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Landmark Study Reveals Persistent Physical and Psychological Trauma in Syrian Men Subjected to Detention, Conflict-Related Sexual Violence (CRSV), and Torture

[London, UK. December 15, 2023]Since March 2011, more than 1 million people, mostly men, have been arrested, detained, and tortured by regime forces. A groundbreaking new study reveals the evolution of disturbing and previously unreported long-term symptoms following detention, sexual violence, and torture in a conflict setting. In this study, Syrian men detained during the civil war showed increasing rates of anger, distrust, and self-isolation in interviews conducted years after release. This research urgently informs the design and delivery of support services and health care for men in conflict settings across the world. 

The study, Long-term physical and psychological symptoms in Syrian men subjected to detention, conflict-related sexual violence (CRSV), and torture: cohort study of self-reported symptom evolution, was published in eClinical Medicine, a Lancet journal.  Researchers from Synergy for Justice, Lawyers and Doctors for Human Rights, and the University of Galway examined the self-reported symptoms experienced after male CRSV in Syrian state detention over a ten-year period (2011-2021). 

Men in the study reported a wide range of traumatic experiences during detention, including being punched, kicked, hit with objects, tortured with multiple devices, burned, and threatened with rape and death, among other forms of violence. Shockingly, 97% reported forced nudity, 45% direct violence to the genitals or anus, 30% collective sexual humiliation, and nearly 10% rape during detention. Despite the horrific nature of the torture, this study uniquely documents the long-term psychological and physical effects of multiple types of torture, not just immediately after detention but for years.

The evolution of self-reported symptoms indicates that while acute physical and psychological conditions fade, over 50% of the men report that avoidance, intrusive memories, lack of trust, self-isolation, chronic pain, anger, and low self-esteem increased over time. Notably, around a quarter of the men also reported erectile dysfunction and faced challenges with sexual and marital relations. 

Dr. Coleen Kivlahan notes, “This phenomenon is not unique to the Syrian conflict or Syrian men. Sexual violence against men is grossly underreported across the world, especially during conflict. The policy implications of this research are broad and include the downstream impact of the long-term symptoms on families and communities, on the development of prevention and earlier access to outcomes-driven programs for men, and the need for enhanced support for similar longitudinal research. Generations of angry, distrustful, isolated men in conflict settings present risks to their own health, to that of their partners, children, and communities, and to peacebuilding.” 

Dr. Ingrid Elliott adds, “This research is striking for a number of reasons. Tracing the evolution of symptoms reported by male CRSV survivors over time and gaining insight into the constellation or grouping of symptoms is vital information for meaningful, life-saving responses. There is a stark reality in the increasing symptoms of anger, loss of trust, isolation, and loss of self-esteem, and the fact that over this extended period, only 3% of the men found support in formal support services. We have to find ways to reduce barriers for men to access assistance, otherwise we will face the real risk of further division, violence and conflict. We hope to follow this publication with insights on why so few men accessed formal support and recommendations on how this could be addressed. Our colleagues at Galway will also publish on the impact of ethical loneliness - the injustice of not being heard or acknowledged for Syrian male CRSV survivors.”  

Dr. Mohammad AlSharif states, “The research also stands out for the way it was designed to allow researchers to interview survivors at various points in time, thereby allowing survivors to overcome their inhibitions and open up regarding otherwise taboo subjects for men. Such disclosure enabled recognition of the gaps and barriers which prevent survivors from accessing services and seeking help in addition to helping us better understand resilience factors. The research highlighted the importance of training clinicians on identifying the unique ways in which men adapt to sexual trauma over time. Hence, this could lay the foundation for designing future response programs which help prevent and mitigate severe symptoms which persist years after release.” 

This study was funded by the United Kingdom Foreign Commonwealth and Development Office and the Arts and Humanities Research Council through the project 'Understanding and Addressing the Impact of Invisibility on Conflict-Related Male Sex Violence in Syria.'

Synergy for Justice is a women-led, multi-disciplinary team working to advance justice and end impunity for torture, sexual violence, and other human rights violations. In collaboration with partner organisations, Synergy for Justice ensures that survivors of torture and sexual violence can access justice, receive the care they need to heal, and fully participate in society. 

Lawyers and Doctors for Human Rights (LDHR) is a human rights organisation that conducts expert medical documentation for legal proceedings for survivors reporting torture, cruel and inhuman treatment, and sexual violence. Its work to date primarily supports the investigation and prosecution of international crimes in Syria, pursued through the use of extra-territorial criminal jurisdiction in Europe.

The University of Galway has earned international recognition as a research-led university with a commitment to top-quality teaching. Its Irish Centre for Human Rights is one of the world's premier academic human rights institutions, dedicated to the study of human rights, peace and conflict, international criminal law and humanitarian law, international refugee and migration law, gender and human rights and climate justice. The Centre has developed a global reputation for excellence in the field of human rights teaching, research and advocacy.

eClinicalMedicine is part of The Lancet Discovery Science – a suite of open-access journals that spans basic, translational, clinical, and health systems research which publishes essential, early evidence that helps researchers and clinicians alike to identify new opportunities with the potential to improve the health and wellbeing of people around the world.  Including this study in a Lancet journal underscores the significance of the research in contributing to our understanding of the long-term impact of conflict-related violence.  

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For media inquiries or further information, please contact:

Anna Dobrohorska, Communications Officer, Synergy for Justice, [email protected]

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[London, UK. June 28, 2022] Synergy for Justice Stichting is pleased to announce the addition of three internationally recognised expert practitioners to its board of directors. Their expertise in international criminal law, transnational organised crime, missing persons, trafficking, and other pressing human rights issues will increase Synergy’s capacity. They will help Synergy ensure survivors of torture and conflict-related sexual violence have the opportunity to hold perpetrators accountable and receive the care they need.

 Tejal Jesrani is an international public lawyer with more than 20 years of experience implementing international conventions, capacity building, and research in countering human trafficking, migrant smuggling, and transnational organised crime.  She is a Program Officer in the Crime Research Section of the UN Office on Drugs and Crime, where she has worked in various roles for 15 years. She is also the head of diversity, equity, and inclusion for Women in Foreign Policy, an organisation that seeks to achieve a foreign policy workforce fully representative of contemporary society.

 Niku Jafarnia is a human rights lawyer with expertise in armed conflict and civilian protection in the Middle East and North Africa. She is currently working with the Center for Civilians for Conflict (CIVIC), investigating violations of international law and advocating for civilian protection in the region. Previously, she worked with Mwatana for Human Rights, a Yemeni civil society organisation, to pursue justice for survivors of the Yemeni war in international courts and through research and reporting.

 Kathryne Bomberger is a multi-disciplinary expert addressing the global challenge of missing persons with more than 25 years of experience in international relations, human rights, and conflict prevention. Since 1998, she has led the development of the International Commission on Missing Persons, which today is the world’s leading organisation dedicated exclusively to addressing missing persons issues arising from war, human rights violations, migration, organised crime, and other causes. Bomberger has worked in more than 14 conflict and post-conflict countries, helping governments, courts, prosecutors, NGOs, and others to build capacity to address the issue of missing persons.

These experts join founding Board members Christy Fujio and Ingrid Elliott and Strategic Board members Erin Gallagher and Stephanie Barbour on Synergy's oversight team. 

 Stephanie Barbour, Chair of the Strategic Board of Synergy for Justice Stichting, is excited to see the capacity of the Synergy for Justice team expanding. “Our new board members have considerable experience working in conflict-affected areas and proven expertise innovating ways to support local partners to make meaningful strides towards tackling impunity. I am thrilled to welcome their voices to Synergy.”

 Christy Fujio, Executive Director of Synergy for Justice Stichting, says, “It’s an exciting time for Synergy as we are expanding programmes and undertaking local and global initiatives to support survivors of torture and sexual violence as they pursue justice. Our new board members will be a tremendous resource for us going forward. They will provide strategic direction for the organisation as we grow and help us connect to key stakeholders in our field.”

 Synergy for Justice Stichting is a dynamic, women-led, multi-disciplinary justice organisation established by seasoned legal and medical practitioners. Synergy directors have developed and enhanced justice processes worldwide.

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[June 1, 2021] Today, Synergy for Justice, a non-governmental organization focused on advancing accountability for torture and sexual violence, published two reports on the continued suffering of women and girls in Syria. Their findings are based on the experience of 80 women and girls, as young as 10 and as old as 65, some of whom had been arrested multiple times. Relying on the detail and rigour of medical expert evaluations, the reports establish a pattern of arbitrary detention, torture, and sexual violence against female victims who opposed the Syrian regime or whose male relatives did. The reports also indicate the direct involvement and knowledge of senior members of the State security apparatus and the judiciary and demonstrate patterns of collaboration and knowledge across different branches and institutions as a whole system of torture, ill-treatment, and violence. 

Christy Fujio, the Executive Director of Synergy said: “As the news cycle moves on to different topics and a number of influential states engage in the normalization of the Syrian regime and attempts to repatriate Syrian refugees, these reports serve as a stark reminder that torture and sexual violence are still occurring on a massive scale in Syria. We urge states and others with influence to use these reports and findings to mobilise the political will to reignite the pressure and debate around women and girls in Syrian detention and to do everything in their power to secure their immediate release.”

The reports were done in collaboration with Lawyers & Doctors for Human Rights (LDHR), a Syrian grass-roots NGO dedicated to civilians in crisis and working to stop human rights violations and assist victims and survivors in seeking justice and rehabilitation. LDHR doctors performed all the forensic medical evaluations of the 80 women and girls who comprise the data set of these two reports, and LDHR lawyers contributed to the data entry and data analysis that underpins the findings in the two reports.

The first report, titled “Lacking Legal Basis,” is an analysis of arbitrary arrest and detention of women and girls in Syria and the second, titled “The Whole World Has Let Me Down,” focuses on the particular horrors they face in arbitrary detention. They follow a report Synergy and LDHR issued earlier this year on the knowledge, attitudes and stigma surrounding sexual violence and its survivors in Syrian communities. Together, the reports describe what life is like for women and girls who are victims of arbitrary detention and sexual violence in Syria – from the legal uncertainty regarding authority to make arrests, to the arbitrariness of the arrest itself, to the torture, cruel treatment and sexual violence in detention, to the stigma they face afterwards. 

The two reports document myriad violations of the Syrian Constitution and laws, international human rights instruments ratified by Syria and international customary law. These violations constitute torture as well as cruel, inhuman and degrading treatment. The findings demonstrate that sexual violence perpetrated against women in Syrian detention centres is pervasive, repetitive, and dehumanising, and that it is implemented as a state policy and a weapon of the regime to attack, suppress, and break its opponents. The medical expert evaluations and victims’ testimonies will support criminal prosecutions for crimes against humanity, murder, extermination, enslavement, deportation and forcible transfer, unlawful arrest, torture, cruel and inhumane treatment, sexual violence including rape, sexual slavery, and other forms of sexual violence as well as persecution based on gender, politics, and religion, and other inhumane acts.

Dr. Ingrid Elliot MBE, Synergy Director and author of “The Whole World has Let Me Down” added: “The courage of these women and girls make it a moral imperative for us to read on, to bear witness, to demand justice and to do whatever we can to prevent repetition. Each one of these women and girls deserve to have their whole stories told in court to bear witness to their stories and ensure that they have access to safe and effective justice in its broadest forms - criminal accountability, acknowledgement, truth telling, reparations and non-repetition.”  

On the methodology 

The reports launched today are based on clinical interviews and forensic medical evaluations of 80 very courageous women and girls, some of whom had been arrested multiple times. The youngest was only 10 years old at the time of arrest and the oldest 65. They had been detained in different parts of Syria, by different entities and institutions and spent an average of nine and a half months in detention. Earlier findings which showed high levels of stigma associated with shame, blame, and myths about sexual violence makes their courage to come forward even more remarkable. For the victims’ protection, the reports do not use their real names. In order to ensure due process, fair trial standards, and full criminal accountability in the future, no individual perpetrators have been named or identified in the reports.

Doctors trained by Synergy and LDHR conducted medical expert evaluations in accordance with the highest international standards and procedures on how to recognise and document the signs and symptoms of torture to serve as valid evidence in court. These standards are laid out in the Istanbul Protocol – the United Nations Manual on the Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. Each medical expert evaluation included a clinical interview, a physical examination, a psychological assessment and any relevant diagnostic tests or consultations. The specialists recorded all findings in a standardised fashion and provided their expert opinion as to the degree of consistency between the narrated events and the medical findings.

The reports detail the impact of the lasting trauma from these women’s lived experiences on their long-term physical, sexual and reproductive health and their psychological, social, and economic well-being. This data is important to inform the effective provision of short, medium, and long-term support. The impact of these conditions may also have relevance to criminal accountability, to fully understanding the nature of the crimes committed and to assisting with appropriate sentencing. Some of the impacts may also shed light on the motivations and policies behind the commission of such crimes.

These reports are especially important because they describe the particular experiences of women and girls in these circumstances. The 100 cases on which the reports are based demonstrate the widespread and systematic use of arbitrary arrest, torture, cruel and inhuman treatment, sexual violence and gendered persecution against women and girls as a weapon to break political opposition to the Syrian government, and to a much lesser extent, other de facto powers in areas outside regime control.

To date, much of the discussion and depiction of methods and tools of torture in Syrian detention centres has centred on images, reports, and artwork almost exclusively portraying men as the victims. Less is known about the collective experience of women and girls, and whether they face similar or different forms or levels of torture and violence in detention centres. For women and girls, the focus tends to rest predominately on sexual violence, and often other experiences and forms of violence disappear from the story. It is important to consider this broader experience of women and girls in detention, to recognise the brutality they face and to consider these crimes through a gender lens. It is also important to understand that not all women and girls face sexual violence in detention, despite assumptions to the contrary. This will also assist in understanding what response is needed to help these women, their families and communities to heal.

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