Victims of General Pinochet's regime are among those the Medical Foundation for the Care of Victims of Torture seeks to help. As the former Chilean dictator waits to hear whether he will be extradited, Wendy Moore reports on its work

General Augusto Pinochet may want to put the past behind him, but for the victims of torture under his dictatorship in Chile, lasting pain provides a constant reminder.

'Pain from injuries can sometimes be alleviated - although often not - but the psychological effects of torture, loss and exile can be devastating, ' says Helen Bamber, director of the Medical Foundation for the Care of Victims of Torture.

Some of the Chileans the charity helps are severely disabled from their injuries. One man, who died of a heart attack not long ago, was confined to a wheelchair because the rod inserted to straighten his spine after childhood polio broke under torture.

Most still complain of pain - the legacy of being suspended by their hands tied behind their backs, beatings on the soles of their feet and repeated electrocution.

But often most destructive are the emotional after-effects of such systematic, sophisticated torture. After being beaten and electrocuted for many months, one Chilean since helped by the foundation was put in front of a firing squad. The guns fired blanks.

Doctors may call the psychological symptoms depression, anxiety and grief. But Mrs Bamber says: 'There are no clinical words for that suffering. It is a very deep, profound form of suffering that people who have been tortured carry with them.'

The arrest of General Pinochet and the Lords hearing of his appeal against extradition to Spain - due to report shortly - has reopened many mental wounds. Forcing Pinochet to face justice might help heal them, believes Mrs Bamber. 'It would be healthy for them, ' she says.

Now aged 73, Mrs Bamber has spent her life fighting cruelty. At 20, she was a member of one of the first relief teams to reach Belsen after the war and helped evacuate children with TB.

Herself Jewish, she later worked with children orphaned at Auschwitz. She began helping victims of torture after joining Amnesty International in the 1960s. But the long-term medical needs of the refugees grew too much for a small unit without administrative back-up.

She set up the foundation in 1986 with the help of a surgeon, Elizabeth Gordon, and a hospital manager, Neil Evans, now a priest. It is still the only service for victims of torture in Britain, providing a breadth and depth of care simply not available on the NHS.

Today its team of more than 100 paid and volunteer clinicians treats torture victims from more than 90 countries.

Clients, almost all refugees, now come from Iran, Iraq, Turkey, Sri Lanka, Kenya and Columbia.

But as well as helping Chileans who arrived after 1973, the charity also still supports survivors of the Holocaust and British soldiers tortured by the Japanese in the Second World War.

'I don't believe, from my experience of working with Holocaust survivors and British Far East prisoners, that time necessarily alleviates, ' says Mrs Bamber. 'Actually it often compounds.'

But while the foundation cannot erase memories, it does help people rebuild their lives, through medical care, counselling and practical support with housing, immigration and welfare rights.

Family therapists work with children who have seen their parents abused or humiliated. A writer is helping a group of Chileans in Sheffield to describe their memories and help explain the past to their children. Often documenting the abuse is the first step, says Dr Gill Hinshelwood, a physician and psychoanalyst.

She treats women - and some men - who have been raped or sexually abused. 'A lot of people don't want to talk about it, ' she says. 'They are much, much better if they do.'

Many women survivors feel permanently damaged or diseased after rape yet - like many victims of torture - feel unable to seek the help they need from the NHS.

Often, says Dr Hinshelwood, torture victims visit their GPs with one complaint after another. They never reveal the real source of their pain and GPs are often too busy to find out.

Torture victims can feel their bodies are no longer part of them. They may complain of pain where electrodes have been applied, yet doctors can find no damage.

Some people are referred to NHS services. More often it is GPs who refer to the foundation. Dr Brian Fisher, a south London GP who has supported the charity since the start, often sends patients for help.

'We are being overwhelmed still with refugees - more so than ever, ' he says.

In the '70s he referred patients from Chile. Today they are from Turkey and Eritrea, but with the same symptoms of pain, caused by beatings and electrocution, and profound depression from 'serial humiliation'.

Many are anxious about talking, he says, especially to doctors who they see as perpetrators of pain, not healers. Mrs Bamber feels there is some collusion by the NHS.

'People don't want to hear about torture and people don't want to speak about it, ' she says. She sees the foundation as providing stepping stones for people to move on from their past.

Many do succeed in finding new jobs and carving out new careers.

'We have many people for whom we can celebrate, ' she says. 'It is not impossible to heal. It is impossible to forget.'