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Soma Ganesan is the medical director of psychiatry for the Vancouver General Hospital and runs a mental health clinic that helps refugees. (Jimmy Jeong For the Globe and Mail)

B.C. doctor on the traumatic refugee experience and mental issues involved

WT24 Desk

Dr. Soma Ganesan sees a lot of similarities between the Syrian refugees now landing in Canada and the tens of thousands of boat people who fled Vietnam to come here several decades ago.

Both groups are from diverse socioeconomic backgrounds. Both escaped a civil war with almost nothing. And both often spent long months in refugee camps before settling in North America. Dr. Ganesan may feel this connection more acutely than others. He came to Canada as a Vietnamese refugee in 1981 and now runs Vancouver General Hospital’s psychiatry department and the Bridge Clinic for refugee health. Since opening two decades ago, his clinic has treated hundreds of vulnerable new Canadians for trauma-related illnesses. This year, the facility has seen an uptick in Syrian refugees. The United Nations has found almost half of this group has survived violence or torture.

 With the first wave of refugees from Syria arriving in British Columbia, Dr. Ganesan spoke with The Globe and Mail about meeting their needs.

Can you describe some of the horrors that your Syrian patients are reliving?

We got people that were referred here after they spent several years in Jordan, in the refugee camp there. They were brought here and sponsored by family, but they were displaced persons for a long time – they started having difficulty talking about the unsafe situation of how they left Syria. They lost family members, they lost properties.

You mentioned there are many other factors affecting the mental health of the average Syrian.

It depends on when they left home or if they saw the civil war there. Even if they were not exposed directly to trauma, people that live in the city see it on the TV and they see it on the foreign networks – those things can cause trauma by themselves. Then, when they leave, it depends on how they leave the country. What happens to them when they leave? Whether they’ve been abused, they’ve been ripped off or their property was confiscated. And when they arrive in refugee camps? How was the reception there? Was it safe, especially for women and children?

How do these symptoms manifest themselves with refugees?

Most of the time, people don’t come in and tell others that ‘Oh, I have depression or anxiety.’ To begin with, they often don’t show up with mental symptoms, but they show up with headaches, with stomachaches, frequently they eat and feel like vomiting. Not because they have an eating disorder, but because of what they went through in the refugee camps, for example.

How do you treat them?

The best thing we always want to do is make sure you create a good rapport with that person and make sure that you listen more than you talk. Attentive listening is a treatment by itself. Take time; don’t rush into their diagnosis. And make sure when you use an interpreter that the interpreter is also a cultural broker that helps you in understanding the cultural background of that person and then work through that.

Stats show roughly a third of all those fleeing Syria have been children 14 years or younger. How do you treat those kids suffering from PTSD?

The Bridge Clinic’s mandate [is only to treat adults], but we have BC Children’s Hospital here and they have a very strong department of psychiatry there. Play therapy is a key part. Sometimes asking them to tell stories by drawing, not by talking. The non-verbal communication and behaviour is so important.

Refugees and their advocates say the hardest period of settlement comes after the initial rush of finding housing, language training and other basic needs. Is that your experience?

We call it the honeymoon time. People are quite excited because they feel safer here and that they have more support. Some people say this is the first time in their life that they’re able to feel safe in their sleep because they know no one would walk in on their door and no bombs will fall in their refugee camp. A lot of people still don’t know what happened to their family back home in Syria. When they come to know that after a while of being settled here, then they begin to worry about that.

How have you been preparing for the influx of Syrians?

One thing that we formally want to do is design a two-day training course for people providing services and also people who are privately sponsoring. That would be also [be available online] across the province because I don’t think everybody should have to come to Vancouver for that. We have to provide services at the right time when people need it – the earlier the better.

Is the language barrier going to be a problem?

We now have a language interpreter bank in Vancouver. We also developed a resource menu for Arabic-speaking professionals in Vancouver. So, let’s say if we identify some issue with urology, we would be able to match that person with a urologist who can speak Arabic.

What are the backgrounds of your staff at the clinic?

Most of the counsellors working likely have immigrant backgrounds themselves and they are bilingual or trilingual. A lot of people are refugees themselves. That helps in providing some sensitivity to the issues and also dealing with people.

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