Chapter 5: Medical Services

This chapter is a resource for physicians and nurses working with or planning services for torture survivors. Preceding chapters outline the purpose of torture and common torture methods. This chapter reviews the long-term effects of torture and describes roles and responsibilities for physicians, psychiatrists, and nurses who are helping torture survivors reduce trauma symptoms and rebuild their lives in the United States. These roles and responsibilities include education, documentation, assessment, treatment, referral, research, and advocacy. While detailed discussion of specific treatment modalities are beyond the scope of this chapter, it will introduce areas deserving further exploration by health care providers. These topics include cultural competence, working with interpreters, use of medications, and improving access to care. In addition to direct treatment approaches, physicians and psychiatrists are encouraged to integrate preventive components into their organization’s programmatic strategies. Examples of such strategies are discussed in Chapter 8. Finally, this chapter describes resources and training opportunities for physicians and nurses interested in conducting medical and psychological forensic evaluations on asylum seekers who have been tortured.