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August 2, 2000

The Not-So-Silent Marks of Torture

Author Affiliations

Author Affiliations: Section of General Internal Medicine (Dr Moreno) and Health Law Department, Boston Center for Refugee Health and Human Rights (Drs Moreno and Grodin), Boston Medical Center, Boston University Schools of Medicine and Public Health, Boston, Mass.


Photo/Essay Section Editor: Roxanne K. Young, Associate Editor.

JAMA. 2000;284(5):538. doi:10.1001/jama.284.5.538

Of all foreign-born patients seen in large urban medical centers, 5% to 10% have experienced some form of torture in their countries of origin.1,2 Although more than 3.5 million refugees and asylum seekers have resettled in the United States since 1975,35 health care providers (ie, physicians, nurses, and public health workers) frequently fail to recognize the symptoms and signs left by torture in this patient population. Three reasons explain this failure: most of the time the presence of physical sequelae is subtle, providers receive little training in how to recognize such signs, and providers are reluctant to discuss torture events with patients.617

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