Repairing the social trauma of crimes against humanity in Chile: a Human Rights approach to the case of the Comprehensive Health Care and Reparation Programme

Abstract

Introduction. At the end of a period of conflict and repression, States must address past human rights violations by establishing a series of measures among which, reparations to victims. In Chile, after the 1973-1990 civic-military dictatorship, one of these measures was the implementation of the Programa de Reparación y Atención Integral de Salud (PRAIS) [the Comprehensive Health Care and Reparation Programme]. The programme has brought about a number of benefits and is currently an international benchmark for this type of policy. Yet the design of the programme presents a series of gaps that have made the reparation task difficult to fulfil. The objective of this work was to analyse the PRAIS programme, assessing its claim to be a reparation policy of social rehabilitation and its adaptation to the human rights approach. Methodology. A qualitative analysis was conducted by applying two strategies: on the one hand, the model of the reconstruction of the programme rationale and on the other, the human rights-based approach. The documentary analysis of the instruments establishing the reparation policy guidelines were used as a source of data. Results. Social trauma and the need for its reparation were identified as a problem, notably the health effects caused by impunity. However, no actions aimed at solving that problem were found. Regarding the orientation of the programme, a biomedical approach was adopted that focused on repairing biopsychosocial damage. Other relevant factors that contributed to the damage caused were not considered, among which impunity, which has a retraumatising effect. Regarding the programme design, there was no explicit relationship between the goals and the strategies developed to effectively solve the problem. Lastly, the programme does not fully guarantee a dignified treatment for the victims and their families, nor their right to take action for human rights violations. Furthermore, the programme does not present a coherent gender or intersectionality perspective either, nor does it allow meeting the criteria that guarantee the right to reparation. Discussion. Given the gaps in the programme, we can affirm that PRAIS has undergone improvisation over time across different governments. Its coordination with legal services has been omitted, and the action of social services has been minimised. At the same time, the programme has been incorporated into a pre-existing sectoral policy of a general nature. Conclusions. The programme rationale does not guarantee the fulfilment of its objectives nor its approach to social trauma. On the contrary, the fact of integrating the programme into a pre-existing policy and of failing to contemplate specific intersectoral actions has hindered effective rehabilitation. For these reasons, the programme seems to be favouring the re-victimisation of its target recipients instead.