Assessing the level of credibility of allegations of physical torture.

BACKGROUND: No means exists to classify the overall credibility of physical torture allegations, which relies on qualitative forensic medical criteria. OBJECTIVES: To develop procedures for processing physical data from torture allegations in order to achieve robust credibility assessments. To assess inter-observer variation in semi-quantitative evaluations. To analyse the importance of physical aspects for the overall assessment of allegations of torture. To assess the correlation between a quantitative description of physical aspects of torture and the appraisal of credibility based on the semi-quantitative model. METHODS: We developed a semi-quantitative model to assess credibility of physical torture allegations and a model to describe allegations quantitatively. Information about physical aspects of ill-treatment in 202 extensive reports made by psychologists (part of a Basque Country Governmental project) was appraised individually and jointly by the two authors in the semi-quantitative model. Inter-observer variation was appraised. The assessed credibility based on physical details was compared with the psychologists' overall assessments and with the quantitative scoring of physical data. FINDINGS: The inter-observer agreement was substantial with kappa values of 0.64-0.77. Peer-reviewing revealed an error; using the defined criteria in the models facilitated achievement of common opinions. Comparison of credibility assessments found by different means suggests that physical data may be given a low priority in the overall assessment of torture allegations. There was a strong correlation (r=0,86, p<0.001) between the semi-quantitative credibility assessment and the quantitative scoring of physical aspects of torture, reinforcing the validity of both means. CONCLUSION: Peer-reviewing of physical aspects of torture based on a qualitative /semi-quantitative /quantitative multi-step analysis leads to robust assessments of credibility. A procedure is needed on how to merge the credibility assessments of the psychological and the physical data into an overall conclusion. We suggest that the highest level of the two evaluations should constitute the overall credibility assessment. LIMITATIONS: The examinations were done years after the detentions, they were not focused on physical details and the data we used was retrieved retrospectively.

Skin changes following defibrillation. The effect of high voltage direct current.

Previously, electrical injuries have been suggested caused only by the concomitant heat developed during the passage of an electrical current. Recent experimental studies on fully anesthetized pigs and the study of one human case have, however, shown typical electrical alterations. The purpose of the present study was further to evaluate the histology of electrically induced changes in the skin in humans. In addition, supplementary in vivo methods for evaluation of skin changes as high-frequency ultrasound and Raman spectroscopy were used. The skin of 11 patients treated with a defibrillation of the heart was examined for macroscopic changes, the skin of eight of them also for histologic changes and for changes observable via supplementary methods. Immediately and 7 days after the defibrillation, fractions of a narrow red ring were observed along the periphery of the tin-foil electrode. Epidermis showed signs previously observed following electrical influence: segmental alterations often related to the openings of sweat ducts, darkstaining or "empty" nuclei and homogeneous cytoplasm, eosinophilic or pale. Dermis did not show the specific sign of electrical influence: deposits of calcium salts on dermal fibres, neither via histologic examination nor via high-frequency ultrasonography and Raman spectroscopy. Fractions of a narrow red ring along the periphery of the electrode showing histological signs of electric influence in epidermis thus appear to be characteristic of high voltage electrical injury.

Rule of law, law and the health profession. Zimbabwe 2002.

INTRODUCTION: Politically motivated violence around elections in Zimbabwe has been documented before. A fact-finding mission was planned and undertaken two months ahead of the presidential election March 2002. METHODOLOGY: We interviewed and examined persons who alleged exposure to politically motivated torture, ill treatment and other human rights abuses. We assessed the validity of individual statements of torture and ill treatment and assessed existing similarities between histories of individual interviewees, e.g., as to timing of the assault and use of torture instruments to further appraise the validity. We analysed the results of our findings in relation to a newly introduced law restricting civil rights, and to the experiences of disrespect for the rule of law in Zimbabwe. RESULTS: Four men gave accounts of being beaten systematically with barbed wire and electrical cable all over their bodies. The clinical findings were in complete agreement herewith and their histories were mutually consistent. In ten additional interviews, we collected evidence of killing, ill treatment and harassment including robbing of ID cards from torture victims. Apart from losing their vote in the forthcoming election, according to the new law, victims with stolen ID cards will be liable to up to six months imprisonment. According to precedents, perpetrators of election violence and torture can expect impunity. The rule of law and the new law undermines democratic rights and free and fair elections and facilitates election violence including torture. We received statements about interference by the police in the delivery of health care services in hospitals and the new law could impede health professionals in documenting and reporting crimes including torture. CONCLUSION: The rule of law, the law points to the deepest disrespect for democratic and human rights in Zimbabwe. Our findings fit into this pattern. Any election under these conditions cannot be free and fair. Health professionals are hindered in exercising their duties both in terms of offering services and in terms of documentation and surveillance of human rights abuses. The international community should monitor the situation in Zimbabwe and strengthen the sanctions if torture systematically is used against opponents of the government or if the food aid is provided selectively to supporters of the government.