After the job is secure, the housing is handled and food is on the table, only the headaches remain.

Sometimes it's stomachaches, or chronic shoulder pain, but advocates for refugees say trauma and torture often show up as recurring physical ailments — and that treating these emotional wounds among Utah's newest residents can be much harder than meeting practical needs.

Consider the emotional trauma contained within the experience of most recent refugees. Many men were kidnapped, beaten, tortured in their homelands. Women were raped. Children were abused. Most refugees have been humiliated and degraded because of their religion, politics or race.

They are all persecuted to some lesser or greater degree — that's why they are here.

And Utah officials say most refugees can't leave the darker side of their histories behind without considerable care and attention. Without treatment, their diagnoses range from isolation to depression to anorexia to psychosis.

"Fifteen to 30 percent have been victims of political torture, and 70 percent have experienced some kind of war, violence or trauma related to their families."

Jalena Paselic, Community Health Specialist, Utah Department of Health

She couldn't eat. She couldn't swallow. Week after week the 24-year-old woman told her doctor about headaches and stomach pain. She said she felt like something was stuck in her throat.

The young woman, a refugee from an East African country, finally was referred to torture experts Kristin Lambert and Mollie Murphy Dale at the Utah Human Rights Project.

Like she does with so many of her clients, Lambert started with seemingly innocuous questions. "What is your life like? How long have you been here? Do you have family in Utah?"

"Immediately, she became very emotional," said Lambert, who carefully inquired about the woman's living situation. The woman said she was so very afraid to be alone. She told Lambert how she hated the dark.

"She talked about how terrifying it was for her at night," Lambert said. "That she would wake up and be so terrified she'd go outside her apartment and just scream."

The young woman was also terrified of men, which was a hint to Lambert about the nature of her trauma.

There is a scale established by Harvard researchers to measure depression and anxiety among refugees. Scores above a 1.75 demonstrate symptoms of both. This young woman was 3.6.

"Do you think any of these symptoms are related to anything that happened in your country?" Lambert asked gently.