The Middle of Everywhere (14 page)

Many newcomers are from areas with absolutely no public health information. They do not know that alcohol can be addictive or that cigarettes cause cancer. They may not know how to cook or understand even basic information about a healthy diet. Some new arrivals have never seen a toothbrush; they do not know what germs are or that it is important to wash their hands.

Many people who have been tortured have injuries they are ashamed to discuss. An older Vietnamese man had a very bad shoulder. He had been yoked like an ox to a plow for years in a POW camp. A Cambodian man had his hip broken under torture. It was never treated and now, of course, it was too late. Many Middle Eastern refugees have been beaten on the feet. Their feet are in perpetual pain and they have trouble walking. Others who have been tortured by electroshock are frightened of EEG machines. Many are brain damaged from head trauma or from nerve gas.

Some refugees come from places where to admit you had a physical or mental problem was to be killed. They are ashamed of these experiences and do not share them with others. But they have physical and psychological scars. Some withdraw from their families. Others are violent or suicidal. Given their histories, it's hard to talk such people into hospitals, which cost a lot of money and involve paperwork and dealing with strangers and unfamiliar treatments. One woman from Mali had chest pains for a week before a public health nurse stopped by for a routine visit. The nurse told me, "She could easily have died of a heart attack."

Mental Health

Every culture has its own ways of expressing and repressing emotional pain. Many complaints that we would consider mental health problems are expressed somatically. Often refugees say they are sick when they really mean "I am incapacitated by stress." People don't sleep well, are always tired, or their back hurts. Middle Eastern people frequendy express emotional pain by talking about pain in their arms or legs. A woman from Liberia complained about blurred vision and eye pain. The doctors could find nothing. Finally I said to her, "I imagine you must have seen terrible things." She answered, "They shot my husband in front of me."

It's more acceptable to speak of physical pain than mental pain. A doctor with training and experience working with refugees will understand that some of their physical problems are stress related. A less-experienced doctor may order expensive and scary tests.

Psychology is irrelevant to most newcomers. This doesn't mean refugees don't have mental health problems. They have high rates of depression and anxiety. But in their hierarchy of needs, these are not their most pressing problems. It's hard to do therapy with someone who is hungry. In fact, it is silly to sit and talk to someone about their need for a ride to the grocery store. It's better to just take them.

Every culture has its own system of healing. All over the world, healing involves calmness, beautiful places, kind people, simple routines, rituals, and temporary protection from everyday problems. Laughter is a part of many healing systems. There is really no period in history when humans didn't laugh. Even during war there is laughter. Music, touch, dancing, food, and prayer are part of healing all over the world. But psychotherapy is a hard sell.

Even before refugees arrive in the United States they must go through interviews to determine their refugee status. Many say this interview, conducted in a foreign language and consisting of odd questions that must be answered precisely, is more stressful than being tortured. Even the smallest mistake can condemn their families to permanendy live in a refugee camp or return to a situation that will get them killed.

Assuming the family establishes refugee status, they begin a lifetime of dealing with bureaucracies. America is awash in paperwork. There is a form for everything from going to the dentist to signing up for a field trip to checking out a library book. These forms are an annoyance if one knows the language, but they can be an insurmountable barrier to adults who cannot read or write in English. There are other barriers as well. Many refugees don't know their age or birthdays. They may not have other vital information about health history and vaccinations, about school and employment, or about dates and places of residence.

Often our categories don't even fit native-born Americans, but they really collide with the cultural traditions of refugees. For example, the Kurdish sisters tried to fill out a scholarship application to the YWCA. But all six sisters were in their twenties and thirties and lived with their mother. The sisters supported her and their sister in Iraq. Who was the primary wage earner in a family when all resources were pooled?

There are privacy issues. Refugees are leery of revealing confidential information about family members. This makes it stressful and sometimes impossible to fill out intake forms at a mental health center, a hospital, a school, a social welfare agency, or a bank. Refugees feel alarmed when they see questions about domestic violence or mental health. These are personal matters, not to be shared with strangers on paper. Questions about education, employment, income, religion, and health problems can also seem invasive.

Many refugees come from places where written information and signatures have gotten people arrested and killed. When they arrive here, they are warned to be careful what they sign. They are leery of signing forms they do not understand, which is prudent, but this wariness makes transactions difficult.

Any procedures that involve the police, such as dealing with a minor traffic offense, reporting a robbery, or even answering questions about a barking dog next door, can frighten refugees. Many come from countries where police are corrupt or associated with repressive governments. As a Siberian woman put it, "In Russia a policeman means trouble is coming." A Kurdish woman said, "Back home if a policeman knocks at your door, it means death."

All of the problems with paperwork and bureaucracy come together in their worst form when newcomers deal with the Immigration and Naturalization Service. The INS is the great American dragon that all must slay to enter the gates of the promised land. It angers, terrifies, and discourages newcomers. Some the INS drives back home; others it drives to suicide; most it eventually grants permanent residency status.

As one lawyer told me, "The INS is the mother of all bureaucracies; compared to the INS, all other bureaucracies are rank amateurs." The INS is incredibly understaffed. For the last few years Congress has funded enforcement but hasn't funded routine service and processing of documents. A recent newspaper article reported that of the 115,000 calls made to national INS offices daily, only 500 are answered.

In Nebraska we create illegals, then arrest and deport them. The INS in Nebraska doesn't have adequate staff to help newcomers secure legal status. People wait three years for routine papers to be processed. Yet, the INS raids meatpacking plants to round up illegals. Refugees live in fear of the INS. It's a Kafkaesque situation. People must cooperate with the INS or they will be deported, but they cannot cooperate because the INS doesn't respond to their attempts.

I know of only one positive story about the INS. It demonstrates that at least some employees are better than the institution. An INS official asked a man from a camp in Saudi Arabia if he wanted to come to America. He said sorrowfully, "I have no one in America." The official held out his hand to him and said, "May I have the honor of being your first American friend?"

One night Sadia, a woman from Afghanistan, brought me a letter that ordered her and her fourteen-year-old daughter to report to Hastings, Nebraska, on a certain day to be fingerprinted. She was frightened by the letter and unsure how to comply with the order. She didn't have a car and couldn't drive to Hastings. There was no bus. She asked me if she could walk there and if it was bigger than Kansas City. I said it was small but one hundred miles away. Sadia wept, certain that she would be deported. I told her I would try to make arrangements to have her fingerprinted here in Lincoln. But if necessary, I would take her and her daughter to Hastings.

As I left, I reflected on Sadia's hard life, most of it spent on the run and in prison camps. Now she worked at a factory and had barely enough money for a small apartment for herself and her daughter. Sadia's daughter was fatherless and learning her third language. She'd missed a lot of school during their years of flight and really didn't need to be pulled from high school to be fingerprinted.

The next day I sat at my phone for two hours rapid-repeat-dialing the INS. The line was always busy. I double-checked the number and called to make sure it was in order. A telephone company supervisor told me that every day she received many complaints like mine. She sighed, "We tell customers to consider that line inoperative." This was frustrating enough for me, but it creates an impossible situation for refugees who have only ten-minute bathroom breaks and a pay phone at their factories.

In despair, I called my senator's office. A special staff member whose sole job was to deal with the INS said he would look into things. Two days later he called back to say there was no way for the prints to be done locally and that the lines in Omaha were even longer than the ones in Hastings.

He said Sadia was being sent to Hastings because there had been a glitch in the computer program that assigns fingerprinting locations by zip code. Many refugees were told to go to faraway stations rather than to the one nearest them.

Two days before we left for Hastings, I called to make sure we would be received. There were no phone numbers on Sadia's letter so I called directory assistance and asked for the Hastings INS. No number was listed. Then, because the stationery also had a Department of Justice insignia, I asked for a Department of Justice number. None was listed for Hastings. I called the toll-free Customer Service number on the letter and was told by a recording that the number was no longer in service. Eventually I reached the Omaha office of the INS. I spoke to a grumpy man who said there was no Hastings office. When I tried to read him the letter, he hung up on me. I had now spent the entire morning on the phone trying to track down this Hastings office. Not only had I been unsuccessful, but by now I was unsure if we were even supposed to go to Hastings.

I called the Department of Justice in Lincoln and finally reached a live human being. She said she would give me a phone number if I promised not to give it to anyone else. I thanked the woman profusely and hung up, feeling hopeful for the first time that day. But when I called the number, it was out of service.

I had entered the twilight zone. This was a mess for me and I am a native-born, English-speaking clinical psychologist with a telephone. What was it like for a desperate refugee with no cultural broker? I again called my senator's office. They must have some secret number because someone called me later and said, "Go to the Hastings police department tomorrow."

So we went. When she heard that we had to go the police department, Sadia immediately associated the place with torture centers. But she got off work and pulled her daughter from school. We drove the three hours to the Hastings police department. It was anticlimactic. A kind middle-aged woman helped them. In one half hour the fingerprints were taken and we were on our way home. I had learned something about how our government works and Sadia was grateful she hadn't been tortured.

Home is where you hang your childhood.

—W
RIGHT
M
ORRIS

In southwestern Minnesota, there is a quarry for pipestone, the rock used by all the Plains Indians to make peace pipes and many other sacred objects. It is a soft, carveable rock that glows red at sunset. Pipestone quarry was a sacred site where all the tribes came together in peace. While they were there, a truce existed; all the tribes mined side by side, then parted to fight on other ground.

Pipestone is a good metaphor for schools. Schools are the sacred ground of refugees, and education is their shared religion. At school, the Croats and Serbs study together, as do the Iranians and Iraqis and the southern and northern Sudanese. Outside school, groups may feud, but inside school, they will be respectful so that they can all quarry the American educational system.

Before their first day of school, many children from traditional cultures have never been away from their mothers for even an hour. At school, they may feel far from home. Everything may be different—the language, customs, the colors of the people, the clothes, the foods, and even the play. Developmental levels of children are not uniform either. Five-year-olds from one culture have very different skills, relationships to family, and comfort levels with strangers than do five-year-olds from another culture.

Schools are often where kids experience their first racism and learn about the socioeconomic split in our country. There is the America of children with violin lessons, hockey tickets, skiing trips, and zoo passes, and there is the America of children in small apartments whose parents work double shifts.

English as Learned Language classes are taught by teachers who are responsible for everything from cultural orientation to teaching English and basic academic skills. The students are grouped according to their ability to speak English, and kids from as many as twenty different language groups may be in one class.

School may be overwhelming at first, but it is school that will enable children to make it in America. School offers students the freedom to develop and to dream big American dreams. In spite of their disadvantages, refugees have lower drop-out rates and better grades than native-born kids.

A determining factor in kids' success is the quality of their family lives. Well-loved, well-nurtured kids from all over the world have a tremendous advantage. Mothers and fathers who carefully select the best from both the new and old cultures have the best-adjusted children. Parental involvement in education varies. In general, refugee parents have high expectations, but limited contact with the schools. They feel that education is the job of the teachers. Parents may want to be involved, but may not understand how to be involved. Also, work schedules, transportation, and language problems make contact with schools difficult.