Settling in a new country is a daunting prospect. Migrants who have willingly left their country of origin often find the settlement process difficult but for refugees who have left their country under traumatic conditions beyond their control, settlement poses an even more complex set of problems.

A refugee arriving in Australia is unlikely to have had the chance to prepare for their life in the new country. With only sparse belongings from their country of origin, they face the stressful task of meeting their most basic needs of food, shelter, language, employment and health care. Their feelings of homesickness will be compounded by the knowledge that they may never see their homeland again or the loved ones who have been left behind, often in dangerous circumstances. They will certainly find themselves dwelling on the injustices which forced them to flee in the first place.

STARTTS’ Early Intervention and Case Management (EICM) program was established in August last year to assist newly arrived refugees to cope with these issues and to minimise the problems associated with settlement. By the end of January this year, 230 people who had recently arrived in Australia under the Refugee and Special Humanitarian Program had sought assistance from the EICM program.

"The program has changed the settlement process [for newly arrived refugees] in that they now have the opportunity for a comprehensive assessment and to be referred to the services that they need right from the beginning. They don’t have to wait for things to develop into a crisis or to go without because they don’t know services are there and how to access them," says Pam Hartgerink, Coordinator of the Program.

The majority of EICM clients have been from the former Yugoslavia (60%) with large numbers also coming from the Middle East (27%), in particular, Iran and Iraq. Nine percent of clients were from the North East African countries of Somalia, Sudan, Algeria and Ethiopia.

The settlement needs of clients may differ according to their country of origin and the socio-economic position they occupied in that country. "Those kinds of factors can help in terms of how well the client can interpret a new cultural system," says EICM Senior Case Manager, Kerry Stewart.

She cites the differences in settlement needs between someone who lived in a city in the former Yugoslavia to a person from a rural area in Africa.

According to EICM Case Manager, Sarah Desmond, the immense cultural differences between Australia and her client’s countries of origin have exacerbated settlement difficulties for them. For example, the dispersion of Sudanese families throughout the suburbs means that it is difficult for them to maintain the social support networks they are used to.

Sudanese and Somali families are particularly distressed at the prospect of deaths of relatives in their country of origin and their inability to return and provide a proper burial in accordance with their traditions.

Kerry emphasises that the similarities between clients are more overwhelming than the differences. "I think for all communities housing is a real need. It is a difficulty for single people because single accommodation is quite hard to afford...and it is a difficulty for large families.

"I think probably across the board, depending on what the culture has been [in the country of origin], the understanding of what the system is and how things work here is quite difficult."

The EICM Program offers a comprehensive assessment and referral service to clients appropriate to the needs they have identified with their case worker. Clients whose settlement is being effected by the impact of torture or the trauma of their refugee experience are offered short to medium term counselling.

Of the clients who had attended the EICM Program by January 31 this year, 27% stayed in the program for counselling on torture and trauma issues. This figure, says Kerry, greatly underestimates the true incidence of torture and trauma among the client group. She points out that the refugee experience is traumatic in itself.

"I think [talking about these issues] can be retraumatising for some people or it might be culturally inappropriate to talk about those kinds of issues.

"For women it might be an issue of shame if it’s related to sexual assault or sexual torture.

"Sometimes it may be too soon for them to go near that... That’s not something you’d talk about in your own country so you may not want to talk with a foreigner that you don’t know. You’ve got to take care of the number one concern of the person," says Kerry.

Pam notes that the distinction between assessment and counselling is often not relevant. "The assessment is carried out is a very client-centred manner and issues relating to trauma may be dealt with as they arise. Helping people understand that what they are feeling is a common reaction to the experiences they have been through can be very beneficial in itself," she says.

Clients are referred to the service on a voluntary basis, as soon as possible after their arrival in Australia. The main sources of referral are Department of Immigration and Multicultural Affairs (DIMA) staff - particularly settlement services officers who work closely with newly arrived refugees in short-term government accommodation - individuals, and community and government organisations.

Establishing an efficient referral network - one that can both receive EICM clients and make referrals to the Program - and developing partnerships with other services has been a major task in the development of the EICM Program.

"While there have been some initial hiccups, on the whole there has been good cooperation from referring agencies and processes are now running smoothly," says Pam.

However DIMA is about to commence a tendering process for many of its services which could result in a vastly different configuration of referring bodies. This will mean that EICM staff will have to start rebuilding the close ties that have been made with referring bodies over the past few months.

"The environment that we are going to be working in when the tender happens is going to be extremely chaotic because nobody really quite knows how it’s going to work...So that process of developing relationships with other services is going to have to go on continually, I would say for the next 12 to 18 months," says Pam.

Recently two focus groups were held for Bosnian and Serbian clients to obtain their feedback on the EICM Program (other nationalities were targeted by similar programs interstate). The outcome suggested that the clients were very satisfied with the services they had received. A Bosnian client attending the group remarked: "Trauma will affect me till the day I die. The EICM worker assisted me in debriefing and offloading the pressure I felt for so many years during the war and as a refugee in other countries."