Psychiatry at the University, teaching and mentoring the residents, but in the last few months, I’ve had to cut back.” He had fought against the body-numbing fatigue as long as he could before requesting part time. “I work a few hours each day with the children and adolescents in the holding centers.”
“Holding centers?” Carl’s words rang out with startling ferocity.
“Places for unaccompanied asylum-seeking minors—children without parents or children who became separated from their parents as they fled their countries.” Pieter’s expression remained that of a professional describing a clinical situation but the gruffness of his voice gave away his feelings. “Orphans, most of them .”
“Dear God, holding centers. Have people forgotten? The Nazis turned the Dutch Westerbork refugee center into a holding center before they put the people on trains for the concentration camps.” He stared at Pieter. “Are you telling me that children are put in Dutch camps?”
“Carl, today we have one of the highest number of refugees seeking asylum of all the European countries.” Pieter stood up and began to pace. “There are 23 refugee centers scattered throughout The Netherlands, eight in Amsterdam alone.” He paused to let Carl appreciate the scope of the problem. “The Holding Centers provide medical care, teach them Dutch, and keep the children safe from predators while they wait to learn if they have been granted asylum.” Exhausted, Pieter dropped back into his chair.
“I had no idea that there were so many refugees seeking asylum in The Netherlands. Where do they come from?
“Wherever there are problems: Iraq, Syria, Afghanistan, and Somalia, some even from China.”
“What is the main reason they come?”
“Probably the most common reason is war in their countries. Some fear persecution for political views, and some come in search of better economic opportunities.” He shot a look at Carl. “Many of the male teenagers come alone to try to earn money to help their families.” His voice dropped to a ragged whisper. “Of course, there is always the problem of child-trafficking.”
“So much human misery,” Carl muttered. “How long are the children held in those camps?”
“It depends on how long it takes to process their applications. Sometimes there is missing information, or an appeal, and so on.” He met Carl’s eyes. “It’s usually about three months but sometimes it’s much longer.” He sighed. “As soon as they turn eighteen, they have to leave the camp.”
“What happens to them then?”
“If their application for asylum was not accepted, they have to leave The Netherlands, return to their country.” He grimaced. “Many stay illegally.” He rubbed his left eye to relieve the twitching. “Those who are granted asylum must leave the center and earn their living.” He groaned. “They are turned out onto the streets of Amsterdam at eighteen with no home, no family, no work skills, and barely able to speak or understand Dutch.”
“The poor children. No family and no home.” Carl sighed deeply. “I’m sure they have psychiatric problems. What are you seeing?”
“Exactly what you’d expect, loneliness, sleep problems, anxiety, depression . . . posttraumatic stress disorder.” His eyes were shadowed. “Very often, these children have experienced sexual abuse in their home country and during their journey. High, very high rates, of posttraumatic stress disorder.”
“How are you treating the children?”
“Their problems are staggering.” Pieter leaned forward in his chair with his hands hanging limply between his knees. “They’ve lost their families, homes, schools, and the cultural rules that governed their lives. Their sense of identity and their hope for the future have been stripped from them.” His shoulders drooped. “And, of course, they don’t speak our language.”
“You speak French and Arabic as I recall,” Carl murmured. “That