In Limbo – Holland’s traumatised asylum-seekers

Painting by a traumatised asylum-seeker
Painting by a traumatised asylum-seeker (© Eric Beauchemin)

Over the past decade, more than 400,000 asylum-seekers have come to Holland. Many of them were fleeing war, torture, or political or ethnic persecution. Large numbers of them were traumatised by their experiences. These would-be immigrants often have to wait for months of even years for their asylum applications to be examined by the Dutch authorities. This long waiting period and the uncertainty about whether they will actually be granted refugee status only exacerbate the asylum-seekers’ traumas. Now the Dutch government wants to expel over 25,000 of those who have exhausted the appeals procedures. 

Producer: Eric Beauchemin

Broadcast: September 14, 2005


Radio Netherlands, the Dutch International Service, presents “In Limbo: Holland’s traumatised asylum-seekers”. The programme is produced and presented by Eric Beauchemin.

Trauma does alter people.

There was some acts of violence in my place. My door was broken and I was beaten.

There are different levels of damage and for some people you can mean a lot but unfortunately there are still people whose soul is dead.

They wanted to kill me on the spot. Many people have been killed like that without reason.

Over 400-thousand asylum-seekers have come to Holland over the past decades from countries such as Iraq, Bosnia, Somalia, Afghanistan and Angola. Many of them were fleeing war, torture, or political or ethnic persecution. Large numbers of them were traumatised by their experiences. These would-be immigrants often have to wait for months of even years for their asylum requests to be examined by the Dutch authorities. This long waiting period and the uncertainty about whether they will actually be granted refugee status only exacerbate the asylum-seekers’ traumas. One of the asylum-seekers who has been waiting for over five years for a ruling on his status is Mohammedi Ali, a handsome 22-year-old Afghan with penetrating dark eyes. He had to flee Taliban rule at the age of 16.

Mohammedi Ali
Mohammedi Ali (© Eric Beauchemin)

One day I was sitting in the bakery where I worked, it was our family business, I was sitting there and I had a little bit long hair, I liked long hair, I was young. They come to me and without saying anything, I was busy working, they just pulled me out, get me from my hair and they pulled me out on the road and without saying a single word, they started beating me with their butts of rifles and they had whips. They started beating me. I said please wait, what is the problem, what have I done? They don’t want to talk to me, they just keep beating me. So I get very angry and without thinking I start saying bad things to them. And in that time, I just said fuck your leader Mullah Omar and his corrupt men and he’s not a Moslem and he’s not a human people, that you people are doing like this to us. And there started the problem. I said the things in the market and everybody heard, so they were very angry at me. They wanted to kill me on the spot. Many people have been killed like that without reason because they have said something about them.

Eventually a group of neighbours came out and started arguing with the Taliban. In the confusion, a man was able to rescue Mohammedi.

He said if you stay here you will just die, that is 100% sure. A few days before one person was killed for the same reason. He was killed on the spot, he was shot through his head and afterwards he was dragged in the whole street to let the people know that if somebody do again something like this, he will get the same consequences.

The Taliban searched the neighbourhood but they were unable to find Mohammedi, so they took his father instead and killed him. Traumatised by the incident, Mohammedi decided to flee Afghanistan. He borrowed $6000 and some human smugglers took him to neighbouring Pakistan. Months later he wound up in Holland where he applied for asylum. Experiences like Mohammedi’s leave deep scars, says Dr. Boris Drozdec, a psychiatrist working for the RIAGG, an institute which provides treatment to people with mental health problems. Dr. Drozdec specialises in treating traumatised asylum-seekers and refugees.

Dr. Boris Drozdec
Dr. Boris Drozdec (© Eric Beauchemin)

Lots of these people come here and they’ve lost everything. They’ve lost the material things, but they have also lost their network, their friends. A lot of them are divided from the families. Their professional roles are gone. Their diplomas are not worth anything here, far away from the country. Their family roles are gone because they are alone. So they are not fathers anymore. They’re fathers at distance. They’re husbands at distance. They’re children of their own parents in distance or even maybe they are bad children because they have left their parents there, and this is not culturally acceptable. On the top of that, they are traumatised. They have been tortured or they have been tortured and after that called by different situations where they have been confronted with war violence. Now they come here, a totally other context, don’t speak the language. They don’t know the norms and values. They even run a great risk of being repatriated.

Many asylum-seekers, says Andrée van Es, the president of the Dutch Mental Health Care Association, find it impossible when they first arrive to tell their story to the Dutch Immigration and Naturalisation Service, the IND.

When people come into the country and they have their first interview with the IND people, when they’re traumatised, people don’t talk about what happened because they don’t dare, because they are afraid or they cannot, they simply do it. It takes time. So what happens is that within this first interview with IND what really happens, it’s not in the interview. So the IND people don’t know it and afterwards, when people are in treatment with their psychologist or psychiatrist or treatment people, hopefully then they will start to talk. So the experience is that after like 6 months or a year or maybe longer, then the truth comes out.

Even 10 years after arriving here, Eva* still finds it difficult to speak about what happened to her. She is a middle-aged Armenian who was born and raised in neighbouring Azerbaijan. In the late 1980s, a conflict broke out between the two former Soviet republics over the region of Nagorno-Karabach. It wasn’t long before Eva and the other 400-thousand Armenians living in Azerbaijan began to feel the consequences. Armenians got hassled and beaten in the streets. Then people started getting killed. Eva chain smokes as she recounts the events.

Till the end we hope nothing will happen serious. Nobody could imagine that later can happen massacres, genocide. We truly believe that we are well protected by our laws and we have been born in Azerbaijan. We lived together with Azeri people. There wasn’t trouble between us and them. And suddenly it happened. Friends turned enemies to each other. EB: What is it that happened to you? Yeah, there was some acts of violence in my place, my living place, and I was beaten, yeah. When it happened, I tried to call by alarm number. So it takes time till soldiers came at my place. Fortunately I wasn’t killed because the help came. EB: Were you badly beaten? Yeah, if you can see the face black eyes, it’s bad or good, it’s up to you. EB: How many people came into your apartment? There was three. EB: Were you alone in your apartment? Yes, I had my own place. EB: And there was nothing you could do. If you screamed, no one would come. Of course, people was afraid. When some Azeris tried to help Armenians, they were also beaten by these hooligans. They’ve been very well instructed because they exactly knew where the Armenians live and they behave in professional way. You cannot say amateur. EB: So the trauma that you have was because of the general fear and because of the beating you experienced. Yes, of course. Two years, it’s not short time. When you are living day by day in fear, you are thinking what’s going to happen this night because we could hear stories which happened with some Armenians, or we could see people who have been beaten on the streets.

Eva and almost all the other Armenians living in Azerbaijan were eventually evacuated by the Soviet army. Eva felt that there was no future left for her in the former USSR. So she made her way to western Europe and eventually ended up in Holland, where she submitted a request for asylum. Her application has been repeatedly denied by the IND, yet she continues to submit appeals. Since she first arrived in Holland over a decade ago, she has been moved over a dozen times, often having to share accommodations with people from very different backgrounds.

If you know the circumstances of the asylum-seekers and refugees in The Netherlands, you know that they are living in over-crowded asylum centres.

Dr. Ronald Reijnders
Dr. Ronald Reijnders (© Eric Beauchemin)

Dr. Ronald Reijnders is a psychiatrist working for de Vonk, which caters for traumatised asylum-seekers and refugees.

It means that they are meeting a lot of people from a lot of different countries. But they are also meeting their own compatriots, and they might also discover…most of the time it’s not true, but sometimes it is…they might discover perpetrators or they might think now I’m back in my own circumstances. And it means that they are really over-stressed 24 hours a day. They can’t sleep well. They’re having attacks of anger, not only towards themselves but also towards their children or their spouses or their neighbours. And this is giving a lot of stress that might isolate people more and more. And as a function of that, they are feeling more over-stressed. It’s a vicious circle. That’s the problem when people are coming to our hospital. And most of them they are completely isolated. None of their friends or former friends want to deal with them any longer because they are overstressed, having attacks of anger. They start to fight easily. They start to isolate themselves. They’re depressed, having anxiety. Sometimes they hear voices. People from abroad might think my fellow compatriot, he’s a lunatic. I don’t want to be with him any longer. And they themselves also start thinking well I’m a lunatic. I’m not worth living any longer. So that’s what we see. A lot of people isolated, suffering from severe psychiatric symptoms, sometimes also willing to end their life.

This is what happened to Mohammedi. Since he was a minor when he arrived, he was sent to a special asylum-seeker centre.

There I was living and I started thinking about my family and what has happened to me. I started thinking, thinking and I was alone. I sit day and night. I cannot sleep. I cannot eat. I just lost my interest in life. I was so shocked and I was so deeply hurt that I didn’t want to live anymore because I had lost everything what I had, my family, my country, my city, the friends I had there. All, all of them I have lost. Day by day, I just keep falling, falling down. And one day I lost my control and I thought it’s better to die than to live like this. Why should I live? For what? All the things that I like, that was important to me, I have lost it. Now it’s only my life and my life without my country, without my family is nothing and I knew that at that time also that even if I go back I cannot go back to my country, I will never like my country again. I will never like the people again. I was fed up with the life in this world and with the religions and how people hate each other in place of loving each other. So one day I decided to put an end to my life. I wanted to burn myself. Now I can tell you what I have heard from the people what I have done. But at that time I was not conscious of what I was doing. So I burn a sofa. I put it on fire. Then I wanted to throw myself in the fire but I don’t know how it happened. Before that I can do that, the police was there and they put the fire out.

Mohammedi says he was put in jail and eventually convicted of destroying property and of wanting to kill other people. After he served 6 months in prison, a judge ordered that he receive psychological treatment. According to Dr. Drozdec, there are a wide variety of treatments available for asylum-seekers and refugees. They’re mostly on an out-patient basis and can involve individual therapy or group therapy.

Let’s look how can you continue with all this limitations that you face. How can you continue your life? And maybe, well, live a life that’s worth living, what gave you that strength and power before in your life? Was that your family? Was that the activity? How can you structure your day again? What were the things you were good in? Can you find something like that for you here? That’s it. The other way, of course, is to say, OK, let’s talk about what happened. Let’s focus on the nightmares you have. Let’s focus on the re-experiencing you have and then try to desensitize in order to diminish your nightmares and all these re-experiencing symptoms and your high arousal that you have. And usually you see that a good treatment is a combination of both: so you focus both on the damage and the healthy capacities.

Painting by a traumatised asylum-seeker
Painting by a traumatised asylum-seeker

We always combine the verbal with the non-verbal experiential which means we combine therapies where you talk about what happened and what your experiences are with other sorts of therapies where you can share and ventilate off your feelings through other media like art in creative therapy, like body movement in psycho-motor therapy or like music in music therapy. So we just want to offer different media to our clients in order to make it easier for them to ventilate off their feelings because usually it’s very difficult to find words for these awful things they’ve been through. Very often you see that they first start to share some of these experiences in other media when they don’t have to use words to share. They draw it or say it in the way what kind of music they choose to express that what they feel and stuff like that.

But for some people, no amount of treatment can help them overcome the trauma they experienced. Dr. Drozdec calls these people “dead souls”.

The dead souls don’t talk much, you know, so it’s difficult to use their words in order to make it more obvious. The dead souls are lying in bed. You know from their biography which was maybe also taken by the lawyer when they came in the country or there have been other sources. So you know from that biography that awful things happened, but they don’t talk about it. They don’t look at you. They don’t look you in the eyes. They don’t make contact. The only thing you see is very often is a huge anxiety. Shaking sometimes, but sometimes also just sitting, just sitting like a plant and not responding to any triggers from your outside, from the outside world, and also making therapists very helpless because you do whatever you can, whatever you have learnt within the years of experience in a practice and it’s just nothing happens. The treatment lasts for years and years, maybe their whole life, where a good therapist must be more of a kind of case manager who is here for years just supporting the patients, the system, the family, being available throughout the time and hoping once maybe over 10 years, the first traces of a contact will just arise. And you also see the families really being burdened by having such a dead soul within it, but also within a context which is absolutely not favourable for a refugee or for an asylum-seeker as it is now in Holland.

When I met Eva, she had just been transferred to this asylum centre outside of Den Bosch. Eva shares one of the prefabricated mobile units with three other people: a Chechnian woman and her son, and an elderly Armenian woman. She’s been receiving psychological support from the RIAGG for several years now.

Years by year, my situation is getting worser and worser so it has effect on my nervous system. During the last 14 years, I’m living in problems. I had very often thinking that I cannot handle any more with such kind of situation, with this life and even I had suicidal thoughts. Sometimes when somebody reminds me about it, yeah, it comes out in my dreams. EB: Do you have nightmares often? Now, no, but in the past yes. EB: And that stopped as a result of the treatment here? I cannot say exactly, but as a result of the treatment that I am getting here, and tablets which I am taking, yeah, I feel better. EB: Besides having nightmares, did you have other problems as a result of the trauma: inability to concentrate, inability to get out of bed in the morning, that type of thing? Yes of course. Yes. I have very bad concentration. I’m very fast irritated, getting irritation from things. Sometimes I cannot control myself, things which are going out of my control. EB: You don’t feel like you have control over your life. Not just my life, myself also.

The uncertainty and the long asylum process complicate treatment, says Dr. Reijnders.

If you are not feeling secure, if you are not feeling safe due to your traumatic experiences, well you can imagine if you get a negative decision from the part of the Ministry of Justice stating that you have to leave the country, it’s not very good for your mental health, and that’s what we see in the majority of our people. They’re not feeling safe due to traumatic circumstances and now they have to deal with the negative decision from the Ministry of Justice, so sometimes we see people we consider quite better compared to how they were when they came to the Vonk and you think well treatment is paying off in a good way, and then we see a negative decision, and then they start having their trauma-related symptoms back again.

The long waiting period in overcrowded centres also affects the well-being of many asylum-seekers, says Dr Joop de Jong of the Transcultural Psychosocial Organisation. It’s the world’s biggest independent organisation dealing with pyschosocial and mental health care for survivors of war and organised violence and is based in the Dutch capital, Amsterdam.

Dr. Joop de Jong, director of the Transcultural Psychosocial Organisation
Dr. Joop de Jong, director of the Transcultural Psychosocial Organisation (© Eric Beauchemin)

One of our Ph.D. students, Kees Laban, found out for the first time in one of the provinces, in Drenthe, that waiting for the status for more than 2 years doubles the amount of psychological problems people have. So that what we already knew on a clinical level is now proven in a scientific way that waiting for the endless asylum procedure is an enormous, traumatic stressor for people. Does this long asylum process mean that people who are already traumatised become more traumatised and those who weren’t traumatised become traumatised? Yes. That’s in a nutshell, you might say that’s what we find.

With an ever-increasing number of asylum requests and growing anti-immigrant sentiments, the Dutch government in 2001 adopted a much stricter asylum policy. It also decided to speed up the procedure to process asylum applications because it felt many asylum-seekers, including those suffering from trauma, were abusing the system through endless appeals in the courts. The government’s measures have been condemned by Human Rights Watch and other organisations for not giving asylum-seekers sufficient opportunities to seek redress in the courts. A year later, in 2002, the government created the post of Minister for Immigration and Integration, making the management of immigration flows and the control and evaluation of refugees’ and migrants’ integration efforts a top priority. Minister Rita Verdonk’s policies have led to a sharp decline in the number of asylum applications, from 44-thousand in the year 2000 to less than 10-thousand last year. Many in Holland, including the Green Party, says MP Marijke Vos, have been critical of the measures, particularly when it comes to traumatised asylum-seekers.

The policy-makers, they say, OK, our asylum procedure is successful because the number of asylum-seekers is going down, but I think they neglect the problem of the people who stay illegally in The Netherlands, because now we say to a person, OK, you can’t stay here and you have to go away, but we do nothing to help these people to get away. So they stay here, and I think especially with traumatised people, there can really be problems, because now they stay illegally in The Netherlands. They have no help at all, no medical help, nothing. So I think with these people we really will have trouble because they can’t help themselves and there is the risk they get aggressive to other people.

Dr. de Jong agrees.

I think we are putting a time bomb under our society. You can kind of lure people into an illegal existence where they are now excluded from social benefits, where they have to steal to survive. We are now seeing increasing numbers of people entering into a circuit without formal papers, and I think that’s a very tricky trend that we are promoting.

Nonetheless, Sybrandt van Haersma Buma, a member of parliament for the ruling Christian Democrat Party, defends the tougher policies.

Sybrandt van Haersma Buma
Sybrandt van Haersma Buma (© Eric Beauchemin)

We have to make sure that people who are traumatised and cannot be sent back are treated well. I think that happens reasonably well. But the other way around is to say that when an asylum-seeker is traumatised in any way, hears a no on his demand for refuge here and will never be sent back, he will not have a future here. To have a future in this country, you must understand the language, the procedures, the culture. You must be able to adapt to the very fast speed in this Western society. If somebody is traumatised and left, not given the clear advice to go back to his country, he will not have a future here until his last day, so to say. You say that they are treated quite well, but the services that are being offered to illegal immigrants are being cut back more and more, and so these people don’t have an opportunity to receive treatment. They don’t have an opportunity to get treatment here, but they have every opportunity for help to go back to their country. Their option of course is not to stay because in the procedure, it has been shown in that case that they are not a refugee, that they have no fear for prosecution. So we say that you have to go back to your country. That’s the issue.

Andrée van Es, Dutch Mental Health Care Association
Andrée van Es, Dutch Mental Health Care Association (© Eric Beauchemin)

But many of these traumatised asylum-seekers are unlikely to receive proper treatment in their country of origin, says Andrée van Es of the Dutch Mental Health Care Association.

Most countries where people come from the state of the mental health care is bad. And what we offer here, it is an illusion that you can say you can continue that in the country you come from because it’s not there. It’s not available.

From a professional point of view, Dr. Reijnders also has problems with the current Dutch policy.

If people are in treatment, it would be wise to end that treatment in the Netherlands. I as a doctor would not be in the position to decide whether they can stay or not in the Netherlands, but I know that if at least they are secure about their staying in the Netherlands, it gives them the opportunity to benefit a lot from treatment. So if you ask me, should people in treatment stay during their treatment in the Netherlands, my answer is affirmative.

Nonetheless, early last year, Minister Verdonk announced that the 26-thousand asylum-seekers who have exhausted the appeals procedures, including those who were traumatised, would be deported. Over 2-thousand have been granted asylum anyway, and several thousand more are likely to remain here in The Netherlands. But like many other of Holland’s asylum-seekers, Eva and Mohammedi live with their traumas, in constant uncertainty.

Entrance to a centre for asylum-seekers
Entrance to a centre for asylum-seekers

In the night, if I just close my eyes for 1 second, I see my dead father’s face or I see my mother crying or I see my brother reaching out for help, crying for help. I’m so afraid that I cannot close my eyes. I sit on my bed or on the chair and I can see the sun go down and it becomes night and the same place I am sitting and I see the sun again come and it’s the next day and I cannot sleep.

Day by day I see the same things. I’m waking up with the same thinking in my head. I cannot see tomorrow. I mean, my own tomorrow is unclear. And not just me, everybody who is here, until they get the status or final decision, they don’t know what’s going to happen to them. For people who are staying here 6 months, 2, 3 years, it’s not as difficult as for people who stay here longer than 5 years. Of course, I lost 10 years. It’s not short time. But now, I’m on zero level. And with no hope of it get any better. No, no, really I don’t have any hope.

My self-confidence is gone. My brain is not functioning normally. I cannot think. If I have a problem, just a little problem, it looks like a big, big burden, and I cannot solve my problems any more. If I put something in my mouth, I cannot taste it. Maybe in 24 hours, I just eat a small piece of bread with a glass of milk. I just sit day and night here and think and wait. I left Afghanistan. My own people, they don’t want me to live there, to have a peaceful life. I come to Europe and here also I don’t get accepted. I have a question to this whole world: if I cannot live in my country, if I cannot live in Europe, where should I go?

“In Limbo” was produced and presented by Eric Beauchemin. This has been a Radio Netherlands’ presentation. 

*Eva is a pseudonym.