Even now, after years of penetrating their armor and finding her way into the dark secrets of refugees, Kim Griswold finds herself taken aback by their stories of trauma and torture.
“What people do to each other,” she says. “It’s hard to wrap your head around.”
For three years, the Buffalo physician has sat with refugees from some of the worst war-torn regions of the world, countries such as Iraq, Syria and the Congo, and heard their stories of physical abuse and personal loss.
They are stories filled with tales of beatings, strip searches and electrocutions, and Griswold will tell you, even now, she sees evidence of cigarette burns, genital cutting and whippings in the refugees she interviews and examines.
She also will tell you that rape remains a popular weapon of war, and that human trafficking of women and children is still a far too common practice in some countries.
As medical director of the Western New York Center for Survivors of Refugee Trauma and Torture, the only program of its kind outside of New York City, she is often called upon to verify the claims made by refugees seeking asylum.
It’s a job full of emotionally difficult demands. One day, she might be helping to photograph wounds and scars and, the next day, she might be face to face with the only known living member of a refugee family.
“You have to learn to listen,” Griswold says. “These are people who have witnessed violence, experienced violence. We want their story. We want to document the torture they went through. But if you probe too much, ask too many questions, they can see it as an interrogation.”
Like an overly protective mother, Griswold is a stickler about her clients' privacy – they have suffered enough in her eyes – and she is reluctant to talk about the most extreme torture cases that have come before her.
What she will tell you is that, after three years of interviewing survivors, she has heard stories of beatings with clubs and belt buckles and of refugees who were hung by their limbs for extended periods of time.
It's not uncommon to find refugees here who were subjected to false executions, humiliating interrogations, electric shock abuse and sexually deviant methods of torture.
More often than not, though, the trauma Griswold sees stems from the deep emotional loss refugees feel when they are forced to flee their homeland, often leaving family members behind. She also sees refugees forced to witness violence against loved ones.
Without exaggeration, she will tell you that these are people who flee with children on their backs.
Griswold has interviewed 52 survivors over the past three years. But one man, in his mid-20s from the Congo, stands out.
She remembers the matter-of-fact manner in which he talked about the loss of his family and his desire for asylum.
And then came the admission she will always remember.
“You may grant me asylum,” he told her, “but you’ll never fix what’s wrong with me.”
In a world full of dark, often brutal secrets, a world Griswold chose to enter three years ago, it was a reminder of the violence and terror many refugees flee when they come to the United States.
Started with funding from the Office of Refugee Resettlement, Jewish Family Services and the New York State Health Foundation, the center was formed to identify and assist a segment of refugees many suspected were falling through the cracks.
The center also partners with Journey's End Refugee Services and the University at Buffalo Department of Family Medicine. Griswold is an associate professor in the department, and UB medical students serve as interns at the center.
Over the past decade, up to 1,500 new refugees arrived here each year, and resettlement organizations, groups such as Journey's End and Vive, have been on the look out for trauma and torture survivors.
These people are the faces behind the violence in their homelands. They have seen the worst of the worst. And if you spend enough time with Griswold and the other people who meet with them, you learn their stories.
You learn about the woman in her 40s from northeast Africa who, while embarrassed to admit it happened to her, was accepting of the genital cutting that took place in her homeland.
Viewed as barbaric here, it’s a practice not uncommon in parts of Asia, Africa and the Middle East, and Griswold admits she found herself in the bizarre position of trying to explain why it was an important development in her asylum case.
“To her, it was something women went through,” she said. “It wasn’t a big deal. To her it was a normal part of what she grew up with.”
You also learn about the asylum seeker, a woman from Nigeria, brand new to the country and prohibited from working right away.
Frustrated with the delays in moving her asylum case forward, she admitted to feeling a deep sense of purposeless, a common complaint among refugees who come here eager to work and make a new life for themselves.
"Most of them share a sense of disappointment," Leonce Byimana, director of the center, said of the refugees he interviews. "What they get is not what they expected."
Like so many refugees, the woman from Nigeria found a way to get through it and she found it at a nearby library.
“She found a total world of possibilities,” Griswold said. “To her it was a little salvation."
There is some commonality to the stories Griswold, Byimana and the other care coordinators hear. Among the men and women they interview, they often see a great degree of personal loss – family members who died of violence – and, not surprisingly, a deep and palpable yearning for peace and security.
They believe the number of local refugees who are trauma survivors has gone vastly underreported and point to the large number of refugees who were forced to leave families behind before coming to Buffalo.
It’s also no secret that in some refugee communities here, including the community of people who fled Bhutan, there have been noticeable spikes in suicide rates. Griswold thinks trauma is one of the factors at work in those communities.
“There’s a humanitarian reason for why this work needs to be done,” said Marlene Schillinger, president of Jewish Family Services.
At the Center for Survivors, the mission is far greater than the objective evaluation of refugees seeking asylum, although Griswold has testified at about 10 immigration hearings on behalf of survivors.
Even more important, perhaps, are the other legs of the center’s holistic approach to helping torture and trauma victims.
The goal is to provide medical, legal and social service assistance to a group of refugees Griswold and others believe was falling through the safety net.
Immigration lawyers say it's not uncommon for asylum cases to last years, a long time to wait to work and go without housing and health care.
At the center, doctors treat refugees on a pro bono basis, lawyers help with their immigration cases and care coordinators assist with housing and other social service needs.
At every step of the way, integrity and credibility are the currencies Griswold, Byimana and the others use to gain their clients' trust. Not surprisingly, many are former refugees themselves.
"We are not authority figures,"says Byimana.
"We are peers. We want them to relate to us. They also know that when I talk, I know what I'm talking about."
Amela Soteli, a care coordinator and a refugee from Bosnia, loves to tell the story of a former client, an older woman, who even now keeps a photo of Soteli in her home. It hangs right next to a photo of Jesus.
"When I wake up," the woman often tells her, "I see Jesus and I see you, and I know I'm going to be OK."
Like Byimana and Griswold, Soteli has sat with torture and trauma survivors, and has run head first into the deep-seated distrust refugees often bring to the center. She knows her background, her experiences as a refugee, are crucial to breaking down that wall of fear and apprehension.
"It's so important," she says. "What's the point of a client sharing their story if it's a blank face staring back at them."
Griswold, who is certified by the Physicians for Human Rights, says the center's role is to objectively evaluate survivors seeking asylum and she acknowledges people “do lie."
She also knows discrepancies and inconsistencies in a refugee's story are not necessarily lies. And she will tell you that one of the important aspects of her job is educating lawyers and judges about the impact on trauma on memory loss.
By all accounts, it’s a job full of emotional minefields and Griswold often talks about “self-care” for the case workers and UB medical students who deal firsthand with trauma and torture survivors.
On any given day, she may find herself sitting with a man or woman who, despite a natural reluctance to trust, will open up about the tragedy that has dogged them for years, sometimes decades.
In some strange way, those are the encounters that give Griswold, Byimana and Soteli hope. With each tragic story also comes a hint of the strong will to survive they see in most refugees.
Yes, they may fear authoritarian figures and, yes, their first reaction may be negative, even hostile. And yet, most of them end up telling their story.
Byimana says it's because they want to, they need to and because refugees are the "most resilient people you'll ever meet."