The epidemiology of torture: a case series of 58 survivors of torture.
INTRODUCTION/CONTEXT: Torture is widely practiced throughout the world and, yet, the ways by which torture is perpetrated, its regional similarities and differences, is not well understood. Our goal for this cases series was to elucidate the methods of torture practiced within different countries to both add to and expand upon previous research. This knowledge is important since it can buttress efforts to assist with torture survivors' recovery--medically, psychologically, and legally.


METHODS
Fifty-eight survivors of torture who presented to a single interviewer over a 15-year period (1990-2005) for purposes of assisting with their claim for political asylum in the U.S. were enrolled into the study. The survivors' legal affidavits were examined and both quantitative and qualitative data were extracted for analysis. This data included the following: (1) duration, condition, and frequency of imprisonment, (2) abductors' affiliation and dress, (3) torture type, method, and frequency (both physical and mental), and (4) qualitative description of above items.


RESULTS
Twenty-three countries were represented in the sample covering six major world regions. Women appear to be at greater risk for sexual torture than men. Sub-Saharan Africans tend to have more abuse compared to other world regions. Furthermore, the length of confinement also appears to trend towards longer duration in those survivors from Sub-Saharan African countries. Certain types of torture were almost universal in their application such as threats of death and beatings, but the manner by which survivors were beaten varied considerably, with hitting/kicking and beating with a stick/baton being the most common. There was no correlation between types of torturous acts and religion.


CONCLUSIONS
This case series confirms some earlier findings about regional similarities and differences in torture methodology. Study results built upon previous studies as well as uncovered new findings suggesting that more work needs to be done. Further, our results will help survivors of torture with their recovery both through improved patient care outcomes and by impacting upon the way asylum cases are adjudicated.
Department of Family and Community Medicine, Medical College of Wisconsin, 1121 E. North Ave, Milwaukee, WI 53212, USA. jsanders@mcw.edu
James
J
Sanders
Melissa Wagner
MW
Schuman
Anne M
AM
Marbella
D003068:Coercion; D054242:Emigrants and Immigrants; D005006:Ethnicity; D005260:Female; D006076:Government; D006801:Humans; D008297:Male; D008722:Methods; D011057:Politics; D011330:Prisons; D044469:Racial Groups; D011902:Rape / Q000706:statistics & numerical data; D012067:Religion; D012189:Retrospective Studies; D012494:Sampling Studies; D012737:Sex Factors; D017741:Survivors; D014104:Torture / Q000523:psychology / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology