It is Thursday at 2:25 p.m., and like every Thursday, I walk into a classroom full of smiling Somali-speaking teenage girls. "Hi edo (aunt) Saida! Hi moma Saida! Salaama Aleykum!" they shout in voices filled with joy and anticipation. They know that the next hour will be filled with fun activities, food and sharing stories. They've spent most of the week looking forward to this.
I lead the Somali girls group, made up of Somalian refugee children in the Boston Public Schools, with Sonia Higginbottom, a Boston University (BU) intern, as part of my work as a Somali-speaking cultural broker at Children's Hospital Boston's Center for Refugee Trauma and a BU social work student. It's part of special outreach program created by Children's. In recent years, Somalis have been among the largest groups of refugees resettled in Massachusetts. Over the past three years, Heidi Ellis, PhD, of Children's Department of Psychiatry, has collaborated with members of the Somali community to identify ways to improve Somali youth's mental healthcare. Nearly all of these young refugees have experienced trauma, and most have significant symptoms of Post-traumatic Stress Disorder. However, most Somali youth in our community never receive mental health services.
The program is a dream come true for me. I've been working with refugee populations for many years. I first moved to Boston in 1997 to run a refugee youth program at the International Rescue Committee and I moved on to manage a refugee health program at Massachusetts General Hospital. I've seen the suffering and pain that families and children go through after experiencing many traumas. Some of the most depressing experiences I've had are watching children and parents struggle to find solutions, watching the pain of parents who are doing whatever we tell them to do to help their children, but don't have the resources to provide the kind of trauma therapy necessary to make real and lasting changes in their lives. I have always felt like a failure for not being able to do more.
The Trauma Systems Therapy (TST) program at Children's and the BU School of Social Work is transforming how we work with traumatized refugee children and their families by training cultural minorities like myself, so we can develop the clinical skills to provide comprehensive care to families in their own language and culture. Children's Center for Refugee Trauma is providing hands-on training in TST and I'm grateful and delighted to have this opportunity to train with such skilled people while continuing to help refugees.
TST starts with evaluating both the child's psychiatric issues and environmental problems that may impede the child's healthy development. It could include a family intervention with a Family Stabilization Team, advocacy for housing and health insurance, parent outreach and support, and legal and educational advocacy for the child. The treatment addresses the child's trauma within the social context, identifying stressors that specifically contribute to a child becoming emotionally dysregulated.
The girls in the group have experienced a lifetime of war and violence and are facing huge new obstacles as newly arrived refugees. All the girls were born after the war broke out in Somalia in 1991. In the refugee camps where the families lived while waiting to be processed for resettlement, they faced constant threats of hunger, malnutrition and lack of educational resources. As refugees in Boston, they face adjustment issues, academic difficulties and language and cultural barriers. Many of their parents don't speak English and don't understand how Boston's school systems work. So they aren't able to advocate for their children or communicate with their teachers.
While the Somali community struggles to adapt to a new life and overcome the horrible experiences they've gone through during the war, they bring forth incredible strengths and inspire other families with their resilience. The large, local Somali community provides social support, as families attend community gatherings where cultural values are shared and passed on to the new generation. There is a strong sense of belonging and support within these families, which makes extended family members strong allies for each healing child.
In my girls group, we build on these cultural ties and strengths. The children express their past and current states of mind through artwork and write stories about their lives. We sing and write poetry. The purpose is to make the groups fun and build on the sense of identity the girls already have. This is why the training for Somali-speaking clinical staff is so important; it allows us to meet patients within their own cultural context. I have shared their pain of living through the war, the struggle to recreate a new life in a new country, the confusion of navigating two cultures. And I have survived. Even thrived. My presence, I think, gives hope to these young girls and their families that they also can thrive and create a good life here.