200. Now, to define what, in light of Article 5(2) of the American Convention, should be understood as “torture,” according to the Court’s case law, an act constitutes torture when the ill-treatment: (a) is intentional; (b) causes severe physical or mental suffering, and (c) is committed with a specific purpose or objective. 272 201. In addition, this Court has indicated that the violation of the right to physical and mental integrity of the individual has different levels of connotation and ranges from torture to other types of abuse, or cruel, inhuman or degrading treatment, the physical and mental consequences of which vary in intensity according to factors that are endogenous and exogenous to the individual (such as duration of the treatment, age, sex, health, context, and vulnerability), which must be analyzed in each specific situation. 273 In other words, the personal characteristics of a supposed victim of torture or cruel, inhuman or degrading treatment, must be taken into account when determining whether his or her personal integrity was violated, because these characteristics can change the individual’s perception of the reality and, consequently, increase the suffering and the feeling of humiliation when subjected to certain types of treatment. 274 202. Moreover, the Court has indicated that, in its capacity as guarantor of the rights established in the Convention, the State is responsible for respecting the right to personal integrity of every individual in its custody. 275 Thus, this Court reiterates that, since the State is responsible for detention centers and prisons, it has the obligation to safeguard the health and well-being of the persons deprived of liberty, and to guarantee that the manner and method of deprivation of liberty does not exceed the inevitable level of suffering inherent in detention. 276 203. In addition, the Court’s case law has indicated that whenever an individual is deprived of liberty in normal health and subsequently displays health problems, the State must provide a satisfactory and credible explanation for this situation 277 and disprove the allegations of its responsibility with adequate probative elements. 278 In circumstances such as those of the instant case, the absence of this explanation leads to the presumption of State responsibility for the injuries revealed by a person who has been in the custody of State agents. 279 the Protection of Victims of Non-international Armed Conflicts (Protocol II), Art. 4.2.a. Cf. Case of Fleury et al. v. Haiti. Merits and reparations, para. 71. 272 Cf. Case of Bueno Alves v. Argentina. Merits, reparations and costs. Judgment of May 11, 2007. Series C No. 164, para. 79, and Case of Fleury et al. v. Haiti, para. 72. 273 Cf. Case of Loayza Tamayo v. Peru. Merits, paras. 57 and 58, and Case of Fleury et al. v. Haiti, para. 73. 274 Cf. Case of Ximenes Lopes v. Brazil. Judgment of July 4, 2006. Series C No. 149, para. 127, and Case of Vélez Restrepo and family members v. Colombia. Preliminary objection, merits, reparations and costs. Judgment of September 3, 2012 Series C No. 248, para. 176. 275 Cf. Case of López Álvarez v. Honduras. Merits, reparations and costs. Judgment of February 1, 2006. Series C No. 141, paras. 104 to 106, and Case of Cabrera García and Montiel Flores v. Mexico. Preliminary objection, merits, reparations and costs. Judgment of November 26, 2010. Series C No. 220, para. 134. 276 Cf. Case of the “Children’s Rehabilitation Institute” v. Paraguay. Preliminary objections, merits, reparations and costs. Judgment of September 2, 2004. Series C No. 112, para. 159, and Case of Díaz Peña v. Venezuela. Preliminary objection, merits, reparations and costs. Judgment of June 26, 2012. Series C No. 244, para. 135. 277 Cf. Case of Juan Humberto Sánchez v. Honduras. Preliminary objection, merits, reparations and costs. Judgment of June 7, 2003. Series C No. 99, para. 100, and Case of Fleury et al. v. Haiti, para. 77. 278 Cf. Case of Juan Humberto Sánchez v. Honduras, para. 111, and Case of Fleury et al. v. Haiti, para. 77. 279 Cf. Case of the “Street Children” (Villagrán Morales et al.) v. Guatemala. Merits, paras. 95 and 170, and Case of Fleury et al. v. Haiti, para. 77. 67

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