Tuesday, July 5

Conflict in Ukraine: is psychological suffering contagious?

Is psychological suffering contagious? Laia, a woman who volunteered during the time we spent in the shelter, asks me about the alert of a possible air attack in the Ukraine conflict. The answer was obvious: of course not. She then she answered me with another question: then, why are all the people I know sad and anguished, even though they have not been in areas affected by the fighting and bombing? Although I was willing to argue how in areas in armed conflict there is an effect of collective fear in the population, for a moment I stopped and remembered the story of a psychologist from our team who had asked me for support to deal with difficult cases.

In reality, psychological suffering is transmitted to the environment of the affected person and especially to the caregiver, particularly in the event that the person has been the victim of some traumatic situation. In addition, the indirect trauma that the mental health professional who cares for people affected by the armed conflict can end up suffering is what is known as “vicarious trauma”. For this reason, that woman was somehow right, psychological pain impacts the environment of those who suffer from it and beyond, because it makes itself felt throughout the community. Being aware of this aspect is being key in the response that the Médecins du Monde mental health team is providing in some areas of Ukraine, such as in the province of kyiv.

After two months of intense fighting and destruction, more than 4 million people have fled to neighboring countries, and more than 13 million people in the country are in need of humanitarian assistance. The inhabitants of the cities and towns of the kyiv metropolitan belt, such as Bucha, have seen their way of life altered by the armed conflict, violence and fighting. These people have lived for more than a month under the threat of projectiles and bombs, facing the daily challenge of survival. In many cases with shortages of some foods and in some areas of supply of water, gas for cooking, heating, electricity or safe transportation.

Most people in Bucha district have emotional disturbances, stress, anxiety reactions, behavioral changes or sleep disturbances. In most of these cases the psychological reactions will be transitory and after the withdrawal of the troops they will subside. However, in other cases, these reactions persist and are affecting the functionality of these people. His life is being conditioned by the decrease in the ability to face daily challenges. In some cases they are not being able to take care of their sons, daughters or the elderly in their family, and in others they are not even able to take care of themselves. Other times, the least, the threats suffered have caused the psychological bankruptcy of these people who are in a state of clear depression or anxiety.

The situation of the seven and a half million people who have fled the combat zones, abandoning their homes and cities, taking refuge in neighboring provinces such as Dnipro or Zaporizhia, or seeking safer areas such as Chernovtsy, in the west of the country, is no better. . Most have integrated into the community, either in apartments rented with savings or after the sale of possessions, or in houses shared in solidarity by their compatriots in towns or cities not affected by the armed conflict. In other cases, these people are distributed in improvised reception centers in student residences, now empty, or in facilities for social, sports or cultural use in the community. These makeshift shelters, with basic comfort conditions, at least guarantee accommodation protected from the low temperatures in this region and provide them with the necessary food. These facilities serve as a refuge for families in which one of the members is missing, either because they are in another part of the country or because they are in the combat front. There you can see elderly people with a resigned face, women with a sad face, adults with disabilities and several boys and girls chasing each other through the corridors, who are reprimanded by the staff in charge of the center who sometimes maintains an attitude that is too rigid, arguing the need to maintain the rules of coexistence. There is an atmosphere of hopelessness and the people who are there express the anguish of uncertainty about their future.

All these people who arrived in other parts of the country, to a mostly unknown and new environment, have left behind part of the family, the home, the possessions, the livelihoods and what is more important, part of their personal history. and their life, which gives them a sense of loss and deep sadness. To this is added the continuous stress of having to survive in very harsh conditions for life, with a lack of all basic services. Some of these people, with whom we managed to establish a relationship of trust, express the climate of violence they have experienced and tell us about the experiences of fear during the bombings or the combats that took place in the streets of the neighborhood. They want the nightmares that disturb their sleep at night to disappear, the shocks caused by any noise or unexpected sound, and the flashbacks they have when the sirens sound and they have to protect themselves in the shelter. These people are trapped by the trauma suffered and require psychological help to overcome it.

To respond to these needs, various mental health and psychosocial support teams from Doctors of the World are providing care in various areas of the country. In the Bucha district, we carry out psychological interventions focused on attention to trauma and complex grief, which, together with symptoms of anxiety, are the most observed psychological reactions.

To access some more remote communities we have an adapted vehicle to carry out interventions inside. This allows us to guarantee confidentiality and protect people from the stigma of the environment.

In addition, support interventions are being carried out for health professionals who have been under great stress during the most critical weeks, working on stress management and self-care.

In the provinces of Dnipro and Chernovtsi, the intervention is aimed at displaced people in reception centers, carrying out group interventions to develop mutual support and foster group resilience. The cases of more intense affectation or of psychological bankruptcy are treated in a consultation that Doctors of the World has in the city. Given the increased demand for care, not only from displaced people but also from host communities, a hotline has recently been set up to respond to the psychological care needs of the Ukrainian population. It is about strengthening the resilience of the population that is suffering from high levels of violence, and promoting the mental health and well-being of the people of Ukraine.