very evening as she got ready for bed, Narmin Al Eethawi knew that when sleep came, so would the nightmare. A woman would appear, dressed in black robes, her face shrouded. She would stalk Narmin — walking when she walked, running when she ran, but never quite catching her. Narmin realized the woman was a witch and tried to evade her. But the witch would release a cloud of smoke that would envelop Narmin’s body.
She would jolt awake, filled with terror.
“I keep crying, and I’m really scared,” she said. “I don’t want to close my eyes. I feel like something will hurt me.”
Narmin, 19, was half a world away from the horror her family experienced in Baghdad: her city in chaos, her father kidnapped, her home bombed. Living in a Northeast Baltimore apartment complex and going to high school, she was finally safe.
But on many nights, Narmin slept just a few hours at a time. During the day, she couldn’t shake the bad feelings. Sometimes she would retreat to the bathroom in her family’s apartment and curl up on the soft bath mat. There, where no one could see her, she would lean against the tub and let herself cry.
For millions of refugees like Narmin, it is a time of harrowing journeys. An estimated 60 million people, including those now risking their lives to get to Europe, flee war and ethnic conflicts in an unprecedented global migration. Some of those refugees — about 70,000 this year and 100,000 by 2017 — will land in the United States, joining tens of thousands of impoverished, undocumented youths from Central America who have arrived in waves over the past two years.
That surge is helping turn immigration into a divisive issue in Congress and the presidential campaign, but Maryland, with its strong economy and affordable housing, has been the landing place for refugees for years. Since 2010, Baltimore has taken in the largest share — 43 percent — of the 6,700 refugees settled in the state.
In few places is the trend as clear as East Baltimore’s Patterson High School, a rambling, 56-year-old brick building in a swath of green grass near the port and the remnants of the steel plant. For generations, Patterson was the portal to assimilation for waves of Poles, Greeks and Italians. Now it’s drawing a new wave of immigrant students, this time from countries such as the Central African Republic, Nepal and Tanzania. These teens speak 24 languages and make up a third of the school’s student body.
In these classrooms, immigrants take the first tentative steps in their next passage. Arriving with little English and no friends — and aching for those left behind — the teens must quickly learn to navigate a complicated new culture. Some stumble. Others show remarkable resilience.
The challenges the Patterson students face are daunting — offering a preview of issues the counties near Baltimore and many areas around the country are beginning to confront. Some teens come to America barely literate, and many are drawn away from school by the need to earn money for their families. Less than half will pass their state high school tests, and about a quarter will drop out.
Like Narmin, many immigrant teens also carry psychic wounds, and their trauma surfaces in the classroom. Mirroring a national trend, teachers are seeing more cases, and more extreme cases, of mental health issues — depression, anxiety and self-mutilation — than ever before. The city school system sent a part-time bilingual counselor to help students cope, but it is not enough.
These are not teens whose families immigrated mainly for better economic prospects, as in past generations. Instead, they came to escape war, gang violence and starvation. They had seen their villages burned, their parents kidnapped and tortured, their friends shot. They had floated across the Rio Grande in darkness and been driven out of Baghdad in the middle of the night. They had run from exploding Syrian cities and walked from African villages overrun by ethnic fighting.
“Even though your body is here, it takes a really long time to bring yourself here,” said Amy Rakusin, a psychotherapist who works with immigrants for the Intercultural Counseling Connection in Baltimore. “The impact of trauma, it stays alive in you for a very long time — in your dreams, in your thoughts, in your memories.”
Even among her Arabic-speaking friends at Patterson, Narmin (pronounced Narmeen) was not a giggly teenager. She sauntered down the school’s wide halls in khaki jeans, tennis shoes and a colorful head scarf, or hijab, pinned perfectly in place. Her teacher, Tom Smith, could see she was bright, and she had an openness that allowed her to work with people from other cultures and try new activities. Last year, she even joined the junior varsity basketball team despite knowing little about the game.
But Smith, a thin 70-year-old who had been teaching English to immigrants for a decade, noticed that when Narmin thought no one was looking, she lost her cheerfulness. He saw sadness in her eyes, sensed her mind wandering to a dark place.
Smith could have retired years ago, but he stayed in his third-floor corner classroom, unable to abandon the daily satisfactions of helping immigrants unfurl their dreams, guiding them through everything from understanding the past perfect verb tense to recognizing the signs of an abusive relationship. Sometimes, he witnessed a student who had arrived speaking no English make extraordinary progress and land in a four-year college. Too often, he saw his students drop out, broken by the need to earn money for their families and the almost impossible task of getting through high school on their limited English. He knew that many, like Narmin, were haunted.
“When I hear where they’re from, I can imagine their stories,” Smith said, “and I don’t want to do anything that will add to their pain.”
Narmin’s nightmares began almost as soon as she landed in the United States in December 2013. Eventually, to feel safer, she dragged her mattress into her parents’ bedroom and positioned it next to her mother’s side of the bed. A night owl, she often stayed up later than her parents, then sneaked into their darkened room to lie down. She kept her cellphone close, so if she needed consoling, she could silently text her boyfriend in Baghdad.
To Narmin, the witch in her dreams had been sent by the devil to put a curse on her. She knew it was a nightmare, but it came to embody all she had endured in Iraq. Her father, a truck driver who once delivered containers of flour, was hired by Americans to haul war supplies. In the eyes of the Mujahedin rebels, he was a traitor, and when Narmin was in elementary school, he was kidnapped. She remembers how the family stayed locked in their home for a week, how her mother frantically gathered $3,000 to pay the ransom, how her father returned with a large gash down the side of his face. The scar is still visible today.
To feed his family, Narmin’s father continued his work, but discreetly. For three years, Narmin’s mother walked her to school, telling her to look straight ahead so she wouldn’t see body parts and bloated, decomposing bodies littering the roadsides. American soldiers occasionally came through and loaded bodies into a truck, but often the corpses rotted in place. Iraqi residents knew that if they tried to retrieve a body, snipers from warring factions might shoot at them, the family said.
The fear was so great that even when Narmin’s mother thought she glimpsed her brother’s face as they drove among the corpses, her father would not turn the car around to see if it was him. They later discovered that the brother, Narmin’s uncle, was still alive. But their worries were legitimate: Four of Narmin’s uncles were killed in the war, a toll her mother said wasn’t unusual for Iraqi families.
“I see people get killed. I see everything,” Narmin said. “This is my country. Where do you go? We have a war. You can’t do anything.”
At the start of an April week at Patterson, six new students showed up to the English as a Second Language program.
Margot Harris, chair of the program, was coaxing a nervous Angolan girl with a head full of curls and a wide, white-toothed smile on an English assessment. The new student couldn’t understand a word Harris put in front of her, but she was trying desperately to pick up clues, her eyes darting from Harris’ face to the paper. Patiently, Harris urged her on, even as she answered every question wrong. The test was the only way Harris could determine what class to put the girl in.
For months, enrollment had been spiking with teens who had fled the Middle East, Africa and Central America. In the past two years, the number of immigrants at Patterson had tripled, to about 370 in a student body of 1,100.
“It feels like we are enrolling one a day,” Harris said.
That morning, Harris barely had time to give the test to the Angolan girl and the new boy from Pakistan when problems started showing up.
One teacher popped in the office to ask if the new students were all supposed to be in one class. Harris made a quick decision that relieved the teacher: “Let’s disperse them and get them through the next 40 days.”
Moments later, another teacher poked her head in. She thought they should check on a girl who had confided she was planning to have an abortion. At the same time, Harris knew she needed to call the parent of a girl who appeared to be skipping school with boys. Later that day, Harris would be pulled aside by a teacher who said that one of her students was having thoughts of hurting himself. She took off to investigate, marching down the third-floor hallway.
Harris was the center of the universe for the third floor, a short-order cook of an administrator who rarely had time to sit down. For months, her office, a converted classroom she decorated with rocking chairs, bookshelves and the warm colors of fabrics from around the world, had felt like a mini-crisis center. She marked a Sunday in December as a turning point.
That day, Harris was standing in a pew waiting for people to file out after a service at the Church of the Holy Apostles in Arbutus. She glanced at her phone and saw a text from a co-worker. A Nepalese student at Patterson had killed herself, and a picture of her body was being circulated by students on Facebook. Harris found herself staring at the image of her student’s body wrapped up and marked with a religious symbol.
Harris collapsed in the pew. The priest came back to her, and they said a short prayer. Then she collected herself to call the principal, Vance Benton. The death, and the photo, sent shock waves through Patterson’s immigrant students, teachers and the African-American students who had grown up with their own share of trauma from city violence. The next day, additional counselors were brought in to help students and staff.
The girl’s family had put her photo on Facebook so relatives in Nepal, who were illiterate, would understand she had died. She was a happy girl who played soccer and had many friends among the American-born students. “She was what we always wanted our kids to be,” Harris said. “She was doing everything right.”
Harris knew that some students were abusing drugs, that others had violent outbursts in class, and that a few seemed, at times, unable to stop crying. Pregnancies had doubled. But the teachers were so overwhelmed with the number of new students that they hadn’t been able to focus on the severity of the emotional issues.
“That is when I really started to see our kids’ trauma,” Harris said. “It was an epiphany.”
A mile down Eastern Avenue, the students’ problems were also turning up in many calls to the Hispanic Psychiatric Clinic at Johns Hopkins Hospital, said Donna Fallon Batkis, the clinic’s senior psychiatric psychotherapist. Young immigrant patients have been kidnapped for ransom, witnessed beheadings and seen dying people abandoned in the Mexican desert. The new waves of youths, she said, come with backgrounds far more violent than those of the Latinos who arrived a decade ago.
In their native countries and on their journeys here, Fallon Batkis said, there are “more rapes than I have ever seen, not just rape of women, but sexual abuse of men.”
The result, she said, comes out in many ways: cutting, eating disorders, depression, suicide. The children are clingy and suffer terrible nightmares. “The protective factors of routine and feeling safe aren’t there for the kids and the adults,” said Fallon Batkis, because they are in a new culture. “It’s like one giant ball of worry.”
Across the nation, the story is the same. “The level of atrocities these kids are experiencing is off the map from my point of view,” said Dr. Richard Mollica, director of the Harvard Program in Refugee Trauma, who has been studying and treating trauma in refugees for 35 years. “I have never seen this before.”
While there has been little research on the effects of trauma specifically in teens, Mollica and other researchers have shown that trauma damages the health of refugees. The short-term impact includes stomach aches, headaches, bad dreams, irritability, poor concentration and anxiety. Over a longer period, they face higher death rates from heart disease and diabetes. The rates of depression and post-traumatic stress disorder are both 10 times higher in adult refugees than in the general population.
At Patterson, after the Nepalese girl’s suicide, Smith changed his approach in class. He had always cracked jokes and laughed with students, but he began to show them more of his emotions, to share more love. And as he did, their stories came pouring out. One day, he knelt at a student’s desk to correct her writing and saw that her arm was scarred with cuts he thought were self-inflicted. He turned over her arm and gently asked her what was wrong. She began to sob.
Down the hall, another girl cut herself during a class. She approached her teacher as the period was ending, blood dripping from her arm. The teacher called the school nurse, who bandaged the girl’s arm. Harris found a social worker to talk to the girl, and then they drove her home and had a long talk with her mother.
Cutting, particularly by immigrant boys, appears to be more common among the new immigrants at Patterson than among other students, according to Eric Haber, a Spanish-speaking social worker who came to the school nearly a year ago. Teenagers who have been through trauma sometimes shut down emotionally, to avoid reliving it. But if they grow numb and depressed, cutting themselves can sometimes provide an endorphin rush and relief.
To help the students, Haber held group support sessions. Students can also see a Johns Hopkins Bayview Medical Center mental health worker available to any Patterson student as part of a citywide initiative. Harris believes more is needed: more counselors, more training for teachers.
Teacher Tammy Mayer agrees. “We are not prepared to deal with these students. They have complicated lives and need a lot more than what we're doing.”
The trauma causes anguish for teachers, too. Kati Casto didn’t anticipate she would become a nurse, mother, friend and social worker to her students. “I felt I was carrying them home with me. I would dream about them.”
Narmin’s phone buzzed with Facebook text messages throughout her day with snippets of news from Iraq. Her sister, in Baghdad, chatted about her 2-year-old son. The boyfriend Narmin left behind, Mustafa, remained her confidant, as close as her clutch of Arabic-speaking girlfriends at Patterson. They texted constantly, relaying every detail of their day. When she got lost in Baltimore and didn’t know what to do, she called 22-year-old Mustafa to help her with directions.
Even though they’d been briefly engaged, they had not seen each other in two years. She felt deeply in love, filled with questions about how they would ever be together. He often pleaded with her to come back home.
“My boyfriend talk with me, ‘Narmin, come back to Iraq,’’’ she said, looking sad. But she feared that if she did return, the people who threatened her father might go after her. “Maybe they find me and kill me. I don’t know what I can do. I am really confused.”
Generations ago, immigrants came by ship, and letters from the homeland took days or months to arrive. Today, it’s much harder to leave behind news and friends — particularly for tech-savvy teens who straddle two worlds.
“It is unbelievably disturbing to have a relative in a foreign country and go to YouTube and see a beheading,” said Harvard’s Mollica.
Teachers like Smith grapple with this every day. He never knew when to intervene and stop the texting going on. Was it just teenage chatter or some vital family communication arriving from thousands of miles away?
He worried about students like Yamen Khalil, a serious Syrian boy who sat in the back of his classroom. At home, in the West Baltimore rowhouse he shared with his father, Yamen could Skype with his mother and disabled brother, stuck in Turkey. But the cellphone was a distraction at school, where Yamen often checked it between classes for news of bombings in his village.
On the third-floor hallway, teachers tried different approaches: One allowed a student who seemed particularly desperate one morning to put her faraway boyfriend on speaker phone, so he could join an English class. Another teacher gave the kids’ phones a “vacation” in a plastic container on her desk with cutouts of a sandy beach and palm trees taped to it. The phones comically buzzed, chirped and jumped during the class, but her students were free to live in the present.
Even amid the tranquillity of a soccer field, Reema Alfaheed, one of Narmin’s best friends, couldn’t escape. She was on the phone with a friend, a boy in Syria, who was lamenting that, because of the war, he couldn’t play soccer or go to school. Then Reema heard an explosion and people screaming. The phone went dead.
Three days later, she learned her friend had survived the bombing, but was left with a head injury and broken leg. Reema felt guilty: “We are safe, and they’re not.”
Narmin picked up a piece of chalk and with a sweeping hand drew the Arabic characters on the blackboard for the word “stay.”
It was an April afternoon, the time immigrant students liked to gather in Smith’s classroom to unwind after hours in mainstream classes. Smith had just tried to write the word in Arabic and asked her for help. Narmin smiled, pulled her fingers down the side of her face to adjust her hijab and corrected her teacher’s flawed attempt. The long trailing lines and flourishes came easily to her.
She had recently told him of her dilemma. She knew it would destroy her father, but she loved Iraq and had a half-baked plan to go back to live there. Iraq held memories of warm summer nights with her close-knit family, of going to her favorite ice cream spot, of caring for her favorite grandmother. “When I was a child, everything is beautiful there,” Narmin recalled. “I have a special life in Baghdad.”
She was 14 the last time she saw the home she grew up in. That night, someone — angry that her father worked for the Americans — threw a bomb into their garage. Her grandmother’s head was hurt, and after rounding up a midwife to stitch her up, all six members of the family jammed into a car. Her mother didn’t grab the family photos, didn’t look back. She only wanted her children to be safe.
They drove 10 hours through the night to the border with Syria, then four more to the capital, Damascus. That began an odyssey typical for refugees. They spent two years in Syria. When war erupted there, they returned secretly to Baghdad, living with friends, including Mustafa’s family, to get their passports renewed. Then they left for Turkey, living there for nearly two years on the proceeds from the sale of their Baghdad house, until they received refugee status.
On Dec. 4, 2013, Narmin, along with her parents; her brother, now 16; and two younger sisters, ages 7 and 10, flew to Baltimore, the city assigned to them by resettlement agencies. They were starting over for the third time in a country that was not theirs. This time, someone had been left behind: Narmin’s grandmother, who didn’t want to leave her homeland.
Her father’s mother had lived with them for years. Narmin had helped care for her, dressing her and waiting on her when she found it difficult to walk. They were close. When her grandmother later realized it was a mistake not to go to the United States, it was too late. She’d lost her refugee status. She fell ill, slipped into a coma and died last winter.
For days, Narmin couldn’t accept this new loss. She grieved that she could not be there, the way her sister was, to hold her grandmother’s hand as she lay dying.
At Patterson in the spring, one of Narmin’s best friends, Reema, lay in a darkened room on brown bean bag seats pulled together as a makeshift bed. Her face was barely visible. Two nurses were taking her blood pressure. A whoosh of aromatic steam came from the corner. No one spoke. Narmin was at her feet, calm and silent, staring into her face.
“She is my sister, she is my friend,” Narmin said, “but sometimes I scared.”
For even as Narmin struggled with her own life during those spring weeks, Reema was taking up more and more of her attention. She started having seizures, and they were becoming more frequent. They happened in the places where Reema felt safest: in Smith’s classroom and the quiet first-floor room set aside for a meditation program.
A 17-year-old Palestinian Iraqi, Reema was playful and friendly. She often wore jeans with colorful high tops. Her hair was braided one day and straight the next. She played soccer and had friends of every nationality.
Narmin thought sometimes that Reema acted like a little girl, as though she was making up for her lost childhood. Reema had endured a lot. Through a translator, her parents explained that they were targeted in Iraq because her father was Palestinian. He was kidnapped and tortured for six months, while held underground, in the dark, in a kind of box.
After he was released, someone slid an envelope under the family’s front door. Inside were two bullets. The family knew what it meant: it was a threat to kill Reema and her older brother, Fahad. They left the next day for Syria, and later, to a makeshift refugee camp. Reema was about 6 years old.
The camp, called al-Waleed, was in a desert near the border of Syria and Iraq. According to the United Nations refugee agency, there were more than 1,500 people in the camp, with little water, nothing more than buckets for bathrooms, and no protection from blazing summer heat and winter snows beyond tents and small stoves. Those stoves proved hazardous: The tent that housed Reema, her two brothers and parents caught fire and burned down.
They lived there for six years, until they received refugee status and, like Narmin’s family, were assigned to the United States, and to Baltimore. The International Rescue Committee, which works with the U.S. State Department, has settled many refugees in Baltimore because of its affordable housing and job opportunities.
At Patterson, Reema’s seizures were happening often enough that Narmin was missing a significant number of classes. One day, Reema starting sobbing in Smith’s classroom, and Narmin cradled her until help arrived. Later, Smith confronted Narmin, telling her that he understood she wanted to help her friend, but that could not be used as an excuse. She was failing two subjects. Narmin must show up at school on time, attend class and do her homework — no matter what. Her future depended on it.
Narmin reacted in a no-nonsense way, promising to do better.
But she was getting little sleep and lacked the mental tenacity for learning English. “My head was too full,” she said later. Narmin wondered what awful experience her friend might have had in the refugee camp. “Maybe she sees ghosts,” she said.
Narmin’s worries came to a climax in the school’s front hall one day. Reema thought someone was after her and was shouting in Arabic as she flailed against a security guard, “They want to take me. They are coming. They are coming.”
An ambulance was called, and paramedics took her to Johns Hopkins Hospital.
For four days, with a tangle of wires attached to her scalp, Reema lay in bed, Narmin sometimes at her side, as physicians observed her. According to Reema and her parents, the doctors could not find any physical explanation for the seizures. They concluded the problem could be an outgrowth of the extreme stress she experienced in the camp. She was referred to mental health counseling and eventually began taking anti-anxiety medicine. The spells faded away.
Narmin eventually began to confide in Smith, her favorite teacher. Toward the end of a school day, Smith pulled up a chair across the desk from her. He sensed something was wrong and after a few minutes of chatting turned the conversation to her troubles. Speaking in hushed tones, Narmin divulged a secret she had told few people — a mystery neither would disclose. The act of sharing it brought her some peace of mind.
But she could not stop the nightmares. In one, she found her boyfriend Mustafa in a pool of blood.
So in May, Narmin reached out to a family friend well-versed in the Quran for help. He gave her a reading, but as she tried to speak the words, she turned red in the face and felt as though she couldn’t breathe. The man stopped her and told her to slip the reading under her pillow. That night, a new dream came: She saw a tiny trail of smoke — the evil curse — coming out of her body, as the religious man told her that she would be fine. In the morning, she felt different.
“It is a dream,” Narmin said, “but I feel happy.”
Slowly, as the weeks passed, she felt stronger. She stopped crying. She moved from her parents’ bedroom to her own.
For some victims of trauma, their entire being has been hurt, almost possessed by the trauma, and it takes time to heal. But experts say everyone has that capacity.
“What we have found is that resilience can be reawakened. It can be dormant,” said Rakusin, the psychotherapist. “The medicine that heals is compassion. We can open our hearts and listen.”
Harvard’s Mollica points to other factors that help these teens do better: networking with friends, being focused on school, playing sports, spirituality. He says they can, and often do, recover.
On the last day of school at Patterson, the building was unbearably hot. Few students showed up. Smith was packed up, finally retiring. But Reema and Narmin had come, with cakes and potato chips, to give him a send-off. Over the past 11 years, he had anguished over these and dozens of other students. “We’ve seen how strong they can be, but we’ve also experienced their fragility,” he said.
In that parting moment with his students, Smith couldn’t help but give them a last lesson. He encouraged Narmin to break off the relationship with Mustafa, gently acknowledging that it would be difficult for her to get him to America. The time she spent on Facebook with Mustafa, he said, is time she could be spending living in America.
“I just want someone to love me,” she said.
Smith explained that with education, she would have more opportunities to find an interesting career and partner. “I want you guys to be in places where you can grow. It is so easy to get stuck.”
Narmin’s family had grabbed the immigrant dream. Her father had a good job driving trucks. They had purchased a small house, and her younger siblings now argued in English. Her mother was taking language classes at a community college. Her friend Reema was getting counseling, and by late August, was hitting the soccer field for team practice.
As Narmin’s senior year started this fall, she buckled down and focused on her classes. She still struggled with English, and anatomy and physiology was a challenge, but she was earning top grades. She wanted a career in medicine. And she had given up all notions of returning to Iraq.
“Now I want to ... care about myself,” she said. For now, the nightmares were gone.
She had come to love the freedom she had achieved, the diversity of thought and acceptance of different kinds of people — even Iraqi girls like herself in head scarves. On a Saturday in September, Narmin took the first step toward teenage freedom. She got her learner’s permit.
“I have my life here,” she said defiantly.
And then, as she sat at the food court at the Eastpoint Mall that afternoon, life halfway around the world intruded. Her phone buzzed with a message, and her heart was pulled back to Baghdad. The past was not done with her yet.
Contact reporter Liz Bowie at firstname.lastname@example.org