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One of the threat letters Amer Kuba received in Baghdad. Photo by Jessica Partnow.

One of the threat letters Amer Kuba received in Baghdad. Photo by Jessica Partnow.


Life After War

Staff Reporter

Today we continue our series that explores the lives of refugees in Puget Sound and the challenges that they face as they settle in to their new communities. New refugees coming to the United States have just a few months to find a job and a place to live. On top of that, they are 10 times as likely as the general population to suffer from post–traumatic stress disorder (PTSD).

Beth Farmer: "We've often thought we should give away t–shirts that say 'I survived my first year in America.'"

That's Beth Farmer, who works with refugees suffering from depression and PTSD.

In today's segment of "Refugees in Puget Sound," reporter Jessica Partnow talks to Iraqi refugees about recovering from life in a war zone.


The Kuba family lives in a small ground–floor apartment in Kent. Their few pieces of furniture are all crowded into one corner of the living room, as if pushing everything close together will make it seem like there is more of it. At dinnertime, they have to squeeze in around a tiny coffee table. The walls are bare.

But there's a lot more space here than they had a few weeks ago, when they were living in their car.

Amer Kuba: "I leave my home. And all my stuff in the street cause I don't have money for truck."

This is Amer Kuba. He is a refugee from Iraq. At his first apartment, rent was $735. But he only got $560 in refugee cash assistance. It caught up with him, and he was evicted.

Kuba: "I take just my clothes and I sleep in my car almost three month. I drive in night, and my family sleep in car."

Back in Baghdad, Amer had a small chain of electronics stores.

He says he was rich. He had 14 employees and three cars. He donated money to charity.

The business was his life.

Kuba: "I open my store in 9:00 morning and I close my store 12:00 in night. Seven days in week."

When the Americans came to Baghdad, Amer learned English so he could sell to them. But then he started to receive threats. Three different sectarian groups sent warning letters. They didn't like him doing business with the US military.

And then Amer was kidnapped.

Kuba: "I sit in the floor and somebody cover my eyes, but I can see little!"

He says he was held along with about 30 other people, including young children.

Kuba: "I, I feel the knife coming to this child behind me, and he say 'Save me, save me, you are behind me, save me,' and I, I, I, I, couldn't be doing anything to him."

Amer finally escaped when US forces took control of the neighborhood. But he hasn't recovered from the trauma.

After the kidnapping, Amer and his family fled across the border to Syria. They stayed in Damascus for four years. Then, Amer, his pregnant wife and their young son came to Seattle in April 2010.

Amer says he didn't leave the house for the first six months. He was afraid al–Qaida would find him here.

Kuba: "And I have psychological problem. And I can't speak with anybody and confuse all the time and I still inside my house, I don't go outside because I afraid."

Amer's clothes are too big for him. His face is tired, his hands are shaky. The fat, smiling businessman in his passport photo looks like a distant relative.

The United States prioritizes refugee cases like Amer's for humanitarian reasons. If people have been tortured, abused or persecuted, they get moved higher on the list: They get to come to the US sooner.

But once they get here, they get in the same line as every arriving refugee. They're competing for jobs and apartments along with everyone else.

Beth Farmer: "So you have a very, very quick, pressured entry into the United States."

Beth Farmer runs the International Counseling Service, a community mental health center. Almost all of her clientele are refugees from Africa, the former Soviet Union and the Middle East.

Farmer: "If you are already having post–traumatic stress disorder symptoms, you are really poised to fall through the cracks."

That's because there is no standardized way to make sure refugees with severe mental health problems are funneled into treatment as soon as they arrive.

Amer didn't get sent to Beth's clinic until he attempted suicide. He tried to jump off the roof of the Department of Social and Health Services building in Downtown Seattle.

Overall, Beth says refugees are 10 times more likely to have PTSD than the general population. But it can be hard to get patients like Amer into treatment.

Many refugees with PTSD share his fear of going outside. And that's only amplified by how hard it can be to find your way around a new city, especially if you don't have a car or speak the language.

Even the idea of mental health treatment can be scary.

Farmer: "For a long time, people didn't think that they could address mental health issues because the stigma in the refugee community was so high."

Getting counseling or psychiatric treatment might be seen as selfish or wimpy, or even dangerous. For some refugees, mental hospitals are a place where political dissidents are sent.

Beth has found that focusing on physical symptoms gets the best results. She starts by asking a patient how they're sleeping.

Farmer: "And what we'll hear a lot is they're afraid to go to sleep because of nightmares. Um, the recurrent imagery of nightmares is a big part of, of one of our first clues that somebody may have post–traumatic stress disorder."

Hamed Al–Ghanim: "Now I have children, it's getting less. I'm busier, I'm happier."

Dr. Hamed Al–Ghanim came to the US from Iraq in 1997.

Al–Ghanim: "I came just with a pants and a shirt and a shoe and socks, that's it."

He says he had severe PTSD when he first arrived.

He had been a medical doctor back in Iraq, but coming to the US meant starting over. He spent seven years getting recertified to practice medicine here. He threw himself into school and work.

Al–Ghanim: "My first job was in a Subway making sandwiches, basically. It was a part time. I took Friday, Saturday, Sunday, then I study on the other four days."

Now he is a primary care doctor at the Everett Clinic. He lives with his wife, who he met in school here, and four kids in a huge house in Mill Creek.

Hamed thinks having a big family and a strong social network are the best ways for Iraqis to cope with post–traumatic stress.

A big family means you always have someone to talk you about how you're feeling. A mother or a cousin or a brother will notice if you are having a bad day. But in the States, those social networks can shrink.

Al–Ghanim: "My brother, he lives just like I would say three miles away from me here. I haven't seen him for a month."

Hamed is starting up a conversation club for Iraqis; a few friends who will get together once a month to talk. He also helps fellow Iraqis as they learn to navigate the hospitals here.

Al–Ghanim: "They, they, they have my cell phone. And I always tell them, I said if you get stuck — even in the middle of the night — and the doctor wants to do something, call me."

But even after being here, and being safe for almost 15 years, Hamed still hasn't recovered from PTSD.

Al–Ghanim: "No you never, you never recover. I, up to this moment, I still have nightmare. I still have like, but it's to a lesser degree, like before every night, now I get it like every two to three months. Like, the army is chasing you or you trap in a corner, or things like that, you still have it."

Back at the Kubas' apartment in Kent, Amer's wife is preparing a big dinner of chicken with rice and salad.

Amer is rummaging through his bag of medications, showing me bottles of Prozac and blood pressure pills; anxiety medication and sleeping pills.

Amer's older son, Yassir, is clinging to his dad's arm. He is almost seven. He's wearing what must be his father's old belt. It's wrapped around his waist twice.

Kuba: "Right now I hope, I have, I feel hope because I have two children, and I want keep myself OK because I want help them."

This apartment is transitional housing, so the family can only stay here for up to a year. Amer is applying for a permanent place in public housing in Lake City.

Once his family is settled in a safe, permanent place to live, Amer says he can start putting full attention on his recovery.

For KUOW, I'm Jessica Partnow.

© Copyright 2012, KUOW