Schistosomiasis, a disease caused by parasitic worms, is the most common ailment, showing up in about half of the Somali and Sudanese refugees, he said. The infection occurs when the skin comes in contact with contaminated water. It can lead to renal failure if not treated. "Malnutrition is also a real problem among the Somali Bantus," Swoboda said.

Sometimes mental illness is immediately apparent.

In acute cases, refugees can't concentrate, can't hold jobs or take care of their children because of depression or anxiety.

"But a lot of it doesn't show up initially," Swoboda said.

Weeks or months later, refugees will complain of headaches and back or chest pain that has no medical explanation. Still, doctors will dispense pain killers until the patients find their way to a mental health facility.

Valley Mental Health psychiatrist Katharina Trede said some refugees who come in are dependent on narcotics, but have no physical diagnosis. Turns out mental illness caused the aches and pains.

"Your body has been the war zone, the battlefield," she said. "It all gets played out in your body."

Coming Thursday: An education

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