Evaluating asylum seekers/torture survivors in urban primary care: a collaborative approach at the Bronx Human Rights Clinic.

Primary care providers who evaluate torture survivors often lack formal training to identify and address their specific needs. We assessed 89 asylum seekers from 30 countries to evaluate the pattern, spectrum, and presentation of abuses and the outcomes of the medico-legal process of seeking asylum. Commonly reported reasons for abuse were political opinion/activity (59%), ethnicity (42%), and religion (32%). The most common means of abuse were punching/kicking (79%), sharp objects (28%), genital electric shock (8%), witnessing murder/decapitation (8%), and rape (7%). Persistent psychological symptoms were common; 40% had post-traumatic stress disorder. The high success rate of asylum approval (79%) in this sample highlights the need for physician witnesses trained in identification and documentation of torture, working in collaboration with human rights organizations.