The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62446

Ramin G. Asgary, MD, MPH¹, Eva E. Metalios, MD¹, and Lanny Smith, MD, DTMH, MPH². (1) Dept of Social Internal Medicine, and Doctors of the World, Montefiore Medical Center, Albert Einstein College of Medicine, 305 East 161st Street, Bronx, NY 10451, (718)579-2500, rasgary@montefiore.org, (2) Albert Einstein College of Medicine, P.O. Box 672444, Bronx, NY 10467

Background: The Human Rights Clinic (HRC) at Montefiore Medical Center/Doctors of the World has been evaluating and supporting torture survivors since 1993, and is the only program in the US incorporating residency training in its mission. Methods: We reviewed files to assess the pattern of human rights abuses experienced by 89 consecutive clients from 30 countries presenting to the HRC from June1998 to September 2002. Results: Mean age was 34 (±8.0); 13% female. 76% were married; 57% had children. 87% were tortured multiple times; 72% (52/72) had been imprisoned; 65% (48/74) reported torture of family members. Mean years from first torture to US entry was 5.5 (± 4.6). Political opinion/activity (60%), ethnicity (43%), religion (33%) were the most common reasons for torture. Abusers were mostly police and military. The most common means used were punching/kicking (80%) and sticks/batons (65%). Other means of torture included: denial of food/water (29%), penetrating weapons (26%), burns (26%), breaking bones (12%), genital electric shock (8%), water submersion (8%), witnessing murder/decapitation (8%), rape (7%), gun shot (4%), family member rape (3%), and being in a cell with a corpse (2%). Most common current psychological symptoms were difficulty sleeping (52%), nightmares (48%), sadness (29%), flashbacks (29%), avoidance (21%), and difficulty concentrating (12%). Scars were documented in 87% [mean length 4.8 cm (±3.7)] and deformity in 19%. PTSD was diagnosed in 40%. Conclusion: Our findings demonstrate the broad range of human rights abuses experienced by asylum seekers, and suggest themes relevant to their evaluation by their physician advocates.

Learning Objectives:

• 1. Recognize the prevalence and spectrum of human rights abuses among asylum seekers, and identify clinical presentations of torture survivors among immigrant populations.
• 2. Gain an understanding of the specific characteristics of torture, and evaluate the physical and psychological complaints of torture survivors
• 3. Develop training for primary care providers in evaluating torture survivors and addressing their specific medical needs.

Keywords: Torture, Human Rights

Related Web page: www.doctorsoftheworld.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Doctors of the World
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.