By Mona Dougani

Asheville, Charlotte, Durham, Greensboro and Raleigh are starting to see Afghan refugees, who were displaced from their home country in August, resettle in North Carolina.

As they arrive, other Afghan residents already in this state have lessons in some of the mental health challenges that often accompany refugees fleeing turmoil who are suddenly thrust into a new life in a foreign place.

Since the Taliban overthrew the Afghan government on Aug. 15 and U.S troops withdrew from the country 15 days later, many who had lived in the country and fled for safety reasons are being dispersed around the globe.

But a larger exodus from Afghanistan has been going on for two decades now. 

Over the years, roughly 6 million Afghans have been forcibly displaced from their homes, according to the United Nations Refugee Agency. Of those 6 million, about 3.5 million are still living in Afghanistan, while 2.6 million are refugees living around the world. 

North Carolina is expecting about 1,169 refugees in this most recent wave. 

A new way of life 

Amina, an Afghan refugee who came to the Triangle nearly a year ago, said though the journey was difficult with the language barrier, she felt that she had support. 

“I got help with finding a job, English classes, finding school for my kids, and my husband was able to find mental health services,” she told NC Health News in an interview in Farsi.

Images of war and violence were haunting her husband. He left Afghanistan with family still there. 

Though Amina left family behind, too, she has been overwhelmed by the support she has found in Raleigh. 

The United States Committee for Refugees and Immigrants, a non-profit organization that set up an office in North Carolina in 2007 to provide support to refugees in their transition to life in this country, has been helpful. 

Amina also found support and work at Designed for Joy, a non-profit in Raleigh that hires and helps women who come from vulnerable situations. At their new shop near the city’s warehouse district, the organization also sells earrings, necklaces, bracelets and other gifts while women stitch together handbags and more in a room attached to the store. 

In the evenings on Monday through Thursday, when Amina is not hard at work making handbags, she takes English classes. She does all this while also tending to her four children, who range in age from a toddler to teens. But memories of war are always a stressor always lurking in the background.

The ongoing war and violence in Afghanistan over the past two decades has taken a serious toll on the mental health of Afghan residents and refugees in this country and elsewhere. 

One yellow handbag (left) and one blue handbag (right) are displayed showcasing Aminas work.
Two larger purses that Amina designed at the Designed for Joy headquarters in Raleigh. Photo Credit: Mona Dougani

PTSD, anxiety and depression

According to a 2019 article from the Human Rights Watch, about half of the Afghan population experiences post-traumatic stress, anxiety or depression

Khadija Bahari, an Afghan woman from the Hazara ethnic group who moved to this country in 2005 and now lives in Virginia, often speaks about seeking equality for women in Afghanistan. In a recent telephone interview, Bahari said that it has been hard to watch and read the news about the Taliban takeover of the government.

“I feel terrible,” Bahari said. “I feel very painful. I can’t describe when the Taliban was moving forward, taking over, I was very much in fear and shock.”

“Nothing is good,” she added. “Every day there is bad news, not one bad news, several bad news.” 

Though the news has been disheartening for Bahari and other Afghans, Bahari is focusing on what is working for her.

“I mean, I have a good life,” Bahari said in August.I have a husband that I love, I love my job, I love my family, I have great friends and support. The best thing I can do is to read the news less and stay away from reading the news.

“For someone like me, who was involved in Afghanistan social activities, it’s hard not to in this critical moment, and not to look at the news and to see what’s going on,” Bahari added.

Some people do not seek professional help to soothe their anxiety and mental stress. Bahari, who understands some of the challenges and disparities that her ethnic group faces in Afghanistan, has found support among other Hazara women. In recent months, they got together and lamented that Hazara Afghans do not seem to be able to leave the country as easily as some of the other ethnic groups. 

A support group of her own

Although Bahari has a support system of her own, she questions whether the most recent arrivals from Afghanistan will have sufficient resources. 

“I don’t think there are very many sources,” Bahari said. “Lots of people, maybe 90 percent of these people cannot speak English. They are coming from rural Afghanistan with those mentalities, and it’s all shocking, even the good things in the U.S. are shocking for them. They have to go through adjusting to a new culture. 

“So, I don’t think there are enough sources, in my opinion, there are, but very limited because all these people need interpreters to translate for them,” Bahari added.

Adam Clarke, director of World Relief Durham, a refugee resettlement agency that helps with school enrollment, housing, job hunting and more, said that the language barrier can sometimes make it difficult for new refugees to access mental health services. 

“What we’re seeing on the news, what Afghans are going through, is unfortunately very common for all refugees coming from all the nations that send the United States refugees,” Clarke said. 

“For decades, there’s been very little access for them to mental health services. The current Afghan evacuees will face the same barriers that all refugees face in the US primarily around language access, but also having sufficient health insurance. In general, they’re just a marginalized population that does not receive as much access as others to mental health support.” 

Creating partnerships

In an attempt to help refugees with mental health services, since 2015, World Relief Durham has been partnering with UNC School of Social Work in their refugee and mental health wellness initiative. 

“By partnering with a university, and professionals in the mental health industry, we are tapping into trauma-based counseling and trauma-informed service training for all of our team,” Clarke said. “We’re able to provide services that are not available to most resettled refugees because of that partnership and our work with them.” 

In addition to the partnership with UNC School of Social Work, World Relief Durham also has a community engagement team to help support refugee mental health. The group focuses on cultural competency training for volunteers to build supportive friendships with refugees and immigrants to combat the social isolation that refugees face. 

Though the Triangle ranks among the larger areas across the country welcoming refugees, people in Charlotte are also aiming to help refugees. 

After Amarra Ghani held a Friendsgiving get-together in 2017, she wanted to do something for refugees from Syria. Her small act of service turned into a non-profit organization called Welcome Home Charlotte to serve new refugees in Charlotte. 

Ghani works full-time at Bank of America but says Welcome Home is her “24/7” job. 

Welcome Home’s main programs include an English language program, a food bank where volunteers can donate food, and an appointment program where volunteers take families to appointments. 

“I never intended, and I don’t think any board members really intended, that it would reach what it’s reached,” Ghani said. 

“We are very grateful and overwhelmed with the support, so now we know that there’s a community behind us, which is great because that means that we can fall back and we can have a community that is going to support us.”

Welcome Home also has seen the need for mental health access. 

“Right now, we’re in the works of connecting our refugee families to those mental health services as well,” Ghani said. 

“There’s nothing completely set in stone, but if there are people out there who are licensed therapists or psychiatrists or are under that mental health field, we will love to hear from them. We will love to partner up with them because we definitely have a scarcity in that section, for sure.”

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Mona Dougani is a recent graduate from Queens University of Charlotte, where she majored in communications and minored in journalism. She was an Emma Bowen Fellow with NC Health News in the summer of 2021...