October 11, 2023

Helping Refugees in Iowa Overcome War Horrors

A single mother of five children, Zara* is a refugee from Afghanistan. Like other refugees in Iowa, she is learning to navigate the American health system, language and culture. And like other refugees, she is facing an invisible challenge: toxic stress that affects brain function.

The Iowa Department of Health and Human Services reports more than 900 Afghan refugees have made their home in Iowa since the Taliban took over the Afghanistan city of Kabul in 2021.

June Klein-Bacon, BSW, CBIST of the Brain Injury Alliance of Iowa says while we often associate traumatic brain injury with concussions or other external factors, brain injury can also be caused by toxic stress. Through extreme and long-lasting adversity, toxic stress impacts the body and brain, and can result in lifelong repercussions.

Toxic Stress Has Lifelong Impact
“This kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment across the lifespan,” says Klein-Bacon. “The very life experiences of a refugee, such as witnessing violence, may contribute to how toxic trauma can alter brain function or brain development.”

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As a refugee, Zara has life experiences that are hard to imagine for most U.S.-born Americans. “Her husband was killed in Afghanistan because of the work he did with the American troops,” says Pam Kracht, an EveryStep case manager who works with Zara in central Iowa. “She and her children had to leave the country for their safety, just prior to the Taliban’s taking over. Prior to leaving, they were part of the horrors that took place at the airport in Kabul, which we all saw on the news.”

The National Child Traumatic Stress Network says refugee children and families experience significant stressors as they try to make a new life for themselves, including:

• Financial stressors.
• Difficulties finding adequate housing.
• Difficulties finding employment.
• Loss of community support.
• Lack of access to resources.
• Transportation difficulties.
• Feelings of loneliness and loss of support network.

Kracht says Zara has experienced all these stressors, and finding adequate housing is among the most urgent. “With five children (ranging in age from 2 to 12 years) and her brother in the home, three bedrooms are the minimum.” Her brother is employed, but it is a challenge to pay the rent on his income alone. “It doesn’t leave much money for anything else.” The constant stress is affecting Zara’s health. “She has migraine headaches and has trouble sleeping,” says Kracht. “She suffers from depression and PTSD.”

The Effect of Toxic Stress on Children
Klein-Bacon says Zara’s children are also at risk of lifelong impacts. Toxic stress is one of the indicators in ACEs (Adverse Childhood Experiences) and has to the potential to shape who the children will be as adults. “These adverse experiences are common among refugee and asylum-seeking populations,” says Klein-Bacon. “Research shows us that trauma is processed and stored in our brain.”

EveryStep works to ensure people like Zara, her children and brother do not fall through the cracks. Kracht says she is helping Zara as she files for disability income support due to the depression and PTSD resulting from her experience in Afghanistan. She’s helping Zara build a support network to meet people in similar situations, as well as attempting to find more affordable housing, which is difficult. EveryStep has also connected Zara with its interpreters to attend therapy for her depression, along with medication from a doctor.

Equally important, Kracht is supporting Zara emotionally. “I show up when I say I will be there to demonstrate that she matters and that even with the language barrier and cultural differences, there are people in this country who care about her and want what is best for her.”

We’ve all faced hard times in life, but some in our community are coping with more difficult circumstances. Iowa is home to more than 175,000 immigrants and refugees, many of whom have experienced traumatic situations like Zara. EveryStep shows up when people need us most – no matter who they are or what circumstances they face. The diversity and breadth of our programs ensure we can meet a variety of needs at once and provide ongoing assistance over time.

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When parents like Zara can provide the life they want for their kids, they engage more fully with their families, workplace and community. When their kids have a strong start, they grow up healthier and are more likely to reach their full potential. You have the power to help those in our community who are struggling. Please consider making a gift to make sure no one falls through the gaps in our community fabric.

*The name has been changed for confidentiality.