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JACKI LYDEN, HOST:

U.S. troops may be looking ahead to the rest of their lives. So are Iraqi civilians, who will with the effects of the war and violence for generations.

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UNIDENTIFIED MAN: Baghdad a few minutes ago where the air raid sirens going off. We could hear in the distance around the city the sound of...

STEVE INSKEEP, BYLINE: Iraq humanitarian groups are warning that civilians will suffer.

UNIDENTIFIED WOMAN: Now, the golden dome in the city of Samarra lies in pieces, blasted by an explosion.

RENEE MONTAGNE, BYLINE: Suicide bomber steered his car a group of U.S. soldiers who were handing out candy and toys to children. Almost all the dead were women and children.

LYDEN: Beyond the hundreds of thousands of civilian lives lost in Iraq, at least several million people have been displaced from their homes. About 60,000 Iraqi refugees have come to the U.S. since 2006, most to the Detroit area, drawn there by a large Arab community that's been there historically. A couple of weeks ago, I paid a visit to see how they were faring in their new home - America.

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LYDEN: Nightly, the lights are ablaze and the atmosphere welcoming at the Bellagio Banquet Hall in Southfield, Michigan. The place also posts a name in Arabic: (Arabic spoken), meaning, An Old Eastern Club - and it looks it. Scores of men sit in shirt sleeves or business suits, smoking the water pipe, the narguila, playing dominoes. Time has agreeably stopped here for male camaraderie. And yet, for many Iraqi refugees, even when the environment is as safe or familiar as it is here, a sense of fragility lurks just below the surface of daily life. Sayf Al-Tabaqchali is medical resident now. He left in 2006, his doctor's career in Baghdad over before it began.

DR. SAYF AL-TABAQCHALI: I have, like, six, seven of my colleagues, friends who were kidnapped. We had two or three professors in the medical university hospital were kidnapped. From our class, maybe 50 percent or more, they left Iraq.

LYDEN: Sayf and his best friend and former classmate, Yaser Al-Hadithi, are both 31. They've had to pass examinations to get new licenses, repeat their residencies in pathology and internal medicine. I'm very optimistic, says Sayf. But talk pivots quickly to older relatives who came here.

AL-TABAQCHALI: It's very hard for the older people, you know, because of the language barriers, because they can't work, you know, they don't have relatives, friends who can help them. For example, my father went back to Jordan, I'm not sure if he's coming back or not.

IMAM AL-AZAWAI: You have to start from zero - start from this beginning.

LYDEN: Imam al-Azawai and her husband, Khaldoun, are both 50. In their rented home in Dearborn, they recall the moment in their car at a checkpoint in Baghdad when the soldiers fired on the family.

AL-AZAWAI: I just lift my head to see if my kids they are alive or they are dead. You know, it's too hard, too hard.

KHALDOUN AL-AZAWAI: So, God protect us.

LYDEN: They decided they had to flee. Their daily challenge is what happens now. They love Michigan, but it's a state with some of the highest unemployment in the country. In three years, they haven't had one job offer. Until the war, life was about success. They met in college. Khaldoun built up a business - sold fuel pumps to gas stations in Iraq. He even returned to Iraq last year to see if he could line up exporting some American products. No go. So they had to turn to government support.

AL-AZAWAI: We got from the welfare, the Department of Human Service, food stamp and the medical insurance, Medicaid, which cover a part.

LYDEN: And in a stunning reversal of the coming to America story, relatives who stayed behind in Iraq, are helping them out financially.

AL-AZAWAI: My brother, he try to help me, he tried to...

AL-AZAWAI: He lent us, sometimes lent us some money. And sometimes his father and mother, their grandpa, they sent money to their kids, you know.

LYDEN: Imam and Khaldoun have thrown themselves into their four children's lives, helping with homework, going on class field trips, anything to keep focused and positive. They don't want to go back to Iraq. Al-Azawais are proud of the fact that they are in the road to U.S. citizenship. You said something about when your kids brought their books home, what would you do?

AL-AZAWAI: Yeah, I tried to read all the history books, especially the American history, the Michigan history.

LYDEN: Will you apply for residency?

AL-AZAWAI: Sure. I got the green card.

LYDEN: And then citizenship?

AL-AZAWAI: It should be five years from the date of entry.

LYDEN: A new study has begun to evaluate the psychological cost borne by Iraqi refugees. The National Institute of Mental Health sponsors the study, which is being carried out by researchers at Wayne State University Department of Family Medicine. It compares a random sample of 300 Iraqi refugees from the first couple months of their arrival over the next three years, contrasting that with 300 non-refugee Arab immigrants. One member of the research team is psychiatrist Yusif Rofa, who was given asylum here in 2006. Iraqi refugees, the majority of whom come here after living in third countries like Syria or Jordan, arrive already heavily stressed. Joblessness and a loss of identify pile up with the money woes. Dr. Rofa tells of one woman who is having real problems with anger.

DR. YUSIF ROFA: She was kidnapped when she was in Iraq. She's having problems here. She got herself in a prison for two days for making a quarrel, shouting, and when people called the police she resisted arrest. And she might be deported back.

LYDEN: But the researchers are also looking for resilience.

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LYDEN: Oras Touma pours tea in her living room. She came to Michigan 10 months ago with her children and her husband, Hesham Abdul Ghani, to escape religious persecution.

HESHAM ABDUL GHANI: We left Iraq basically because of the violence events happened to the minority religions. We are Mandean. So...

LYDEN: Very small religious minority.

GHANI: Not more than 70,000 in the whole world.

LYDEN: Mandeans are followers of John the Baptist, and there are pictures in their small apartment of the family. They have two kids wearing white, and being baptized again in a Michigan river. Oras and her husband, Hesham and their extended family have had a nightmarish decade. In 2002, Oras survived a kidnapping attempt by kinsman of Saddam Hussein.

Hesham's brother was kidnapped and tortured. Now, Lutheran Social Services of Michigan has helped them get resettled. And the two engineers - she's a civil engineer, he's a mechanical engineer - spend a lot of time looking for work. Oras is 36, Hesham 42.

ORAS TOUMA: We are trying. Yeah. We made our resumes and we are searching on Google. We are searching on companies, contract companies.

LYDEN: This week, Oras got some good news. She's going to start work next week as a supervisor for an international call center. She may indeed have a happy ending to her story.

But war doesn't claim its victims all at once. Sometimes it takes years. At the William Beaumont Hospital, a giant complex in Royal Oak, Michigan, Dr. Najeeb Hanoudi bends over his severely brain-injured son, who has been kept alive on life support systems for nearly eight years.

DR. NAJEEB HANOUDI: He was deprived from oxygen, the brain I mean, the central nervous system for something like 14 minutes, you see? The patient is left with what is called I mean a vegetative state.

LYDEN: It's been a litany of agony following an accidental shooting in 2004 by an American soldier. Najeeb Hanoudi was a prominent eye surgeon in Baghdad. He would never have come to America but for this. The 77-year-old and his wife, Firyal, are worn out and ill from the hours spent at their son's side in a nursing home. When Dr. Hanoudi thinks back to April of 2004, when it happened, he recalls that an American official visited them.

HANOUDI: He came one day and saw us at home in Baghdad. And when he left he said I'd like you to write me something as a kind of reminder or a report or something. And I ended at 500 words, three, 400 words: We are waiting for a miracle. There has never been a miracle.

LYDEN: And while Najeeb Hanoudi is not bitter at the shooter nor even angry that he has been forced to leave his practice and plans in Baghdad for a nursing home in Michigan. Yes, he is angry about the war.

HANOUDI: In the end, the war proved to have been something crazy, stupid. What for? I mean why did the Americans went there? Five, 6,000 kids were killed, dozens of thousands of sea of people who were injured. Hundreds of vegetative cases which I have seen myself in Walter Reed Hospital. You see, Americans, young ones. What for?

LYDEN: It's all very sad, he says, part of the nightmare. Ten days ago, after being in a twilight state for so long, Nazar Hanoudi finally passed away. That part of their story is, at last, finished.

Their hopes now rest on their other children and Nazar's young daughter, a daughter her father never had the chance to meet before the accident.

Yet to a person, all the Iraqi refugees in this story, whatever their struggles, their sorrows, their longing for an Iraq that no longer exists, not one person wanted to return. They've set their sights on America now. And here, they will remain.

For more on this story and pictures of the Iraqi refugees, go to our website, NPR.org.

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LYDEN: You're listening to WEEKEND EDITION from NPR News.

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