BackgroundTorture continues to be a global problem and there is a need for prevention and rehabilitation efforts. There is little available data on torture survivors from studies designed and conducted by health professionals in low income countries. This study is a collaboration between five centres from Gaza, Egypt, Mexico, Honduras and South Africa who provide health, social and legal services to torture survivors, advocate for the prevention of torture and are part of the network of the International Rehabilitation Council for Torture Victims (IRCT).MethodsSocio-demographic, clinical and torture exposure data was collected on the torture survivors attending the five centres at presentation and then at three and six month follow-up periods. This sample of torture survivors is presented using a range of descriptive statistics. Change over time is demonstrated with repeated measures analysis of variance.ResultsOf the 306 torture survivors, 23% were asylum seekers or refugees, 24% were socially isolated, 11% in prison. A high level of traumatic events was experienced. 64% had suffered head injury whilst tortured and 24% had ongoing torture injury problems. There was high prevalence of symptoms of anxiety, depression, post traumatic stress as well as medically unexplained somatic symptoms. The analysis demonstrates a modest drop in symptoms over the six months of the study.ConclusionsData showed that the torture survivors seen in these five centres had high levels of exposure to torture events and high rates of clinical symptoms. In order to provide effective services to torture survivors, health professionals at torture rehabilitation centres in low income countries need to be supported to collect relevant data to document the needs of torture survivors and to evaluate the centres' interventions.

Moving from socio-ecological perspectives, our work aims to explore and analyse the synergy of public healthand human rights-informed frameworks in the provision of mental health services in The Gaza Strip, a context characterised by war, trauma, and human rights violations over the past several decades. We discuss issues related to human rights violations and link these to the primary, secondary, and tertiary levels of prevention in public mental health. Two case studies about families affected by war and violence in 2009 will be analysed to highlight how human rights issues are deeply embedded in interventions aimed at promoting functioning and subjective wellbeing in individuals and families living in conditions of chronic uncertainty. Working with families affected by ongoing political violence requires constant attention to human rights, which goes beyond psychotherapeutic and psychobiological interventions. Mental health services help communities living under occupation by developing resilience and survival skills throughout participative approaches. Directions for clinical work and research are discussed. Key Points1 In conflict zones, family and community are severely affected and rendered dysfunctional. 2 Ecologically and culturally informed family and community-based interventions promote salutogenesis and healing processes within the community. 3 Fostering resilience occurs in the service of human rights and allows citizens to function optimally under the present traumatic reality. 4 Working with families affected by ongoing political violence requires constant attention to human rights. 5 A synergistic approach to human rights and public mental health can reduce symptoms of psychopathology and create active and engaged citizens.

No abstract

No abstract