Compassion is the theme for Refugee Week (19 to 25 June 2023), and we spoke to Nsimire Aimee Bisimwa, Highly Specialist Systemic Psychotherapist, and lecturer, on why compassion matters and what it looks like in action.
Refugee Week is the world’s largest arts and culture festival celebrating the contributions, creativity and resilience of refugees and people seeking sanctuary.
Nsimire Bisimwa had just met up with a refugee client, a teenaged girl who was in the middle of her school exams. She looked exhausted.
“She didn’t say much, and the room was quite hot so I took her for a walk and went down to the garden. First I got some water for her to drink and we sat on a bench, and then I realised she looked absent, not ok,” said Nsimire.
The girl was talking about how challenging things were at home, when Nsimire noted that it was 2pm, so she asked the young client if she had had lunch. The girl shrugged it off and told her not to worry.
“I insisted and said: it’s lunch time, did you get a chance to have lunch? And she said, ‘actually I’m hungry.’ Her family was living in a temporary accommodation with no furniture nor cooker. We went to a café, and I got her a sandwich and cup of tea. This small gesture of care made a difference for her as I noticed that after we went back to where we were, the session was different. She connected. We had to meet those basic needs before talking about her mental health,” said Nsimire.
Nsimire works with the Tavistock and Portman NHS Foundation Trust, offering specialised tailored refugee services – holistic trauma-informed and culturally sensitive therapeutic interventions for refugee families in the Family Mental Health Team. These families will have often experienced multiple traumatic events and extreme adversities in their home countries, on their journey to the UK and in the UK whilst awaiting for their asylum application to be processed by the Home Office. They present with complex needs and a great deal of resourcefulness and resilience.
She is also a Fellow of the Higher Education Academy and the course lead for the Master’s degree in Refugee Care Course at the Trust’s training arm in partnership with the University of Essex. This course responds to the uniqueness of the refugee phenomenon; it offers a rich learning experience as it combines multiple psychological and psychosocial approaches, on how to best attend to the complex needs of refugees.
The fear of not knowing, life in limbo
Small acts of compassion help asylum seekers and refugees feel safe in the host country. Safety is crucial to their healing process and full integration.
On average, it takes one to three years to get an initial decision on an asylum case, and some cases take longer than five years. During this period, it is impossible for the applicants to feel safe as they live in fear of being returned to their countries. The not knowing has a negative impact on the mental and physical health of people seeking asylum.
“I see people with high levels of anxiety due to the uncertainties about their present and their future; they feel unsafe, hopeless, and helpless. In fact, living in limbo after experiencing extreme traumatic experiences can be re-traumatising for many. Facing the hostile political environment, the housing crisis, the complex legal process, experiencing discrimination & xenophobia, and the high cost of living in the UK, affect people’s resilience and sense of worth. I see people starting to self-harm and becoming suicidal. As a compassionate clinician, I offer a welcoming context and create a safe space where I bear witness to their suffering. I draw from culturally sensitive therapeutic interventions to re-connect people with their values and things that have so far sustained them, and this way bring hope in hopeless situations. In my practice, I have also found resources-based approaches helpful in connecting people to their strengths and resilience. This enables them to connect with the whole of themselves, not just the vulnerable side of themselves.
In addition, I reach out to other organisations to ensure that these young people and families’ basic needs are met through an integrated care. This helps with restoring people’s dignity.”
Refugees are often dehumanised and marginalised. “I believe that connecting on a human level helps create small islands of safety which enable people to feel ‘human’ again, and engage with therapeutic work to start the healing process and rebuild their lives.”
The need for cultural sensitivity
In addition to that, Nsimire points out that psychotherapy is not something many cultures around the world are used to, it is mostly a western concept. Therefore, a service such as this one has to be culturally sensitive and must provide services that are more congruent with people’s own constructions of mental health problems and healing. Our services need to be meaningful to refugee people if we want to be helpful. There is much work to be done on this, and Nsimire said all professionals working with refugees should get appropriate culturally sensitive and trauma-informed training so as not to re-traumatise the people they work with.
At the start of Refugee Week, Nsimire hosted a free webinar ‘Taking a compassionate stance when working with refugees.’
“It starts with seeing refugees as human beings, and by doing so, we will attend to the totality of the person and offer them the appropriate level of care, kindness and compassion they need to feel safe and overcome the extreme adversities they have experienced,” she said.
Visit the Refugee Week website for ideas on how to get involved.
What is a refugee
A refugee is a person who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to avail himself of the protection of that country’ – UN Refugee Agency (UNHCR).
According to UNHCR (2022), the level of forced displacement worldwide is “unprecedented “since the founding of the UN in 1951; the number of refugees, asylum-seekers and internally displaced people around the world has topped 100 million of which 26.6 million have refugee status.
The UK currently hosts 231,597 refugees and has 166,000 pending asylum cases, and 5,483 stateless persons (Refugee Council).