Building A Torture Treatment Network for Ukraine
Summary
In 2023, the Marjorie Kovler Center (MKC) at Heartland Alliance International committed to adapting its evidence-based, holistic treatment model and technical expertise to support Ukrainian torture survivors and the professionals who serve them. The Ukrainian government estimates there could be as many as 10,000 civilian detainees in Russian prisons where torture is routine. With additional reports of rampant use of torture on civilians and prisoners of war from local organizations, the severe physical and psychological injuries survivors face will require ongoing support for years to come. Based on their partner network and needs assessment, MKC will launch a capacity building program involving a train-the trainer curriculum and professional exchange, as well as a direct service pilot program. Through this work, MKC will directly train 440 medical professionals in specialized torture treatment, provide wraparound services for 30 survivors of torture, and impact 4,400 survivors over 2 years.
Approach
The Marjorie Kovler Center (MKC) commits to adapting its evidence-based, holistic treatment model and technical expertise to support Ukrainian torture survivors and the professionals who serve them. Based on a network of local and global partnerships and a needs assessment currently in progress, MKC will use a multi-pronged approach to strengthen specialized torture treatment for Ukrainians.
Capacity Building: MKC will develop a custom train-the-trainer curriculum and professional exchange program to support mental health, medical, and social service practitioners working with torture survivors inside and outside Ukraine. In two cohorts, a total of 40 practitioners will convene in Moldova and Poland to learn from each other, MKC, and local experts. Topics will include specific needs of torture survivors, tools for treatment and documentation, and the intersection of direct services and larger human rights issues. In-person participants will then implement the localized torture treatment curriculum in rural and urban hubs throughout the region, reaching approximately 10 additional practitioners per hub and creating a specialized network of torture treatment professionals. MKC and partners will host regular coaching sessions to support and guide the network hubs, including virtual seminars and clinical consultations. Professional trainees will continue to serve torture survivors in their daily work, bringing advanced torture treatment services to an estimated 4,400 Ukrainian survivors.
Direct Service Pilot Programs: In partnership with local medical providers, MKC will pilot culturally-adapted direct service programs to bring the holistic model of torture rehabilitation to areas of highest need in Ukraine. Services will be free of charge to survivors and tailored to individual needs. This includes psychotherapy, primary care, specialty medical treatment, case management, legal support, complementary therapies, and group programs. Pilot treatment programs will reach approximately 30 Ukrainian survivors of torture for a minimum of one year of wraparound services.
From its primary location MKC will also provide capacity building and direct services to Ukranian refugees and survivors of torture resettling in Chicago.
Action Plan
Aug to Sept 2023: Phase One Launch
Structured partnership conversations with key local, regional, and global contacts serving Ukrainian survivors of torture;
Needs assessment: gaps in service and geographic coverage across the region
Oct to Dec 2023: Research & Network Development
Final analysis and dissemination of research findings on Russian state-sponsored torture;
Site visits in Ukraine: meetings with partner organizations; listening sessions with communities and torture survivors; local personnel recruitment and hiring
Jan to Mar 2024: Phase Two Launch
Development of customized curriculum in partnership with local trainers;
Ukraine Network Leaders (UNLs: 40 mental health, medical, or social service professionals working with survivors of torture) are identified and complete pre-training baseline knowledge assessments;
UNLs attend one-week trainings in Moldova and Poland
Apr to June 2024: Treatment Hubs & Pilot Programs
UNL post-training evaluation (short term) ;
Torture Treatment Hubs launch: 40 hubs across Ukraine and the region, each supported by 1 UNL + 10 practitioners under UNL training (40 in-person + 400 virtual direct participants) ;
Hubs and Network Practitioners serve Ukrainian survivors of torture (440 providers, 10 survivors each = 4,400 indirect participants served) ;
Direct service pilot programs launch in partnership with local healthcare organization (30 direct participants served with wraparound medical, psychotherapeutic, case management, and legal services) July to Sept 2024: Service Delivery & CE
Hubs and pilot programs operate with robust support – minimum 6 continuing education seminars and 6 dedicated clinical consultation sessions
Oct 2024 to Mar 2025: Service Delivery, CE, & Monitoring
Hubs continue service delivery for 4,400 survivors, supported by minimum 2 continuing education seminars and 4 dedicated clinical consultation sessions;
Pilot programs continue direct service provision for 30 participants and conduct midyear clinical evaluations;
UNL post-training evaluation (long term) April 2025: Phase Two Evaluation
Final progress evaluations for direct service participants; clients referred for continuing services as needed;
Assess commitment impact and opportunities for phase three
Background
The Marjorie Kovler Center (MKC) , a program of Heartland Alliance International, is one of the world’s preeminent programs for specialized services for survivors of torture and severe trauma, including mental health care, physical health care, and case management. Based in Chicago, MKC has provided care for thousands of survivors and has trained hundreds of providers. MKC was recently contacted by a human rights partner organization in Ukraine, Yahad-In Unum, with a request for expansion of the program into Ukraine, the rampant use of torture as a tactic of war by Russian forces necessitates imminent specialized support and treatment for survivors. According to the United Nations (UN) Special Rapporteur on Torture, multiple reports and testimonies indicate that Russian military forces are “consistently and intentionally” carrying out acts of torture in Ukraine, inflicting severe physical and psychological pain on both Ukrainian civilians and prisoners of war. The government of Ukraine estimates that there could be as many as 10,000 civilians detained in Russian prisons in which the use of torture is routine, and there are plans to hold possibly thousands more (source: Associated Press) . UN reports indicate that detainees and released survivors have experienced “physical and psychological traumas, hallucinations, damage to internal organs, fractures and cracks in bones, extreme weight loss, sensory impairment as well as motor losses, strokes or the exacerbation of chronic diseases”. Furthermore, the majority of these individuals report inadequate access to medical care during detention. The need for specialized, evidence-based and culturally/linguistically adapted torture treatment services in Ukraine is both acute and long-term. Severe physical and psychological injuries must be treated in the short-term to ensure survival. The longer-term effects, which often include neurological damage, chronic pain, and extreme anxiety and depression, will require ongoing support for years to come.
Progress Update
Partnership Opportunities
MKC seeks 1) additional financial resources to complete and scale the commitment; 2) Ukrainian and international partners in mental health and psychosocial support (MHPSS) , anti-impunity, primary healthcare, and legal support; 3) office space in Ukraine; and 4) academic and/or research partners
MKC offers 1) its tested torture treatment model; 2) training opportunities for local Ukrainian providers; 3) technical expertise and best practices informed by decades of experience of MKC staff; and 4) a robust global network of torture treatment providers. Additionally, upon the completion of phase one of the commitment, MKC will broadly share the findings of its research and literature review on the specific needs and experiences of survivors of Russian torture.