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BackgroundTorture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT).MethodsSocio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance.ResultsOf the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study.ConclusionsData showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions.

In the last 6 decades, large sections of the global population have been exposed to ongoing dangers in circumstances of pervasive conflict, violence and trauma. In this article, we revisit the concept of continuous traumatic stress, originally proposed by South African researcher-practitioners to characterize mental health conditions and challenges under apartheid, and explore its viability as an alternative and supplementary framework for understanding and addressing exposure to situations of ongoing threat. The article highlights the political and mental health limitations associated with the dominance of posttraumatic stress conceptualizations of these forms of human suffering and distress, and calls for more nuanced and complex understandings of such complicated psychosocial conditions and their effects. It concludes by foregrounding several critical debates related to continuous traumatic stress, namely, the importance of understanding contexts of ongoing exposure to danger as both political and psychological (psychopolitical) in nature; of developing socially relevant clinical and conceptual models that can meaningfully account for the varied impacts of, and responses to, these conditions of continuous threat; and the need to extend our intervention practices to include culturally and contextually appropriate intervention strategies that are both clinical and psychosocial in orientation.

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and the University of the Witwatersrand The mental health of torture survivors is most commonly conceptualized in terms of posttraumatic stress disorder (PTSD) and related theory. This body of work is based on the assumption that the trauma is in the past and that care takes place in a relatively safe environment. However, many torture survivors in Africa live in extremely precarious situations and their mental health must also be understood in relation to the continuous traumatic stress under which they live. In this paper, I present a narrative analysis of interviews with torture survivors and their counselors. These narratives draw on constructs relating to PTSD, as well as to those associated with continuous traumatic stress. A descriptive framework of continuous traumatic stress in torture survivors is developed from the narratives and its implications for counseling are discussed.