Demons of war

A war-torn land upon which blood is spilled heals quickly; its people, however, do not. Those fortunate enough to have fled the atrocities carried out in Vietnam and Cambodia nearly three decades ago may well have left the scenes of terror behind - but the ghosts of chaos and suffering will remain with them for life.

For many of New York's 15,000 Vietnamese and Cambodian refugees, and its Asian community on the whole, mental-health treatment continues to be problematic at best. Not because their nightmares, hallucinations, panic attacks and depression are any worse than suffered elsewhere in the world - but because the city is unable to allocate enough resources to provide professional psychological care in a way that is culturally and linguistically effective.

Despite the fact that more than one out of 10 New Yorkers is from Asia, there's still a gulf in the provision of suitable care, with the greatest obstructions being barriers of culture and language. Official census data puts the number of official Chinese immigrants, for example, at about 300,000. Add on reasonable estimates of those without official paperwork, however, and that figure triples.

For refugees, living conditions compound the issue. In the Vietnamese community, about four out of 10 children in New York live in poverty. Only 60 per cent of them speak English and only 42 per cent have graduated from high school. According to a needs assessment compiled by the Asian American Association of New York, 'most mental-health programmes and services, including those designed to serve Asian Americans, lack trained professionals with bilingual capabilities and cultural competence' to work with Asian families.

Attempting to broach that gap is the city's only mental-health clinic to employ full-time Asian staff. It offers tailored outreach to Asians living in the city with mental-health problems. Hamilton Madison House, in Lower Manhattan's Two Bridges/Chinatown neighbourhood, runs a multicultural clinic based on the needs of immigrants from China, Korea and Japan, and those from Southeast Asia.

It is now on the frontline in dealing with an affliction burdening 62 per cent of Cambodian refugees and 70 per cent of all Vietnamese war survivors who seek treatment: post-traumatic stress disorder.