This boy was one of more than 6.5 million Afghanis made refugees during the long war in Afghanistan. The country is under strict Islamic rule by a group called the Taliban, and hundreds of thousands of people remain displaced.
Photo courtesy of the US Committee for Refugees and photo © Hiram A. Ruiz.
Many Cambodian refugees fished and farmed before being expelled from their home country. In Wisconsin, they remain avid gardeners and fishers.
Photo © David Tenenbaum.
Treatment -- or cure?
Not according to the folks we spoke to. Debora Munczek, who works with Latin American refugees and torture victims, says, "These are not small, they are huge, gaping wounds. There is no way you can do justice to them. These are not things that can be cured."
She points out that the work can be frustrating. Refugees often have trouble sticking with treatments that focus on painful memories, as she pointed out in "Short-Term Treatment... " (see bibliography. For another insider's look at the therapist's experience, see "Traumatization of Group Leaders..." in the bibliography).
With more than 10 years of experience working with Cambodian refugees, Wisconsin psychologist Roger Garms has limited expectations for psychotherapy. "You can't medicate life," he says. "These things really happened, they are losses that can't be replaced. Treatment pales next to the damage done."
Some people with chronic PTSD can be helped by anti-depressants, but Garms says that even if the worst symptoms are controlled, "That doesn't replace losses, doesn't replace a sense of safety, trust or optimism. This kind of experience destroys your assumption that the world is more or less fair, that you are more or less safe, that people can be more or less trusted, that God is not going to let anything bad happen because you are a pretty good person."
In a sense, this kind of intense victimization has put refugees beyond the normal categories of mental health. "We naturally assume that everything is treatable," Garms says. The symptoms of anger, sleeplessness and distrust many refugees experience are often defined as an illness, he adds, "When it's a natural result of being subjected to overwhelming violence and loss."
Readings and roamings on displacement.
We've seen some innovative ways to treat traumatized refugees and torture victims. Next question: Can they be "made whole" again?
