Intended for healthcare professionals

Education And Debate Asylum seekers and refugees in Britain

The health of survivors of torture and organised violence

BMJ 2001; 322 doi: (Published 10 March 2001) Cite this as: BMJ 2001;322:606
  1. Angela Burnett (, senior medical examiner,
  2. Michael Peel, senior medical examiner
  1. Medical Foundation for the Care of Victims of Torture, London NW5 3EJ
  1. Correspondence to: A Burnett

    This is the last in a series of three articles

    This final article in the series describes how torture and organised violence may affect the health of survivors. A definition of torture, often used for asylum purposes, is shown in the box. It should be noted, however, that not all those who employ torture are acting in an official capacity.

    United Nations' definition of torture1

    Any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as:

    obtaining from him or a third person information or a confession,

    punishing him for an act that he or a third person has committed or is suspected of having committed,

    or intimidating or coercing him or a third person,

    or for any reason based on discrimination of any kind,

    when such pain or suffering is inflicted by or at the instigation of a public official acting in an official capacity.

    Summary points

    Torture and organised violence are still prevalent in many countries and have previously been experienced by some refugees in the United Kingdom

    The problems of survivors of torture and organised violence are not fully appreciated within the health services

    Survivors of torture may not volunteer their history due to feelings of guilt, shame, or mistrust; consideration must be given to building a relationship of trust

    Much can be done by health workers to alleviate the physical and psychological difficulties that face survivors

    Organised violence is defined as violence which has a political motive. Survivors of torture or organised violence have often been ill treated by government agents such as the army, police, or security forces or other groups perpetrating organised violence, including rebel groups. States have a duty to prevent, investigate, and prosecute cases of torture, but if those who are supposed to do this are themselves the …

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