0. Introduction

This book aims to be a resource and practical guide for health and social care professionals to prepare them to work with, and provide services for, people with refugee experience. It is targeted at health and social care professionals who are new to working with people who have been forcibly displaced. As the number of people with refugee experience continues to increase, health and social care professionals in a range of contexts will be tasked with providing effective, equitable, and culturally responsive health and social care to refugee populations whose needs are complex and often unmet. Research has demonstrated that refugees can present with complex and unmet healthcare needs, and that health professionals can feel underprepared to adequately meet these needs. The intention of this book is to provide practical suggestions and evidence-based approaches to assist health and social care professionals to improve the services they provide to people with refugee experience. It is not only for health and social care professionals, but also policymakers, educators, students, and anyone committed to building more inclusive and equitable healthcare systems.

Personal Narrative 1: Before and After

There is a deep scar that divides my life into before and after the war. Everything else is in between.

Before

In Between

The war swept my homeland, catching us unprepared for all the horrors that it brought. Some saw it coming, but for the majority of us it was inconceivable to think that it could happen to us. We lived and loved together, shared values, respected each other, and built the country and our future together. The country in which I was born fell apart. Our friends became enemies. “Our army” with its heavy artillery besieged the city with tanks and cannons targeting the city. We demonstrated for peace. We took over the streets that were blocked by masked gunmen. Until they started killing us. Every day, every moment from every weapon they had. In disbelief that the war was happening to us, we started to gather the pieces of our destroyed lives, homes, families, friendships, libraries, schools, hospitals… like kintsugi, the Japanese art of repairing broken pottery by connecting it with gold… we started putting our lives together, connected by the only gold we had, our unbreakable bonds of love, respect, solidarity, and friendship.

In my head I rewound millions of times the memories from the beginning of the war. The scenes I had watched from the window of my office: the enemy tank just two blocks away firing at the municipal building. In black and white. Sounds of the shells being launched. Sounds of the shells coming towards you. Sounds of explosions. The thick unbreathable air filled with the dust of destroyed buildings and smell of gunpowder mixed with burned lives and livelihoods.

The bread-line massacre. The first of many massacres of people trying to live. 

No water. No electricity. No food. No windows. No fuel. No communication. No transportation. No…

Destroyed libraries, research institutes, educational institutions, health facilities… A gaping hole in the ceiling of my brother’s room. My cousin killed while collecting water. Her two small children survived. The entrance to my building blown up. My little cousin killed while playing with his brother in front of their building, his brother severely wounded. 

People killed and wounded in their homes, offices, streets, shelters, while collecting water, waiting in the bread lines, attending the funerals. Children killed and wounded everywhere, while they were playing inside and outside. On their way to and from schools and during their classes. Health workers killed while saving lives. News of family members, friends, neighbours who had been killed, wounded. 

Dead bodies lined up in front of the hospital morgue. Washing the office floor in the hospital, the blood, flesh, and brain of an unknown person killed in front of it. Cleaning the debris of what was left of our sitting room after being directly hit by a shell. Hoping for this nightmare to end. 

Peacekeepers. International humanitarian agencies. Incredible humanitarians of all professions who left the comfort and safety of their homes to support us, defend our collective humanity, experience the horror, help, witness, and share. 

The power of life. Finding energy to survive from precious moments we shared with others. Joy of seeing loved ones alive. Long and strong hugs we gave each other every time we met, like it was the last time. Warm, irresistible scent of the tasty pie that mama magically made of rice and flour, the only staples we had. Being fit from always running to avoid snipers and carrying dozens of litres of water to the top floor of the building on the top of the hill where we lived. Listening to the music on a crackling radio connected to the car battery. Celebrating when the rabbit-shaped thermometer showed the room temperature of eight degrees next to the woodstove in the middle of the long and cold winter. 

We carried on. Fought back by being dignified in life and death. By going to work, distributing medicines and medical supplies, helping others, sharing, partying, grieving and hoping together, by organizing make-shift shelters, health facilities, support centres, radio programs, exhibitions, performances, concerts, book readings, festivals… 

Every day every citizen of this besieged city was going towards her or his shell or bullet, or away from it. 

No past. No future. Present, in between.

No safe place. Fear for my family, fear for my friends, fear for my life. Will this bloody war ever finish? 

News from home. Genocide.

Resettlement.

Military intervention.

Crying uncontrollably.

Recurring nightmare: endless columns of the enemy soldiers and tanks are advancing towards my home city. 

Peace. 

After

Through work witnessing peace negotiated in two countries after decades of war. Hearing a helicopter triggers the memory. Violently shaking.

Keeping positive and hopeful. My tears dried out but the excruciating pain of seeing other people suffering remains.

Returning to my country of origin and being there for its rebuilding and fragile recovery.

I remember. Walking through the streets of a once-besieged city that looks like any other European city. Beautiful and vibrant. As I walk her streets, I remember people killed and wounded in this street, at that corner. I can still clearly see where once the sign “be aware of sniper” was placed. I can still hear sniper bullets around my head. As I cross this bridge, I see my cousin crawling over it from the occupied part of the city while they were shooting at her. When I climb the mountains around the city, I realize what easy targets we were. I hate fireworks. 

Recurring nightmare: endless columns of the enemy soldiers and tanks are advancing towards my home city. 

Somehow, 29 years later still feeling vulnerable. 

I am not safe and free until everyone is safe and free.

Personal Narrative 2: A Son of a Stateless Society

Telling or writing your own story might seem like an easy task, but it is far more challenging than it appears. To narrate a life spent in continuous struggle, fighting just to declare “I am alive”, this is no simple feat. I ask myself, was this struggle my choice? Or did I fight because there was no other option but to resist the darkness that sought to consume me, to annihilate me? 

Imagine the worst atrocities that a hegemonic structure bent on annihilating an entire people could commit: civil wars, massacres, deaths, the stench of blood, tortures. Envision babies, children, the elderly, women, pregnant women, and helpless people being brutally burned alive. Is it possible to stay silent in the face of such horrors? To remain indifferent? I couldn’t stay silent. To be silent, I would either have to kill myself or be killed. 

I wanted to describe myself this way: I am a son of a stateless society. To know this, to be aware of it and to live with this awareness, and either to be totally silent in the face of a system that is so thoroughly assimilationist, or to fight against it. This is my reality. I had no other choice. The poverty that enveloped me and my family, and all the negative conditions it caused, stemmed from the colonisation of my country. It took me a few years to understand and recognize this.

During such a period, my master’s thesis was also obstructed, and the institute where I was to conduct my research threatened me, saying, “We cannot accept this work; if you insist, we will expel you from school.” However, I did not want to give up, and I completed my research and wrote my thesis. Unfortunately, as expected, my thesis was not accepted by the institute, and I was forced to find a new thesis topic. However, I did not abandon my research field. This entire process made life increasingly unbearable for me. I had to either remain silent, becoming a mute devil, because, for me, remaining silent in the face of oppression is also supporting it, or find a new alternative to continue my activism. These harsh conditions led me to emigrate from the country because I needed to feel free to say that I was truly living. 

In Exile 

Exile should be read as a place of escape, a refuge for dissenters, not only from a totalitarian regime, war, and violence but also from a society steeped in hatred. Hence, although I may be in exile out of necessity, this necessity also presents itself as a desire. For me, this situation is not merely a trap or a pit of nostalgia. When I came into exile, I asked myself how I could turn the political consequences of this into a new living space. How can we resist fascism? How have those who have been unable to see their families and loved ones for years endured exile? Imagine coming from a deranged social realm and experience of political power, and, for you, exile is both a refuge and a place where you can consciously shape your daily existence into a form of personal political resistance.

While exile often leads to some becoming pathologically introverted, it functions exactly as the veil Said mentions. For Kurds and other stateless peoples, it becomes a space to meet, encounter, and dialogue with transnational values. Exile is a form of neighbourliness; it is a place where you recreate and share certain values through your own agency. In this sense, exile has been for me an area where I established my dark memory with an anti-colonial consciousness and viewed it as a place to liberate that memory. 

With such an understanding, I reconstructed the reality that made me a subject in the diaspora. I completed my master’s degree with a thesis focusing on Kurdistan’s century-long colonization in a northern European country where I have lived for about seven years without ever falling into despair. I strive to strengthen and transform the struggle I maintain for my people using the advantages my current circumstances provide. For me, the diaspora has been a space where I develop new perspectives and strategies, meet people from different nations who share common concerns that strengthen my struggle, and nurture my hope further. This struggle and hope have allowed me to work in a field today where I can create solutions for the challenges of people from various nations and serve them. 

Personal Narrative 3: My Only Sorrow

Writing this text wasn’t easy for me. I opened my laptop several times and sat down to write, each time starting with a thought that would take me on a journey, dragging me down like a terrifying nightmare. Along with the fear, anxiety, and worry that tormented me, I would close my laptop again, with a heart full of sorrow, without having written anything. I sought help from my friends who were writing about their own experiences. It was effective; I felt that I wasn’t alone, that all of us were going through similar pain, and that this shared feeling was a source of comfort and healing for our wounds. 

Amir Abdur Rahman Khan, who spared no effort to exile and massacre my people, even forcing religious clerics to issue a Fatwa to justify his actions, began the slaughter and exile of the Hazara people. Many still believe in that Fatwa today, and it has been the ideological basis for terrorist groups in Afghanistan for the genocide of the Hazara people (Hakimi, 2023). 

When the Soviet war and the civil wars intensified, the fear of war, the killing of innocent people, and famine forced my father, a poor, illiterate villager who was opposed to migration, to leave his homeland. The only seemingly better destination was Iran, due to the linguistic and religious similarities and our limited financial means, given the young age of his children.

I was born in Iran in a state hospital. My mother said that Iran was at war with Iraq at the time, but it was still better than Afghanistan. While I was in the hospital due to some medical problem in the neonatal ward, a rocket hit nearby. My family thought I might not survive, but the part of the hospital where I was remained undamaged. Many times, in my life, I have wished that the rocket had hit the part where I was; maybe it would have been easier, simpler for me. But fate seemed to have another plan for me—to survive and fight for my life. 

We lived in Iran for years with a special ID card for Afghan refugees, labelled with large red letters. Without any human or civil rights, my only chance was being able to go to school. Despite the relative calm during that time, even with that ID, my father was arrested and humiliated several times under the pretext of not being allowed to work or to be in Iran, before being released. But even that seemed better than being in Afghanistan, especially during the initial period when the Taliban were taking over. Every day, we were tormented by distressing news of Hazara massacres, hoping that the Iranian government wouldn’t force us to return. 

In 2002, Tabriz, the border city where we were living, was declared a restricted area for Afghans. We had to leave the city and everything that we had made from scratch—our home and friends that we had grown accustomed to and found some solace in. This time, my father was no longer young; the wrinkles on his forehead testified to his tiredness and inability to endure more humiliation, relocation, and confusion. After discussing with friends and relatives, and with the relative calm created by the presence of the United States and its allies, and the fall of the Taliban regime, hopes were higher, and my father was determined to go back to Afghanistan. Despite all the challenges, I had just been accepted into university and wanted to celebrate this, but I knew I would be alone and had to continue the journey on my own. My father, who had always been my support during tough times, squeezed my arms and said, “You have grown up now. Stay and finish your studies so that you don’t end up like me—displaced. Have a better fate.” I found strength and tried to continue. 

In Afghanistan, I was intensely involved in my work, focused only on my goals—improving the department and teaching. During my lectures, I had found a unique opportunity to not only teach anatomy and share my experiences but also to speak about enlightenment and resistance against Taliban brutality and dictatorial ideologies. Many welcomed this, although some gave me hostile looks and whispered among themselves. 

In the department, my colleagues and I (as the first anatomist of anatomy department) managed to obtain religious and court permissions for cadaver dissection for the first time in years. With the help of the International Organization for Migration (IOM), we acquired a cadaver, and I became responsible for the dissection. Despite the fears and threats from religious extremists who opposed the dissection, we began our work. Establishing the first dissection centre after so many years was truly gratifying. 

I became determined to do something for the sake of my family, my daughters, the younger members of my extended family who looked up to me, and for all the years of hard work I had invested. I knocked on every door until, finally, one opened, and an opportunity to go to Norway as a researcher presented itself. It felt as if I had been reborn after all the despair, and I felt closer to my friends. I was happy, though my daughter was upset at the thought of losing her school friends again. All I could offer was a fatherly promise that this might be the last move. 

This was now my new home. I began to enjoy going to university again and the smiles I received from people as I was walking the streets and starting everything from scratch—something I had learned to do several times before. But it wasn’t long into my stay that I received the heart-breaking news of my father’s death. It was unbelievable; I could never see him again, nor could I be by his side or attend his funeral in Afghanistan. I had lost the pillar of my support, the one whose prayers had sustained me through the hardest days of my life. It was tough, but I endured it, just as I had endured all the hardships in my life, like so many other Afghans. At least I find some comfort in knowing that my father saw my progress and knew I had reached a safe country with my family. My only sorrow is for my fellow countrymen who are left behind, stranded in Afghanistan, and whom I can’t help.

Voltaire, Francois. 2004. Philosophical dictionary (Penguin: UK). 

Yücel, Adnan. 2013. Yeryüzü Aşkın Yüzü Oluncaya Dek (Yurt Kitap Yayın).