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How much does it cost to settle a refugee in San Diego?

Costs, culture clashes, and the presidential threat.

Refugee children on their first ever beach outing. The scene is deceiving, says Kristin Burke: What El Cajon-based refugees have compares poorly to what’s available to Atlanta refugees. - Image by Kristin Burke
Refugee children on their first ever beach outing. The scene is deceiving, says Kristin Burke: What El Cajon-based refugees have compares poorly to what’s available to Atlanta refugees.

On an airplane over the Atlantic Ocean, Talal Shaheen, his wife and three sons, who are Syrian refugees, looked forward to a new life in Florida. Shaheen says that American government officials had told him he was going to Miami, because he had relatives there. The statement squares with a U.S. State Department spokesperson’s comment as quoted in the November 20, 2015, issue of U.S. News & World Report: “The most common reason for a refugee to be assigned to a particular place is a personal or family connection. We try very hard to get refugees close to people that they know because we think that they have a better chance of success if they have a support network when they first arrive, aside from just the volunteers.”

Day at the beach can't come too soon

Shaheen was shocked upon landing in Miami when officials told the family to stay on the plane. They were continuing on to California instead.

When they arrived at Los Angeles International Airport, there was a van and driver from the International Rescue Committee waiting to pick them up. Since no one in the family understood English, they were able to learn nothing of where they were going. A 12-hour drive later, they arrived. But where?

The International Rescue Committee is one of the busiest nongovernmental resettlement agencies nationally. It acts in conjunction with the federal Office of Refugee Resettlement to assist Syrian refugees to start over in the United States. For Shaheen and his family, the committee had already located an apartment in the mystery location and gave him money to pay the first month’s rent and basic furnishings.

Talal Shaheen has a long abdominal scar from being caught in crossfire.

Right away Shaheen experienced the town he was in to be “an empty place” whose small-town Americana culture made his family feel out of place and without job prospects. He would learn later that the town was Turlock, almost 90 miles southeast of Sacramento and one of California’s locations for resettling Syrian refugees. Turlock is the home of California State University Stanislaus.

Shaheen wanted to know who it was who had changed his family’s Miami destination.

Learning of an 80-year-old mom sleeping on the floor prompted Kristin Burke to begin helping refugees.

At the International Rescue Committee offices days after his family’s arrival in Turlock, he met several Iraqi men. Speaking in Arabic, they recommended that he consider moving to the San Diego area. It turned out, Shaheen’s wife reminded him, that she had relatives in El Cajon, next to San Diego. That was all he needed to hear. Soon he had the International Rescue Committee convinced to help him relocate his family. The agency agreed to buy Greyhound bus tickets for each of his family members and sent them on their way. But he could not reclaim the first month’s rent for his Turlock apartment, and he would have to abandon furniture he’d already bought to put in it.

The El Cajon International Rescue Committee office had closed on a Friday night by the time the Greyhound bus arrived in town. So Shaheen and his three sons slept in the park downtown over the first weekend, and his wife’s relatives came to take her to their home. Afterward, the family spent eight days in a hotel before the committee found them an apartment.

Like other refugees I spoke to, Shaheen has hopes that Syria eventually recovers from its current civil war. “It is a beautiful country,” he said, “and I would definitely go back if it returns to normal.”

Sponsored
Sponsored

Welcome cash

It was in late January that I met Shaheen. He’s a man of 50 with a short, neatly trimmed, gray beard. We sat in the apartment of Iraqi refugee Rafid Al Bawi, who had previously worked for the American government as a humanitarian aide in Baghdad. Acting now as our translator, Al Bawi was trying to give me a sense of how grueling it had been for Shaheen and his family as they lived in a Jordanian refugee camp for two years while undergoing the detailed immigration vetting process all seekers of asylum in the U.S. go through. On January 21, the New York Times listed 20 separate background checks and orientations refugees must undergo before been granted the asylum.

As if to say, “Don’t forget this,” Shaheen suddenly stands and pulls up his shirt to display a long abdominal scar where he had been shot in the crossfire between Syrian Army forces and the country’s rebels in his hometown of Homs. He points to places on his arms and legs where other bullets had wounded him.

In the wake of the Turlock episode, Shaheen was now suspicious that the local International Rescue Committee had siphoned off his welcome cash and applied it to his rent. By “welcome cash,” both Shaheen and Al Bawi meant a $200 sum refugees receive from the federal Office of Refugee Resettlement beyond what it pays for their first month’s rent. Their understanding was that welcome cash is intended to cover apartment furnishings and other items to help families begin a livable new life. Other refugees I would later meet had suspicions similar to Shaheen’s about what happened to their welcome cash.

The International Rescue Committee has not responded to two voicemail messages I’ve left to learn its understanding of welcome cash. Jimmy Dervishi, director of the Alliance for African Assistance, another resettlement organization in San Diego County, was quick to return my call. After not fully grasping what he told me, I emailed him to get the policy in writing. By return email, he gave me a somewhat ambiguous view that, using much of his language, I believe is best interpreted in the following way.

A sum of $925, wrote Dervishi, “must be spent for each refugee client on items such as housing [first month’s apartment rent], food, furniture, supplies, and other necessary resettlement items and supplies.” But the $200, which Dervishi calls “flex money,” not “welcome cash,” is not a guaranteed payment to each client. It is flexible in two senses. First, the resettlement agency is permitted to transfer it to another “vulnerable family” that, for example, may be “experiencing an emergency medical or dental problem” or other dire situation. Second, a client’s flex money, at the resettlement agency’s discretion, may be put into a “pooling fund,” again for sudden needs any refugee may experience, such as wheelchairs or utility deposits.

But refugees I met have not been aware of this policy. They think the $200 additional money is strictly their own and their suspicion that it is sometimes being diverted amounts to accusing their resettlement agency of being corrupt.

In a related way, the case of Talal Shaheen is hard to comprehend. After paying for the apartment he left behind in Turlock, the International Rescue Committee, he said, paid him $3500 for his first three months’ rent in El Cajon. Still, Shaheen feels that overall he got the short end of the stick.

“The problem,” I was told by a volunteer during a February 11 Resource Day gathering at the Family Welcome Center on East Main Street in El Cajon, “is that the resettlement agencies give refugees too little explanation of policy or actual benefits they might or might not qualify to receive. Of course, it doesn’t help that the agencies are overwhelmed by the recent flood of refugee arrivals.”

The Los Angeles Times, on February 18, stated that “nearly 800 Syrian refugees...arrived in San Diego County last year and settled in El Cajon.”

I could not look away

The purpose of the Resource Day gathering at the Family Welcome Center — attended by an estimated 30 to 40 people — was to remedy the scarcity of official communication. Informed volunteers, several having driven down from Los Angeles, sat at tables and answered questions about issues the resettlement agencies are supposed to help refugees navigate. These include how to find jobs, get legal advice, enroll themselves and their kids in schools, and find medical, disability, or mental health services. At one table I discovered there is a federal Medical Assistance Program for refugees. Hardly anyone else seemed to have heard of it.

The Resource Day was organized by Kristin Burke, a costume designer in the Hollywood movie industry who lives in Los Angeles. While working on a movie set in Atlanta, Burke read about Syrian refugees living there and became interested in their lives. She discovered that some of them were seamstresses or tailors. “After asking around, I learned it was legal to hire them. So that’s what I did,” she tells me. “I discovered they were very skilled and hard workers.”

An Empowering Refugees - Atlanta employee learned that Burke often visits her mother in San Diego County and asked if she would look into the conditions of refugees living in El Cajon after she got back to California. That launched her efforts to help locally. What she found was that, among refugees who had gotten apartments in El Cajon, many had little food and no furniture, bedding, cleaning devices, or kitchen utensils.

Burke found the living conditions of one family she met especially appalling. They had been sleeping on the floor of an unfurnished apartment for a month. That included an “80-year-old mom,” Burke told me. “I saw the conditions of other people who were existing in El Cajon, and when you contrasted those to what the refugees in Atlanta had, it was night and day. And I said, ‘Not in my backyard! I could not look away, as I realized I had the real capacity to help — I could motivate others to get involved.”

On October 16, 2016, Burke put a link on Facebook called “Second Families.” The page uses Amazon Lists to itemize numerous products the refugees need to start their new life. Once people purchase them online, said Burke, “all the items for Second Families peeps go directly to the family. No middleman.” Items such as chairs, sofas, beds, mops, clothing, blankets, pots and pans, and towels immediately began showing up on refugees’ doorsteps. In addition to the requests for needed items on the Facebook page, she has enlisted a cadre of volunteers from both San Diego and Los Angeles.

“We have over 1100 followers on Facebook,” said Burke. “As for donors, I don’t have the numbers. But if you figure that each family has 100 items on their list, and we had lists from 40 families, that is a lot of items. I have had feedback from all over the world, so I know people from many countries are buying items for these families. All of our donors are anonymous. I wish I could thank every one of them personally, but there is no way for us to know who they are.”

Blinded by torture

The federal Office of Refugee Resettlement aims at assisting the “most vulnerable,” especially those who have been injured in war or tortured, have been subsisting in Middle Eastern camps on cash assistance, or have serious medical conditions.

Most recently Kristin Burke has been helping a few Syrian families who desperately need medical attention. Although the refugees are automatically enrolled by their resettlement agencies in Medi-Cal upon their arrival in California, they often cannot figure out how to make appointments with a doctor who takes it. But even by phone from Los Angeles, Burke can arrange local Medi-Cal appointments for refugees by virtue of them granting her status as their HIPAA representative. (The acronym stands for Health Insurance Portability and Accountability Act, a federal law protecting the privacy of patients’ medical information.)

In all, I met six male refugees, two of their wives, and some of their children. Five of the six families have at least one member with significant medical needs. Shaheen still needs medical attention for the gunshot wound to his abdomen; also a high blood-sugar problem. Blood sugar issues seem common in the community.

Several refugees talked about their medical issues but wanted to remain anonymous out of fears engendered by President Trump’s recent attempt to enact a travel ban against people from seven Middle Eastern countries. For them I have used other names Shaheen and Raphid Al Bawi suggested to me.

The second El Cajon apartment I visited in late January was occupied by Abu Ahmed, his wife, and five children. The furnishings here were very modest. The family had come from Daraa in Syria, a city at the center of the country’s civil war. In 2011, the Bashar al-Assad regime spread a wide net in Daraa to capture citizens who had rebel sympathies. Abu Ahmed was arrested and, for 45 days, was tortured with electric shocks applied to his temples, leaving him blind.

A week after his release, he was arrested again and spent nine days in jail. He was arrested a third time a month later, this time with his five-year-old son. The two of them spent four days in jail.

As soon as they could, Abu Ahmed and his family fled the country, walking across the border into Jordan. They stayed four years in a refugee camp in Jordan while going through the refugee vetting process. They arrived in El Cajon in August 2016 to an empty apartment and spent the first 11 days with only the food offered to them by neighbors. Finally, an International Rescue Committee caseworker came with a check for $350.

Meanwhile, Abu Ahmed was taken to a hospital emergency room where doctors discovered he had a blood-sugar level of 400 milligrams per deciliter, a condition verging on coma. He was told his cortisol level was high, too. He was prescribed a medicine costing $172, he said, “but we never received our welcome cash.”

In Abu Ahmed’s apartment, a small group of other Syrians listen to him tell his story. Hassain, another refugee, arrives just as the story is winding down. He looks muscular and strong but is fidgeting nervously and appears to be under great stress. One of the translators introduces Hassain to me, saying he is “extremely disappointed” in the International Rescue Committee for not helping him get medical attention.

Hassain is married with four daughters and two sons. The entire family spent their first two months here in a hotel room. Hassain has one working kidney and needs surgery on the other, which currently is blocked by stones. One of his sons, he said, has a heart problem that was diagnosed during the family’s stay in Jordan; he needs to see a doctor, too.

Why not help them there?

The cost to taxpayers of medical service for Syrian refugees has not gone unnoticed by those who oppose the asylum that the select few are receiving in the United States. A report by the Office of Refugee Resettlement states that the “average annual payment” to Middle Eastern refugees for Medicaid is $6897. This figure plays a prominent role in a study published online by Karen Zeigler and Steven Camarota, titled “The High Cost of Resettling Middle Eastern Refugees.” Using the same source, Zeigler and Camarota go on to project the “average five-year” cost of Medicaid for each Middle Eastern refugee at $21,450 among a series additional statistics.

When all the other benefits refugees receive are added in, the total “average five-year costs” for each refugee rises to $64,370. The most expensive of these are Supplemental Security Income ($13,494), Public Education ($12,401), Public/Subsidized Housing ($7644), and Temporary Assistance for Needy Families ($5061). “Refugees have the most generous access to welfare programs of any population in the country,” according to the authors.

However, they argue, the U.S. has a choice: “We can help a relatively tiny number of refugees who in effect win what might be called the ‘migration lottery’ and are resettled here, or [we] can devote the limited resources available to helping many more refugees in the region [from which they came] for the same amount of money. If the goal is to help as many people as possible, then assisting Middle Eastern refugees in their home region gives a far greater return on public money.”

Besides “being more cost-effective,” say the authors, there are two other “advantages” to this approach. “First, other countries in the region have similar cultures, while adapting to the United States can be challenging for people who have already suffered from war and deprivation. Second, if refugees remain in the region, they will be much more likely to return home once the war is over. If, on the other hand, they are resettled on the other side of the world in this country, it is much less likely they will ever return to their home country.”

The article by Zeigler and Camarota was published by the nonprofit Center for Immigration Studies in November 2015. The center’s director, Mark Krikorian, has been a longtime critic of U.S. immigration policy.

“Immigrant narratives comprise the Krikorian family lore,” according to a June 17, 2013, profile in the Washington Post. “His grandfathers came to the United States in the years before World War I to escape repression in the Ottoman Empire. His Armenian grandmother survived the carnage of World War I, only to be captured and sold into slavery and later to find her way to Marseilles, France, as a servant girl. An arranged marriage, held in Havana so she could legally enter the United States, sprung her from that life.”

The article maintains, “In Krikorian’s world view there is good immigration — the kind that happened long ago. And there is bad immigration — the kind that happens now…. ‘America has outgrown mass immigration,’ he says.”

You have no rights here

Among the refugees in El Cajon, there is an experienced businessman, originally a chef, who over the years in Syria employed many of his fellow citizens in two businesses: a restaurant and a perfume company. Al Omer (not his real name) fled the country with his family after the government seized his businesses to the tune of $300,000. He went first to Egypt, where a militia, in collusion with the police, took $25,000 more. He complained to authorities but was told, “You’re a refugee; you have no rights here.”

Now in El Cajon, his wife has a disc problem in her back and may need surgery. But Al Omer is not moping around waiting for help to arrive. He is working out plans to open a new restaurant in San Diego County.

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Refugee children on their first ever beach outing. The scene is deceiving, says Kristin Burke: What El Cajon-based refugees have compares poorly to what’s available to Atlanta refugees. - Image by Kristin Burke
Refugee children on their first ever beach outing. The scene is deceiving, says Kristin Burke: What El Cajon-based refugees have compares poorly to what’s available to Atlanta refugees.

On an airplane over the Atlantic Ocean, Talal Shaheen, his wife and three sons, who are Syrian refugees, looked forward to a new life in Florida. Shaheen says that American government officials had told him he was going to Miami, because he had relatives there. The statement squares with a U.S. State Department spokesperson’s comment as quoted in the November 20, 2015, issue of U.S. News & World Report: “The most common reason for a refugee to be assigned to a particular place is a personal or family connection. We try very hard to get refugees close to people that they know because we think that they have a better chance of success if they have a support network when they first arrive, aside from just the volunteers.”

Day at the beach can't come too soon

Shaheen was shocked upon landing in Miami when officials told the family to stay on the plane. They were continuing on to California instead.

When they arrived at Los Angeles International Airport, there was a van and driver from the International Rescue Committee waiting to pick them up. Since no one in the family understood English, they were able to learn nothing of where they were going. A 12-hour drive later, they arrived. But where?

The International Rescue Committee is one of the busiest nongovernmental resettlement agencies nationally. It acts in conjunction with the federal Office of Refugee Resettlement to assist Syrian refugees to start over in the United States. For Shaheen and his family, the committee had already located an apartment in the mystery location and gave him money to pay the first month’s rent and basic furnishings.

Talal Shaheen has a long abdominal scar from being caught in crossfire.

Right away Shaheen experienced the town he was in to be “an empty place” whose small-town Americana culture made his family feel out of place and without job prospects. He would learn later that the town was Turlock, almost 90 miles southeast of Sacramento and one of California’s locations for resettling Syrian refugees. Turlock is the home of California State University Stanislaus.

Shaheen wanted to know who it was who had changed his family’s Miami destination.

Learning of an 80-year-old mom sleeping on the floor prompted Kristin Burke to begin helping refugees.

At the International Rescue Committee offices days after his family’s arrival in Turlock, he met several Iraqi men. Speaking in Arabic, they recommended that he consider moving to the San Diego area. It turned out, Shaheen’s wife reminded him, that she had relatives in El Cajon, next to San Diego. That was all he needed to hear. Soon he had the International Rescue Committee convinced to help him relocate his family. The agency agreed to buy Greyhound bus tickets for each of his family members and sent them on their way. But he could not reclaim the first month’s rent for his Turlock apartment, and he would have to abandon furniture he’d already bought to put in it.

The El Cajon International Rescue Committee office had closed on a Friday night by the time the Greyhound bus arrived in town. So Shaheen and his three sons slept in the park downtown over the first weekend, and his wife’s relatives came to take her to their home. Afterward, the family spent eight days in a hotel before the committee found them an apartment.

Like other refugees I spoke to, Shaheen has hopes that Syria eventually recovers from its current civil war. “It is a beautiful country,” he said, “and I would definitely go back if it returns to normal.”

Sponsored
Sponsored

Welcome cash

It was in late January that I met Shaheen. He’s a man of 50 with a short, neatly trimmed, gray beard. We sat in the apartment of Iraqi refugee Rafid Al Bawi, who had previously worked for the American government as a humanitarian aide in Baghdad. Acting now as our translator, Al Bawi was trying to give me a sense of how grueling it had been for Shaheen and his family as they lived in a Jordanian refugee camp for two years while undergoing the detailed immigration vetting process all seekers of asylum in the U.S. go through. On January 21, the New York Times listed 20 separate background checks and orientations refugees must undergo before been granted the asylum.

As if to say, “Don’t forget this,” Shaheen suddenly stands and pulls up his shirt to display a long abdominal scar where he had been shot in the crossfire between Syrian Army forces and the country’s rebels in his hometown of Homs. He points to places on his arms and legs where other bullets had wounded him.

In the wake of the Turlock episode, Shaheen was now suspicious that the local International Rescue Committee had siphoned off his welcome cash and applied it to his rent. By “welcome cash,” both Shaheen and Al Bawi meant a $200 sum refugees receive from the federal Office of Refugee Resettlement beyond what it pays for their first month’s rent. Their understanding was that welcome cash is intended to cover apartment furnishings and other items to help families begin a livable new life. Other refugees I would later meet had suspicions similar to Shaheen’s about what happened to their welcome cash.

The International Rescue Committee has not responded to two voicemail messages I’ve left to learn its understanding of welcome cash. Jimmy Dervishi, director of the Alliance for African Assistance, another resettlement organization in San Diego County, was quick to return my call. After not fully grasping what he told me, I emailed him to get the policy in writing. By return email, he gave me a somewhat ambiguous view that, using much of his language, I believe is best interpreted in the following way.

A sum of $925, wrote Dervishi, “must be spent for each refugee client on items such as housing [first month’s apartment rent], food, furniture, supplies, and other necessary resettlement items and supplies.” But the $200, which Dervishi calls “flex money,” not “welcome cash,” is not a guaranteed payment to each client. It is flexible in two senses. First, the resettlement agency is permitted to transfer it to another “vulnerable family” that, for example, may be “experiencing an emergency medical or dental problem” or other dire situation. Second, a client’s flex money, at the resettlement agency’s discretion, may be put into a “pooling fund,” again for sudden needs any refugee may experience, such as wheelchairs or utility deposits.

But refugees I met have not been aware of this policy. They think the $200 additional money is strictly their own and their suspicion that it is sometimes being diverted amounts to accusing their resettlement agency of being corrupt.

In a related way, the case of Talal Shaheen is hard to comprehend. After paying for the apartment he left behind in Turlock, the International Rescue Committee, he said, paid him $3500 for his first three months’ rent in El Cajon. Still, Shaheen feels that overall he got the short end of the stick.

“The problem,” I was told by a volunteer during a February 11 Resource Day gathering at the Family Welcome Center on East Main Street in El Cajon, “is that the resettlement agencies give refugees too little explanation of policy or actual benefits they might or might not qualify to receive. Of course, it doesn’t help that the agencies are overwhelmed by the recent flood of refugee arrivals.”

The Los Angeles Times, on February 18, stated that “nearly 800 Syrian refugees...arrived in San Diego County last year and settled in El Cajon.”

I could not look away

The purpose of the Resource Day gathering at the Family Welcome Center — attended by an estimated 30 to 40 people — was to remedy the scarcity of official communication. Informed volunteers, several having driven down from Los Angeles, sat at tables and answered questions about issues the resettlement agencies are supposed to help refugees navigate. These include how to find jobs, get legal advice, enroll themselves and their kids in schools, and find medical, disability, or mental health services. At one table I discovered there is a federal Medical Assistance Program for refugees. Hardly anyone else seemed to have heard of it.

The Resource Day was organized by Kristin Burke, a costume designer in the Hollywood movie industry who lives in Los Angeles. While working on a movie set in Atlanta, Burke read about Syrian refugees living there and became interested in their lives. She discovered that some of them were seamstresses or tailors. “After asking around, I learned it was legal to hire them. So that’s what I did,” she tells me. “I discovered they were very skilled and hard workers.”

An Empowering Refugees - Atlanta employee learned that Burke often visits her mother in San Diego County and asked if she would look into the conditions of refugees living in El Cajon after she got back to California. That launched her efforts to help locally. What she found was that, among refugees who had gotten apartments in El Cajon, many had little food and no furniture, bedding, cleaning devices, or kitchen utensils.

Burke found the living conditions of one family she met especially appalling. They had been sleeping on the floor of an unfurnished apartment for a month. That included an “80-year-old mom,” Burke told me. “I saw the conditions of other people who were existing in El Cajon, and when you contrasted those to what the refugees in Atlanta had, it was night and day. And I said, ‘Not in my backyard! I could not look away, as I realized I had the real capacity to help — I could motivate others to get involved.”

On October 16, 2016, Burke put a link on Facebook called “Second Families.” The page uses Amazon Lists to itemize numerous products the refugees need to start their new life. Once people purchase them online, said Burke, “all the items for Second Families peeps go directly to the family. No middleman.” Items such as chairs, sofas, beds, mops, clothing, blankets, pots and pans, and towels immediately began showing up on refugees’ doorsteps. In addition to the requests for needed items on the Facebook page, she has enlisted a cadre of volunteers from both San Diego and Los Angeles.

“We have over 1100 followers on Facebook,” said Burke. “As for donors, I don’t have the numbers. But if you figure that each family has 100 items on their list, and we had lists from 40 families, that is a lot of items. I have had feedback from all over the world, so I know people from many countries are buying items for these families. All of our donors are anonymous. I wish I could thank every one of them personally, but there is no way for us to know who they are.”

Blinded by torture

The federal Office of Refugee Resettlement aims at assisting the “most vulnerable,” especially those who have been injured in war or tortured, have been subsisting in Middle Eastern camps on cash assistance, or have serious medical conditions.

Most recently Kristin Burke has been helping a few Syrian families who desperately need medical attention. Although the refugees are automatically enrolled by their resettlement agencies in Medi-Cal upon their arrival in California, they often cannot figure out how to make appointments with a doctor who takes it. But even by phone from Los Angeles, Burke can arrange local Medi-Cal appointments for refugees by virtue of them granting her status as their HIPAA representative. (The acronym stands for Health Insurance Portability and Accountability Act, a federal law protecting the privacy of patients’ medical information.)

In all, I met six male refugees, two of their wives, and some of their children. Five of the six families have at least one member with significant medical needs. Shaheen still needs medical attention for the gunshot wound to his abdomen; also a high blood-sugar problem. Blood sugar issues seem common in the community.

Several refugees talked about their medical issues but wanted to remain anonymous out of fears engendered by President Trump’s recent attempt to enact a travel ban against people from seven Middle Eastern countries. For them I have used other names Shaheen and Raphid Al Bawi suggested to me.

The second El Cajon apartment I visited in late January was occupied by Abu Ahmed, his wife, and five children. The furnishings here were very modest. The family had come from Daraa in Syria, a city at the center of the country’s civil war. In 2011, the Bashar al-Assad regime spread a wide net in Daraa to capture citizens who had rebel sympathies. Abu Ahmed was arrested and, for 45 days, was tortured with electric shocks applied to his temples, leaving him blind.

A week after his release, he was arrested again and spent nine days in jail. He was arrested a third time a month later, this time with his five-year-old son. The two of them spent four days in jail.

As soon as they could, Abu Ahmed and his family fled the country, walking across the border into Jordan. They stayed four years in a refugee camp in Jordan while going through the refugee vetting process. They arrived in El Cajon in August 2016 to an empty apartment and spent the first 11 days with only the food offered to them by neighbors. Finally, an International Rescue Committee caseworker came with a check for $350.

Meanwhile, Abu Ahmed was taken to a hospital emergency room where doctors discovered he had a blood-sugar level of 400 milligrams per deciliter, a condition verging on coma. He was told his cortisol level was high, too. He was prescribed a medicine costing $172, he said, “but we never received our welcome cash.”

In Abu Ahmed’s apartment, a small group of other Syrians listen to him tell his story. Hassain, another refugee, arrives just as the story is winding down. He looks muscular and strong but is fidgeting nervously and appears to be under great stress. One of the translators introduces Hassain to me, saying he is “extremely disappointed” in the International Rescue Committee for not helping him get medical attention.

Hassain is married with four daughters and two sons. The entire family spent their first two months here in a hotel room. Hassain has one working kidney and needs surgery on the other, which currently is blocked by stones. One of his sons, he said, has a heart problem that was diagnosed during the family’s stay in Jordan; he needs to see a doctor, too.

Why not help them there?

The cost to taxpayers of medical service for Syrian refugees has not gone unnoticed by those who oppose the asylum that the select few are receiving in the United States. A report by the Office of Refugee Resettlement states that the “average annual payment” to Middle Eastern refugees for Medicaid is $6897. This figure plays a prominent role in a study published online by Karen Zeigler and Steven Camarota, titled “The High Cost of Resettling Middle Eastern Refugees.” Using the same source, Zeigler and Camarota go on to project the “average five-year” cost of Medicaid for each Middle Eastern refugee at $21,450 among a series additional statistics.

When all the other benefits refugees receive are added in, the total “average five-year costs” for each refugee rises to $64,370. The most expensive of these are Supplemental Security Income ($13,494), Public Education ($12,401), Public/Subsidized Housing ($7644), and Temporary Assistance for Needy Families ($5061). “Refugees have the most generous access to welfare programs of any population in the country,” according to the authors.

However, they argue, the U.S. has a choice: “We can help a relatively tiny number of refugees who in effect win what might be called the ‘migration lottery’ and are resettled here, or [we] can devote the limited resources available to helping many more refugees in the region [from which they came] for the same amount of money. If the goal is to help as many people as possible, then assisting Middle Eastern refugees in their home region gives a far greater return on public money.”

Besides “being more cost-effective,” say the authors, there are two other “advantages” to this approach. “First, other countries in the region have similar cultures, while adapting to the United States can be challenging for people who have already suffered from war and deprivation. Second, if refugees remain in the region, they will be much more likely to return home once the war is over. If, on the other hand, they are resettled on the other side of the world in this country, it is much less likely they will ever return to their home country.”

The article by Zeigler and Camarota was published by the nonprofit Center for Immigration Studies in November 2015. The center’s director, Mark Krikorian, has been a longtime critic of U.S. immigration policy.

“Immigrant narratives comprise the Krikorian family lore,” according to a June 17, 2013, profile in the Washington Post. “His grandfathers came to the United States in the years before World War I to escape repression in the Ottoman Empire. His Armenian grandmother survived the carnage of World War I, only to be captured and sold into slavery and later to find her way to Marseilles, France, as a servant girl. An arranged marriage, held in Havana so she could legally enter the United States, sprung her from that life.”

The article maintains, “In Krikorian’s world view there is good immigration — the kind that happened long ago. And there is bad immigration — the kind that happens now…. ‘America has outgrown mass immigration,’ he says.”

You have no rights here

Among the refugees in El Cajon, there is an experienced businessman, originally a chef, who over the years in Syria employed many of his fellow citizens in two businesses: a restaurant and a perfume company. Al Omer (not his real name) fled the country with his family after the government seized his businesses to the tune of $300,000. He went first to Egypt, where a militia, in collusion with the police, took $25,000 more. He complained to authorities but was told, “You’re a refugee; you have no rights here.”

Now in El Cajon, his wife has a disc problem in her back and may need surgery. But Al Omer is not moping around waiting for help to arrive. He is working out plans to open a new restaurant in San Diego County.

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