ASYLUM SEEKERS: SKIN AND TORTURE

Morrone A., Franco G., Toma L., D’Arca T., Tumiati C., Latini O.

21° WORLD CONGRESS OF DERMATOLOGY
Buenos Aires, September 30 – October 5 2007

BACKGROUND
The torture is a social and political issue more and more prominent in the society. It may be considered a public health emergency, because usually affect people at risk of social exclusion , especially applicants for political asylum, illegal immigrants and the homeless.
The dermatologist frequently observes the physical consequences of torture for the first time, sometimes by mere change.
During this years, people migrating from one country to other are increasing, and a dermatologist could often see cutaneous lesions that are difficult to explain. These findings sometimes may be similar to common diseases, even if the etiopathogenesis is different: these are a sequelae caused by tortures.
MATERIAL AND METHODS
San Gallicano Institute has been participating to European Project “Italian Network for the rehabilitation of the victim of torture” since 1st November 2001 as Center for psychological, physical and social rehabilitation of the victim of torture.
The patients referring to our Center received assistance from a multidisciplinary team composed by dermatologists, physicians, psychologists, linguistic-cultural mediators, in order to support them both physically and psychologically.
For each patient, the clinical examination was carried out according to the guidelines of Istanbul Protocol. The skin lesions were observed and linked to the type of torture, listening to the clinical history also.
RESULTS
Until the 31 December 2006, 1,134 asylum seeker/refugees has been observed. 51% of them presented sequelae of tortures. In particular cutaneous lesions observed could be classified in 4 type: scar, from prolonged immobilization in a unnatural position, from rape, from psychological harm.
CONCLUSION
We underline the importance and the role of dermatologist in the diagnosis of torture-related cutaneous lesions. Aim of the clinical examination is not only to find the skin lesions that could be linked to the tortures referred by the patients, but also to exclude that those lesions have been due by other causes. Therefore, the dermatological examination has a central role in the determination of the status of victim of torture and in the concession of the political asylum.
REFERENCES
1. UN OFFICE OF THE HIGH COMMISSIONER FOR HUMAN RIGHTS, Professional training series no 8: Istanbul protocol - manual on the effective investigation and documentation of torture and other cruel, inhuman or degrading treatment or punishment, New York, United Nation Publication, 1999
2. DANIELSEN L, RASMUSSEN OV., Dermatological findings after alleged torture. Torture. 2006;16(2):108-27.
3. ROUTH HB, PARISH LC, LA SEN S, BHOWMIK B., Skin torture, Clin Dermatol. 2005 May-Jun;23(3):307-9