Rehabilitation of torture survivors in five countries: common themes and challenges.
BACKGROUND
Torture 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).


METHODS
Socio-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.


RESULTS
Of 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.


CONCLUSIONS
Data 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.
McColl
Helen
H
International Rehabilitation Council for Torture Victims, Borgergade 13, P.O. Box 9049, 1022 Copenhagen K., Denmark.
Higson-Smith
Craig
C
South African Institute for Traumatic Stress, 302 Ideal Village, 30 Hannaben Street, Johannesburg 2198, South Africa.
Gjerding
Sarah
S
International Rehabilitation Council for Torture Victims, Borgergade 13, P.O. Box 9049, 1022 Copenhagen K., Denmark.
Omar
Mostafa H
MH
El Nadim Centre for the Management and Rehabilitation of Victims of Violence, 3A Soliman El Halabi Street from Rasmis Street, Cairo, Egypt.
Rahman
Basma Abdel
BA
El Nadim Centre for the Management and Rehabilitation of Victims of Violence, 3A Soliman El Halabi Street from Rasmis Street, Cairo, Egypt.
Hamed
Mona
M
El Nadim Centre for the Management and Rehabilitation of Victims of Violence, 3A Soliman El Halabi Street from Rasmis Street, Cairo, Egypt.
El Dawla
Aida S
AS
El Nadim Centre for the Management and Rehabilitation of Victims of Violence, 3A Soliman El Halabi Street from Rasmis Street, Cairo, Egypt.
Fredericks
Miriam
M
Trauma Centre of Survivors of Violence and Torture, Cowley House, 126 Chapel Street, Woodstock 7925, Cape Town, South Africa.
Paulsen
Nicole
N
Trauma Centre of Survivors of Violence and Torture, Cowley House, 126 Chapel Street, Woodstock 7925, Cape Town, South Africa.
Shabalala
Gugu
G
Trauma Centre of Survivors of Violence and Torture, Cowley House, 126 Chapel Street, Woodstock 7925, Cape Town, South Africa.
Low-Shang
Carmen
C
Trauma Centre of Survivors of Violence and Torture, Cowley House, 126 Chapel Street, Woodstock 7925, Cape Town, South Africa.
Perez
Fernando Valadez
FV
Collective Against Torture and Impunity, Pitágoras 1210, 16 Col. Del Valle, 03100 Mexico DF, Mexico.
Colin
Liliana S
LS
Collective Against Torture and Impunity, Pitágoras 1210, 16 Col. Del Valle, 03100 Mexico DF, Mexico.
Hernandez
Aurora D
AD
Collective Against Torture and Impunity, Pitágoras 1210, 16 Col. Del Valle, 03100 Mexico DF, Mexico.
Lavaire
Eliomara
E
Centre for Prevention, Treatment and Rehabilitation of Victims of Torture and their Relatives, Col. La Reforma, Calle Principal 109, Contiguo a Centro IDEAL, Tegucigalpa M.D.C., Honduras.
Zuñiga
Arely Pa
AP
Centre for Prevention, Treatment and Rehabilitation of Victims of Torture and their Relatives, Col. La Reforma, Calle Principal 109, Contiguo a Centro IDEAL, Tegucigalpa M.D.C., Honduras.
Calidonio
Lucia
L
Centre for Prevention, Treatment and Rehabilitation of Victims of Torture and their Relatives, Col. La Reforma, Calle Principal 109, Contiguo a Centro IDEAL, Tegucigalpa M.D.C., Honduras.
Martinez
Carmen L
CL
Centre for Prevention, Treatment and Rehabilitation of Victims of Torture and their Relatives, Col. La Reforma, Calle Principal 109, Contiguo a Centro IDEAL, Tegucigalpa M.D.C., Honduras.
Jamei
Yasser Abu
YA
Gaza Community Mental Health Programme, Sheikh Ejleen-El Rasheed Street, P.O. Box 1049, Gaza City, Gaza Strip, Palestinian Occupied Territories.
Awad
Zeyad
Z
Gaza Community Mental Health Programme, Sheikh Ejleen-El Rasheed Street, P.O. Box 1049, Gaza City, Gaza Strip, Palestinian Occupied Territories.