Torture

The World Medical Association's Declaration of Tokyo in 1975 defined torture as "the deliberate, systematic or wanton infliction of physical or mental suffering by one or more persons acting alone or on the orders of any authority, to force another person to yield information, to make a confession, or for any other reason" (9). The declaration also established guidelines for doctors when faced with cases of suspected torture. Clinicians view torture in two main contexts: first, torture that is perpetrated by criminals and terrorist organizations, and second, torture that is carried out, or allegedly carried out, by the police or other security force personnel during the detention and interrogation of prisoners and suspects. Nonjudicial justice is now meted out worldwide in several ways.

Criminal groups and paramilitary organizations may torture their captives for numerous reasons. It may be to extract information from an opposing gang or faction, to discipline informants and others engaged in unsanctioned criminal activity, or simply to instill fear and division within a community. The methods used are crude and barbaric. The victim is usually bound, blindfolded, and gagged, and the wrists and ankles may bear the pale streaky linear bruises and abrasions caused by ligatures. "Beating up" is typical, with extensive bruises and abrasions scattered on the head, trunk, and limbs. Black eyes, fractures of the nose and jaws, and dislodgment of the teeth are all fairly typical. Cigarette burns, usually seen as discrete circular areas of reddish-yellow, parchmented skin, are also quite common. Patterned injuries resulting from being struck with the butt of a gun or tramline bruising owing to blows with a truncheon or baseball bat may be seen; in Northern Ireland, shooting through the lower limbs ("knee-capping") is a favored method of punishment by paramilitary organizations.

Systematic torture by security personnel, usually during interrogation of suspects, ranges from the subtle use of threats and intimidation to physical violence. Hooding, prolonged standing, and the use of high-pitched sound have all been used, as have attempts to disorientate prisoners by offering food at erratic times, frequent waking up after short intervals of sleep, and burning a light in the cell 24 hours a day. Physical abuse includes beating of the soles of the feet, so-called falanga, which, although extremely painful and debilitating, does not usually cause any significant bruising. Repeated dipping of the victim's head under water, known as submarining, may prove fatal if prolonged, as can the induction of partial asphyxia by enveloping the head in a plastic bag.

Electric torture is well documented and carries the risk of local electric shocks and fatal electrocution. Telefono, as it is known in Latin America, consists of repeated slapping of the sides of the head by the open palms, resulting in tympanic membrane rupture.

Doctors who have access to prisoners in custody have a heavy responsibility to ensure that they are properly treated during detention and interrogation. In all cases of suspected or alleged ill-treatment of prisoners, it is essential that the doctor carry out a methodical and detailed "head-to-toe" examination. All injuries and marks must be accurately recorded and photographed, and the appropriate authorities must be informed immediately. Increasingly, forensic physicians are involved in assessments of refugees and asylum seekers to establish whether accounts of torture (both physical and psychological) are true. This role is likely to expand in the future, and the principles of independent assessment, documentation, and interpretation are, as with other areas discussed, vital in ensuring that courts and tribunals have the appropriate information to allow fair judgments to be reached (1).

Baseball For Boys

Baseball For Boys

Since World War II, there has been a tremendous change in the makeup and direction of kid baseball, as it is called. Adults, showing an unprecedented interest in the activity, have initiated and developed programs in thousands of towns across the United States programs that providebr wholesome recreation for millions of youngsters and are often a source of pride and joy to the community in which they exist.

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