Currently, 25.4 million people live as refugees worldwide. Forced migration and refugee resettlement is not only a crisis of mass displacement, but one of health. Having been exposed to extreme trauma and sometimes torture, many experience psychological issues, such as isolation, depression, and PTSD, mental health issues that can affect the overall health of the individual. Theo Herman suffered through the many issues of forced migration, but eventually built a life in the United States with a new community.
Theo Herman is an adjunct professor at Bryant and Stratton College, a medical case manager at Evergreen Health, husband, and father of one young third grader. Theo holds an associate’s degree in health, bachelor’s degree in health care administration, master’s degree in public administration, and is currently a student working towards a PhD in Health Sciences at D’Youville College.
Theo’s drive for success and accomplishments stem from a life of hardship and suffering. Born in Rwanda, Theo endured a civil war, and the painful loss of both family and home. Theo’s neighbors and friends died for the resources they desperately needed to survive.
He spent close to a decade living in refugee camps located in Tanzania and the Democratic Republic of Congo, where “according to the International Rescue Committee, since 1998, an estimated 5.4 million people...died, most from preventable diseases as a result of the collapse of infrastructure, lack of food security, displacement, and destroyed health-care systems.” There, Theo faced disease, hunger, and constant brutal realities of war in a region that was rich in resources, but economically impoverished.
Although he faced tragedy, hardship and the unknown, Theo successfully completed high school and looked to America with the hope of living without the constant sounds of gunshots and grim warfare. He wanted to be formally educated and successful in order to help others do the same. With these dreams, Theo applied for refugee resettlement to the U.S. in 2010 at the age of twenty-six.
Theo transitioned into life in the U.S. abruptly. He was met in Dayton, Ohio, by the state’s respective “Reception and Placement Program,” which provides refugee resettlement support for the first 30 to 90 days upon arrival. Through this program, refugees receive a one-time sum that, “goes mostly towards rent, furnishings, food, and clothing, as well as costs of the agency staff case management and other integration services.”
The estimated 2 million people who fled the country were given the bare minimum, as international organizations such as the United Nations (UN) feared that providing much for those displaced would create a “pull factor” that would further inflate the rising number of refugees. Many countries in the international community froze or denied aid to Rwanda in response to evidence of genocide. Disease and illness spread quickly – cholera and other contagious diseases accounted for tens of thousands of deaths during July of 1994 alone – and monthly aid delivered by the UN Children’s Fund and the UN High Commissioner for Refugees was insufficient in stopping such tragedies. Any medical care received by the camps was basic, and not nearly enough to help all of the people who were afflicted. As a result, food was difficult to access, and people were lucky if they ate once a day. The camp lacked formal jobs or economic opportunities; when trouble arose, people worked together and did their best to help those around them, supporting one another as they endured an experience in which an estimated one million neighbors, family, and friends were killed within a three month period.
As he made his way through this initial transition process, Theo’s goal to become a nurse brought him to Buffalo, which led to an exploration of the resources that could fund his path to success. Though he acknowledges the efforts of some local organizations for support, Theo ultimately credits his own hard work and educational programs such as Education Opportunity Programs (EOP) and Higher Education Opportunity Programs (HEOP) as most influential. These two government funded programs provided Theo with support services like personal counseling, academic advisement, tutoring, professional development workshops, and supplemental instruction and mentoring.
While working towards his degree, Theo first worked as a cleaner – a job that did not provide supplemental healthcare, leaving him with Medicaid alone. For Theo, this coverage was inadequate, however, this was still more care than many immigrant and refugee populations receive. Due to a lack of knowledge as to what healthcare options are available to them, or how to begin signing up for these services, many newcomers work multiple jobs in order to afford medications necessary to health and wellbeing – and Theo and his wife were no different, despite provided healthcare coverage. Separating them from many others though was one commonly forgotten health supplement: the support that they provided to one another. This kind of emotional support is vital to the well-being of those undergoing the high stress task of starting a new life in a wildly new environment, as increased quality or quantity of social networks is linked to a decreased risk of mortality. Resettled refugees especially suffer from depression, anxiety and PTSD due to a lack of social support in a new environment like the U.S. For Theo and many like him, the support of the community and family around him was nearly as essential as medical care.
Theo thinks back positively to the social support structure that was in place in Rwanda and the refugee camp. Despite all of the disease and destruction that affected the community, the people built a safeguard around themselves and each other through their community. By traveling and adapting to a new life with his wife and child, Theo brought a portion of this safeguard with him, and they continue to support one another through challenges every day.
Today, Theo reflects on the benefits of living in the US, citing the abundant educational opportunities, the resources at one’s fingertips to support their endeavors, and a lower cost of living in comparison to his experience in Rwanda. As he enters the field of health sciences, his dream of helping erase preventable disease and suffering is hindered by the current state of healthcare. Large-scale programs, such as Obamacare, Medicare, and Medicaid, provide most people with basic care and coverage, but many are still left waiting and wondering. Through Theo’s eyes, present systems in place are functional, but inefficient and insufficient.
Though an improvement from the conditions faced in a refugee camp, Theo understands that the United States could be doing a lot more to support its citizens medically. Healthcare does not necessarily need to be a universally perfect fit, but does need to undergo constant progression and adaptation to others’ needs, as well as to new standards of living. For some, a heightened standard means better coverage and availability of medications or treatment, but for many experiencing resettlement, it means the chance at leaving hunger, pain, and disease in the past. Leaving a refugee camp does not guarantee this, but a good social support system and adequate healthcare holds the potential to lessen the chance of forming further mental and emotional barriers or new physical ailments. With his own social support system, Theo hopes to spend the life they built doing everything in his power to improve the healthcare system and world around him, while enjoying his life in Buffalo.