly detained, and in a very controversial place, must be feeling anger after being released.

B.A.: Normally if you are exposed to helplessness and you are not in control, you will have both feelings, feelings of helplessness and of anger. I think these people can control their emotions. But if not, if they have fantasies of aggression they should be treated because it is a very important part of the treatment that they gain control of their feelings.

But I would assume they would have more depressive feelings now rather than aggressive, and keep it inside. But that means they are at a higher level of tension and have more pain or other stress symptoms in the body. But you can treat it.

swissinfo.ch: How long would rehabilitation take?

B.A.: The length depends on the individual. But we start with 20 sessions for about half a year. Our experience is that in one or two years you can have a good rehabilitation. How far you can go depends on the individual capacities and of the relationship between former detainees and therapists.

You will know very soon how far you can go. If you see his condition has stabilised and he has developed coping strategies, then his prognosis is quite good.

swissinfo.ch: The lawyer representing the two Uighur detainees who have been accepted by canton Jura said Switzerland had a good record in helping rehabilitation of torture victims and they were well placed to come here. Why?

B.A.: We [the Red Cross] have done this for about 12 years now. We have learnt a lot from our patients over all these years, we are connected with other centres in Europe or other countries and we have specialised team members.

Here in Switzerland, they [detainees] have a variety of possibilities. They have good medical care, psychological care, they can have body therapy, very individually. I think that is very special. One thing that is very important is that they can talk in their mother tongue – that’s guaranteed in our centres.

swissinfo.ch: Is this care relatively new then?

B.A.: I think the whole field is quite new. In the past, psychiatrists did not really know that a lot of people were suffering from post-traumatic stress disorder. After 9/11 a lot of research was done in this field and I think every psychiatrist or psychologist needs to know about it.

But this combination [of symptoms among Guantanamo detainees] – long imprisonment, a lot of symptoms, extreme traumatisation, immigration – is a package and there’s only certain centres that can deal with it. It’s a bad package.

Jessica Dacey, swissinfo.ch

Red Cross clinic

The outpatient clinic for victims of torture and war enables those affected to work through their traumatic experiences, develop their personal skills and build family and social resources.

It says that regaining good health, self-determination and dignity is a key condition for these people to become integrated into society.

The clinic has an annual budget of around SFr3 million ($2.8 million). Most of its funding comes from the Swiss Red Cross but it also relies on donations.

Staff includes doctors, psychiatrists, body therapists, psychologists and social counsellors.

The clinic treats around 360 people a year.

Key facts

The first prisoners were transferred to the US detention camp in Guantanamo Bay in Cuba on January 11, 2002.

The US government designated them “enemy combatants”, and declared that they were not covered by the Geneva Conventions which safeguard the rights of prisoners of war.

At its highest point the prison population reached 800. There are currently around 200 left.

Many detainees were eventually ruled not to have links with terrorist groups, but fear arrest and torture if they returned to their own countries.

US President Barack Obama long criticised the interrogation practices used, saying they amounted to torture.

An Uzbek national was granted asylum by the Swiss authorities in 2009 and settled in the country in January 2010.

Another ex-detainee, an Algerian, whose asylum application was rejected by the Swiss Migration Office, won an appeal to Switzerland’s Federal Administrative Court on December 18, and will have his case re-examined.

On February 3 the Swiss cabinet said two Guantanamo prisoners – Uighurs from the Chinese province of Xinjiang – would be admitted, and would reside in canton Jura.

Under Swiss regulations, Guanatamo detainees have to be accepted by the government and a canton found which is willing to receive them.