Millions in eastern Ukraine endure invisible wounds of war

The thought of one more night sheltering in her dark, damp basement makes Maryna*, 56, tremble, after five years of conflict in eastern Ukraine.

While the recurrent shelling outside is terrifying, it is the drawn-out silence between the blasts that frightens her the most.

“When everything gets quiet, I feel like nothing will ever change,” says Maryna, a dressmaker and mother of two. “I feel like the conflict is endless.”

Maryna is among millions living in the conflict zone who are paying a heavy psychological price for the ongoing violence in Ukraine.

To date, the conflict has uprooted around 1.4 million people, while many more endure cold, hunger, hardship and the threat of sudden death at home. In all, 3.4 million are in need of humanitarian assistance and protection.

Almost 40 per cent of people who live in the Donetsk and Luhansk regions have experienced trauma resulting in stress, depression, anxiety and post-traumatic stress disorder (PTSD) as a result of the violence, according to a recent study.

“I was on the edge, not wanting to live."

For many like Maryna, a cancer survivor who lives with her elderly mother just two kilometers from the frontline, living amid conflict has been devastating.

“I was on the edge, not wanting to live. Nothing could help me. For the first time in my life, it felt like I was going to die,” she says. “Even when I was diagnosed with cancer in 2005, I didn’t feel this bad.”

She is far from alone.

One in five people who have experienced war or other conflict over the last 10 years have mental health conditions, according to the World Health Organization. Some five per cent suffer serious disorders, such as bipolar disorder, psychosis, severe forms of depression or PTSD, whose symptoms may include flashbacks, nightmares and severe anxiety.

Fortunately, for people living on the frontline in eastern Ukraine, some help is at hand. Proliska, an organization which partners with UNHCR, the UN Refugee Agency, is among aid groups redoubling their efforts to provide psychosocial assistance to people whose lives have been shattered by the conflict.

Since October 2018, Proliska’s 11 psychologists have been reaching out to communities in government-controlled areas. While needs are huge, since the beginning of 2019 they have provided counselling to 1,100 people, of whom 72 per cent are women.

• See also: This is what it’s like to live through freezing winter in a war zone

“We want to show that, despite not being able to ‘switch the war off’, we can help [people] to cope with what is going on,” says Olha Klymovska, a coordinator of psychosocial support activities at Proliska. “The way we deal with a situation, the way we use our internal resources, can play a decisive role,” she adds.

On the outreach team is psychologist Svitlana Doroshenko. On visits to frontline communities, she teaches coping skills and techniques that use breathing and physical exercises to help people control their emotional response.

"I tell them that the healing is a long process."

“I tell them that the healing is a long process and it’s possible to have setbacks on the way,” Svitlana says. “What is important is to know which methods and techniques can be used to help people get out of this black hole.”

Among the people that she works with is Maryna, whose two children left at the start of the conflict and have not returned home. Svitlana talks her through her loss and is teaching her relaxation techniques to overcome insomnia and anxiety.

The assistance is gradually helping her to see a way forward in her life – and out of the hopelessness she felt trapped in her dark basement.

• See also: Mental health first aid on the frontlines of the Rohingya crisis

Her smile has returned, and she has found the strength to renovate her apartment, where the windows were shattered by shellfire. Maryna shares her experiences to help others, and is finally thinking of restarting what she loved before the conflict started – designing dresses for graduation balls.

“It was very difficult for me, as a creative person, who saw everything through pink lenses, to suddenly realize that there is only grey colour around,” she explains. “But now I am able to recognize other colours again.”

Wars and persecution drove 70.8 million people from their homes by the close of 2018. UNHCR’s senior mental health officer, Peter Ventevogel, says mental health and psychosocial support should be an integral part of the humanitarian response in crisis and emergency situations around the world.

To promote the rapid adoption of these services, UNHCR staff and refugees will be taking part in an international conference, hosted by the Dutch Minister for Foreign Trade and International Cooperation, on 7 and 8 October 2019.

“The work of Proliska in Ukraine is encouraging, and the numbers of people assisted are impressive,” says Ventevogel.

“Nevertheless, globally, many more who are in need do not yet receive basic mental health and psychosocial support services. All humanitarian partners, UN agencies, non-governmental agencies and governments need to step up their efforts to make such services part of the humanitarian response.”

* Names have been changed for protection reasons