Alp Ayan , Izmir, Turkey

Dr. Ayan, M.D., a Turkish psychiatrist and psychotherapist, has dedicated his professional life to the treatment and rehabilitation of torture survivors, individual and systems advocacy for victims, and to the development of techniques for the detection and documentation of evidence of torture.

In 1990, Dr. Ayan helped to establish the internationally-respected Human Rights Foundation of Turkey (HRFT) to address the problem of torture, particularly in detention centers. Since 1994 he has worked at great personal risk as a psychiatrist at the HRFT’s Treatment and Rehabilitation Center in Izmir. Since its founding, the HRFT has provided torture treatment and rehabilitation to some 10,500 people and currently treats about 850 clients annually. Utilizing milieu therapy where Dr. Ayan and his colleagues establish an atmosphere of safety and equality, many therapeutic techniques are incorporated that are helpful to the individual needs of clients.

Of the torture survivors who are presently being treated by the HRTF, 90% were beaten in detention, 20% have received a psychological diagnosis of post-traumatic stress disorder, and 55% had physical wounds. Of HRFT’s client base, 70% did not have access to lawyers while in detention, and 63% were released from custody without ever being charged or appearing before a judge. In 2003, the HRFT monitored 41 trials in the Turkish judiciary of individuals who were accused of involvement in torture. Only four of the defendants were sentenced to prison time. Thus, the HRFT works in an environment where torturers continue to enjoy impunity.

Internationally recognized as an authority on the treatment and rehabilitation of tortured people, Dr. Ayan has published extensively and presented papers about his research and experiences at the HRFT’s Izmir Center at numerous scientific conferences. He has long been committed to training other health professionals to work in this area as well.

Dr. Ayan is a contributing author to the Istanbul Protocol, a manual for the effective investigation and documentation of torture, and a joint project of the HRFT, Association of Forensic Medical Specialists (ATUD), and Turkish Medical Association, among other organizations. After submission to the United Nations High Commissioner for Human Rights in August 1999, Dr. Ayan and a team from these three institutions prepared training modules based on the manual for physicians and lawyers and organized seminars in several Turkish cities. Later, he became a part of the team that spearheaded the Istanbul Protocol Implementation Project (IPIP). In this capacity, he collaborated in the preparation of an International Generic Module, which is being used for training in five pilot countries in five different regions of the world.

From 2000 to 2001, Dr. Ayan was the spokesperson for the Izmir Anti-Isolation Platform, a nongovernmental organization founded to peacefully speak out against the Turkish government’s use of new maximum security F-type prisons—consisting solely of single cells or cells for three prisoners—and to inform the public about the negative effects that the harsh conditions of confinement in such prisons have on the physical and mental health of those incarcerated therein. The Platform’s concern that the isolation of inmates in F-style prisons would make them particularly vulnerable to increased abuse by prison guards and officials has been heightened by reliable reports of mistreatment, including torture and extended periods in solitary confinement.

More recently, since 2002, Dr. Ayan has been the HRFT representative to the Independent Prison Observation Group (IPOGI). IPOGI was formed by the HRFT, the Izmir Bar Association, the Izmir Medical Association, the Human Rights Association, and the Union of Chambers of Architects and Engineers in Turkey to research the negative effects of isolation on the psychological health of prisoners and to use its findings to advocate on their behalf. According to Dr. Ayan, the IPOGI’s initial request to the Ministry of Justice for direct access to prisons within the province of Izmir was denied. Despite this and other obstacles, the IPOGI is developing a methodology that it hopes to use to do a “civilian audit” of prisons in Izmir.

Over the years Dr. Ayan has been repeatedly harassed by the Turkish authorities because of his work and because he has peacefully expressed his opinions with regard to torture and prison conditions in his country. Since 1996, he has been a defendant in 41 cases in which the authorities have accused him of wrongdoing and has attended approximately 200 court hearings. To date, Dr. Ayan has been acquitted in all but two of these cases, often following lengthy trials and numerous court appearances. At times, he has been jailed during part of the legal proceedings against him.

Dr. Ayan is now appealing guilty verdicts before the Supreme Court of Turkey (Yargitay) in the two cases that remain pending against him. If the higher court upholds these convictions, Dr. Ayan faces a prison sentence of three years and one day. He is currently at liberty, pending the outcome of these appeals. Amnesty International has stated that, if he is imprisoned, it will consider Dr. Ayan to be a prisoner of conscience.

During the 2005-2006 academic year, Dr. Ayan was a visiting scholar at Harvard University and the Department of Psychiatry at Massachusetts General Hospital. Nominated by the Committee on Human Rights of the U.S. National Academy of Sciences, National Academy of Engineering, and Institute of Medicine, he was selected for this position by Harvard University’s Committee on Human Rights Studies and by the Scholars at Risk Network. During this time Dr. Ayan worked on psychophysiology with Dr. Roger K. Pitman and his PTSD Research Laboratory team.

While his work remains incomplete, Dr. Ayan has focused his attention on three topics—the psychological effects of isolation, “care for caregivers,” and ways to conceptualize and address trauma on a societal level.

With regard to the first topic, Dr. Ayan’s goal was to develop a methodology that the IPOGI can use to conduct a multi-layered research project in prisons in the province of Izmir in Turkey. To do this, he examined the research methodologies used previously in studies that have been conducted in maximum security prisons in Europe and the United States to document isolation’s negative effects on the psychological health of prisoners. He also sought suggestions and feedback on his proposed methodology from Harvard academicians and other interested colleagues.

Over the course of the last decade, Dr. Ayan has given considerable thought and professional attention to the second topic of “care for caregivers.” He is keenly aware that professionals and volunteers—including physicians, lawyers, human rights activists —involved in work with torture survivors often experience “secondary trauma” and need prophylactic support to avoid burnout. Despite exceptional difficulties and challenges, in almost 15 years of work, the HRFT team in Izmir has not lost a single member. He attributes this to actions that the team has taken to mobilize its own inner resources to provide “interactive group supervision” for one another, as well to volunteer therapists who facilitate a “care for caregivers” program for the team. This year he observed and began to participate in “care for caregivers” activities facilitated by those working in the field in the U.S., with an eye on finding ways to further strengthen the HRFT-Izmir program and establishing other such programs throughout Turkey.

Through his work on the third topic, Dr. Ayan has sought to prepare himself for the day when it becomes possible to openly discuss the reality that Turkey is a “traumatized society.” Turkey endured a 15-year civil war that lasted from 1984 until 1999 and resulted in over 40,000 casualties. Estimates are that more than one million torture survivors live within Turkey’s borders. According to Dr. Ayan, approximately eight percent of Turkey’s population has been directly affected by the “man-made trauma” of torture and the mental disorders associated with it. Post-traumatic stress disorders, major depression, and somatoform disorders are present on a massive scale and are contributing factors for serious social problems that must be faced by the nation. He is studying how other traumatized societies, such as South Africa, Rwanda, and Guatemala, have sought to address similar problems. He has begun to explore how best to facilitate a “mourning process” for Turkish society as a whole.

Dr. Ayan’s brilliantly conveys the tremendous importance and positive impact of the many dedicated souls whose lives are dedicated in helping to heal tortured people:

“There is a network of hundreds of centers have evolved worldwide, including human rights activists, professionals and volunteers who have dedicated themselves to working in solidarity with those who have suffered torture. I feel extremely lucky to work with very experienced and motivated teams -- physicians, social workers, medical secretaries and innumerable other volunteer colleagues in Izmir at one of five national centers in Turkey -- which is representative of this international network of thousands of volunteers seeking to struggle against torture in worldwide in all its forms. It is encouraging that despite the enormity of this horrific problem, the even greater scale of the response to torture is inspiring. Even in this negative political climate, it is important to note that our movement is not weak. Both in Turkey, the U.S., and in countries around the world, people continue to struggle against injustice, boding extremely well for future generations.

In spite of many obstacles, in spite of many difficulties I most sincerely believe that eventually humanity will prevail…

We shall prevail…

We shall overcome…”