27 Nov 2016
Treating trauma among refugees and asylum seekers in Sweden


In the heart of Sweden’s third biggest city, Malmø, lies one of the Swedish Red Cross Treatment Center for persons affected by war and torture. Every day the centre provides specialised treatment to torture survivors from all corners of the world. Since the centre first opened its doors in the late 1980s, it has helped nearly 5,000 traumatised men and women who have escaped violence and persecution, war and armed conflict.

Treating trauma among refugees and asylum seekers in Sweden

On some occasions, the trauma from torture will not rear its ugly head until decades after the incident, explains Anette Carnemalm, Head of the centre in Malmø. She has seen this happening with many of her clients, particularly women victims of torture, who only start to suffer from trauma and depression years later when their children are grown up and their time is no longer filled with caring for them on a daily basis. This shows in the group of clients that the centre treats.

“Of course we have many clients from the Middle East, but there are still many clients from the Balkans, especially women who survived the war,” says Anette. “What happens is that when a family arrives, the woman is consumed with looking after the family. When the children move from home the woman will often experience an existential crisis, which can lead to the trauma and depression that was left dormant for so many years.”

Knowing this, it is perhaps not surprising that Anette predicts that we will see a similar thing with Syrian women 20 years from now.

While the consequences of torture haven’t changed, the refugees coming to Sweden have. Before the war in the Former Yugoslavia, there were the dictatorships in Latin America during the 1970s, which saw an influx of refugees from this part of the world. Today, many of the refugees coming to Sweden are from Syria, Iraq and Lebanon as well as Somalia and Eritrea.

“It’s been a year since Sweden saw a great raise of influx in refugees arriving in the country, but we only started receiving clients much later, which is a natural consequence of refugees trying to integrate and settle. Not until they’re beyond the acute crisis will they seek help for trauma symptoms,” says Anette and continues: “The real influx in clients will be seen in a year or two from now.”

Unlike other Red Cross centres in Sweden that take many asylum seekers waiting for their case to be processed, the centre in Malmø treats a higher number of people with permanent residency. In fact, Malmø is Sweden’s most multicultural city and in the inner city there are residential areas, which are home to a large number of families with an immigrant background, as well as students and artists.

Despite this, Sweden at present has the lowest denominating standard in the EU when it comes to asylum seeking law, after just recently having introduced increasingly strict legislation on immigration. For many traumatised asylum seekers, this means they face a great deal of uncertainty, which often hinders their treatment.

“It is important to create a safe environment for a client in order for them to seek treatment, but it’s very hard in the present situation to convey that this is not a threatening environment, when it does seem threatening for a refugee who is here alone and doesn’t know if he or she will be allowed to stay,”
says Anette, as she points out that the situation for centres like hers is also uncertain. Even though her centre has so far been protected from any funding cuts, there are no guarantees.

“The political climate has changed and we now see political parties objecting to our funding so we don’t know where we’re heading in this sense.” So far, the centre has managed to expand to meet a growing demand for its services and today it has 22 staff, 19 full-time and three part-time. Their work has made a difference to not only many of their clients, but also to the torture rehabilitation movement.

“We see our efforts make a great difference in our work with the Istanbul Protocol, documenting torture, but also when a patient tells us that they are feeling better. It is immensely rewarding working, or even just sharing a coffee, with a person who has survived such terrible circumstances. See them fighting to get their life back, improving their relationship with their family and regain some of the trust that has been lost.”

“It is clear that Anette treasures her work despite the challenges that her and her colleagues face: “From here I don’t know where to go. I’m with the Red Cross and I am doing this job, and I don’t know where I would want to go that could be any better. It’s a very rewarding job, but obviously also very strenuous. As the Head of the centre it is very important to ensure that my staff don’t get too overwhelmed or stressed and stay healthy.”

Work challenges and strict immigration policies aside, Anette does hope that her centre, as well as the global rehabilitation movement will become better at sharing knowledge and influencing the current political climate.

“I hope that our knowledge will influence the political debates to a larger extent and that we can convey our knowledge about torture and rehabilitation to the rest of the world so we can change people’s opinions and understanding. There is this political movement, which is global, but there is also a growing knowledge of trauma, which is a good thing. We do a lot of lectures and people are always taken aback when they hear about our work. They didn’t know… so we need to be better at sharing knowledge and raising awareness.

“I hope that we continue to build our scientific knowledge about trauma and how best to help. As an example, there is a lot of research on how to treat PTSD among war veterans, but not much research on how to treat PTSD among people in exile - people who are supposed to integrate in a different country. What is it like to suffer from trauma in a different country, without your family and your social network, not knowing the culture nor the language?”

It is clear that the rehabilitation sector still has work to do in terms of developing and sharing its knowledge about trauma among refugees and asylum seekers and what the best treatment methods are. It is also clear that centres like the one in Malmø have a key role to play in doing so.

Anette Carnemalm is among the presenters at the IRCT 10th International Scientific Symposium, which takes place from 4-7 December in Mexico City. The Symposium will bring together more than 350 participants from across professions, sectors and countries.

Images: Copyright (c) Swedish Red Cross, Ola Torkelsson

For more information


www.redcross.se

“I hope that our knowledge will influence the political debates to a larger extent and that we can convey our knowledge about torture and rehabilitation to the rest of the world so we can change people’s opinions and understanding."

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