Iraqi refugees prompts need for PTSD treatment




Ekhlas Gorgees kept her composure as she recounted the horrific traumas she and her family endured in Iraq.

She calmly recalled how her husband was severely wounded after a bomb exploded outside of his Baghdad plumbing shop, how she was threatened at gunpoint while walking home from church and how her family tried to escape north to the city of Mosul just before a bloody attack on civilians sent them fleeing back to the capital. It wasn't until later when she talked about the difficulty of leaving her homeland that the tears came.

"We are the native people of Iraq — it's hard for us to leave our native country," she said through an interpreter. "The hope — even now — is to go back to my country."

Such stories are told with increasing regularity in the Detroit suburb of Sterling Heights, the center of a growing population of refugees who fled the war in Iraq and home to a new facility for refugee victims of post-traumatic stress, torture and other war trauma. The center, run by the nonprofit Arab Community Center for Economic and Social Services, has become a hub for healing as thousands of Iraqis, both Christian and Muslim, try to put their lives back together.

Lead therapist Husam Abdulkhaleq said the conflicts in Iraq affect new and old clients alike, regardless of ethnic or religious background. And because many were persecuted because of who they are, resettling alone doesn't solve their problems. They continue to struggle with insomnia, depression and anxiety, he said."You do not know when the patient is going to be able to deal with the trauma in their lives and move on," he said.

The Sterling Heights office, which is the second treatment center run by the nonprofit in Michigan dedicated to serving refugees from 21 countries who suffer from post-traumatic stress, is the latest sign that many Iraqis who have left their homeland have struggled to overcome the violence and other trauma they and their families experienced.

They are funded by the federal government and the United Nations and are part of a national consortium in the U.S. of treatment centers aimed at helping refugees from conflict-ridden countries. The first center opened in 2000, initially to serve Shiite Muslims from Iraq who fled after a failed uprising against then-ruler Saddam Hussein. But to meet the growing need in Michigan's Iraqi community — especially Christians who have fled the war-torn country — the second center opened in October.

Abdulkhaleq said he and fellow therapists find some of the common therapies used to treat post-traumatic stress don't work for his clients. For instance, he said, Iraqi refugees tend to express their psychological problems in a physical way, such as through headaches or stomach pain. He recalled becoming trained a few years ago in a popular therapy that involves desensitizing patients to negative thoughts and images. The technique didn't work with his Iraqi clients.

"They laugh at me — they laugh big time," Abdulkhaleq said.

The treatment is "one negative image at a time," he said. "Imagine how many negative images you're going to be dealing with with someone coming from Iraq?"The road to Michigan was long and harrowing for the Gorgees family, who shared their story with The Associated Press recently in a small office at the Sterling Heights center.

On an October morning in 2005, Ekhlas' husband Khalid Gorgees was walking to his small plumbing shop in Baghdad when a bomb intended for U.S. troops exploded nearby — knocking him unconscious, tearing apart one leg and severely wounding his back. He awoke in the hospital, where he endured three surgeries and stayed for six months.

Three years later, Ekhlas was threatened at gunpoint by men who jumped out of a car as she walked home from church. A few days later, the same car pulled up to the Gorgees' house and fired two shots. Ten minutes later, the phone rang and the person on the other end delivered this message: "In 24 hours, if we see you here, we're going to bomb the house."

They fled north to Mosul, arriving just before an attack on civilians. They escaped harm, but soon after several masked men knocked on the door where they were staying and told them to leave.They returned to family in Baghdad, where Ekhlas' brother helped them financially until they fled to Lebanon in December 2008 to seek asylum. Once registered as refugees, resettlement officials said they should go to the U.S. to be near close relatives.

Ekhlas, 40, and Khalid, 43, still feel psychological pain from their experiences. Both suffer from PTSD, with symptoms including flashbacks, nightmares and insomnia, as well as crying and anger spells. He also continues to deal with the physical pain from his injuries, though he is grateful for a successful hip replacement surgery after arriving in the U.S. this spring.

Adjusting to life in Michigan with their two small children has been difficult. Khalid said he wants to work but still cannot, so the family relies on government and family support.

It's too early to say how they will respond to their therapy sessions. So far they have met just a few times with therapist Haitham Safo, who himself has family in Iraq. At one point while translating for the couple, Safo stopped mid-sentence."I'm sorry," he said, wiping away tears, then correcting himself as he regained composure. "I'm not sorry — this is reality. We all share this story.

Copyright 2010 Associated Press.

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