10/28/2011 01:26 pm ET Updated Dec 28, 2011

The Real Haunted House

My first day at Nairobi's UNHCR compound this summer, I was working at a computer when a woman's scream tore into the air. I froze; I had come to work with refugee girls through the UNHCR, but I wasn't an official employee. I looked out the window. Where were the screams coming from? Was that laughter? Relief?

Yet another shriek, ripping through the compound. No, that was agony.

Accounts would vary: one Community Services officer would say the woman was taken to a hospital for overnight and her son taken into custody. Another would say she found the woman alone that evening accompanied by only one guard who was untrained in handling trauma victims and staying later than he was paid to do.

Everyone agreed on the following: the woman was an Ethiopian who had been denied refugee status and wiggled out. She kicked her 3-year-old son, stripped off her clothes, and tried to hang herself with her scarf.

Trauma is inherent to the refugee experience, which guarantees at least the loss of one's home and a long journey of escape -- and at most a chain of murder, rape, losing all possessions, losing family, seeing them murdered, being tortured. Simply, working with refugees is working with traumatized persons, and Nairobi's UNHCR office alone has processed well over 400,000 refugees (about the same number of people who now populate Dadaab, the refugee camp on the Sudanese border). Depending on how much support a refugee has received, and how consistent their surroundings are in the non-home place they find themselves, they can go from trauma victim to trauma survivor, but the journey is long, and most live in asylum-seeker "limbo" for years on end before resettlement. And limbo is not the state in which the brain can calm itself and return to normal function from years in the mental no-man's-land of anxiety, impulse, and despair of brain-stem stimulated adrenaline and cortisol release.

I didn't witness any violence firsthand in Kenya, and initially wondered if my constant thoughts of it being around the corner were simply the product of a lifetime of mediated messages about carnage in Africa. Then I met Khainga, secretary of PEN Kenya, a slight and quiet man with endearingly large glasses, rounded shoes, and a suit funkified enough to make me think of Saturday Night Fever. Khainga parted his hair to show the scar where a machete did not succeed in killing him in spite of the thugs who attacked him as he left an event.

I met Annette, a translator at the UNHCR -- the only job refugees themselves are allowed to have there -- who spoke French, Swahili, Rwandese, and English. She dressed like a trendy girl from Brooklyn: heels, lip ring, multiple earring studs, permed hair. I sat with her behind the glass that separates UNHCR employees from the lines of refugees every Tuesday, the day Community Services assists refugees with no appointment. The refugees would gather early, there by 5-7 a.m., the barely walking toddlers, the barely walking old and infirm, while the morning mist still carried the scent of the eucalyptus trees populating the compound.

Annette did not cry when I asked about the father she had not mentioned. "He want back to Rwanda. We had a house. He went there. They killed him," she said simply.

Sudan has the most Internally Displaced Persons (a woefully apropos label) with at least 5 million. One devastating and immediate indicator of civil unrest in a region is the amount of people forced to flee their homes. But the most devastating is the human carnage and the ravaged mental remains of those who witness it. The number of refugees today varies; the UNHCR's figure of 43 million is a conservative one, but in any case, even the lower figure is a larger group of people than that which populates the largest city in the world.

One of the most ironic abbreviations is "F.O.R.": Fear Of Return. A refugee needs to establish credible threat to their well-being in the place they flee from to qualify for Refugee status and resettlement through UNHCR. The UNHCR, founded after World War II to serve and manage hoards of Eastern Europeans who had fled their homeland, has certain criteria for this. A family whose father and son have been killed by the Tutsis, whose mother bears knife wounds for being Rwandan in Congo, whose daughter's head injury riddled her body with permanent vertigo -- she keeps falling into the stove fireplace -- won't have much trouble there.

Torture victims won't either, though they might find trouble with the medical check-up refugees are required to get as part of their resettlement. "Medically Inadmissible" is the damning sentence handed down to some refugees in the last steps of relocation, often to those who need advanced medical care the most. Schizophrenia and like states are not uncommon in torture victims and those who have seen their families butchered. Traumatic memories are stored differently in the brain, which is why some torture victims don't even know how many times they have been detained. It blurs together, this pain of sensation-images the body instead of a chronological sense of events.

The city whose population these people would constitute, at the very least more populous than Tokyo, than Sao Paulo, might be a shadowed one, the streets electric with tension and fear. People would walk in circles, talking to themselves, some cowering, some seized with erratic spasms and desperate fits of violence, some wandering in a daze. There would be no direct sunlight and no clocks. Many would have no identifying documents. There might be buildings, condemned blocs swelling with crime and rats, but no one would be able to stay in any one of them for long, and for the most part they would walk endlessly, crossing street after street and back again. And all of them, at least the ones with some thread of consciousness still attached, would know how to wait.

On Halloween, there will be 7 billion people on the planet. The ghosts we imagine on Halloween? Spirits with unmet needs, wailing specters of pain? There are 43 million of them, trapped in the shadowed houses of their own minds.

Give them relief here.