By Andrew Keefe
Marie was arrested and imprisoned for attending a peaceful anti-government demonstration organised by students at her university in the Democratic Republic of Congo. During her three months in detention she was raped, beaten and burned with cigarettes almost every day.
She arrived in the UK bearing both physical and psychological scars. Like most of the 1,000 torture survivors currently in treatment at Freedom from Torture, she displayed severe symptoms of trauma including post-traumatic stress disorder, depression and anxiety which greatly affected her daily functioning.
The sound of rattling keys and chains, doors slamming and heavy footsteps all induced flashbacks and terror for Marie. More than once the smell of cigarette smoke caused her to faint, as it was so strongly associated in her mind with her ordeal.
But when she came in for her weekly therapy sessions, Marie was often unable to talk through these deeply disturbing psychological phenomena, because she was preoccupied with far more mundane matters arising from the simple fact that she was living in dismal poverty.
In the UK most asylum seekers do not have the right to work and earn an income. They are entirely dependent on the UK government which currently gives them just £36 per week to live on. This means that most have to make difficult decisions about essential living needs, for example whether to prioritise buying food for a nutritious meal or laundry detergent so they can wash the only set of clothes they own.
For torture survivors in particular the impact of this additional stress can be devastating.
Research conducted by Freedom from Torture among 100 of their clients, and 18 of their frontline clinicians paints a bleak picture of financial insecurity, social exclusion and hopelessness. It confirms a disturbing reality for survivors of torture living in the UK: that their experiences of poverty compound their trauma and impede their rehabilitation.
Typically, the first phase of treatment for torture survivors involves enabling them to feel safe, secure and stable. Yet when our clients were asked about asylum support rates, the majority of those who responded said they worried 'all the time' about meeting their essential living needs. Almost all those remaining said they worried 'most' or 'some' of the time.
Poverty, and the associated insecurity, experienced by torture survivors living on asylum support in the UK reinforces symptoms of depression and post-traumatic stress disorder.
The social isolation that comes from not being able to afford to make a phone call or travel to visit family and friends, and the enforced dependency of living on asylum support, also act to reaffirm the sense of worthlessness and humiliation that is the legacy of torture on its victims.
Some of our clients also told us that a lack of funds to travel to appointments and to maintain postal or telephone contact with their therapists, GPs and other healthcare providers led to them missing appointments or even discontinuing treatment.
Another common problem our clinicians reported is that their clients are unable to participate effectively in therapy because they frequently miss meals and commonly experience hunger, poor nutrition and inadequate diet. This results in poor cognitive functioning and an inability to concentrate.
Put bluntly, it's hard to process and engage with your psychological therapy for severe trauma when you are hungry and don't know where your next meal is coming from.
On 9th April this year the high court ruled that the secretary of state Theresa May had used insufficient information to reach a rational decision about asylum support rates, which have remained the same for the past three years in spite of substantial increases in the cost of living. Current asylum support rates are around 50% of income support rates.
Theresa May now has until August 9th to re-assess the level at which asylum support is set in accordance with this high court judgement. This review has the potential to lift some 20,000 of the UK's most vulnerable people, including torture survivors like Marie, out of poverty.
Both experience, and research have clearly demonstrated to those of us in the field of torture rehabilitation that levels of poverty experienced by those living on current asylum support levels actively hamper torture survivors from engaging effectively in therapy and places significant obstacles in the way of their recovery from trauma.
So as well as failing in their obligations under the Refugee Convention to offer protection to those fleeing persecution, the Home Office is currently also violating the UK's commitments under the United Nations Convention Against Torture, by which it is obliged to provide the means for the fullest rehabilitation possible to torture survivors.
Many of these concerns and findings have been echoed by myriad organisations working with asylum seekers, as well as by the home affairs select committee in their October 2013 report. Now the high court has ordered the Home Office to review how it sets the level of this support.
Having decided not to appeal the high court judgement, and with the August 9th deadline for review looming, we eagerly await to see what Theresa May determines a sufficient amount to allow a dignified standard of living for asylum seekers.
And we hope it is increased to a level sufficient to allow torture survivors to engage effectively with rehabilitation and begin their recovery.
Andrew Keefe is the national director of clinical services at Freedom from Torture, one of the world's largest specialist torture treatment centres. He is a psychodynamic psychotherapist and has been working with survivors of torture for the past 14 years. See www.freedomfromtorture.org for more information. Marie is a composite case study based on 34 of Freedom from Torture's female clients from the Democratic Republic of Congo. The details are all based on the typical experiences of their clients.
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