Easter suffering down the ages

This Easter in the Philippines

This Easter I’m in the Philippines, the most incredibly beautiful and diverse South-East Asian archipelago nation with complex religious traditions partly rooted in Roman Catholicism. Since 2015 and barring the first two years of the COVID-19 Pandemic, I’ve spent approximately a fifth of my working life based out here. I even have a second home here.

I absolutely love the Philippine people. Their warmth and respect are second to none. And although I still have much to learn, I’m now very comfortable with many of their perspectives and customs - save for one…

Volunteers for flagellation

Self-flagellating Filipino

This is the third or fourth Easter I’ve celebrated out here. And although I appreciate much about the Roman Catholic Church’s celebration of Easter, one thing I have not adjusted to is the non-orthodox yet widespread practice of voluntary self-flagellation and even voluntary crucifixion every Good Friday.

This practice jars with me most particularly because I have expertise in the detection and prevention of torture and ill-treatment, and so sometimes I have to examine torture victims who have been flogged. And a severe flogging was just part of the barbaric execution method inflicted on Jesus at the original Easter…

The original Easter in Israel

The Roman form of crucifixion was the ultimate control mechanism: feared by everyone within the Roman Empire, it acted as both deterrent and punishment…

Victim of crucifixion

The very first Easter saw God the Son, Jesus suffering and dying at the hands of others. He did so not because he wanted to - he wasn’t a masochist. Rather, he begged God the Father to spare him from his forthcoming ordeal:-

My Father, if it is possible, may this cup be taken from me.
(Matthew 26:39)

But it was not to be. Jesus was arrested, tried, sentenced, tortured and executed. This makes him history’s most famous torture victim.

SENTENCED FOR US

So, why was Jesus sentenced to death? Not because God the Father was a cosmic child abuser - a charge levelled by some modern-day liberal theologians. No, Jesus was executed in our place for our sins.:-

But he was pierced for our transgressions, he was crushed for our iniquities;
the punishment that brought us peace was on him, and by his wounds we are healed.
(Isaiah 53:5)

All we have to do is accept this incredible gift…

For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life.
(John 3:16)

… and follow the teachings of Jesus, our incredible Saviour:-

Then Jesus said to his disciples, “Whoever wants to be my disciple must deny themselves and take up their cross and follow me.
(Matthew 16:24)

With no disrespect intended, try as I might, I cannot understand why anyone who has truly understood Easter would perform self-flagellation. As I often say, ‘Jesus was tortured and died - so we don’t have to’.

Taking up our cross

So what did Jesus mean when he said we should take up our cross and follow him? Did he mean that we should self-harm every Easter? No! Did he mean that we should look for ways to goad those who are in a position to torture and execute us? Again, no!

No, by ‘follow me’ he meant that we should decide to follow his teachings. And by ‘take up his cross’ he meant that committing to follow him was not a nice, vague concept but a profound and self-denying lifestyle decision.

And yes, both then and now, following Jesus may lead to punishment and death. It is thought that the vast majority of Jesus’ original disciples met violent ends. But they did not volunteer to suffer and die, and they did not hurt themselves. No, they merely carried out their Lord’s final set of earthly instructions - with fatal consequences:-

Then Jesus came to them and said, “All authority in heaven and on earth has been given to me. Therefore go and make disciples of all nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, and teaching them to obey everything I have commanded you. And surely I am with you always, to the very end of the age.”
(Matthew 28:18-20)

Almost two thousand years later, crucifixion is rare (though still crops up from time to time) and so thankfully I have yet to be asked to examine a case - fatal or otherwise. Yet there are many other ways to become a martyr…

WarTime Easter in Germany

The date on which Easter is celebrated fluctuates, as it is tied to the lunar rather than solar calendar. And by macabre coincidence, this Easter Sunday (9th April 2023) marks the 78th anniversary of the 1945 martyrdom - just eight days after that year’s Easter Sunday - of a great Christian hero…

Victim of hanging

Pastor Dietrich Bonhoeffer
(Image provided by Encyclopædia Britannica)

Pastor Dietrich Bonhoeffer was German born and raised. Yet he steadfastly opposed Nazi dictatorship and championed Christian discipleship, despite the unwelcome yet inevitable cost.

He participated in rescuing Jews. He refused to cooperate with the Nazification of the German Church. And he was linked to attempts to overthrow Hitler.

He didn’t want to suffer and die. Even though he was doing these incredibly dangerous things, which he knew risked capture and death, he was also planning for the future of the church after World War II. He even planned for his personal future - by getting engaged to be married!

Finally though, the inevitable happened: he was arrested in April 1943. He spent the last two years of his life in detention. Firstly, he was put in Tegel Prison, Berlin awaiting trial. Next he was sent to Buchenwald concentration camp. And then finally he was transferred to Flossenbürg concentration camp for a quick show trial. He was hanged the very next day, on 9th April 1945, just one month before Germany surrendered. During his detention he suffered both physically and psychologically; the manner of his death by hanging was also possibly more cruel than some biographies state.

During his years as a prisoner he lived a life devoted to Christ, sharing God’s offer of salvation with fellow prisoners and prison officers. He also wrote fervently to friends, family, and his fiancée. Posthumously his letters and some of their replies were compiled into a well-known book, Letter and Papers From Prison. Reading these letters is both encouraging and humbling.

CONSIDERING the suffering

Bonhoeffer had lived experience of Matthew 16:24. He also witnessed much suffering of others, and during his imprisonment he wrote:-

We must learn to regard people less in the light of what they do or omit to do, and more in the light of what they suffer.
(Letters and Papers from Prison)

How true. Yet how often do we fail to evaluate people in light of their past, their trauma and their suffering, rather than reacting directly to their words and behaviour?

JamMING The Wheel

Also whilst behind bars, Bonhoeffer wrote what may be his most famous quotation:-

Medieval torture wheel

We are not to simply bandage the wounds of victims beneath the wheels of injustice, we are to drive a spoke into the wheel itself.
(Letters and Papers from Prison)

This sentence encapsulated all that he lived for. He did not simply write and teach on the morals and ethics of the Christian life. He lived it too. His firm belief was not just in helping those crushed by the weight of this world’s injustices, but in radically intervening for the oppressed and averting the course of injustice so as to stop ‘the wheel of injustice’ from moving on to crush others in the future. And it cost him his life.

Future easters behind bars

Logo of our expertise and advocacy services

As a Christian faith-inspired organisation with a heart for detainees, we are inspired by the life and words of Bonhoeffer. All too often, we discover modern-day victims with wounds that need bandaging and wheels that need jamming.

Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy.
(Proverbs 31:8-9)

May God bless you this Easter.

Dr Rachael Pickering, adapted from the 2019 article co-authored with Dr Esme MacKrill

PS we always welcome prayers and donations for the Gerry Serrano Centre.

ASD + Bars: Hi I'm Zoe

My name is Zoe. I am 20 years old and I live in England. As a teenager I was detained (sometimes called ‘sectioned’) twice under my country’s Mental Health Act (MHA). I even spent my 17th birthday in hospital. It was a very distressing time. I don’t remember all of it but what I do recall still upsets me. Thinking about it makes me cry. I’m crying now as I type. 

Thankfully I haven’t needed another admission since then, but I am still very affected by my disabilities. You might be looking at my photograph and asking yourself, ‘What disability?’ It’s called Asperger Syndrome, which is an Autistic Spectrum Disorder (ASD). I also have bipolar mood disorder, another life-long condition. Disabilities like mine, which are not obvious at first glance, are called ‘hidden disabilities’. If you met me, you wouldn’t notice anything was amiss - not at first anyway. Yet my conditions do affect just about every part of my life.

Me (and my mum) telling mental healthcare workers about my experiences in hospital

I am trying to find my way in the world and this includes having a zero-hours job as Integritas’ autism and disabilities advocate (ADA). It helps that my mum is the chief medical officer and my dad is on the board, so they are around to help me when I need their support with this work. I am so lucky in this regard. Most young people with autism are completely out of employment, yet alone those who have another mental health challenge like my bipolar mood disorder.

In addition to their Integritas roles, both my parents are jobbing English prison doctors, and my mum has a special interest in mental health. So I’m quite used to hearing talk about the problems of caring for detained patients who have mental health issues. But my own lived experience of having been detained in hospital has given me personal insight into what needs to change for autistic people held in hospitals, prisons and other types of secure environment around the world.

And so throughout 2022 I’m going to be exploring various aspects of detention that affect detainees with ASD who may also have additional mental health needs. My intention is to help raise awareness and advocate for positive change. I do hope that you read my series and tell other people about it.

Until later this month…

Miss Zoe Pickering

PS If you’d like to support my work on this series, please donate to our Winter Appeal.

International Day in Support of Victims of Torture

On June 26th we remembered the UN International Day in Support of Victims of Torture. This date was chosen as it marks the day when the UN Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) was implemented as a legal instrument in 1987.

History of torture prevention

In 1948 the Universal Declaration of Human Rights was adopted by the United Nations General Assembly states in Article 5:-

No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.

Then in 1975 the General Assembly adopted the Declaration of the Protection of All Persons from Being Subjected to Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, condemning torture and providing methods to prevent it.

Progress was made in the following two decades and eventually in 1984 the CAT was published, coming into force in 1987. This prohibits torture in all its forms and declares it cannot be justified under any circumstances.

How we support victims of torture

Regardless of whether they are signatories to national and international humanitarian laws forbidding ill-treatment, interrogation methods are brutal in many parts of the world both rich and poor. Rule of law may not prevail. And cultures of inter-prisoner violence (IPV) are often ignored or even encouraged by the authorities.

I signed my confession because I knew I would be beaten until I did. It was an easy decision.
(Detainee with strike marks on torso)

We utilise our expertise & advocacy in the detection and prevention of torture & ill-treatment. Patients, clinicians, relatives and legal representatives contact us for expert advice and advocacy. We also cooperate with the embassies of countries concerned that their citizens detained overseas are being torture or ill-treated.

The Gerry Serrano Centre is an institution based at Integritas House Olongapo in the Philippines. It provides healthcare, expert witness, advocacy, research and training for and about detainees past and present, especially those who have been tortured or ill-treated within the Western Pacific and South-East Asia.

The Gerry Serrano Centre is named in honour of the late Mr Gerry Serrano who was a long-term detained patient we were proud to know, care, and advocate for. He spent more than two decades behind bars facing many challenges but eventually, after 22 years, he was found innocent and released. He was free but his body could not recover sufficiently and he sadly died a year or so after release. Before he died, Gerry agreed that his story should be used in our work - promoting offender healthcare and opposing ill-treatment. And so we decided to preserve his memory by naming this centre after him.

Our advocacy and expertise work are needed more than ever to oppose ill-treatment and torture. In Spring 2021 we highlighted the many forms that torture and ill-treatment may take and how, despite international legal standards, torture still continues to this day. If you have been moved to support victims of torture and you’d like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.

A Day in The Life of a Clinical Fellow

I’m Esme, an honorary clinical fellow with Integritas Healthcare. I’m a junior doctor based in the UK, currently taking time out of formal medical training.

I have been a clinical fellow with Integritas since January 2021, having been a participant on the new Health & Justice course run by Integritas in partnership with Christian Medical Fellowship (CMF) since Autumn 2020. Through this track I was inspired and encouraged to pursue my interest of working with vulnerable patient groups by joining the team!

Being a clinical fellow is really flexible to fit around my other commitments. I work in a part-time manner, doing two and a half days a week. Here is a breakdown of what a typical day might look like for me:

7:15am: I wake up and get myself ready for the day.

8am: I log on to zoom for telemedicine clinic, it is 3pm in the Philippines and our Integridad team are ready to show us the patients for the day. They have sent us a pre-filled clinic record with the patient’s details, observations and the presenting complaint before we begin. I accompany one of the more senior clinicians and complete the online electronic medical record as we go along. We see a variety of complaints from foot ulcers and diabetes management, to communicable diseases and ENT problems!

9am: Clinic finishes promptly at 4pm Philippines time, when the detainees must go back to their cells. Our European and Philippines team now meet online for devotions - a time of bible study and prayer. This is a wonderful time of fellowship and helps me get ready for the day ahead.

9:15am: I make a cup of tea before I check my emails and come up with a list of tasks for the day.

9:30am: I log on to our website editing suite and start a new opinion piece for our current blog series on torture and ill-treatment. A large part of my work is advocating for vulnerable patient groups, which I do through writing blog posts and raising awareness on social media. Through this I have been able to stretch my writing skills and develop my knowledge of the difficulties faced by those in secure environments.

12:30pm: My lunch break is pretty flexible, and I usually use it as a chance to stretch my legs and get come fresh air after sitting at my desk all morning!

1:30pm: I log on to zoom for a meeting with a colleague I am creating training videos with. We prepare in advance an interview script to record, and once we are done I edit it to ensure it looks professional. I upload this to dropbox for later use.

4:00pm: And that’s me done for the day!  

Every day can be very different - sometimes I attend board meetings, sometimes I get involved in other projects, and sometimes I work outside my normal hours to write a statement for a breaking news story. It can be challenging but I have certainly learned a lot and would recommend this position to anyone!

If you are thinking about taking a gap year either as a student or junior healthcare professional and you’d like to be involved in advocacy work, you can apply to join us here! We welcome all enthusiastic Christian healthcare professionals who want to learn and grow with us as an organisation. If you have any questions please get in touch.

Autism Awareness in April

Today, the last day of April, marks the end of Autism Awareness Month, raising awareness about a condition that is close to our hearts…

There are around 11 million detainees in the world. Autism affects around 1% of the population. So in theory that’s approximately 110,000 autistic people behind bars across the world. However, we know that autistic people are over-represented within some secure environments - for example, one English prison found that 4.5% of its population had an autistic spectrum condition. Outside of work I care for an autistic person so I am more aware of the condition than your average UK doctor, and I take this awareness to my job as a UK prison GP. Most weeks I spot patients who are quite obviously autistic yet who have got to an advanced stage of life without it being formally diagnosed or even recognised as such.

Regardless of exactly how many autistic people are behind bars though, they are some of the most vulnerable detainees. It fills me with sadness that they live in stressful, unsuitable environments. I still remember with horror an incident from the earlier days of my career behind bars, when I attended the death scene of an autistic man. My colleagues and I had tried to help him, but his despair was too much for him to bear. He managed to kill himself despite our best efforts to prevent him from doing so. It was a tragedy.

Whilst the UK’s criminal justice system still struggles to know what to do with autistic people, it is encouraging that a small minority of the UK’s prisons have succeeded in the challenge of achieving accreditation with the Autism Accreditation Service, which is provided by the National Autistic Society (NAS). One of these accredited prisons is HMP Wakefield, a high secure estate; another is YOI Feltham, a notoriously busy young offenders institution. If these particularly challenging secure environments can do it, then surely all other UK detention settings could manage to follow suit.

As a medical organisation with a heart for detainees, we’ve spent April considering how to amplify our autism & disabilities advocacy. We welcome all suggestions. But for starters, we’ve decided to become NAS-accredited ourselves. Why not turn to organisations within your sphere of influence and draw their attention to this fabulous scheme?

Jamming the Wheel: Remembering Dietrich Bonhoeffer

Who was Dietrich Bonhoeffer?

Pastor Dietrich Bonhoeffer

Image provided by Encyclopædia Britannica

76 years ago today theologian and dissenting minister of religion Dietrich Bonhoeffer was executed at Flossenbürg concentration camp. German born and raised, he opposed Nazi dictatorship and championed Christian discipleship despite the cost.

His participation in rescuing Jews, his refusal to cooperate with the Nazification of the German Church, and his links to plots to overthrow Hitler eventually led to his downfall.

After being arrested in April 1943, he spent the next two years in detention. Firstly, in Tegel Prison, Berlin awaiting trial. Then he was sent to Buchenwald concentration camp. And finally he was transferred to Flossenbürg for a quick show trial. He was hanged the very next day, on 9th April 1945, just one month before Germany surrendered. During his detention he suffered both physically and psychologically; the manner of his death was also possibly more cruel than some biographies state.

During his time in prison he lived a life devoted to Christ, sharing God’s offer of salvation with fellow prisoners and prison officers. He also wrote fervently to friends, family, and his fiancée. Posthumously his letters and some of their replies were compiled into a well-known book, Letter and Papers From Prison. Reading these letters is both encouraging and humbling.

CONSIDERING the suffering

Memorial plaque to Bonhoeffer and others at the site of his execution

Bonhoeffer understood suffering more than most. His faith in Christ led to his own suffering and death. He was a righteous man who knew what it was to take up his cross and follow his Lord Jesus, who was tortured and executed for us on Good Friday, just as the first disciples were taught:-

Then he [Jesus] said to them all: “Whoever wants to be my disciple must deny themselves and take up their cross daily and follow me.” 
(Luke 9:23)

Blessed are those who are persecuted because of righteousness, for theirs is the kingdom of heaven.
(Matthew 5:10)

Bonhoeffer had lived experience of these gospel passages. And during his imprisonment, Bonhoeffer reflected on the suffering of others that he was witnessing:-

We must learn to regard people less in the light of what they do or omit to do, and more in the light of what they suffer.
(Letters and Papers from Prison)

How true. Yet how often do we fail to evaluate people in light of their past, their trauma and their suffering, rather than reacting directly to their words and behaviour?

Behaviour of mentally unwell detainees is often misunderstood, resulting in them being restrained and even fixated unnecessarily

In medicine we are privileged to see people at the very beginning and end of their lives. We bear witness to heart-breaking moments and life-changing situations. Human beings are fragile. In times of tension, emotions run high. Unpleasant outbursts happen, filled with anger and blame. Some patients turn repeatedly to vices we wish they would stop for the sakes of their health and family.

Yet despite all this they are still children of God, valued and respected by Him. A good healthcare professional will see beyond what their patient is doing or saying, choosing instead to view the behaviour or words through the lens of their troubles.

And outside of the healthcare arena also, we should be challenged by this piece of wisdom. We need to look for the inestimable worth and dignity of our fellow human beings. Let’s give one another the respect each one of us deserves, whether we are free or behind bars.

JamMING The Wheel

Also whilst behind bars, Bonhoeffer wrote what may be his most famous quotation:-

We are not to simply bandage the wounds of victims beneath the wheels of injustice, we are to drive a spoke into the wheel itself.
(Letters and Papers from Prison)

Medieval torture wheel

This sentence encapsulated all that he lived for. He did not simply write and teach on the morals and ethics of the Christian life. He lived it too. His firm belief was not just in helping those crushed by the weight of this world’s injustices, but in radically intervening for the oppressed and averting the course of injustice so as to stop ‘the wheel of injustice’ from moving on to crush others in the future. And it cost him his life.

Detainees are one of the world’s most vulnerable patient groups. Without their freedom, they have very little power to express their rights. And in many countries detainees who are unwell, disabled, poor or from a minority background are especially vulnerable.

JAMMING WHEELS TODAY

Logo of our expertise and advocacy services

As a medical organisation with a heart for detainees, we are all too familiar with wounds in need of literal or metaphorical bandaging. Whilst performing holistic healthcare, we also see the overwhelming need to advocate for our patients and to take a stand against the injustices many of them are facing. So in our own way we are trying to ‘drive a spoke into the wheel’ of injustice towards detainees, through our expertise and advocacy services.

As a Christian faith-inspired organisation, we will be forever encouraged in our work by the great example of Pastor Dietrich Bonhoeffer. Yet it is not a choice. God commands all of His followers to advocate for the disempowered:-

Speak up for those who cannot speak for themselves, for the rights of all who are destitute. Speak up and judge fairly; defend the rights of the poor and needy.
(Proverbs 31:8-9)

Dr Esme MacKrill with Dr Rachael Pickering

PS If you’d like to support our anti-torture & ill-treatment work, we welcome donations towards the Gerry Serrano Centre.