Economic burden of torture for a refugee host country: development of a model and presentation of a country case study

Abstract

Emmanuel Kabengele Mpinga,1,* Conrad Frey,2,* Philippe Chastonay1,*1Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland; 2Psychiatric Clinic, Obwalden Cantonal Hospital, Sarnen, Switzerland*These authors contributed equally to this workBackground: Torture is an important social and political problem worldwide that affects millions of people. Many host countries give victims of torture the status of refugee and take care of them as far as basic needs; health care, professional reinsertion, and education. Little is known about the costs of torture. However, this knowledge could serve as an additional argument for the prevention and social mobilization to fight against torture and to provide a powerful basis of advocacy for rehabilitation programs and judiciary claims.Objectives: Development of a model for estimating the economic costs of torture and applying the model to a specific country.Methods: The estimation of the possible prevalence of victims of torture was based on a review of the literature. The identification of the socioeconomic factors to be considered was done by analogy with various health problems. The estimation of the loss of the productivity and of the economic burden of disease related to torture was done through the human capital approach and the component technique analysis.Case study: The model was applied to the situation in Switzerland of estimated torture victims Switzerland is confronted with.Results: When applied to the case study, the direct costs – such as housing, food, and clothing – represent roughly 130 million Swiss francs (CHF) per year; whereas, health care costs amount to 16 million CHF per year, and the costs related to education of young people to 34 million CHF per year. Indirect costs, namely those costs related to the loss of the productivity of direct survivors of torture, have been estimated to one-third of 1 billion CHF per year. This jumps to 10,073,419,200 CHF in the loss of productivity if one would consider 30 years of loss per survivor.Conclusion: Our study shows that a rough estimation of the costs related to torture is possible with some prerequisites, such as access to social and economic indicators at the country level.Keywords: cost of torture, victims, violence, state violence, post-traumatic stress disorder, abuse