Organs |
Complaints |
Possible causes. What to check for. |
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Eyes
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Blurred vision, double vision, problems with accommodation
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Chronic conjunctivitis, possibly caused by wearing a dirty hood for long periods. If no abnormality, check for whiplash syndrome, paying special attention to status of cervical spine
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Ear, Nose, Throat
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Impaired hearing, vertigo, tinnitus, earache, poor air flow through nose
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Blows to face and ears. Beating both ears at the same time (telefono) can result in damage to middle and inner ear, and chronic otitis media. If tinnitus and vertigo cannot be explained, whiplash syndrome should be considered
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Teeth
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Teeth missing/ broken/aching, bleeding gums, poor chewing, headaches, pain in face, possibly dyspepsia
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Possible causes:
- blows to face.
- teeth may have been extracted without anaesthesia
- poor food and poor dental hygiene
Check for gingivitis
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Lungs
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Sometimes persistent irritable cough
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Possible cause:
- By aspiration of dirty water during mock drowning (submarino)
- Other infection a result of poor and insufficient food and stress during imprisonment
Check for TB and other infectious illness
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Heart
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Brief stabbing precordial pain, palpitations, difficulty breathing
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Often no physiological cause found but precordial pain may be an after effect of suspension. Pain from vertebral column and whiplash syndrome may imitate precordial pain
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Alimentary canal
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Complaints of symptoms very common. May complain of symptoms typical of gastric ulcer - epigastric pain, hunger pains with relief on eating, acid regurgitation, loss of weight, nausea and, less commonly, vomiting
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Despite complaints, gastroscopy reveals that only small numbers have ulcers
May have pain and bleeding from anus and rectum, fissures etc. Probably from sexual torture when objects forced into rectum
May show signs of previous infections with Hepatitis A, although B and C also seen
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Complaints of constipation/diarrhea
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Depending on country of origin, may present with chronic parasitic conditions, e.g., bilharzia, malaria, and intestinal worms. (In NZ refugees who have spent their first few weeks at MRRC are checked for parasites and infections, but others who arrive as asylum seekers or under the family reunification scheme may not have had these checks)
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Urogenital system
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Complaints of dysuria and frequency
Women may complain of chronic stress, disturbances of menstruation (oligomenorrhea), lower back pain, problems with urination and defecation, dysfunction of pelvic muscles and joints
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Physiological basis for these complaints are rare
May be sequelae of sexual torture. Check for chronic inflammation of internal sex organs. Check also for referred pain from the spine
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Men may complain of anal problems, premature ejaculation, reduced potency |
May be sequelae of sexual torture
Check men and women for AIDS and Hepatitis B
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Central and peripheral nervous system
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Headache (many types, including migraine) reduced ability to concentrate, reduced memory, cognitive difficulties, vertigo, tiredness
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Probable causes:
- many direct blows to head, especially if client has been rendered unconscious
- electric torture causing convulsions
- mock drowning (submarino) resulting in anoxia to brain
Check for whiplash syndrome, dysfunction of teeth as possible causes of headache
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Parasthesias. Complaints of strong shooting pain in localised area, neuralgia. If this pain occurs in bouts, it may be described as muscle cramps. Complaints of superficial burning, smarting sensations in area, caused or aggravated by light touch, but decreasing with firm touch |
Symptoms similar to dementia, especially poor memory may be psychogenic and respond to psychotherapy
Probable causes:
- constriction of extremities by cuffs or rope
- hanging from arms when arms tied behind the back (Palestinian suspension)
- repeated and violent trauma to areas of body where peripheral nerves close to surface, including soles of feet (falanga)
Depending on area about which complaint is made, check for damage to trigeminal nerve, brachial plexus, nerves of soles of feet. Check also for sensory disturbance to pinprick and temperature
Pain may be chronic or intermittent. Failure to find physiological basis for pain can be harmful to psychological well-being of client
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Musculo-skeletal system
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Complaints about muscles, tendons, nerves and joints extremely common
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Probable causes:
- continuous beating of body and extremities, electric torture
- high levels of stress causing extreme muscle tension and sometimes faulty posture
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Pain in arms, radiating to corresponding extremity, parasthesiae and tiredness. Pain in/around the heart |
Suspension by arms. Besides checking for damage to brachial plexus, check for strained and malfunctioning muscular connections of arms/shoulders and thorax. This may trigger precordial pain |
Lower back pain without radiation to lower extremities |
Possible cause:
Being forced to crouch in restricted cage for long periods. May cause over-stretching of stabilizing ligaments and joint capsules of spine. This results in segmentary instability and malfunction. May also cause irritation of afferent sympathetic nerves with segmentary radiation to viscera and skin. Depending on the segment of the spine that is affected, symptoms may mimic cardiac, gastrointestinal, urogenital conditions etc.
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Intermittent, often burning pain of lower legs and feet, Made worse by walking |
Damage to tissue of feet as a result of beatings to feet (falanga). Destruction of fatty pads of foot during beatings |
Varied complaints of pain in the neck possibly with radiation to one or both upper extremities. Blurred vision, dizziness, tinnitus, migrainous head, paraesthesie of face, toothache, chest pain |
Possible cause:
- whiplash from being beaten or pushed from behind while blindfolded and unable to predict the blow
- damage to cervical spine, discs and ligaments, also to vessels and nerves supplying head and neck
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Skin
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Not usually associated with complaints of pain
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Check for scars from whipping, cigarette burns, electric torture, cutting and stabbing, application of acid
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