Patterns of torture among forcibly displaced Eritreans in California: A cross-sectional study

Autores/as

  • P. Suzanne Portnoy, D.N. P. Northern California Human Rights Clinic and CommuniCare Health Center
  • Alejandro Diaz, M.D. Northern California Human Rights Clinic
  • Jenna Kupa Northern California Human Rights Clinic
  • Isabelle Rocroi, B.A. Northern California Human Rights Clinic
  • Emily Tatel, FNP-C University of California, San Francisco
  • Kala Mehta, DSc, MPH University of California, San Francisco School of Medicine
  • Nicholas Nelson, M.B.B.S. Northern California Human Rights Clinic

DOI:

https://doi.org/10.7146/torture.v31i1.121786

Palabras clave:

asylum seekers, tortures, physical assessment, scars

Resumen

Abstract

Introduction: Unprecedented global increases in involuntary migration have created large populations of forcibly displaced people, who are disproportionately likely to have experienced abuse and torture. We undertook this study to better understand the frequency and consequences of specific types of torture and abuse within an immigrant population in our community, San Francisco, East Bay.

Methods and Results: We conducted a cross-sectional study of 59 Eritreans seeking asylum in the United States presenting to a human rights clinic for forensic medical and psychological evaluations. Demographic features of individuals, reported history and specific types of torture, and physical and psychological sequelae were analyzed. Over 300 instances of torture were reported, an average of about 6 per person. The primary forms of torture reported were beating and forced positioning, and many others were reported sporadically. 90% of asylum seekers examined had clinical findings which were consistent with the torture they reported, and some physical findings had clinical as well as forensic significance. 86% met diagnostic criteria for post-traumatic stress disorder.

Discussion: Forcibly displaced people are likely to have witnessed and experience violence, deprivation, and abuse, and for this reason bear a disproportionate burden of physical, psychological, and social morbidity. Our study describes the epidemiology of torture and its consequences in a specific population, and demonstrates why understanding local and general epidemiology of torture and other forms of abuse is necessary to provide excellent biopsychosocial care to forcibly displaced people.

Biografía del autor/a

P. Suzanne Portnoy, D.N. P., Northern California Human Rights Clinic and CommuniCare Health Center

Suzanne Portnoy is a board-certified family nurse practitioner. She received her master’s degree from Samuel Merritt University (2011) and her doctorate in nursing practice from Oregon Health & Science University (2017). She is trained on forensic asylum examination by Physicians for Human Rights. In 2014, she began performing medical and psychological forensic asylum evaluations at the Highland Human Rights Clinic. In 2018, she joined Richard Fine People’s Clinic at Zuckerberg San Francisco General Hospital. In addition to performing forensic evaluations, Suzanne works to build community capacity by training clinicians on forensic exam techniques and mentoring peers one-on-one.

Alejandro Diaz, M.D., Northern California Human Rights Clinic

Alejandro Díaz, MD 
Attending Physician Department of Medicine
Director Community Outreach & Home Visit Program | Internal Medicine Residency Program
Associate Medical Director | Highland Human Rights Clinic
Highland Hospital
1411 East 31st Street | Oakland, CA 94602
(510)535-7689 (Office) | (510)718-5218 (Pager)

Jenna Kupa, Northern California Human Rights Clinic

Jenna Kupa is a senior at Tufts University in Boston.  She has been accepted into Tufts Unversity Medical School with matriculation date of September 2021.  Ms. Kupa was a research assistant on the project.

Isabelle Rocroi, B.A., Northern California Human Rights Clinic

Isabelle Rocroi graduated Summa Cum Laude with a Bachelor of Arts Chemistry from Barnard College in New York. She is currently working as a research assistant in the University of Oxford, Department of Psychiatry.  Ms. Rocroi was a research assistant for this project.

Emily Tatel, FNP-C, University of California, San Francisco

Emily is a nurse practitioner specializing in women's health and documentation and management of female genital cutting. She was a contributing author to this research and an active member of the Highland Human Rights Clinic.

Kala Mehta, DSc, MPH, University of California, San Francisco School of Medicine

Associate Professor, Epidemiology & Biostatistics
University of California,San Francisco School of Medicine
550 16th. Street
San Francisco CA 94158
415-205-8780
Kala.Mehta@ucsf.edu

 

Kala is an Associate Adjunct Professor in the Department of Epidemiology and Biostatistics at the University of California, San Francisco. Kala also teaches clinical research methods to undergraduates, medical students, residents, fellows, and international faculty. She uses different styles in her teaching including traditional ‘brick and mortar’ as well as cutting-edge online education technologies. She is also faculty of the SFBUILD, a pipeline program to promote diversity in science. In this program she works with undergraduate students, teaches them clinical research skills, and then works with them to find research placements in labs at UCSF and San Francisco State University.

In terms of research, Kala focuses on both domestic and international vulnerable populations. Her early work examines disparities in older adult health. Her more recent work focuses on the intersection of social entrepreneurship and health in a global context. From 2011-2014, she was a faculty affiliate of the Stanford Graduate School of Business, where she led a research evaluation on the impact of a management and transportation intervention on health in Zambia. Her current research evaluates a large maternal and child health intervention in Bihar, India.

Kala received her DSc. in Epidemiology from the Erasmus University Medical School in Rotterdam, the Netherlands, and has obtained post-graduate specialization in epidemiology and clinical research from the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.

Nicholas Nelson, M.B.B.S., Northern California Human Rights Clinic

Highland Hospital Internal Medicine Resident Training Program, Core Faculty
Medical Director, Human Rights Clinic
Affiliated Faculty, Berkely Center for Social Medicine
Assistant Clinical Professor of Medicine, UCSF

Citas

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Publicado

2021-05-11

Cómo citar

Portnoy, P. S., Diaz, A., Kupa, J., Rocroi, I., Tatel, E., Mehta, K., & Nelson, N. (2021). Patterns of torture among forcibly displaced Eritreans in California: A cross-sectional study. Torture Journal, 31(1), 53–63. https://doi.org/10.7146/torture.v31i1.121786