Solace for the souls of the tortured

Sheila Cassidy praises a life dedicated to healing the victims of torture.

Neil Belton's biography of Helen Bamber is a remarkable book about a most remarkable woman - a little-known heroine of our time. I have known her for years, but I had no idea what a powerful person she was until I read The Good Listener . Belton's book is an enthralling though not an easy read, skilfully interweaving Bamber's story with some of the more terrible history of the past six decades, in only 350 pages. His focus moves easily from close-ups of the woman herself to historical scene setting, for although Bamber is a "one-off" she is always a woman of her time, responding and reacting to the circumstances around her. If her world seems an alien one, uncomfortable to hear about, it is still our world - it is just that Helen is somehow drawn towards those who inhabit the shadows: the exiles, the refugees and, always, those who have been tortured.

For those who do not know her, Bamber, now in her seventies, is a key figure in the British human rights scene. Having worked for many years for Amnesty International, as a founder member of the Amnesty Medical Group, in the mid-1980s she had the vision to set up the Medical Foundation for the Care of Victims of Torture.

I had known for some time that the young Helen worked with Holocaust survivors at Belsen in the early postwar months, but I had not realised how her childhood had formed her for this work. I was going to say, prepared her, but nothing could prepare a human being for what Helen met in those terrible days. Her family background and late adolescence in war-torn London had, however, branded her and left her with the capacity to empathise with and care for victims of disaster.

As a doctor who works with cancer patients I am very clear about the distinction between sympathy and empathy. Sympathy involves pity and may spur us to give time and money, but empathy is something quite different. Empathy, according to American psychotherapist Carl Rogers, is "the ability to enter into the world of the other and experience it as if it were one's own, without losing the as-if quality". Empathy is a costly gift - it costs to acquire it and it costs to use it - but it is the gift that makes the difference: it sorts out the women from the girls, the healers from the carers.

Bamber was born in London in May 1925. Both her parents were of Polish origin, her father Louis Balmuth having been born in the US but raised in Eastern Europe and then in the UK. Belton vividly describes what he calls the refugee trail. The houses reek of the unexotic poverty of the immigrant worker, single men frowning with anxiety outside cafes or the doors to first-floor cab offices. This is the terrain of the legal and illegal alien, successive waves of immigration out of Europe and the old British Empire inching up through what used to be "outcast London - Whitechapel, Bow, Spitalfields, Shoreditch - and on through Dalston and Clapton on the drained marshes on the banks of the river Lea".

Helen was raised with her extended family in quite a splendid house, against a background of constant family strife. "The Balmuths were a noisy, divided, bitterly inseparable family. Relations between the siblings were close and abrasive. Bamber remembers vicious disputes in Yiddish, French and English: 'They were clever and all of them good linguists. But they quarrelled about everything, each other, their politics, and their partners. They were all curiously mad and none of them, really, understood children'." She goes on to say: "I think whatever ability I have now to contain anger and upheaval started with that family, because it was my only means of surviving."

It can be no coincidence that this child of displaced people has become a champion of the displaced and her story is poignantly relevant at this moment when Europe is again in turmoil and hundreds of thousands of refugees are on the move. Will some of the hunted Kosovo Albanians of today's troubles take root in Finsbury Park, I wonder, and will another Helen Bamber emerge from the ashes of a warring family?

As a teenager, she found an ally in the person of her mother's sister, her aunt Mina, a woman who "made the most of herself" and "must have stood out like a sexy exotic among the dour puritans of the British Communist Party, for whom style was an unfailing indicator of social betrayal". Belton describes this friendship as "a tangle of erotic and political yearnings" and tells that Mina was a woman of vitality and passion. Mina took her young niece to restaurants and to the theatre and she left her mark: "The combination of elegance and sensual enjoyment with commitment remains for Bamber a kind of model of how to live." Mina's sartorial influence on her niece is apparent to this day for Helen is an elegant dresser. (As an inveterate "shopaholic" myself, this pleases me, for I love to see the stereotype of the Oxfam-dressed human rights worker exploded from time to time.)

By the time Helen was seven, Hitler was in power and three years later the Jews were being stripped of their rights as citizens. She was 13, an adolescent in the British-Jewish diaspora when the violence of Kristallnacht , the Nazis's "night of glass", shocked the world. Then came the bombing of London: "Helen Bamber said that she was no longer very frightened: the rituals of crawling and running, of collective sheltering, had a way of normalising fear."

In 1941, however, tragedy hit the family when aunt Mina died in the blitz, the night the Cafe de Paris in Soho suffered a direct hit. The devastation was so complete that no remains were found: Mina had disappeared without trace. "Mina had been my saviour; she had drama and humour in her bones. It felt as if doors were closing, after that."

In 1944, the last year of the war, Bamber took a job as secretary to a doctor in Harley Street. Her poise, competence and intelligence clearly stood her in good stead for she has done similar work from time to time over the years and counts several very powerful doctors among her friends. It is this familiarity with medicine and its practitioners that gave her the know-how and the clout to found London's only private clinic for torture survivors. But there was to be a lifetime of adventure before she undertook the work for which she is now famous.

I have dwelt at some length on Bamber's childhood and adolescence, partly because it fascinates me, but also because it must provide the key to understanding her. How differently she might have turned out - for hers was clearly a very dysfunctional family, its older members having suffered so much. What magical combination of nature and nurture ignited within her the fire that is as yet unquenched? When I saw her in the House of Lords just a few weeks ago at the latest Pinochet hearing, her contribution was wise and well ordered and delivered with her usual poise: I took pride at the way she nodded in affirmation during my own not-very-articulate speech.

In April 1945, the British Army entered Belsen. Helen was only 19 when she made her decision to go there, and joined the Jewish Relief Unit. After what Belton describes as a "rudimentary" training, she was on her way. In chapter three, there is a harrowing description of the state of the inmates: the filth, the hunger and the mind-boggling numbers who died. All this, of course, I knew. What I had not realised was that many of the prisoners stayed on, some for years, after the camp was liberated.

"It is pleasing to think of the end of the war and of liberation, comforting to imagine the survivors being fed after the gates opened and, when they were well enough, riding to freedom on a democratic truck. But the Jews of Belsen travelled a bare mile, to the old Panzer grounds, and there they stayed for another three years. They had been redefined: they were now displaced persons or DPs, and the British preferred to call the camp Hohne, rather than Belsen. But naming is much more than a verbal act, and the Jewish survivors were unhappy with the new language. The DPs could not leave the camp on their own terms - or rather, they were free to go but only to the last places on earth they wished to see." The British, says Belton, "could not grasp the real nature of the disaster that had befallen the Jews and were deeply suspicious of their emergent nationalism".

For 18 months, Bamber worked among these people. It was here that she learned the importance of listening and developed the gift that was to shape her future life. "Above all else," she said, "there was the need (for them) to tell you everything, over and over and over again. And this was the most significant thing for me, realising that you had to take it all. There wasn't much crying at that time, it was much later that they really began to grieve; some people had got far beyond that and they might never again have been able to weep; it wasn't so much grief as a pouring out of some ghastly vomit like a kind of horror, it just came out in all directions ... I remember some of the women were so angry about the death of their loved ones, and the fact that you could not do anything about that and they would be angry about things they still wanted, pounding the floor, sobbing, pulling their hair, banging their heads against the wall. You would sit with a person and, you would rock, literally rock with them in a terrible grief and weeping. It was a weeping in which there were fewer tears than I see in the work now; the weeping seemed to come from their throats, from much lower down, a kind of sobbing. A terrible noise."

After 18 months, Bamber returned to London and her boyfriend Rudi, whom she later married. It was not to be an easy marriage and they separated some years later. She and Rudi had two sons, David and Jonathan. The early years of their marriage were hard going financially and they made frequent visits to the pawn shop, "the tennis racquet going in and out of hock along with the watches and jewellery". Rudi, like Helen, came from a family traumatised by war. On Kristallnacht he had held on to his pistol while he was beaten and his father was murdered. "I remember him saying to me that he would never, ever, carry a gun again. And I think he was saying something about himself and his life, and about the difference between us. He would use his intellect for thinking about issues, but that was all: he would not commit himself to anything; he needed the distance."

Bamber returned to work at the Jewish Refugee Committee: here at least she did not have to explain herself. Here she was head-hunted by Oscar Friedman, from the Committee for the Care of Children from Concentration Camps. Just over 700 children had been allowed into Britain by a government fearful that they would form "a permanent addition to the foreign population competing in the employment market with British subjects", while Ernie Bevin hoped to "confine them to farm labour in order to prevent them from finding openings in commerce". Belton's account of the background of these children is chilling: mostly boys and young men, they had emerged from slave labour at camps such as Auschwitz and Dora-Nordhausen. Before that they had been cooped up in ghettos such as Lodz, where the Nazis forced people to work until they dropped dead. Bamber worked for Friedman and his refugee children until 1950, when she was 25 years old: an old head on young shoulders.

In these days, when no one can do paid work with distressed people unless they have a counselling qualification, it is fascinating to see the way Bamber was appreciated for her skills and experience. She would have liked to have studied medicine but had neither the confidence nor the money, so she chose to work among doctors, hoping that her way forward would become clearer. She took a secretarial post at St George's in the East, a small hospital near her home but was promoted to acting almoner when the post-holder died in childbirth. It was here she met the outspoken idealist Maurice Pappworth, a man who was to introduce her to the shady side of hospital medicine in the 1950s. Like Bamber, Pappworth was a Jew and had suffered from the innate anti-Semitism then prevalent in the higher echelons of British hospital medicine. Although he had passed the examination of the Royal College of Physicians as early as 1936, he was refused a consultant post on the grounds that "no Jew could ever be a gentleman". During the following years Bamber helped Pappworth with his private letters and teaching notes. Belton writes of their relationship:

"Helen chose Pappworth at least as much as she was chosen by him: his influence on her went deep."

Pappworth was a highly able and dedicated physician who took passionate exception to the practice of what would now be classed as unnecessary "invasive" procedures, practised in the name of science. It was exciting work, but certain doctors got carried away and some patients died. Bamber began to understand the dockers' wives fear of "them teaching hospitals - you never know what they'll do to you".

In 1958, when Bamber was in her early 30s, stories of torture began to emerge from Algeria and her belief, shared by so many hopefuls, that never again would human beings deliberately hurt each other, was shattered. Of this realisation, she says: "I could no longer hide behind the bad Germans who had done it all, the idea that it could never happen again."

From this realisation came a new conviction: "I was beginning vaguely to realise that you have to be aware of both, of what causes the release of this incredible capacity for brutality - and this is about privilege and power, certainly - but always, also, the individual who is suffering. If you care only about the latter you may become some Mother Teresa figure, but if you only care about the social causes you are doing Stalinist sociology."

In this understanding, Bamber found a blueprint for her life's work: the marriage between compassion and political action. It is a heady and powerful formula, which in another country could have led to martyrdom.

It was not until the 1970s, however, that Bamber began to work with Amnesty International. Belton's description of the key members of Amnesty during the 1970s and 1980s is absolutely rivetting and confirms my knowledge that so many organisations of dedicated people are torn apart by conflict. In her work with Amnesty, Bamber gravitated naturally to work among the health professionals in the medical group. Belton writes: "Word spread that there were doctors in London who were willing to examine torture victims and to testify on their behalf if they could discover evidence on the body. Lawyers sent refugees to Helen Bamber, who would send them to (surgeon) Betty Gordon or another specialist. Their medical reports would help an application for asylum."

As time went by, Bamber began to see more survivors and talk to them and realised the need for medical and psychological care for these wounded men and women. She was given an old custodian's hut in the basement car park at Amnesty and there, among the petrol fumes, she listened to them. In these early days, many of the survivors were from Pinochet's Chile. From their testimony emerged the story of one of the most famous of the disappeared, the Anglo-Chilean businessman William Beausire.

Bill Beausire, as he was known, was an upper-class Chilean whose father was English. He had two sisters, Juana Francisca and Mary Ann, the second of whom just happened to be the girlfriend of President Salvador Allende's nephew, Andres Pascal Allende. In 1974, the year after the coup, Andres Pascal was head of the banned Revolutionary Left Movement, the MIR. As such, he was a wanted man and Bill Beausire was picked up by the secret police, the Directorate of National Intelligence, in the hope that he would lead them to his sister and hence to the young Allende. He was kept alive for nearly a year, moved from torture centre to torture centre and then, in July 1975, it seems that he was killed.

We know quite a lot about Bill's time in captivity from a woman called Adriana Borquez, a social worker from the south of Chile who was in prison with him for some time in one of the Santiago torture centres. Belton's portrait of the friendship between Bill and Adriana and the sufferings of each of them is extremely moving and must be a classic piece of writing in the saga of Pinochet's Chile. It would make salutary reading for the general's British supporters. For me, it is especially gripping, since my detention was for treating a wounded revolutionary, Nelson Gutierrez, second in command to Andres Pascal, and when I treated Nelson in the house of some American nuns, it was William's sister, Mary Ann, who helped me sterilise my surgical instruments. It is, as they say, a small world.

The last chapter of the book, "Remaking the world", tells the story of Bamber's current work, the treatment of victims of torture. Helen was 61, a year past the retiring age for women, when she embarked upon this project, the mature fruit of her life's work. She and her co-workers, backed by the presidents of the Royal Colleges of Medicine, Surgery and Psychiatry, were given two rooms at the National Temperance Hospital in north-west London: the Medical Foundation for the Care of Victims of Torture had opened its doors. "The centre of it would be a room in which a person's world might be remade - not a new world, because torture can enter too far into the future for that, but at least the existing world made bearable." The room is a holding space, the professionals say, where anger and pain can be acknowledged. Two or more people working intimately in such a room would try to re-enact and reverse what torture does. Above all, the survivors would be allowed to help themselves.

It is hard to believe the numbers of patients who come: to acknowledge that there are so many torture victims in this green and pleasant land. By the early 1990s they were seeing 600 people a year, by 1995, 1,000, and by 1997, 2,000. To do this work, Bamber has gathered together a remarkable band of wounded healers: psychotherapist John Schlapobersky, who worked in South Africa; Antonia Hunt, who had been a refugee in Austria and had worked with Bamber on Uganda and repressive technology. Tom Landau is a retired doctor and a refugee from Hitler's Berlin, Erol Yesilyurt, a former victim of torture in Turkey, and Perico Rodriguez, a former prisoner of conscience in Argentina. Working with them are two English doctors, Gordon Wills and Gill Hinchelwood, who is also a psychoanalyst. And there is John Rundle, an English neurologist, older than the others, who sees his work at the foundation as an expression of good medicine. He tells Belton: "You have to listen to the patient: there is no substitute for that. Of course you also need a broad and deep knowledge of medicine; you should never stop studying, and the last book you read should be the one they prise out of your hands in the coffin ... [But] there are situations no medical school ever trained you for 

... You have to move into the torture chamber with them. Each question makes the situation less ambiguous and clearer. Were you wearing a blindfold? Was there a light? Were you seated? What did they use to hit you? What shape was it? How were your hands tied?" I recognise in this description a parallel with my own work with cancer patients. The combination of careful medical history taking and examination with compassionate, undivided attention is a powerful one, and it is the beginning of healing. At the foundation, treatment is (in Belton's words) "as flexible and imaginative as the ingenious cruelty it undermines. Their clients do not come because they feel their souls have been damaged, but for what seem like practical reasons: they have inexplicable back pains, or acute insomnia and nightmares. They may have been referred by some hospital as when a homeless man picked up off the streets tells a story that horrifies a young doctor. Or they need asylum, because they are terrified of being sent back to Algeria or Iraq. The darker matter often erupts only in the course of dealing with these immediate problems."

Some patients have individual psychotherapy, others are treated in groups. There is a women's psychotherapy group and craft groups of various kinds. I recognise again a parallel with my own work here in Plymouth: we have a drop-in centre where we listen to patients and relatives as they struggle to come to terms with their illness. I run groups for young mothers with breast cancer, who find great support from each other and often form long-standing friendships. This is what is known in the trade as person-centred or holistic care - treating patients as people. When I have to teach doctors and nurses about my work I show them the Chinese character for listening. It is a composite sign. It includes a sign for listening with the ear -you must hear a person's story, but also the tone of their voice, the inflections, the break when they are near to tears. Then there is a sign for the eye - I make eye contact but I also take in the person's dress, face and body posture; people usually change posture dramatically when they are afraid or ashamed. Finally there is a sign for the heart - we must listen with the heart, allow the person's pain to enter into us or vice versa, experiencing it as if it were our own. These are the attributes of the good listener; and my prime exemplar is Helen Bamber.

Sheila Cassidy is a specialist in pyschosocial oncology, Derriford Hospital, Plymouth. She was imprisoned and tortured in Chile for two months in 1975.