title: Asylum seekers alleging torture in their countries: Evaluation of a French center.
abstract: METHODS
  Over a 6-year period, 570 survivors gave consent to this study and were examined by forensic medical doctors in academic French hospital. They evaluated with the aim of cataloguing the physical evidence of torture. Sociological data, declared violence (single physical altercation, repeated physical violence less than one year or more than one year, incarceration not more than one week or more than 1 week), and method of violence (blows by blunt object, crushing, burns, electrical shocks, attempted drowning, smothering, incision, or gunshot) were studied. An association between victims' statements and physical evidence of torture was determined.
  
  
  RESULTS
  70% were male with an average age of 31.9 years and ages between 1 and 70 years old. Dagestan, Guinea-Conakry and Guinea-Bissau were the countries most represented among asylum seekers. Beatings were reported by 27.89%, confinement was reported by 40.22%, and repeated violence by 30.16% of refugees. The average time interval between the first assault and forensic evaluation was 53 months. Forms of torture reported included: blunt force trauma (82.51%) truncheon blows (27.50%), arm incision (30%), and burns (16.3%). Statistically, truncheon blows were experienced more often by males in confinement due to political conflict. The use of crushing methods and electrical shocks also were experienced more often by males during confinement. Victims who had received incision wounds were significantly younger. Gunshots were statistically associated with male survivors of political conflict. Men experienced drowning and electrical shocks while in confinement in the Balkans, Asia, and Russia. Electrical shocks were reported by males during confinement and in northern Caucasus countries. The association was significant between assertions of burns and the presence of cutaneous scars (p = 0.0105); similarly, assertions of incision wounds were significantly corroborated by evidence of scars (p = 0.0009).
  
  
  CONCLUSIONS
  Asylum seekers assessed were usually young men. Beatings with blunt objects were the most often reported form of torture used during episodes of repeated violence and during confinement. Assertions of burns were not associated with any particular circumstances. Electrical shocks were reported during confinement and most often in countries of the northern Caucasus. Attempted drowning, smothering, and shocking were noted, but these methods typically do not leave physical evidence. Wounds resulting from burns and incisions usually leave scars that corroborate refugee statements. Torture by crushing and gunshot were reported by asylum seekers for the first time.
  
  
  CONCLUSIONS
  Investigation of the types of torture and circumstances under which torture occurs is critical for efficient forensic evaluation of claims of torture experienced by asylum seekers.
authors.affiliation: Laboratory of Forensic Medicine, Faculty of Medicine, 1 Rue Gaston Veil, 44035 Nantes Cedex, France; Unit of Forensic Medicine, Chu de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France. Electronic address: renaud.clement@univ-nantes.fr.
authors.forename: Renaud
authors.initials: R
authors.lastname: Clément
authors.affiliation: Unit of Forensic Medicine, Chu de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France.
authors.forename: David
authors.initials: D
authors.lastname: Lebossé
authors.affiliation: Unit of Forensic Medicine, Chu de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France.
authors.forename: Lucia
authors.initials: L
authors.lastname: Barrios
authors.affiliation: Laboratory of Forensic Medicine, Faculty of Medicine, 1 Rue Gaston Veil, 44035 Nantes Cedex, France; Unit of Forensic Medicine, Chu de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rodat
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004597:Electroshock / Q000706:statistics & numerical data; D005260:Female; D005554:Forensic Medicine; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010808:Physical Examination; D012036:Refugees / Q000706:statistics & numerical data*; D014104:Torture / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult
keywords: Asylum seekers; Physical assessment; Scars; Tortures