San Hessami, 38, saw the unimaginable during his time working as a medical assistant in Syria. And though he tried to keep his spirits up by singing to his patients as he tended to their wounds, the war took its toll on him mentally. His close friends, pumped full of bullets, died in his arms. Detonated bombs in bunkers often sent him ducking for cover.
In April 2015, the Kurdish molecular biologist fled the war to Turkey, then Egypt. He traveled through Europe and eventually landed in Norway, where he found Dr. Jone Schanche Olsen, a 65-year-old psychiatrist specializing in treating refugees at the Transcultural Centre, part of the Stavanger University Hospital. Stavanger, about 280 miles southwest of Oslo, is a quiet coastal town. It was the country’s first “City of Refuge” for persecuted writers, with a rich history dating back to 1125 AD and the motto “Open Port.” In keeping with the city’s identity as a sanctuary, Schanche Olsen has created a welcoming enclave for asylum seekers, many of whom come from cultures that place a stigma on mental illness. They come from Afghanistan, Syria, Ethiopia, and Eritrea, and have suffered some of the worst terrors.
In January, President Trump said he didn’t want immigrants from “shithole countries” coming to the United States, but would welcome those from Norway. In a twist, it is a program in Norway that’s supporting refugees from some of the world’s most dangerous places. The Transcultural Centre has treated some 650 refugees in total, and the therapy hinges on storytelling, often in the third person, so asylum seekers can remove themselves from and confront the trauma they faced.
Though Norway has typically had some of the more welcoming policies toward immigrants in Europe, increasingly conservative policies are cooling that reception. So as asylum seekers try to start a new life in Norway, Schanche Olsen and his Transcultural Centre offer a rare bastion of hope for refugees in need of psychotherapy and a chance for a new start.
Schanche Olsen, who has a shock of Richard Branson–like blondish-white hair and wears plaid shirts with dark blazers, speaks in a hypnotic baritone. His perfect English has British inflections and a slight Norwegian crispness. Over a Skype call this past spring, he explained that he opened the Transcultural Centre in 2014 after a career treating refugees, trauma victims, and torture survivors across the world, from Cambodia to Zimbabwe. He’d had ideas for such a center for years, “but of course, the war in Syria and the refugees who came at that time consolidated the basic idea that there were needs for specific mental-health services,” he said. Refugees like Hessami find their way to Olsen’s clinic, a specialized service within a university hospital, by referral—through social workers, nurses, teachers, and asylum centers. As a result of their experience, many of the patients suffer from post-traumatic stress disorder (PTSD), depression, and anxiety.
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His technique hinges on what he calls a “narrative approach,” where he has patients like Hessami process their trauma through elaborate storytelling. In some group-therapy sessions, he employs what he calls “group storytelling intervention.” In this method, his patients make up tales about scenarios similar to the ones they’ve been through. Given that many of these patients come from cultures that stigmatize mental-health care, it makes the therapy more comfortable for them.
In one meaningful example, a nurse and he traveled into the local municipality outside of the clinic to have 10 90-minute sessions with young men from Eritrea. The refugees, as they were instructed, fictionalized stories about a hypothetical person traveling from Eritrea to Norway. By participating in the story of someone else in this method, refugees disassociate themselves from the direct narrative but find a disarming way of understanding what they went through on their journey. It provides a sort of asking-for-a-friend cushion.
“In storytelling, they are processing their own story—fleeing Eritrea, going through the Sahara, going from Sudan to Libya,” Schanche Olsen said.
Hessami has deep-set, gentle brown eyes that betray a certain somberness; you can tell he’s been through a lot. But when we spoke for hours over multiple Skype sessions, his tone was upbeat, even as he recounted his trauma. The tale Hessami might tell in one of his sessions goes something like this.
He was born in 1981 in Sanandaj, the capital of Iran’s Kurdistan Province. His father, Seyed Salahaldin Hessami, is a prominent imam in Iran and for more than 20 years was the leader of the country’s Sunni Muslims. Unlike his father, though, Sam was never one for religion and took to science instead, taking his bachelor’s degree in laboratory science and his master’s in microbiology to the field. Hessami began working for UNICEF in 2012 at age 31 as a medical assistant at camps for internally-displaced persons in Iraq in the cities of Erbil, Dohuk, and Zakho, but after the war broke out in Syria, he volunteered to go there in 2014. He heard there was a dearth of doctors and nurses and felt he could make a more significant contribution if he made the move.
First, he worked for about two and a half months in a refugee camp in Kobani, where he treated teenagers and children whom ISIS had displaced. Then it was on to Derik, Syria, where he worked at a hospital for almost two months, and Sinjar, Iraq, where he helped treat the wounded in the field. Despite the violence and danger the war foisted upon him, he stayed committed to his duties. But one incident pushed him over the edge mentally and drove him to run away to Europe. It was April 2015, and a dear friend, with whom he’d had a meaningful conversation just that morning, died.
After treating his friend’s body in the traditional Muslim way, Hessami had difficulty functioning when the commander of the forces with whom he was embedded said there would be an attack the next day. He started shaking; his body wasn’t responding to his desire to calm down. He knew he didn’t want to face more explosions, gunfire, and blood. He’d been lucky in his survival up to that point. Two times bombs landed in his bunker but didn’t explode. Twice he stepped on land mines that didn’t go off. Three times he was lost in a city with ISIS soldiers and somehow slipped away from them.
After the loss of his friend and the promise of more violence, he knew it was time to leave. His nervous system was rattled, something that traveling more than 3,000 miles wouldn’t solve alone. But getting away was a start.
When he decided to leave the war that next day, he had to sneak from Sinjar to Erbil by wearing the military garb of the Peshmerga, the military forces of Iraqi Kurdistan. He couldn’t settle back in Iran with his family. As a result of his time in Syria, authorities there thought he’d become radicalized or was working as a spy.
He’d spent his career helping displaced people, and now he was one himself.
From Erbil, he went to Turkey. Then it was onto Egypt on an inflatable rubber boat “like a big tire,” he said. Next he went to Cyprus and onto Serbia, Croatia, Slovenia, Austria, and Germany. In November 2015, he made it to Norway from Germany via Denmark and Sweden. All told, the journey from Sinjar to Oslo took about eight months. Once in Oslo, Hessami’s peripatetic lifestyle wasn’t completely over. He changed refugee camps six times.
But one night in a refugee camp in Oslo, his body started to shake uncontrollably in his sleep. This became a common occurrence: He was suffering from PTSD. First, a nurse at the camp gave him some drugs to calm him down, but he wanted to face the root of the problem. Hessami’s friend suggested he see a psychologist, and he got a referral to Schanche Olsen.
Welcoming attitudes in Norway for refugees in need like Hessami are waning, and getting them the right care can be increasingly challenging. Norway, a country of 5.3 million people with immigrants making up about 14 percent of the population, has recently developed a more closed-off policy toward asylum-seekers. In 2015, the year Hessami arrived in Norway, the number of asylum-seekers was 31,150. By contrast, in the first eight months of 2018, Norway has scaled back its reception of asylum seekers: just 2,192 people lodged asylum applications in the country through August this year.
Norway’s immigration policy has tracked that trend across the continent. Since 2013, Norwegian Prime Minister Erna Solberg has led the conservative Høyre (“Right”) Party, which has a populist coalition partner, the Progress Party (Fremskrittspartiet, or FrP), with libertarian, small-government roots, as well as a center-right partner, the Venstre party. The fact that the Høyre Party holds half the country’s cabinet posts is a factor in the shift to a more restrictive immigration policy, but there’s another major force at play: The Progress Party, whose member Tor Mikkel Wara shapes Norway’s immigration policy as Minister of Justice, Public Security and Immigration, espouses even more antagonistic attitudes toward refugees.
Nima Sanandaji, Iranian-Swedish author of Scandinavian Unexceptionalism and Debunking Utopia: Exposing the Myth of Nordic Socialism, interprets Norway’s growing aversion to immigrants as a response to Sweden’s own recent experience when it had 162,450 asylum applicants arrive to the country in 2015. “Erna Solberg and her supporters have pointed to the Swedish policy as the alternative that they do not want to see for Norway,” Sanandaji said.
What’s more, the dissemination of anti-immigration reports in the press have helped to shape Norway’s increasingly negative stance toward asylum-seekers. “There has been a steady rise in xenophobia within Norway—as well as Scandinavia, Europe, and other regions in the world—based in part on xenophobic narratives promoted by the media, social media, populist parties, most prominently by FrP, not Høyre,” said Cecilia Marcela Bailliet, a professor at the University of Oslo in the department of public and international law. She said these are “fear tactics” to link the risk of terrorism to immigration.
Hessami has seen these changes in practice and how they have affected his fellow refugees. He said half of the people who were in the Oslo refugee camps with him were forced to flee Norway, as the government made it difficult for them to stay. He faced similar pressure himself while in refugee camps.
For the first month after his meltdown in the refugee camp, Hessami saw Schanche Olsen once a week. He never had an easy time opening up about his feelings. “I have no trust [in] anybody, not just for talking during treatment—for normal talking,” Hessami said. But in Norway, he couldn’t put the war in Syria behind him. He couldn’t shake the trauma. “In five months [in the war], I lost 600 persons, and every day, you know—every day, was emotional,” Hessami said. “To die for me was some gift, you know?”
Schanche Olsen was patient, and though initially there was a translator in the room, the psychiatrist suggested they talk, just the two of them, to help Hessami open up. Hessami said he sensed Schanche Olsen’s empathy and trusted his experience. But needing to talk about his feelings made Hessami feel inept, like he didn’t have the mental fortitude to process his own experience into cogent thought.
“You know actually, all of my life, I don’t talk about nothing,” Hessami said. “I put everything in my inside and repress it.”
Even though the terrible memories persisted, Schanche Olsen encouraged Hessami to focus on his positive thoughts and tell tales about the help he provided in Syria. Schanche Olsen teased those stories out from Hessami’s memory during their sessions. Soon enough, Hessami began recounting narratives about the good times in Syria and formed concrete storytelling footholds he could access later. He focused on his propensity for singing and twirl dancing when people fell into a downtrodden mood. He spun yarns about the lives he saved.
In his storytelling during therapy, Hessami also spoke about a peculiar twist of fate that restored his faith in his purpose. When he was in Derik working at a hospital for the People’s Protection Units (YPG), a militia in Syria consisting mostly of Kurds, Hessami treated a mysterious wounded Arab soldier. Hessami was known as the “Kissing Doctor,” given his propensity to plant a kiss on the cheek of his patients when they were enduring pain. As the man convalesced for the week he cared for him, Hessami was his typical jovial self and gave him a peck. Two weeks later, a member of a covert YPG unit asked Hessami to come with him to a dark, basement jail to treat an ISIS spy who had infiltrated his cohort. When Hessami got to the cell, the prisoner, sure enough, was the same Arab soldier Hessami had nursed back to health. A smile spread across the man’s face at seeing Hessami.
“Even if I show love to someone like Daesh, you can make some difference,” Hessami said. “Treatment is not just about medicine. With feel, you can treat people.” That was his philosophy in his own time as a caregiver, and that has helped him appreciate Schanche Olsen’s method.
Currently, Hessami sees Schanche Olsen for a session every two months. He doesn’t have night terrors anymore and is slowly adjusting to life in Norway. Beyond the PTSD, depression, anxiety disorder, and prolonged and complicated grief-disorder refugees like Hessami can face, there are new challenges waiting, said Pieter Ventevogel, senior mental -health officer at the United Nations High Commissioner for Refugees.
“Many of these mental-health problems are not exclusively related to the war-related experiences in the country of origin,” he said. “Daily stressors and the hardships of being a refugee or asylum seeker and difficulties related to legal procedure and refugee status play an important role as well.”
Indeed, the uncertainty of refugees’ future in a new country can be detrimental to their mental state, said Izza Leghtas, a senior advocate focused on Europe at Refugees International, a nonprofit humanitarian organization that helps displaced and stateless people. “They are in a situation of limbo, and in mental health that is…very damaging,” she said.
Hessami’s journey toward normalcy is in progress. He is attending Norwegian-language school in Stavanger—he must speak the language to stay in the country long-term and work on getting citizenship. Because of Norway’s excellent social programs, the government provides him with a stipend as he studies. He has a house to himself he rents from a Turkish Kurd. After years of sleeping next to people in bunkers and refugee camps, he’s happy to have his own large bed. He has a three-year resident permit from the Norwegian Directorate of Immigration and will have to reapply for another permit once it expires. The uncertainty looms, but he’s hopeful about the prospect of settling long-term in Norway.
Given that he is highly educated, Hessami can use his microbiology and medical background to secure gainful employment in Norway. He’s hoping to work for an oil company, a hospital, or a food or pharmaceutical company.
In the country that administers the Nobel Peace Prize, Hessami has found his peace. Norway has started to feel like home in a way that his native Iran never did.
He’ll have a continued battle ahead to integrate into society, but he has the mental tools to cope with his past and meet the challenges of his future.
For Schanche Olsen’s part, he is doing all he can to make sure asylum seekers in Norway like Hessami get proper care even as his country’s more stringent policies toward immigrants frustrate him.
“The change in attitude toward refugees and asylum seekers, it challenges our humanity,” Schanche Olsen said. “It challenges our human-rights perspectives. Our hospital is a counterattack to the government who wants everyone to know that to be an asylum seeker in Norway is terrible. That’s what they want the world to think, because then nobody will come.”
The Transcultural Centre sees patients who have been denied citizenship and then go underground for fear of being expelled from the country. These asylum seekers often have no support provided to them, and the clinic offers them mental-health support for free. That’s proven invaluable for Hessami.
“Dr. Jone is some miracle,” Hessami said. “After what I saw in this war…Dr. Jone, I think, is a gift for us. Not just me. Many people like me.”