Patients arriving at the care centre are in a state of great suffering. The physical after-effects, such as joint pain and severe headaches, are compounded by serious psychological problems. In France, the precarious material situation, the difficulties in obtaining a protective status and the recurrent suspicion that hangs over exiled people hamper their reconstruction.

Patients’ backgrounds

The people who come to the Primo Levi Centre come from all five continents and from different backgrounds, but they have all suffered violence and torture in their countries of origin, as well as on the road to exile. Here are the stories of four of them:

Asmaa arrived in France two years after leaving Syria. Two years on the road, in camps, then on the road again and finally crossing the Mediterranean at the mercy of smugglers to reach Europe. Two years without school, surviving more than living. That’s a long time when you’re 8 years old… Referred to the Primo Levi Centre by an association that manages the reception of refugee families, she started seeing a psychologist a few months ago. Asmaa regularly has the same nightmare: the boat, the water so cold, so dark. In her nightmares, it’s as if she’s still in the middle of the waves, with adults screaming and children crying… She really thought she was going to die.

With the psychologist from the Primo Levi Centre, Asmaa talked about her school in Syria and her friends. At first, it was hard to remember, it’s been so long since she left. And then she was sad to think of her friends whom she no longer sees. But it was also good to remember them. Asmaa would so much like to go back to school. But it’s complicated at the moment because she lives in a hotel with her mum and they never stay in the same place. Asmaa doesn’t like the hotel. It’s better than the camps, but she would really like to have her own house.

Like many children from Syria, Asmaa is in a terrible state of exhaustion. These children have withstood so much tension, fear and uncertainty about the future. But we also know that they have tremendous capacity to rebuild. They are quick to learn French, and the school helps them to forge links with other children. This reconstruction requires careful support and guidance.

At the Primo Levi Centre, sustained psychotherapeutic care helps children like Asmaa to rediscover their childhood. In addition, close social support aims to stabilise the family’s accommodation and avoid them having to change schools if they move to another place. We need to get help with canteen meals and school supplies. We also need to forge links with all those involved in the child’s life: teachers, headteachers, parents, etc., to help them understand her difficulties and overcome them. It will take Asmaa a long time to get back to sleep without nightmares. The shipwreck, the war, the long road of exile are now part of her life, part of her story. But she needs help to detach herself from them, to turn them into elements of her past, to help her invest in the present and build the future.

Mrs N. is Iranian. She is a teacher, married with two children. In 2009, after the elections, she took part in demonstrations, like many of her compatriots. She was arrested by the police along with other demonstrators. She was arbitrarily detained for several days. During her imprisonment, she was tortured, beaten and raped. She eventually managed to leave Iran with her family. When she arrived in France, she went to an Amnesty International refugee centre, which referred her to the Primo Levi Centre. At the reception interview, Ms N. expressed the need for psychological support, as well as medical treatment to help her regain some peace and sleep. She is haunted by nightmares, regularly reliving scenes of torture. She feels guilty and ashamed of what has happened to her. Fearing rejection, she has never been able to tell her husband that she was a victim of rape. Yet it obsesses her day after day.

Treatment at the Primo Levi Centre began with one appointment a week with a psychologist and one every fortnight with a general practitioner. Very early on, Mrs N. expressed a desire to go back to work. For her, it was a question of dignity. She used to earn her living in Iran, and she doesn’t want to be dependent on society in France; she wants to be financially independent. She used to be a teacher in her country, but now she wants to work with children again. The social worker began by advising her to improve her level of French and referred her to an association offering French courses. Ms N. made rapid progress and then started training to look after children. Her mental state improved after a year in care. She now works as a home childminder for private individuals. She has obtained refugee status and continues to see a psychologist about once a month. Unfortunately, her accommodation conditions are still very precarious and remain an obstacle to her full reconstruction…

Mr V. is Kurdish, originally from Turkey. He has been imprisoned several times for his opposition to Turkish government policy, during which time he has suffered daily violence and humiliation. Mr V. weighed just 37 kg when he was finally released and fled the country. He suffers from extremely violent migraines, foot pain and memory and concentration problems. He often has nightmares about scenes he experienced in prison.

Despite the risks he faces, confirmed by recent threats, Mr V.’s asylum applications in France have only been rejected. These successive rejections plunged him into depression, then anger. He lost everything when he left his country, his family and his job. His efforts to obtain refugee status, he says, are the only thing he has left: it’s a question of honour. Despite having been in France for several years, he cannot bring himself to apply for regularisation, when he would have every chance of obtaining a residence permit for treatment. In his eyes, to obtain papers without refugee status would place him in the position of a pauper, on welfare. It would also mean renouncing a symbolic political act and the struggle of the generations that preceded him, those of his father and grandfather, who were also activists.

Mrs B. comes from the Democratic Republic of Congo. Her partner was a member of a group opposed to the government. Soldiers came to her house, beat and raped her several times and tortured and killed her partner in front of her. Taking advantage of a moment when she was no longer being watched, she managed to escape with her baby. Hunted by the soldiers, she managed to hide, find help from her family and leave the country. After a long journey, she managed to reach France. While she was being beaten and raped, Ms B.’s arms were tied. During her first consultations at the Primo Levi Centre, she presented with a left arm that was completely paralysed and extremely painful. She also suffered severe back pain. Psychologically, Mrs B. suffers from major sleep disorders and constantly relives the scenes of violence. Medical treatment was put in place, supplemented by physiotherapy sessions to try to relieve Mrs B.’s suffering, both through medical treatment and by working on her body’s mobility, using gentle massages. She is also offered psychotherapy. It seems that the dysfunction in her arm is a way for Mrs B. to distance herself from a body that has suffered so much, and to put traumatic events behind her. A long course of therapy was successfully completed, enabling Mrs B. to reclaim her body and regain confidence in herself and her ability to look after her child.