October 5, 1999
Refugee bureau creates mental health program

Katie Weeks
digital•iowa staff reporter
Drake University

DES MOINES, Iowa-- Iowa's Bureau of Refugee Services, one of only 10 in the United States, is creating a new mental health program for its immigrant clients dealing with atrocities in their homelands.

Refugee specialist Edina Letica said the idea for the mental health program came when case managers at the bureau began to notice symptoms of Post-Traumatic Stress Disorder among many refugees. Letica and an American social worker will team up to counsel families and individuals.

The need for the program becomes apparent as soon as one walks into the bureau. The crowded waiting room is hot. You can feel the humidity and smell body odor immediately. Upon entering the room and looking at the faces of the mothers, children and men all waiting, you can feel the sadness, tension and anxiousness for their new lives in America to be settled.

While one mother attempts to calm a fair-skinned litlle girl fidgeting on her lap in their native language, another holds her own head in her hands as though she has been waiting for hours. The mother is obviously exhausted. The skin under her eyes droops as she looks straight ahead.

A newly arrived Bosnian family stands in a circle in the center of the room. The men joke and laugh, attempting to forget all that has brought them to this musty, standing-room only place. But the truth of what has brought them here is not hidden on the face of the blonde child sitting in the last chair remaining.

Clearly, the life-threatening situations refugees undergo are reason enough to want to talk to someone who understands what they have gone through.

Who better than someone who has been through it herself?

Letica, as well as the majority of the bureau staff, came to the United States as a refugee and now works to help others in her former situation.

Letica came to America in 1996. In her hometown of Banjaluka, Bosnia, she was a physician for 20 years. But to practice medicine in the United States, Letica would have to go back to school.

"Sometimes I am sorry when I see physicians here," she said. "But I have a daughter in college that I must support."

And so Letica must work immediately. She does not have time or money now to be a student. But she said her job is fulfilling.

"[BRS] gave me a chance to learn English," Letica said. "These people had horrible experiences during the war and have mostly come from concentration camps. It is important for the person who counsels them to know a lot about Bosnian culture."

Many of the symptoms refugees have experienced, Letica said, include flashbacks, insomnia, nightmares, irritability and self-isolation.

"That is a real need to work on mental health," Letica said. "Many men don't like to talk about what happened with them during the war, but especially with Bosnian men."

In Bosnian culture, Letica said the father is the head of the household. But the children are learning English much faster than the parents. She said this puts the child at the head of the household, because they must play the role of interpreter.

"It puts much stress on the child," she said. "This is a big pressure. Coming here is different."

She said stress on the parents also comes from not being able to stay in the same occupation due to the language barrier or education equivalencies. But other stress comes from family losses.

"Many single mothers' children are killed," Letica said. "Others still have hope that they are just in concentration camps instead. But I think they are mostly killed."

Executive officer David Jones, who has worked for the bureau under the Iowa Department of Human Services for two and one-half years, said talking to refugees can be an emotional experience.

"People break down and cry all the time," Jones said.

This is one reason he said the mental health program will be a much-needed addition to the bureau.

Most refugees come with their families, but Jones said he also sees individuals.

"There may be some weeks where no refugees come in," he said. "But sometimes they come in every day of the week."

The number of refugees allowed to come into the country,which is detemined by the president and Congress, varies every year, Jones said.

"It goes in waves, depending on what type of atrocities are happening around the world," he said. "It may be up one year and down the next."

In 1998 the bureau and its seven affiliates around the state resettled 1,677 refugees into Iowa. Of those, 1,328 were Bosnian. The country with the second most refugees resettled in Iowa in 1998 was Vietnam with 169.

The other nine main bureaus in the United States are in Virginia, New York and Washington, D.C.

One of the first steps for the bureaus is finding sponsors to assist the refugees in resettlement. The sponsor has no financial or legal reponsibility for the refugees.

"The sponsor is there to help the refugees understand the way our system works," Jones said. "They are there to help the refugee adjust and feel comfortable in America."

To Jones and Letica, if this means creating a special program for mental awareness, they are willing to take that step at the bureau.

Letica said many cultures think if one needs mental health counseling, he or she is "crazy."

"We must go to their homes," she said."That is very important for our connection. When we go to the family, not only are we able to help with one person, but with the whole family."