'A random system'

Introduction: This article addresses the provision of rehabilitation services for torture victims with a refugee background in Norway. It engages the topic from the outset of relevant rehabilitation rights and duties, presenting the organisation of rehabilitation services within the Norwegian health care system, and exploring the challenges and opportunities professionals see and experience as they seek to provide adequate treatment and rehabilitation for torture victims. Methods and material: The article is based on qualitative interviews with 46 experts and practitioners that contribute to or otherwise focus on treatment and rehabilitation for torture victims in Norway, conducted between March and August 2019. Findings and discussion: Rehabilitation services for torture victims in Norway are fragmented, and the resulting practice is highly person dependent. Public services are characterised by insufficient knowledge about torture injuries and rehabilitation and a generalised lack of familiarity with international protocols for identification and documentation of torture. Moreover, the quality of rehabilitation services suffers from a lack of coordination and inclusion of actors that can contribute to comprehensive rehabilitation processes. Conclusion: Individuals with a refugee background are far from guaranteed adequate rehabilitation for torture-related injuries in Norway. Rehabilitation services suffer from the absence of a systematic approach to identification and documentation, and an unclear division of responsibilities. Three recommendations are proposed in order to ensure minimum standards in rehabilitation services for this group: 1) developing and implementing a national plan of action on torture rehabilitation; 2) knowledge and capacity-building within relevant educational programmes, the national health services and other relevant public sector services; and 3) strengthening and institutionalising interdisciplinary communities of practice with specialised expertise on the topic at all relevant levels.