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Emergency Psychology Earns Its Stripes in Ukraine War


Ukraine Relief

HromadaHub's emergency psychology coordinator Melinda Endrefy demonstrates methods of interaction with those impacted by crisis in the frontline city of Kherson, Ukraine, on June 12, 2023. (Nick Allen/Direct Relief)

UKRAINE – “You are in a house that is being shelled, I am here, and I will stay with you,” the instructor tells a volunteer simulating shock during a role-play in a basement. In the city outside, two actual shells fired by Russian forces suddenly boom upon impact. Training doesn’t get much more lifelike than this.

The focus of the event is emergency psychological aid, which comprises techniques that trainees – in this case, first responders in Kherson – can use to assist people impacted by floods, earthquakes, war, terrorist attacks, fires, traffic accidents, or any calamity where people can become disoriented, distraught or angry.

“I [also] teach people who are not psychologists how to connect with victims from the first moment,” says Melinda Endrefy, emergency psychology coordinator at the Ukrainian NGO HromadaHub, based in the western city of Chernivtsi.

This can entail using concise speech, eye contact, breathing exercises, and sensory stimulation that will help bring a dissociated adult or child back into the moment and understand what is happening.

It can also mean quickly building trust with someone suffering from trauma accumulated over longer periods: “Many people are like an inflated balloon. You talk to them, and it pricks that balloon – you are the first person to talk to them like that,” adds Endrefy, who cites herformer professor and mentor Teresa Martinez during her teaching years in Spain: “We are the pillow that protects the glass when it falls.”

A professional psychologist, Endrefy honed her skills over the years working in various countries, including Nigeria, Spain, especially during the Covid-19 pandemic and the 2021 volcanic eruption in the Canary Islands, and Ukraine since the full-scale Russian invasion began in February last year.

On May 21, 2023, Ukrainian NGO HromadaHub, supported by Direct Relief, conducted a field mission in the frontline city of Kherson under its “Food4Body, Food4Soul” project to provide food aid and emergency psychological support to the civilian population. “Together with Direct Relief, we took 14 psychologists there. That’s making history in the mental health field,” said emergency psychology trainer and mission leader Melinda Endrefy. The team conducted individual sessions with almost 70 women and children before the event was cut short amid reports of renewed shelling. (Nick Allen/Direct Relief)

The emergency psychological aid training in mid-June for nine first responders in Kherson was an extra element added to an ongoing six-month project aimed at qualified psychologists across Ukraine. During intensive five-day courses, more than 300 participants so far learned new skills that are applicable in crisis situations, rather than in serene surroundings one might expect in psychological care, like quiet rooms with deep armchairs and potted plants.

As recent months showed, it is just as likely to be dark bomb shelters, chaotic train stations or hospital wards following strikes on civilian areas.

The courses often segued directly into field missions to assist the population in locations that are prone to attack or have been liberated from Russian occupation. One training in Dnipro concluded as a Russian missile hit an outpatient clinic in the eastern city on May 26, killing two people and injuring around 30.

In coordination with the health authorities, the psychologists used their new skills while interacting with those impacted by trauma and their relatives. “Heavy day, but I am happy to be here,” Endrefy wrote that evening. “Right place, right time and right people.”

Artwork on an apartment block in Kherson nurtures hopes for eventual peace. (Nick Allen/Direct Relief)

Some of the war’s ill effects on the population stem from the constant stresses: “In Dnipro, we had to deal with a woman, a volunteer at a shelter, who fainted every time there was an air alarm,” she says. “[A sense of] helplessness is a problem we will encounter more and more.”

It is also crucial to nip in the bud things which, if neglected, can cause serious mental and behavioral issues in later life: “If children saw a dead body, especially with a missing part, it is very important to take immediate action.”

In Kherson, which was occupied by the Russians for eight months, shelled for seven months, and partially flooded in the Kakhovka dam explosion on June 6, exhausted local volunteers specially requested the emergency psychological aid course. Although they were involved in daily rescue and evacuation efforts, they often didn’t know how to respond to emotional distress in people.

“The training is really useful,” says participant Lena. “We were doing a lot of things incorrectly, like hugging them when it was not appropriate.”

“We’ll not only use what we have learned, but we will build on it,” adds her colleague Sveta.

On May 21, 2023, Ukrainian NGO HromadaHub, supported by Direct Relief, conducted a field mission from Odesa to the frontline city of Kherson under its “Food4Body, Food4Soul” project to provide food aid and emergency psychological support to the civilian population. Thirteen psychologists prepare to drive the final stretch to Kherson after donning their body armor vests. The mission was led by trainer Melinda Endrefy (sixth from left) (Nick Allen/Direct Relief)

HromadaHub, which together with Endrefy, founded the “Food4Body, Food4Soul” emergency psychology project with support from Direct Relief, also wants to build on the experience gained by expanding the project in Ukraine.

“By organizing the training we are not giving the fish but the fishing rod to the psychologists so they can start helping their communities,” says the NGO’s head Lily Bortych. The goal is to build up the resilience and sustainability of the country’s psychological support system: “Ukraine doesn’t have to rely only on foreign specialists but can build up an army of trained emergency psychologists speaking the same language, living in the same area, and sharing the same problems with the people they help.” 

Meanwhile, Ukraine’s DSNS civil defense authority has already started to implement the principles of emergency psychology in its staff training after attending the project’s events.

In further recognition of its impact, Endrefy, who served as the Euroasia representative of the International Federation of Emergency Psychology, was also named President of the World Association of Emergency Psychology for Ukraine in late June.

Direct Relief supported the Food4Body, Food4Soul program with a $320,000 grant to expand psychological services in Ukraine.

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