Clinical psychologist Samuel Kebede explains PTSD as an “unhinged memory.”
When a person suffers extreme fear, Kebede says the brain can cause that memory to splinter. It becomes inaccessible, as if it’s “scattered in places where it doesn’t belong.”
Then, even when the person is safe — perhaps re-established in Canada, 12,000 kilometres away from the dirt roads where the trauma occurred — they’re still triggering those fragments of broken memory.
Kebede, who is a refugee himself, has seen memories from the violence and precarity of refugee journeys cause flashbacks, panic, depression and sleep problems, and ruin relationships.
A group of Eritrean community members are banding together to try to bring Kebede to Calgary, hoping to help the community of roughly 5,000 people access the kind of support that’s chronically difficult for many newcomers to get in the mainstream health-care system.
Kebede is keen to treat Eritrean refugees in their mother tongue, Tigrinya, helping them patch these memories together in a safe way.
“It seems easy, but it’s not easy,” he said. “It’s not just narrating the situation or telling the story about it.”
But it brings relief.
“It’s very successful if it is conducted by an experienced therapist,” he said. “It … has a nice outcome, and we can observe positive changes in that person right away.”
Eritrean community hit hard
Kebede fled Eritrea in 2011, when he was 19. He studied psychology in Addis Ababa and has been working with Eritrean refugees in Ethiopia since.
Members of the Eritrean community reached out after a tragedy struck here.
In Calgary, five people have been killed in the last three years at after-hours drinking events in and around International Avenue. All of the victims and known perpetrators were young newcomers from the Eritrean community, and community leaders say the blame, in part, should be laid on untreated trauma.
Community leaders connected with Kebede virtually to help one victim’s family. Then they wrote a job offer, and have been trying to sponsor him through a fast-track Canadian immigration program that combines economic need and refugee status.
“We need this person,” said Syn Amanuel, an immigration consultant and volunteer with the Eritrean Canadian Community Association of Calgary.
“It’s very hard to see the victims’ families.”
She said while there are other therapists who speak Tigrinya, she hasn’t been able to find any clinical psychologists in Calgary who speak it, and the need is high.
Amanuel volunteered her services to cover the immigration process, and the aunt of one victim donated money to cover the immigration fees.
‘They need the extra care to open up’
In Calgary, many newcomers struggle to access mental health support through Alberta Health Services, and several newcomer service agencies and cultural communities provide alternatives.
Mohammad Raihan, a University of Calgary PhD candidate who has been studying these barriers, said people who are new to the country often don’t know what’s available or how to navigate the system. Plus, they often need translation, which means there’s a third stranger involved in an already sensitive conversation.
Raihan said culturally-based efforts, like health clinics set up by the Punjabi and Chinese communities in Calgary, are important.
“They are not alternatives to the health-care system at all. They are natural pathways into the mainstream system,” he said. “It’s a great initiative because mental health is very sensitive, especially for those who experience trauma. They need the extra care to open up.”
Dr. Annalee Coakley, a family doctor who specializes in care for refugees, agreed it’s hard to get mental health services within Alberta Health Services.
That’s why the Centre for Newcomers, Calgary Catholic Immigration Society and the Immigrant Education Society all have mental health teams with various language skills.
“Frankly, the mainstream system doesn’t work for anyone. But if you face additional barriers — whether it’s financial, language, cultural — the mainstream system really falls through,” said Coakley, who is also a director with the University of Calgary’s Cumming School of Medicine.
“This is why, organically, different agencies have created their own services. … It’s a fragmented system.”
When she heard of the effort to sponsor Kebede, she wondered how long it would take him to get recertified, because that’s been a huge barrier for many foreign-trained physicians moving to Canada.
A long wait
One other community organization that supports some Eritrean refugees said there are Tigrinya-speaking psychologists in Calgary now who are struggling to get certified.
The College of Alberta Psychologists requires them to get their credentials reviewed, then find a supervisor so they can practise as a provisional psychologist until they pass two different exams.
Amanuel said the community is willing to support Kebede as he works through all the requirements, even though it will take time.
Kebede has been waiting to hear from Immigration, Refugees and Citizenship Canada since the application was submitted in May. The fast-tracked pathway was estimated to take six months.
Calgary police and bylaw officers are cracking down on after-hours liquor service on International Avenue after the business district saw a series of early-morning deaths in recent years. In an interview with the CBC Calgary News at 6, reporter Elise Stolte explains how the most recent death prompted the community to renew calls for a meeting with city officials. (Photo credit: Youtube/My Eccac)
Speaking on a video call from Ethiopia, Kebede said he fled Eritrea for several reasons but the biggest was to avoid military conscription. Two of his brothers have been forced into military service, despite the fact Eritrea is not at war. He considers himself lucky to have avoided being shot, trafficked or caught as he snuck across the border.
He decided to study psychology in Ethiopia after seeing the pain around him.
PTSD is a mental wound that no one can see.– Samuel Kebede
When he graduated, he worked with the Centre for Victims of Torture in Alem-Wach, a refugee camp near Dabat in the Amhara region of Ethiopia, where the Eritrean population was doubly displaced. They fled their first refugee camps in the Tigray region in 2020 during the civil war, trying to hide from soldiers and traffickers, and mostly walking more than 250 kilometres to Alem-Wach.
“I knew unimaginable psychological traumas,” he said, noting overwhelming instances of rape and torture. “Me and my colleagues, we managed to treat hundreds of Eritreans in group and in individual therapy.”
He stepped away for personal health reasons, and several private donors have been funding his new private practice, Hope Psychological Services, so that he can offer sessions to refugees for free.
But Addis Ababa is not safe for refugees. Ethiopia stopped registering refugees in 2020; there are reports of arbitrary detention by Ethiopian police, and many refugees have fled farther to Kenya and Uganda.
According to Canada’s 2021 census, this country has welcomed more than 31,000 Eritrean refugees and immigrants, including 16,000 since 2016. The United Nations says Eritrea has one of the highest number of refugees per capita.
Coming to Canada would give Kebede a new status and safety.
“Mental health is not a luxury. PTSD is a mental wound that no one can see. Only the person who carries it knows the pain,” he said.
“I really want to help my community in Canada. It will create an opportunity for me to … create a change and to bring meaningful results for the Eritrean community.”
