Evaluating Asylum Seekers/Torture Survivors in Urban Primary Care: A Collaborative Approach at the Bronx Human Rights Clinic

Abstract

Primary care providers who evaluate torture survivors often lack formal training to identify and address their specific needs. We assessed 89 asylum seekers from 30 countries to evaluate the pattern, spectrum, and presentation of abuses and the outcomes of the medico-legal process of seeking asylum. Commonly reported reasons for abuse were political opinion/activity (59%), ethnicity (42%), and religion (32%). The most common means of abuse were punching/kicking (79%), sharp objects (28%), genital electric shock (8%), witnessing murder/decapitation (8%), and rape (7%). Persistent psychological symptoms were common; 40% had post-traumatic stress disorder. The high success rate of asylum approval (79%) in this sample highlights the need for physician witnesses trained in identification and documentation of torture, working in collaboration with human rights organizations.

Survivors of Torture: Prevalence in an Urban Emergency Department

“…The questions rely on self‐reporting and are quickly administered. Self‐reporting has been demonstrated to have a sensitivity of 82% and a specificity of 92% 32,33 . Family is included in this screening instrument, as physical torture is frequently directed toward family members to inflict psychological terror and coerce subjects 34,35 .…”

Common mental health problems in immigrants and refugees: general approach in primary care

“…12 Table 1 lists some of the migration-related factors that influence mental health and that can be explored in a clinical assessment. [12][13][14][15][16][17][18][19][20][21][22][23] The effect of these factors varies greatly with their severity and with their specific meaning for patients, their families and their communities, as well as for the wider society. Postmigration factors that moderate the effects of premigration stress and that ensure employment and economic stability are especially important in ensuring good health outcomes.…”

Diagnosis of torture after 32 years: Assessment of three alleged torture victims during the 1980 military coup in Turkey

“…Electrical torture is practiced on fingers or toes, tongue, earlobes, nipples, and genitalia [6,7,15,17,[22][23][24][25]. The cases described electrical torture to their fingers, toes, and penis more than once.…”