During NCTTP’s 16th Annual Symposium on March 18, 2024, Coleen Kivlahan MD, MSPH and Mohammed AlSharif, MD presented “Intensity of their suffering: Long-term physical and psychological symptoms in detained Syrian men, subjected to CRSV, torture and displacement.”
Abstract:
The decade long war in Syria is a model for understanding forced displacement and its impact. More than 1 million people have been arrested, detained, and tortured. Two cohorts of survivors were evaluated to determine long term impact: 106 male survivors with forensic medical evaluations (FMEs) and subsequent interviews over 10 years, and 234 males and females with FMEs. Almost all reported forced displacement, domestic and international. A published paper in the Lancet journal eCM and a report for IIIM reflects the constellation and evolution of their self-reported symptoms and conditions.
40% of men spent years in detention. While detained, almost all were subjected to forced nudity, multiple types of blunt trauma, almost half were burned/electrocuted and endured direct violence to their genitals/anus. Years later, the intensity of their suffering is defined by their reports of avoidance, intrusive memories, lack of trust, self-isolation, chronic pain, and anger. Similar findings are reported in the female population. Immigration detention is known to result in severe mental health consequences, and conflict-related detention has even greater impact. Policy literature describes anger as a powerful determining factor in conflict settings, witness Russia/Ukraine and Israel/Palestine as current examples. The unique constellation of findings and their evolution in displaced CRSV survivors must urgently inform design and delivery of research and support services, for moral reasons and the tremendous risk to community cohesion and peace for all.
Authors:
- Mohammed AlSharifMedical degree, Aleppo University, 2011. Primary care doctor working in northwest Syria with various medical relief organizations. Currently working as a medical director for several hospitals and health centers with the Syria Relief and Development Organization (SRD). Basic and advanced training in child and adult forensic medical evaluations (FMEs) of sexual violence, torture and inhuman treatment in accordance with UN Manual on the Effective Investigation and Documentation of Torture and Other Inhuman and Degrading Treatment or Punishment (Istanbul Protocol). Current LDHR FME and United Nations Population Fund (UNFPA) trainer. Co-first author of Kivlahan, Al Sharif, Elliott et al (2023) Long-term physical and psychological symptoms in Syrian men subjected to detention, conflict-related sexual violence and torture: cohort study of self-reported symptom evolution. eClinicalMedicine, 2024;67: 102373.
- Coleen KivlahanMedical degree Medical College of Ohio, 1977. Board certified Family Medicine and Professor University of California, San Francisco. MSPH, 1983 Robert Wood Johnson scholar in research. Medical consultant to, and founder of, the UCSF Health and Human Rights Initiative, and Medical Director of Synergy for Justice, UK. Perform and teach asylum and torture forensic evaluations for >20 years. Special training in forensic evaluation of children, trained in advanced child interviewing in 2023, performed more than 500 forensic exams of children and adults survivors of physical abuse and sexual violence. Extensive field experience in conflict settings. Developed robust database of types of violence in asylum seekers. Most recent of many related publications: Kivlahan, Al Sharif, Elliott et al (2023) Long-term physical and psychological symptoms in Syrian men subjected to detention, conflict-related sexual violence and torture: cohort study of self-reported symptom evolution eClinicalMedicine, 2024;67: 102373.