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Ohio refugees escape from war, but isolation and illness make it hard to shed the trauma

Shabir Mayar sits at a table inside Neighborhood Family Practice.
J. Nungesser
Ideastream Public Media
Shabir Mayar, an Afghan refugee, sits at a table inside Neighborhood Family Practice.

Nearly 3,000 war refugees arrived in Ohio in 2023, with nearly half settling in Northeast Ohio.

These refugees, who mainly hail from the Democratic Republic of Congo, Afghanistan, Sudan and Syria, arrived to escape the terrors of war and start their lives anew. But before they can do so, they must overcome the physical and mental scars they carry from war.

Congolese refugee Juvens Niyonzima, a translator who works for the Cleveland office of the U.S. Committee for Refugees and Immigrants, said refugees' lives are in tremendous upheaval in their home countries, like in the Democratic Republic of Congo where there is a civil war.

"No schools. No health care. No shelter. No food. Shooting guns. Not sleeping well. Not living a good life," Niyonzima said, adding that the need for support is often immediate.

“Normally when people coming in here, most of them in need of health care because of many years not seeing doctors. They have really some disease, sickness they've been holding for years without even knowing,” Niyonzima said.

That's where institutions such as the Committee and Neighborhood Family Practice come in. The Committee is a resettlement agency that supports new arrivals to the area, including by scheduling initial health screenings with NFP. NFP has served the refugee community since 2010, providing initial screenings and other care to 95% of refugees arriving in the region.

NFP provides this immediate care and assessment, said Chief Medical Officer Melanie Golembiewski.

“Our hope is to pick up any kind of initial chronic disease that they might have or continue their medication that they're coming over with or make changes that might be helpful to them," she said.

NFP also assesses whether refugees are suffering from PTSD, depression or anxiety, Golembiewski said.

“Our care, our providers and our staff have really been trained in trauma informed care and kind of understand a little bit more about the situations that people are coming from, and use that as a lens to providing their care,” she said.

Building culture and economies

Shabir Mayar, a case manager at Catholic Charities Migration and Refugee Services, agreed that mental health support is important for war refugees.

“In Afghan communities, lots of challenges like culture, like also financial problems because the loss of their family left in Afghanistan, so it is kind of very difficult life for them here," he said. "I see most of them experiencing mental health, so this is why we have our programs.”

His agency partners with NFP to provide mental health care for Afghan refugees. Mayar is a refugee himself, from Afghanistan.

Mental health continues to be an issue due, in part, to cultural differences between African countries and America, Niyonzima added.

“U.S. culture is about you working on your own," he said. "I think there is too much aloneness. In Africa, people mingle a lot. People socialize a lot. Here, the isolation is really at a high level. That kind of isolation is kind of terrible.”

You put somebody who was in medical school, you put him into Orlando Baking Company. Now he's making bread instead of continuing what he should have continued.
Mayele Ngemba Degaule

This is where refugees' peers can play a role, Niyonzima said. For example, he runs a youth group for Congolese refugees, known as "the comrades," who visit new arrivals who are feeling isolated.

“Here in Ohio, we try to build that culture back whereby we have community members, just a group of youth," he said. "They take their time off and visit people.”

Such care and support is not only beneficial for the refugee community itself, but also the local economy through increased household spending, home purchases and new businesses, said the Committee’s Graham Ball.

“An economic impact study that we did a few years ago found that for every dollar invested in refugee resettlement outputs, there’s $10 in economic activity," he said. "And that's specifically for Cleveland.”

The goal is self-sufficiency in six months, but refugees routinely outpace that goal, Ball said.

“We find that two years after resettlement, refugees are employed at higher rates than native citizens and are on public assistance at lower rates," he said.

More help needed

However, Congolese refugee Degaule Mayele said that despite the range of services available, more can be done. For example, language barriers make it difficult to access basic services, like obtaining a driver’s license, he said.

Mayele, who teaches Swahili at John Marshall High School on Cleveland’s West Side, said one solution is providing refugees with translators and materials translated into Swahili, a language commonly spoken by African refugees.

He added the language barrier can be a problem for both refugees and their children, who are used as translators for their parents.

“You are supposed to be now the adult because you're in charge now of making those kind of appointments for your parents," Mayele explained. "And you have to miss school. It is a big problem for our community.”

He added another issue is the lack of emphasis on refugees continuing the professions they pursued in their home countries.

Degaule Mayele sits and talks at a table inside Neighborhood Family Practice.
J. Nungesser
Ideastream Public Media
Degaule Mayele, a Congolese refugee, said one way to provide better assimilation for refugees is to bridge them with connections and resources to help them continue the professions they pursued in their home countries.

“I think what tends to happen is agencies tend to ignore those skills that refugees are coming with," Mayele said. "So, you put somebody who was in medical school, you put him into Orlando Baking Company. Now he's making bread instead of continuing what he should have continued.”

He said the problem is that the U.S. government just wants to ensure refugees have a job, rather than one based on their previous training.

“I'm educated," Mayele said. "Just give me a chance."

Stephen Langel is a health reporter with Ideastream Public Media's engaged journalism team.