What is waterboarding?
Waterboarding is one of the oldest and most recognized forms of torture (1). Waterboarding is when an individual is restrained to a board or table, a cloth is placed over the mouth and nose and water is poured over the cloth blocking off the flow of air (2,3). This method of torture may be referred to as chiffon and is a form of asphyxiation (the deprivation of oxygen) using water. Other forms of asphyxiation using water may include submerging a person’s head in a container of liquid such as water or urine, a method referred to as wet submarine/submarino (4).
Waterboarding is recognized as a method of torture by the European Court of Human Rights (5,6), the UN Committee against Torture (7), and is now explicitly prohibited by US military regulations (8).
In the aftermath of the Twin Towers attack in the US, the US Department of Justice determined that a broad array of “enhanced interrogation techniques” were lawful, thereby justifying the use of waterboarding in the so-called “War on Terror” (8–10). Waterboarding was consequently used on suspected terrorists captured in Afghanistan and Iraq. It was practiced in US military prisons as well as in other countries and overseen by US staff and sometimes monitored by US military doctors (11). The use of waterboarding has also been documented in Argentina, Bangladesh, Lebanon, Peru, Syria, Uganda, Uruguay, and likely occurs in many more countries across the world (12–14).
Health consequences of waterboarding
Waterboarding and its variants are an example of a physical torture method that produces immediate physical and mental suffering and leads to major psychological distress.
The inhalation of water may cause the victims to drown or almost drown. Drowning is a complex process involving halting breath, struggling, physical exhaustion, rising carbon dioxide levels, the inhalation and intake of liquid, coughing, vomiting, loss of consciousness, respiratory failure and cardiac arrest. Physical consequences of waterboarding include Hypothermia (reduced body temperature), Aspiration pneumonia (lung infection), Laryngospasm (sudden spasm of the vocal cords which disables speech and breath), incontinence, memory deficits, epilepsy, acute brain damage, and an increased risk of cardiovascular diseases (2,15).
The experience of drowning has been described as one of the most traumatic experiences a human being can endure (15). and is associated with a range of long-term psychological effects including panic attacks, depression, post-traumatic stress disorder (PTSD) and changes in personality (12). Waterboarding often leads to shock, confusion, distrust, lack of sleep, mental exhaustion, and isolation (12,15).
Waterboarding is a form of torture by wet asphyxiation with severe physical and psychological consequences. There is a need for comprehensive training of medical and judicial professionals to expand awareness and understanding of waterboarding as a torture method, and to train medical staff in treatment of the torture victims.
- Kanstroom D. On “Waterboarding”: Legal Interpretation and the Continuing Struggle for Human Rights. Boston Coll Int Comp Law Rev. 2009 May 1;32(2):203.
- Beynon J. ‘Not waving, drowning’. Asphyxia and torture: the myth of simulated drowning and other forms of torture. Torture Q J Rehabil Torture Vict Prev Torture. 2012;22 Suppl 1:25–9.
- Moreno A, Grodin MA. Torture and its neurological sequelae. Spinal Cord. 2002 May;40(5):213–23.
- United Nations, editor. Istanbul Protocol: manual on the effective investigation and documentation of torture and other cruel, inhuman, or degrading treatment or punishment. Rev. 1. New York: United Nations; 2004. 76 p. (Professional training series).
- ECHR. Al Nashiri v. Poland, 28761/11. 2014.
- ECHR. Husayn (Zubaydah) v. Poland, 7511/13. 2014.
- UN Committee Against Torture. Conclusions and Recommendations, USA. CAT/C/USA/CO/2. 2006 Jul.
- Graham LO, Connolly PR. Waterboarding: Issues and Lessons for Judge Advocates. Air Force Law Rev. 2013 Jan;69:65–90.
- Marcovitz H. Exposing torture: centuries of cruelty. Minneapolis, MN: Twenty-First Century Books; 2015. 112 p.
- Borchelt G, Physicians for Human Rights (U.S.). Break them down: systematic use of psychological torture by U.S. Forces. Cambridge, MA: Physicians for Human Rights; 2005.
- Xenakis SN. Neuropsychiatric evidence of waterboarding and other abusive treatments. Torture. 2012;22(1).
- Correa C. Waterboarding Prisoners and Justifying Torture: Lessons for the U.S. from the Chilean Experience. Hum Rights Brief [Internet]. 2007 Jan 1;14(2). Available from: http://digitalcommons.wcl.american.edu/hrbrief/vol14/iss2/5
- Ghaddar A, Elsouri G, Abboud Z. Torture and Long-Term Health Effects Among Lebanese Female Political Prisoners. J Interpers Violence. 2016 Feb;31(3):500–14.
- Moisander PA, Edston E. Torture and its sequel--a comparison between victims from six countries. Forensic Sci Int. 2003 Nov 26;137(2–3):133–40.
- Reyes H. The worst scars are in the mind : psychological torture. IRRC. 2017 Sep;89(867).
Researched and written by:
Marie My Warborg Larsen, Maha Aon and Ergun Cakal with contribution by Jens Modvig, Marie Brasholt and Brenda Van Den Bergh.
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