Repercussions of Torture

A STUDY OF CHILEAN REFUGEE CHILDREN IN DENMARK

In a refugee camp for Kashmiris it was stated that children had been exposed to torture and ill-treatment; consequently, we decided to appraise the validity of such statements. Ten boys allegedly exposed to torture and 10 children who were said to have been ill-treated were interviewed and examined. The veracity of the individual statements about exposure was appraised through an assessment of the consistency between the history and the clinical findings. In all cases of alleged torture, the history was in agreement with clinical findings ascribed to torture. Torture methods included cuts with bayonets and burns with items easily available in any setting. In five of the 10 cases of torture, the scars were highly indicative of intentionally inflicted injuries, by their shapes, their presence in clusters and their localization in regions not normally exposed to traumatization. Nine of the 10 children allegedly exposed to ill-treatment had scars in accordance with their histories. In all cases, Indian security forces were said to have been responsible for the inflicted violence. The histories and the clinical findings were in accordance with results of examinations of adult victims of organized violence from the same region. On the basis of the physical evidence, in each case in agreement with the history, it is concluded that torture of children has occurred in Kashmir. Series of children with physical evidence of torture have not previously been described in the medical literature.

The effect of forced disappearance on the physical and psychological health of family members was assessed by interviews carried out in Honduras. Families of the disappeared were compared with two control groups: (1) families who lost a member due to accident or illness; and (2) families where no one had died within the past 10 years. Constellations of stress-related symptoms commonly seen in post-traumatic stress disorder and other anxiety disorders were approx. 2 times more prevalent in families of the disappeared as compared to the other two groups, indicating that families of the disappeared suffer over and above that due to normal grieving. It is suggested that the atmosphere of fear and isolation experienced by families of the disappeared is a causative factor in the prolongation of stress-related disorders years after the traumatic event.

We undertook a systematic search and review of individual, family, community, and societal risk and protective factors for mental health in children and adolescents who are forcibly displaced to high-income countries. Exposure to violence has been shown to be a key risk factor, whereas stable settlement and social support in the host country have a positive effect on the child's psychological functioning. Further research is needed to identify the relevant processes, contexts, and interplay between the many predictor variables hitherto identified as affecting mental health vulnerability and resilience. Research designs are needed that enable longitudinal investigation of individual, community, and societal contexts, rather than designs restricted to investigation of the associations between adverse exposures and psychological symptoms. We emphasise the need to develop comprehensive policies to ensure a rapid resolution of asylum claims and the effective integration of internally displaced and refugee children.