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How do you help young Afghan refugees heal? A new program in Maine offers a way

By Rhitu Chatterjee

Published September 15, 2024 at 7:00 AM EDT

Khadija Rahmani says her son, Mujib Ur Rahman, 12, looks forward to visits from Shabana Siddiqui, a health educator who left Afghanistan in 2022. The Rahmani family arrived in the U.S. in January and settled in Maine.

It’s midafternoon, and Shabana Siddiqui has just hopped into an Uber.

Siddiqui, who is from Afghanistan, moved to the United States with her husband in 2022, and for the past couple of years, she’s worked in Maine with a project helping other Afghan refugee families with children.

On this day, Siddiqui is visiting a family she’s been working with for a few months. The parents moved to the U.S. in January with their two youngest sons, ages 19 and 12.

The family spent more than two years living in fear under the Taliban. “When the government collapsed and the Taliban took over, they were really scared for their lives,” explains Siddiqui.

But since their arrival in Lewiston, the 12-year-old boy has struggled with symptoms of anxiety and post-traumatic stress, says Siddiqui.

Khadija Rahmani speaks with health educator Shabana Siddiqui, left, as she leaves the Rahmani’s new home in Lewiston, Maine.

“One day he was at school and he got pushed by a bully,” she says. “It triggered him so much that he started crying and he even had a panic attack. And he called his mom and he was like, ‘Mom, can you come pick me up? I cannot breathe.’”

Research shows that when people fleeing violence and persecution resettle in a new country as refugees, the toll of the trauma they’ve been through can haunt them for a long time. Children are especially vulnerable. The toxic mix of past traumas and the stresses of resettlement puts such kids at a significantly higher risk of long term mental health challenges, researchers say.

“We know from years of research that children exposed to violence, separation and loss due to armed conflict and forced migration have elevated risks for problems with depression, anxiety, traumatic stress reactions,” says Theresa Betancourt, director of the research program on children and adversity at Boston College.

Studies have shown that rates of depression among refugee and asylum-seeking children range from 10% to 33%. and post-traumatic stress disorder (PTSD) rates range from 19% to 53%. Anxiety disorders are also prevalent with rates ranging from 9% to 32%.

A double burden for parents

Parents or primary caregivers can buffer against these long-term mental health consequences, but refugee parents are often struggling with their own mental health and hesitant to seek care, says Betancourt.

“Parents may feel stigma in mentioning their own struggles with problems like depression or anxiety,” she says. “And they may be concerned about discussing their child's emotional behavioral problems, too.”

That’s why Betancourt and her colleagues launched an effort to support refugee parents and children in the United States, as a way to prevent long term mental health and behavioral problems. It’s an effort run jointly by Boston College and the local non-profit Maine Immigrant and Refugee Services in the Lewiston-Auburn area.

Shabana Siddiqui at her home in Auburn, Maine. An Afghan migrant herself, the health educator says that when she visits Afghan families, “You go there as a friend and you build [a] rapport, so they can easily share everything with you."

“We're really trying to work with the family a lot earlier with a prevention focus and a mental health promotion focus,” says Betancourt.

Their approach employs people like Siddiqui who share the same language, culture and lived experience with newly arrived families. Siddiqui and her colleagues receive training to provide evidence-based emotional, social and practical support to parents and children. The organizers have used it successfully in resettled Somali Bantu and Bhutanese communities in Maine. Now, they have adapted that solution for recently resettled Afghan families in Maine and Michigan.

The shadow of past traumas

The Uber drops off Siddiqui on a wide, tree-lined street in Lewiston with big houses on either side. She walks up to a house and knocks on the front door. A lanky boy with big eyes and thick, black hair opens the door and greets Siddiqui in Dari, their shared language.

This is Mujib Ur Rahman, the 12-year-old Siddiqui told me about. His parents — Khadija and Mohammad Rahmani — are waiting upstairs, outside their first floor apartment. They greet her with smiles and an effusive welcome in Dari.

“You go there as a friend and you build [a] rapport, so they can easily share everything with you,” Siddiqui says.

The Rahmanis welcome Siddiqui into their rental apartment. Khadija brings out a large silver platter filled with dried apricots and almonds, and two thermoses full of cardamom tea, before settling into the sofa next to Mujib and Shabana. Her husband, Mohammad, sits across from them on a chair.

The family is from Afghanistan’s third largest city, Herat, where Mohammad owned a small grocery store. They still have a house in Herat with a big garden where they grew vegetables and fruit.

Mujib remembers spending most of his summer evenings doing the thing he loved most.

“After I came home from school, I would play with kites on the roof of my house,” he says.

He particularly enjoyed kite fighting with his neighbors. It’s a beloved tradition in Afghanistan and neighboring Pakistan and India, where people try to cut others’ kite strings with their own and set others’ kites free. (Although it's a bit controversial because the strings are sometimes coated with glass and other additives to sharpen them; the Taliban has banned the practice.)

“When they saw me flying kites, they would take down their kites,” says Mujib, beaming as he brags about his kite-fighting skills. “There was one who rivaled my skill and I could never free his kite. We were in competition.”

But life as Mujib knew it came to a halt in 2021, when the Taliban took control of the country.

“They did a lot of scary things right in front of people’s eyes,” he says, his voice getting softer, more hesitant as he remembers that time. ”For example, hitting and stabbing people with knives, arresting them. I thought they would come to my home and arrest me and beat me, too.”

His mom, Khadija, had been a well-known nurse and women’s rights advocate in their community. Part of her job was to identify and advocate for girls and women who were forced into marriage or were victims of domestic violence. This work made her a target for the Taliban.

So Khadija and Mohammad moved to a relative’s house along with their two younger sons, Mujib and the then 17-year-old Munib. The family stayed in hiding for two years.

“We didn’t sleep all the time, we were scared,” says Khadija. “When there was any noise, we were thinking how to run from home. For example, if the Taliban came from this side, how could we jump over the wall and run?

Then, in 2023, the family received news that they could leave Afghanistan with her two youngest sons. Despite having to leave her mother, and two adult kids — her oldest son and a daughter — behind, Khadija feels grateful to be in the United States with Mohammad, Mujib and Munib.

“We thank God a thousand times that we can start our life anew here,” she says.

But the chronic stress of the past few years has followed them here. “My husband and I stay awake until 1:30, 2 or 3 o'clock at night,” says Khadija, “because I still have that trauma from the Taliban’s regime in my brain.”

And 12-year-old Mujib has struggled the most. He is easily triggered by sudden noises, she says. “He gets pale, and his breathing gets hard. He gets panicked and runs to get out. One time there was a knock on the door, and he started crying non-stop.”

“A lot of the responses that you see in a young boy like that, those are expectable when you've been through the sort of frightening, traumatic events that he's been through,” says Betancourt.

Khadija’s training and professional experience working with victims of domestic and sexual violence have helped her understand trauma reactions and identify them in her son.

But most refugee parents might not know or understand similar reactions in their children, says Betancourt. They might not understand that if their child is acting out or having trouble following their parents’ directions, it may be related to their past trauma or current stress.

“And the child can feel quite alone in their experience,” she says, which increases the risk of symptoms of mental illnesses like depression and anxiety.

Stresses of starting a new life

Like many newly resettled refugee kids, Mujib has struggled at school.

“He’d say to me, 'Mother, I don’t want to go to this school because everyone is bullying me, and I don’t like this school. I don’t understand their language,’” says Khadija.

Mujib Ur Rahman plays a video game on a phone in his living room in Lewiston, Maine, while his parents Mohammad Rahmani, center, and Khadija Rahmani, left, talk. The family arrived in Maine in January and are coping with the stresses of a new life in a country where they don't know the language.

The language barrier is a big source of stress for Khadija and her husband, Mohammad, too. She wants to get certified to work as a nurse here, but she needs fluency in English first. She and Mohammad have been desperately looking for jobs, but most positions require some language proficiency.

“We have to learn the language because we have a hard time not knowing the language,” says Khadija.

They are taking driving lessons, even though it may be a long time before they can afford to buy a car. For now, they depend on other people in the Afghan community to give them rides for everything from grocery shopping to health appointments to visits with others in their community.

These are common sources of stress among newly resettled refugees, says Siddiqui.

It can take a long time for refugees to find a job even if they’re fluent in English, as Siddiqui was when she arrived.

“I applied for like three or four jobs at a time,” she recalls. Nothing came through for a while.

“That takes a really big toll on your mental health,” explains Siddiqui. “I was so anxious. I was diagnosed with anxiety, because my mind was running 100 miles per hour just to get a job.”

It also took months for Siddiqui and her husband to find an apartment they could rent because they had no credit history; they lived with relatives while they looked for a place of their own.

All this stress, she says, takes a toll on families.

“I can even tell you from my own experience, that the lack of getting a job, or unemployment, really strains your relationship,” says Siddiqui.

Shabana Siddiqui at her home in Auburn, Maine. As a refugee from Afghanistan, she knows firsthand how challenging it is to adjust to a new life — and the toll it takes on a family. “The lack of getting a job, or unemployment, really strains your relationship,” she says.

And strained relationships lead to family conflicts. There can sometimes be an elevated risk for violence within the home, says Betancourt, because parents are also struggling with their past traumas.

“We know this from military families, that when parents are exposed to significant violence in other settings, and they come back to rejoin their family environments,” says Betancourt, “we can see elevated problems with emotion regulation and sometimes more harsh disciplinary practices or harsh interactions between parents and children.”

She and her colleagues have also seen this in the refugee communities they have worked in.

Those harsh interactions can hurt a child’s emotional development and increase their risk of mental health problems later on, she says.

But when parents are doing well, they are better able to buffer their kids from the long term impacts of past trauma and stresses.

Help refugee kids by supporting their parents

“We really want to think about addressing those harsh interactions between parents and children and providing parents with the skills to navigate better, to regulate their own emotions, to not take those sort of violent actions towards their children,” says Betancourt.

Siddiqui and her colleagues who work with individual families, teach parents positive parenting skills, as well as ways to better manage their own stress through mindfulness strategies. Practicing gratitude, looking for moments of joy and various breathing techniques are some of the mindfulness tools that parents learn.

The peer educators also help parents navigate the everyday problems of starting afresh in a new and unfamiliar place.

Betancourt and her team found that families who participated reported fewer family arguments and a reduction in symptoms of depression and traumatic stress in their kids.

Khadija Rahmani tells me how Shabana Siddiqui has supported her, for example, when she was feeling disheartened about learning English.

“She motivated me, saying ‘It’s not hard. At least you are educated and you can read and write, and it will help you to learn English.’”

Siddiqui also helped Khadija find a job at a FedEx packaging facility where other Afghan women work, too. The position did not require knowledge of English..

And the tools of communication and emotional support that Khadija has learned from Siddiqui have helped her support Mujib.

She tries to boost Mujib’s confidence so he feels better about going to school.

Mujib Ur Rahman plays a video game on a phone. The boy is anxious about his new school; his mother tries to boost his confidence by telling him, "No one is better than you."

“To motivate him, I say ‘No one is better than you. No one is more handsome than you,’ ” Khadija says, smiling. Studies show that this kind of warm, supportive relationship with a parent is protective for kids who have experienced trauma.

Mujib still struggles with homesickness. “The first thing that I miss most is our garden, the rest of my family, my land, my home and my dog,” says Mujib.

And he misses flying kites so much he sometimes cries about it.

An Afghan boy flies a kite on the outskirts of Herat in September 2021.

But Siddiqui herself has had a huge impact on Mujib, his mother says.

“Shabana sat with him, told him good stories, and talked about safety and security. She said ‘This place is safe and you don’t need to stress.’”

Siddiqui also encouraged him to engage more at school — a big source of anxiety for him.

Mujib says he looks forward to visits from Siddiqui and talks to her a lot about his life.

“We talk about learning English,” says Mujib. “We talk about my school. We talk about everything.”

It’s helping him start to move past the shadow of old traumas and toward building a hopeful future in this country.

And in recent months his attitude toward school has become more positive. "I like learning English, I like playing soccer, I also like the gym," Mujib says. "I like all sorts of things."

Photography by Raquel C. Zaldívar. Visuals editing by Ben de la Cruz. Editing by Diane Webber and Marc Silver.
Fauzia Tamanna contributed translations for this story and, along with Rahman Aziz, did voiceovers for the audio version.