For Muntaser, it’s the memory of militiamen raiding his village in Darfur. For Ahmad, who fled Afghanistan as a child, it’s the terrible vision of his father murdering his mother and sister. Abdul saw his home city devastated by Saudi bombs.

Hundreds of thousands of migrants have crossed deserts, the snows of the Alps, or Balkan forests carrying the weight of similarly traumatic events, to find a new life in an increasingly inhospitable Europe. Once they get there – if they do – how do they begin to process the painful experiences that prompted their journeys?

Depression, PTSD, anxiety, self-harming, insomnia and panic attacks are among the growing mental health issues faced by asylum seekers who find themselves trapped in fear and uncertainty in Europe. In camps on the outskirts of major cities, or in safe houses, or on the pavements of European capitals, a million people await their destiny. Aid groups such as Médecins Sans Frontières (MSF) have been forced to step in to provide psychiatric care for this population of often highly disturbed people.

Where do you start? Gordana Maksimovic, a psychologist with MSF in Belgrade, says that a large part of her role is listening to people’s stories and offering them a human response. “Torture works by isolating you from others,” she says. “The only way to help is to reconnect on a human level and bring people back to society, where they belong. To reduce stigma by saying that they are not abnormal – but that what has happened to them is.”

‘When they learned of my sex change at the university, I was sacked’

Moona, 33, left Iran in 2018 and now lives in a safe house in Belgrade, Serbia

Moona was thrilled when her wife told her she was expecting a baby – and decided in that moment never to hide her true identity from her child. Though she had dreamed of being pregnant herself, Moona was not yet able to be the woman she is today; she was then living as a male Iranian university professor, married to her cousin. After learning of the pregnancy, she decided to transition, “because I wanted to be a true mother to my child, rather than a false father”.

Moona was born and raised in a small town in western Iran. “I remember once asking my mother if I could wear makeup before attending a wedding,” she says. “She told me that my father would kill both of us if I did. That’s when I understood the danger of expressing my true self in public, and decided to follow the strict rules of society.”

Instead she threw herself into her education. On the advice of her family, and a doctor to whom she expressed her gender identity, she married, but after four years decided to transition. Iran forbids homosexuality, but it does allow citizens to undergo state-funded gender affirmation surgery. At the beginning of 2015, tired of living as a man, Moona signed up.

Soon after, she fell in love with a man and remarried. It cost her dearly, however, as her ex-wife – who refused to allow her to see her daughter – threatened to expose her. “When they learned of my sex change at work, I was sacked,” Moona says. “A few nights later, my father came and told me that my brother would kill me if I didn’t leave. So in August 2018 I made it to Serbia on a fake British passport that a smuggler had given me. At the border I was kept in detention with 24 men in the same small room without any protection – they wanted to force me to return home.”

Today Moona lives in Belgrade, and suffers from panic and anxiety attacks, far from both her daughter and the man she loves. She has been granted asylum and offered resettlement in France, but is waiting for details. Meanwhile, she lives in a safe house for vulnerable people.

A few months ago she began undergoing therapy at the MSF clinic. “Therapy is helping me – we meet regularly. But things are changing very slowly. I’m lonely and homesick, and feel out of control of my life.”

She, too, likes to paint, and hopes to exhibit her work. “In a normal world, my choice would have granted me happiness. But taking possession of my sexuality has cost me everything I had.”

‘Every day I live with the terror of seeing my father’s face in the mirror’

Ahmad, 16, fled Afghanistan aged seven and now lives in a migrants’ camp in Belgrade

Ahmad says he will never forget the crazed look in his father’s eyes. Sent into a rage by Ahmad’s sister’s choice to marry a man of whom he didn’t approve, his father stabbed her in front of the whole family. When their mother tried to intervene, she was killed, too. The young Ahmad, then just seven years old, looked on paralysed with horror.

He had no choice but to flee his village. “My uncle said that if I stayed, my father would have also killed me,” he says. “He paid a smuggler to take me to Iran.” For two hours he was locked in the boot of a car speeding along the bumpy roads of Afghanistan. When he reached Iran, he became one of more than 2 million asylum seekers in the country – 800,000 of them children. Like many Afghan migrants, Ahmad found himself homeless, and lived on the streets for two years. “I was eating from the garbage. I got by begging for money,” he says.

At 10, Ahmad began working illegally for a construction company; after an injury on site, he chose to leave and head to Turkey. His journey continued for another year, passing through Istanbul before moving on to Bulgaria, where he experienced terrible cruelty and abuse. “There is no respect for migrants in Bulgaria,” he says. “In the camps, minors are victims of sexual violence and the police don’t care. I witnessed the rape of a boy. If you were alone, you became an easy target. I was sexually harassed a few times.”

In 2018 he arrived in Belgrade, where scars on his body caught the attention of Serbian volunteers, who urged him to go to the MSF clinic in the city. “Those wounds were self-inflicted,” Ahmad says. “I was depressed, suicidal, and I began self-harming. I tried to end my life a few times. I felt alone.”

Ahmad now lives in a safe house for young people, and sees a psychologist regularly. He spends most of his days with his friend Mohammed, a fellow Afghan who was his travelling companion during the arduous journey from Bulgaria to Serbia. Therapists say their close friendship has helped them to share their ordeal.

Ahmad’s first asylum request has been rejected. He says he didn’t have the courage to reveal what he describes now as “the incident”: witnessing his father murder his mother and sister. “I hid this story from the authorities because I felt ashamed. But every day I live with the terror of seeing the reflection of his face in the mirror.”

According to Maksimovic, who works with Ahmad and other young migrants, this is a common problem. “Minors who have experienced the worst trauma are often denied refugee status, because they feel too ashamed to report the abuses they have experienced.”

Memories continue to torment Ahmad, but he is starting to feel better. He attends school and goes to an art class in the afternoons; he spends much of his time in Belgrade, drawing the faces of the migrants he meets in the clinic. His dream is to exhibit in the city’s galleries.

‘I’m a grownup now. I have to make it on my own’

Aazar, 16, was separated from his father after they left Iran in 2018 and now lives in a migrants’ camp in Belgrade

At just 16, Aazar’s hair has begun to turn grey. “They say it is because of stress,” he says. “I’ve been through a lot – too much. My head is still dealing with many of the things I’ve seen.” Aazar and his father, a doctor, left Iran in 2018. “My father paid a smuggler in Turkey, and after that we tried to reach Croatia from Bosnia. But it was a disaster.”

Every year, thousands of asylum seekers who have been captured by police while attempting to cross the border into the EU are brutally beaten before being sent back. Migrants call it The Game. “One day, as we were running through the forest in Bosnia, the police caught me. My father made it. The smuggler promised my dad he would have me brought back to him in a few days. But he never answered my father’s calls.”

Father and son have not seen each other since. Aazar ended up in Belgrade, where he makes hamburgers in a burger van for €350 a month.

“My father made it to Belgium,” Aazar says. “Lucky him! The funny thing is he doesn’t have a job, so I send him money – around €150 a month. At the end of the month I have no money left.”

His shift ends around midnight and, often too tired to return home to the camp, he spends many nights on the banks of the Danube and in parks, sleeping in playgrounds. He sometimes struggles to control his anger. “It’s tough,” he says. “But I’m a grownup now. I have to make it on my own.”

“Minors like Aazar are experiencing a developmental crisis and a life crisis at the same time,” Maksimovic tells me. “Imagine having teenage issues while facing this journey. Everything from the noise at night in the camps to border violence worsens their situation.” Some children enter local schools, but the contrast with their peers can make adjusting harder. “Schools are good tools of integration, but at the same time these kids see their peers with families, living a more fortunate life, which reminds them that they are disadvantaged.”

Aazar’s dream is to reach Belgium and reunite with his father; this will bring him stability, but take him away from the treatment he is currently getting from Maksimovic. “The most frustrating part of our job is that I start therapy with a migrant and then, suddenly, he disappears to continue his journey,” she says. “But it’s even more frustrating when you think about the thousands of people out there who suffer and never even make it to a clinic.”

‘I want to return to my studies, to think about something else’

Maha, 23, fled from Syria and has lived in Greece for 18 months with her three children

At 23, Maha is sure of one thing: she may have escaped the bloody conflict that has engulfed her country but, 18 months after reaching Europe, she is still captive to it. “I feel as if I am living the war all over again, although this time it is a war that is fought within the four walls of my apartment, a psychological war that inhabits my mind.” She could write a book about the suffering of refugees, says the bubbly mother of three. “Actually, when I get the time, when my mind quietens a bit, that is what I have decided to do.”

A former volunteer nurse, Maha arrived in Greece ahead of her husband, Hussein. She tried and failed nine times to cross the land border from Turkey. Each time the refugees with whom she was travelling were pushed and beaten back by frontier guards. “They hit us, kicked us and even took the pacifier out of my baby’s mouth,” she says. “But we kept saying, ‘We’re not going to give up trying. There’s freedom there, we’ll be back.’”

It is that resilience that Melanie Vasilopoulou and her fellow psychologists try to nurture when treating asylum seekers in Athens. Flashbacks, hallucinations and PTSD are among the most common symptoms seen by Vasilopoulou. This is all accentuated by the long waits asylum seekers are subjected to by Greece’s overwhelmed asylum service.

“It’s the limbo, this endless state of waiting for asylum claims to be processed that breaks people,” she says. “I tell them to focus on their resilience, not on their problems. After all, we’re talking about incredibly strong people who have done so much to get here.”

For Maha, whose youngest child is five months old, the process of acquiring the right paperwork has been relatively easy – because she’s Syrian. But although a recognised refugee, she still lacks the travel documents that would enable her to leave Greece and visit her three siblings, who left Idlib in 2014 and are scattered across Europe.

Depression has given way to a growing sense of displacement. “I feel so lonely, so cut off,” she sighs. “I want so much to return to my studies so I can think about something else. I live in an apartment 12 metro stops from the city centre. I hardly ever see Hussein, because he doesn’t have papers and so lives somewhere else. All we do is eat and sleep, and worry.”

She has been seeing Vasilopoulou since November. “I tell Melanie all my problems. I don’t have anyone else and she is like my friend. Greece is beautiful, but it is a poor country. I don’t feel I can have any dreams here. It’s not where I want to be.”

Interview by Helena Smith

‘I was smuggled for four days across the desert’

Abdul, 26, left Yemen in 2016 and now lives in a migrants’ camp near Brussels

Abdul hasn’t been able to sleep deeply since 11 February 2016, when Saudi bombing raids in Sana’a, Yemen, forced him to leave his country and his family. Three years later, his journey in search of a new life is ongoing. Now living on the periphery of Brussels, he suffers from panic attacks and insomnia. “I’ve lost the desire to be around people,” he says. “I just don’t see any future here. You think your life couldn’t get worse, but it actually does.”

Abdul’s extraordinary journey took him from Yemen to Malaysia (one of the few countries where Yemenis can work without a visa), then to Sudan and Armenia, where he spent a year in a UNHCR camp. He moved on, stopping in Mali and paying a human trafficker to take him across the desert to Morocco. “The desert was a death sentence if you attempted the crossing yourself. They smuggled us for four days in the desert and I reached Melilla.” He was finally in Europe – a migrants’ camp in the tiny Spanish city on the north coast of Africa. “The camp was made for 100 people, but at the time contained 1,000. You cannot breathe there. There were fights every day, and the police humiliated the migrants.”

He wanted to head for the UK, to get help from the Yemeni community in London. “But the traffickers asked for £15,000 to reach London. That’s why I chose Belgium.” He was first transferred to Madrid by the Spanish government, and then in March 2018 got to the migrant camp on the outskirts of Brussels with a trafficker.

It was here that he was offered therapy by MSF, who carried out a medical checkup at the camp. Abdul now travels once a week to the city to meet a therapist. “With therapy, things started to get a little better, but I still feel this isn’t my home.” The therapy sessions are of limited value while the rest of his life is so chaotic; because the rooms in the camp are crowded and noisy, Abdul prefers to spend most of his time in the city, walking the streets.

Hélène Duvivier, mental health activity manager for MSF in Brussels, sees many common symptoms among the migrants she works with: “Loss of hope, isolation, intense sadness, and a lack of will to do anything towards meeting their goal – because they feel they have lost that goal.”

Abdul, who studied engineering in Yemen, and would like to continue his studies, has had one request to stay in Belgium rejected already. While he prepares to reapply, all he can do is walk the streets, and wait for something to change.

‘I want people to know that, in spite of everything, there is hope’

Muntaser, 30, left Darfur in 2016 and now lives in Belgium

Muntaser was 13 when he first saw the militiamen in his village in Darfur. “They confiscated all of our possessions, weapons, knives,” he says. “I remember children and women being killed in front of me.” A member of one of the majority African ethnic groups, his family were among the victims of genocide perpetrated by the Janjaweed, a group of Arab militiamen. Financed by the Sudanese government, they were responsible for the deaths of 200,000 to 400,000 people, in a war that began in 2003.

Aged 26, Muntaser was held in prison and tortured, after being accused of supporting opposition forces. “I was a farmer, and during the conflict I helped collect food in my village which was distributed among the villages plundered by the Janjaweed,” he says. Months later, he was released on condition that he collaborate as a spy. “Obviously, I didn’t agree. With that refusal began my flight.”

In March 2016, Muntaser left Sudan, crossed the desert and arrived in Sabha, Libya. He had gone from one disaster to another. “The country was unstable. Things worsened when fighting broke out between the militias and the Libyan National Army. If they captured you, they accused you of having joined one group or the other. I found myself in a similar situation to the one I had left.”

After some months, Muntaser boarded a dinghy bound for Sicily and then headed for the Alps. Now he is stuck in Belgium – unable to afford a clandestine route to London, where there is a big South Sudanese community that could help him find a job. When it gets really cold, he spends the night at a local family’s home, arranged through a community initiative to find migrants a bed. His wife and two daughters are still in Darfur.

“We’d all like to live a better life in Europe,” he says, “but when we got here, things are not as we had hoped. We live in fear, and all these things make our lives more stressful and unhappy.” He has been suffering from flashbacks. “I see the children who were killed in front of me in Darfur. In this state of despair, I have considered hurting myself.”

The therapy he attends at an MSF clinic has begun to help; today Muntaser works as a volunteer, helping new arrivals settle in Belgium. “At first it felt strange to go to a psychologist,” he says. “In my mind, that is the doctor for crazy people.” But he now encourages others to seek similar help.

Overcoming this hurdle is part of the battle for the MSF therapists: “There is a big stigmatisation of psychologists,” says Maksimovic. “Sometimes the clinic is the first time a migrant has heard of therapy.”

“I feel bad for my friends who are not getting any help here in Belgium,” says Muntaser. “I want them to know that despite everything, there is still hope.”

‘The intelligence service arrested two fellow communists. They were after me next’

Arghavan, 46, an Iranian mother and divorcee, has sought political asylum in Greece

It was political conviction that brought Arghavan to Greece. The Iranian had never wanted to make the journey to “such a different world”, but when the regime’s crackdown on communists intensified she was left with little choice. “I’d already experienced prison – I knew what it was like to be tortured. I was very scared,” she says, her eyes fixed on the floor of a room in the Athens office of MSF. “In Iran it’s illegal to be a communist. They had arrested my leader and mentor. The intelligence service was after me next.”

For the 46-year-old, escape meant survival but also the beginning of “a desire to move forward”. Almost three years later, afflicted by health problems, unable to leave Athens and struggling to survive on a UN stipend of €150 a month, she feels more marooned than ever. The instincts that once prompted the political activist to board a train from Tehran to Tabriz, take a car to the border city of Bazargan and trek, with the aid of smugglers, into Turkey have been replaced by feelings of helplessness.

Arghavan’s days are spent walking her dog, visiting an MSF doctor for the diabetes she has developed and attending monthly counselling sessions. It is not a life she ever envisaged. “I wanted to be what I am, an atheist and a feminist, and all of that I found in communism,” says the former driving instructor, who has a hammer and sickle tattooed above her left wrist. “Today I feel like a mouse in a trap.”

Like many, Arghavan never intended to stay in Greece. Her destination was the UK, and until her arrival on Samos, the eastern Aegean island opposite Turkey, that is where she thought she was heading. “I had my son, Hamed, with me because he didn’t want me to make the journey alone. We paid smugglers to get to England but they lied, again and again.”

Samos meant seven months of detainment in a desperately overcrowded camp. It was another two years before the asylum process began, a drill in mastering the art of patience. “The only thing I have learned is to be patient,” she says, apologising as she begins to weep. “I’ve no idea when my application will be ready. So many months have passed.”

Fears of her asylum request being rejected have been compounded by the other thing that dominates her life: Yasmin, the 18-year-old daughter she was forced to leave behind. Meanwhile Hamed, 28, made his way to Germany as a stowaway on a truck over a year ago.

Around 70,000 refugees are now in Greece, with the vast majority slated to remain in the country, given the closure of borders elsewhere. “I want to move forward. If the regime were to change I’d go back to Iran, but that’s not an option. I suffer every day here, but I also have a dream – to go to Germany to be with my son.”

Interview by Helena Smith

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