It has been a year since Canada started getting an unprecedented influx of Syrian refugees, with more than 2,000 settling in Calgary alone. This is Part 1 in a five-part series looking at how those refugees are doing a year in and the effects of that influx on their support agencies.

Fariborz Birjandian, CEO of the Calgary Catholic Immigration Society, says the biggest challenge was the volume of refugees who came to Calgary. (Bryan Labby)

Settlement agencies in Alberta are bracing for up to 700 more Syrian refugees — while still struggling to cope with a surge of 4,200 who arrived in the first few months of the year.

Calgary alone has welcomed 2,400 Syrian refugees with more to come.

"We don't want 2,000 people in three months — nobody wants that. This is chaos, it's not good," says Fariborz Birjandian, CEO of the Calgary Catholic Immigration Society, one of the lead settlement agencies in Calgary.

'Empowering Syrian Refugees' is a workshop hosted by the Calgary Immigrant Education Society. (Bryan Labby)

Canada immigration officials say up to 500 government-assisted refugees could arrive in Alberta by the end of the month, and another 200 privately-sponsored refugees early next year.

Nancy Caron, a spokesperson for Immigration, Refugees and Citizenship Canada, says the number of privately-sponsored refugees is approximate, and could change depending on a number of factors, including when people are available to travel.

"Those who aren't able to travel before the end of year will arrive in 2017," Caron wrote in an email to CBC News.

Cesar Suva, with the Calgary Immigrant Education Society, helped put together a program to teach Syrian refugees the basics of early integration in Calgary. (Bryan Labby )

"It's a little bit of a struggle to keep our head above water," says Cesar Suva, a program manager for the Calgary Immigrant Education Society.

Suva put together a program called Empowering Syrian Refugees, which received $56,000 from the city of Calgary's Emergency Resiliency Fund.

Suva says the goal is to teach refugees the basics, including how to find a doctor or open a bank account.

"It could determine in fact whether this family is able to get a footing in the new community, or becoming economically or socially isolated," says Suva.

'Wild adventure'

The surge of Syrian refugees is the largest resettlement of refugees in Canada in a generation, not seen since the arrival of the 60,000 so-called 'Boat People' who came from Vietnam in 1979-80.

"[The year] 2016 has absolutely been a wild adventure for our clinic," says Cheryl San Juan, the primary care manager of the Mosaic Refugee Health Clinic in northeast Calgary.

Cheryl San Juan is the primary care manager at the refugee health clinic. She says they saw 732 refugees in a four month period, the same number of refugees they see in one year.

"It was really all hands on deck," says San Juan.

The clinic offers newcomers a variety of services from physicians and specialists — including pediatricians and obstetricians, gynecologists, nurses, social workers, dieticians and mental health therapists.

One of the emerging issues health care providers are dealing with is the cultural barrier among Muslim women, who are reluctant to speak to practitioners, especially male health care providers, on their own.

The clinic is looking at bringing in more female mental health therapists.

"The women refugees that we see coming in are experiencing that culture shift," says San Juan.

She says clinic staff are trying to educate and empower them "to find their voice as a woman."

Settlement agencies in Alberta are bracing for up to 700 more Syrian refugees — while still struggling to cope with a surge of 4,200 who arrived in the first few months of the year. 0:55

'Awful state'

The clinic is also looking at forming a refugee support group for men who are dealing with trauma, related to torture and other atrocities they endured during the conflict.

"I can name you 20 illnesses that are completely [untreated] of patients I've seen that we're trying to deal with now," says Dr. Gabriel Fabreau who treats patients at the Refugee Health Clinic.

Dr. Gabriel Fabreau spends a few days each month treating patients at the Mosaic Refugee Health Clinic in Calgary's northeast Marlborough Mall.

Dr. Fabreau says on the mental health side, some patients suffer post-traumatic stress disorder, generalized anxiety disorder and major depression.

"Up to 30 per cent of all refugees, five years after arrival, are still suffering from mental illness," says Fabreau, who referenced medical studies done on the settlement of refugees.

​Birjandian, a former refugee himself, says the settlement process will take time and it's not an easy transition.

He is proud of Calgarians' response to help the refugees. He says more private sponsors stepped forward on a per capita basis than any other city in Canada.

"We don't make decisions about who comes to Calgary, this is a government decision, however when they come here we have to do the best job possible," he said.