Taking History of Torture

Political Violence as Health Disparity

Among the health disparities prevalent among asylum seekers, refugees and immigrants is a history of political violence in the form of imprisonment, war fare, interrogation, threats and torture.  You will find that this experience is shared by Vietnamese survivors of the re-education camps, Egyptian students, gay men from Pakistan, Ethiopian shopkeepers, Angolan obstetricians, and the political opposition from Congo. In the diversity of occupation, gender and ethnicity is a shared experience of a violent suppression of democracy that plays itself out in their lives through dislocation, chronic pain and disease, sometimes for decades. 

We developed materials about taking torture histories because our residents told us they were uncomfortable broaching this topic during a routine history and had never seen this kind of history-taking modeled. They felt it was irrelevant to the chief complaint and intrusive, after all there is no clinical intervention for history. But we have found otherwise, that knowing a person’s torture experience can make sense of disjointed symptoms, explain the significance of certain symptoms or diseases and their linkages, help to forge a therapeutic relationship, and make sure we “do no harm.”

We first introduced some of these materials in 2012, but since that time our experience with torture survivors and asylum seekers has broadened and deepened. We have just released a new resource on EthnoMed, Taking a History of Torture, which reflects that experience. This collection of videos and related material emphasizes the relevance of torture histories to the ongoing care of torture survivors and their symptoms and chronic conditions.

Most of the survivors who graciously offered up their stories for educational purposes were detained and abused because they acted on behalf of, or spoke up for, their fledgling democracies and for democratic principles, either as part of the Arab Spring or as political organizers or sympathizers. This is a disparity in experience only a small minority of Americans have had, although sadly much more common among Native and Black Americans.

Please note that these materials are difficult to watch. They are a stark reminder of the true cost for many of participatory democracy.