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Dr Nalin Swaris, ALRC
Associate Member, Sri Lanka
The College of Anaesthesiologists of Sri Lanka
and the Ethics Committee of the Sri Lanka Medical Association
held a symposium on Ethical Issues in Critical Care on June 26,
2002 in Colombo. The symposium addressed some of the challenges
and ethical dilemmas that today's advanced medical
technologies pose to the medical profession. I was invited
towards the end of May, to read a paper on the
philosophico-ethical aspects of critical care. Experts in the
field spoke on the sophisticated technologies available today, in
particular, of life support systems that can take over the
functions of the heart, the lungs and kidneys of critically ill
patients.
I was aware of the issues and the
medico-ethical dilemmas of critical care, as this is a subject
discussed by students of social work in the Netherlands, whom I
taught for 17 years. To get more up to date information I called
a couple of Roman Catholic priest friends to inquire if they had
any recent literature on the subject. None had. But one of them
told me: "If you want to get first hand experience of the
new technologies, you could visit a patient lying in the
Intensive Care Unit of Private Hospital 'X'. He is now
on a life support system after having been savagely beaten and
tortured by the police in my area."
I went to the hospital, introduced myself and
was allowed a brief visit to see this victim of police torture.
There were tubes in just about every orifice of his body. A
ventilator kept his lungs working. He was fed nasally with
liquids. He was given oxygen through a funnel attached to another
tube. In the police station, his hands had been tied behind his
back and he had been suspended by them from a roof beam, and
beaten with rods for more than an hour. He had lost the use of
both hands. The beatings had severely damaged his muscle tissue.
Enzymes from the damaged tissue cells had flowed into the blood
stream and clogged his kidneys, which were now only 10%
functional. A dialysis machine was doing their work. Fluid was
fillings his lung, making breathing impossible. They had to be
drained regularly. A few days after he was admitted the victim
became unconscious.
He was laid out on his side when I saw him,
head turned to a side, eyes closed, unconscious-a vegetal
adjunct to machines. The sight reminded me of those medieval
paintings of the limp and twisted body of Jesus lying on the
ground after having been brought down from the cross. Jesus is
history's most famous victim of torture. He was whipped,
crowned with thorns and crucified to death. He was innocent.
The paper on medical ethics I was preparing
ceased being an abstract disquisition. The patient-object is a
38-year-old person with dreams and hopes like you and me. He is a
loving husband and father of two little children aged five and
three. He had clocked in for work at the Colombo Dockyard using
his bar code card at 12noon on June 2. Around 2:30pm that day,
there had been a gangland killing in the village where he had
grown up. He finished his shift and clocked out at 9am the next
morning. This is known, as the arrivals and departures of Colombo
Dockyard workers are computer registered. If the criminals in
khaki had asked him where he was the previous afternoon, he had a
watertight alibi: a bar code registration and the testimony of
several workmates who did the shift with him. But most of these
'investigators' are unintelligent beef-heads who have
their own methods.
Meanwhile, the police had received information
that one of the murderers was a notorious hired killer called
Jeyraj. When the police asked the brother of one of the murdered
men, whether he knew a Jeyraj, the man had heard
'Gerard', the name of the torture victim, and said he
knew the person as he grew up in the village but that he had
married and moved to the Gampaha area. The police obtained his
address and went in a civilian jeep, which was in police custody
in relation to an earlier murder case. They took the
suspect's 32-year-old wife and three year old son hostage,
locked them in the jeep and waited for him to come home, just as
predatory beasts wait for their prey.
The morning after the goons in uniform had
battered and wrecked an innocent man, the officer in charge of
the station told him: "Samaavende kollo baduwa maattu
(Sorry boy, we trapped the culprit). Your people are here. You
can go home." The victim was brought to an Ayurvedic
hospital, because he complained of unbearable pain throughout his
body. The doctor, shocked by his condition, said he must be
admitted without delay to a hospital with good emergency care.
The Colombo Dockyard provides up to Rs.50,000 medical coverage
for their minor employees. So his workmates had him admitted to
one of the best-equipped private hospitals in Colombo.
On Saturday June 29, 2002, the day of the
Symposium on Critical Care, the torture victim was still on life
support. The team of doctors, full of compassion and concern for
the tragic waste of a life were doing their best to save the
victim of police brutality. Today is July 9. The victim was taken
off the life support system five days ago. Yesterday he was moved
to a ward in the National Hospital. The dark and dreadful side of
human nature produces tragedies like this. They sometimes also
bring out its fine and noble side. Whether the hospital security
guards, nurses, doctors in attendance, or specialists, each in
their own way battled to protect and save a poor working class
man, even though they knew his family would never be able to meet
the medical costs. When the victim was moved to the National
Hospital and the final tally was made, the costs had soared to
above one million and two hundred thousand. The team of
specialists waived their fees for more than a month of treatment.
This brought the costs down by a couple of lakhs. A poor man was
'wasted' by agents of the state. In any decent nation
the state would pay the medical bills. The victim's lawyer
has written to the President, the Prime Minister and the Minister
of the Interior, requesting such an act of decency. Appeals have
also been made to the ambassadors of Western countries.
On the day of the symposium, I departed from my
prepared script. I spoke of my confrontation with life-support
systems and reflected on the irony of the day's
deliberations. Here we are, I said, discussing our moral scruples
about a single patient whose life hangs on a wire. Are we not
incongruities, I asked, in a moral wilderness? Our society has
lost respect for the sanctity of life. We are living a
frighteningly necrogenic and necrophilic culture, I said.
Torture, sometimes unto death, is an integral part of our
'system of justice'. Must the Attorney General's
Office wake up only when a crime of torture receives
international notoriety and questions are asked? Sri Lanka has
ratified the UN Convention Against Torture. Has any torturer been
prosecuted and punished under Act 22 of 1994, which incorporated
this Convention into Sri Lankan law? None has, so far as I am
aware.
The Prophet Isaiah comforted his people with
assurance of Yahweh's immense compassion: "He shall not
crush the bruised reed or quench the smoking flax". Seeing
the twisted frame of an innocent man on a life support system, I
was reminded of this verse. We humans are like reeds -
vulnerable, crushable and killable. Police torturers bruise and
crush the fragile reed of life. Because of the fragility and
preciousness of life, the Buddha urged humans to practise mutual
self-care, "For in protecting oneself, one protects others
and in protecting others, one protects oneself". But what
happens when the greatest threat to life and limb comes from the
very custodians of the law? Our justice system is in a state of
collapse. Class justice is endemic to it. It is cruel to the
socially weak. The privileged have caviar and champagne in
custody. The consciences of our politicians seem to be quickened
or deadened depending on whether a victim of injustice happens to
be 'one of ours or one of theirs'. In such a social and
political climate one must despairingly ask, with the ancient
Roman philosopher Juvenal: "Who will guard the guardians of
the law?"
Appendix
In the above article Dr Nalin Swaris has made
reference to the case of Gerard Perera. ALRC's sister
organization, the Asian Human Rights Commission (AHRC) has made
several interventions on this case, some of which are reproduced
below. The following websites also contain further information on
his case:
AHRC Urgent Appeals Programme [www.ahrchk.net/ua
]
[Search for "Sri Lanka"]
World Organisation Against Torture [www.omct.org
]
[Search for "Case LKA 170602"]
AHRC MEDIA RELEASE
17 June 2002
MR-13-2002
SRI LANKA: A young man on life-support system
after being tortured by eight police officers
Victim: Waragodamudalige Gerard Mervin Perera
(39)
AHRC is alarmed by the torture of
Waragodamudalige Gerard Mervin Perera, 39, father of two
children, by eight police officers at the Wattala Police Station
in Sri Lanka. The victim is presently on a life-support system in
a hospital due to the injuries caused by the police.
Gerard Perera was arrested by officers of the
Wattala Police Station at about 12:45pm on 3 June 2002, in the
presence of his wife W P Padma Wickramaratne. Ten officers were
present at the time of the arrest and none of them wore police
uniforms. Then Gerard Perera was taken into the Wattala Police
Station and was brutally assaulted by the officers attached to
this station, namely, Sena Suraweera, the Officer In Charge (OIC)
of the police station; Sub Inspector (SI) Kosala Navaratne, OIC
Crimes; SI Suresh Gunaratne; SI Weerasinghe; SI Renuka; Police
Constable (PC) Nalin Jayasinghe; PC Perera and another police
personnel.
Gerard Perera's hands were tied behind his
back, his eyes were blindfolded and he was hung from a beam and
brutally tortured for about one hour. He was questioned about a
murder case of which he knew nothing. He was kept at the police
station on the night of 3 June 2002 and was later told that it
was due to some misinformation that he was arrested. On the
morning of 4 June 2002 Ranjit Perera, brother of Gerard Perera,
along with the Chairman and the Vice Chairman of the Pradhesiya
Sabha (Provincial Council), visited the police station and
inquired about Gerard Perera from the OIC of the police station,
who said that he had been taken to custody due to false
information.
Gerard Perera was released from the police
station on the morning of 4 June 2002. As he was complaining of
severe pains he was taken to Yakkala Wickramarachchi Ayurvedic
Hospital. The doctor who examined him advised that he should be
taken to a good hospital as he was in serious condition. Gerard
Perera was then taken to Navaloka Hospital in Colombo and has
been there until now. While in the hospital Gerard Perera made a
statement to an officer from Grandpass Police Station, Colombo,
about the way he came to have the injuries. While all efforts
have been made to save Gerard Perera's life, the situation
turned worse by 15 June 2002 and the doctors have advised the
family that the situation is very critical and that he may not
survive.
Basil Fernando, executive director of the Asian
Human Rights Commission said,
The government of Sri Lanka must guarantee
that all medical care is supplied to this torture victim. It
is quite likely that the life support system may be removed,
as the cost of it is very high. As this is a disaster brought
about by the state agents it is necessary for the state to
take the responsibility for all the costs and do whatever it
can to save the life of this unfortunate victim. Meanwhile it
is also essential to immediately arrest all the perpetrators
(eight police officers) of this crime. This crime falls under
Act No.22 of 1994, which prescribes a mandatory seven-year
imprisonment for torture by any state officer and if the
victim does not survive, the crime will be one of murder.
Asian Human Rights Commission - AHRC
17 June 2002, Hong Kong
ASIAN HUMAN RIGHTS COMMISSION - URGENT APPEALS
PROGRAM
Update on Urgent Appeal 21 June 2002
UP-44-2002 (RE: UA/18 and 19/2002 - Torture by
police, impunity, denial of proper rehabilitation
(Extract)
Gerard Perera continues to be on a life-support
system The police, when asked by the BBC Sinhala Service, said
that they used only minimum force on him. Meanwhile, the
residents of the area where he used to live organised a protest
from 4pm to 8pm yesterday. About 500 people participated in the
protest meeting and the demonstrations. The BBC Sinhala service
quoted an organiser of the demonstration who said that complaints
have been made to the Prime Minister, Inspector General of
Police, Chief Justice, and opposition party leaders, but no
action has been taken yet. A fundamental rights violation
application has been filed on his behalf with the assistance of
the Asian Human Rights Commission (AHRC). Pressure is being
brought by some officers to have their names removed from this
application.
Posted on 2002-08-15
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