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UKRAINE – The streets of Kharkiv reveal many wounds of the war that has wracked Ukraine for the past 19 months: from shattered buildings to wailing air alarms and children on their way to study in subway stations, to afflicted residents and displaced persons who lost homes, businesses, limbs, loved ones.
And those who still fear a premature, violent death like Oleksandr. The infantryman in his fifties is about to return to the frontline 60 miles (100km) away at Kupiansk, where Ukrainian forces are fighting hard to prevent a major Russian breakthrough.
“In our platoon of 30 guys, we lost five… and one who lost both legs in just the past month,” he says, standing on the central Pushkin Street in uniform with a backpack and sleeping mat, freshly discharged from hospital after treatment for an injury. “It’s roulette. You spend two days on the line, trembling in a hole, looking up at the sky and waiting for a Russian drone to drop something on you.”
Kharkiv is badly damaged, inside and out, but walking through Ukraine’s second-largest city on a balmy, early-fall evening, there are still places displaying no obvious signs of war. No defiant patriotic banners, billboards mourning fallen soldiers, or the ubiquitous planked-up windows. Music wafts through the air, parents push strollers, and children play around whimsical bronze statues in public gardens.
But no one reacts when sirens sound for the fifth time that day, even though it may mean guided missiles are speeding in from Russia, just 25 miles (40 km) away. People got tired of running because of false alarms and now simply trust in their luck.
“The abnormal became normal,” says Iryna Lysikova, who runs a new psychological support center organized by the NGO Razom for Ukraine. Compared with a year ago, the less frequent enemy strikes, in a way, became harder to cope with, she says. “Back then, it was constant, but when it happens now, you get retraumatized.”
Employing five psychologists on its staff of seven, the “Together with You” center in Kharkiv is one of a ten-center network that Razom for Ukraine is developing around the country with support from Direct Relief. Lysikova’s team immediately received a flood of requests for appointments when they opened to the public in late July.
Some are from internally displaced persons (IDPs) from Kupiansk after their compulsory evacuation due to the fighting. Others are from residents who endured the worst shelling from February to September 2022, when the Russians were finally pushed out of artillery range – even if their drones and missiles continue to smash into the city on bad days.
“Some people lived for months down in the metro,” Lysikova says, while opposing the recent decision to conduct classes for around 2,000 children in some of the city’s metro stations from September 1. They are not deep enough to afford protection from attacks and are too poorly ventilated, she believes.
Sure, the center’s capacity is a “drop in the ocean” of the psychosocial care needed among Kharkiv’s current estimated 1.2 million civilian population (the military runs its own psychosocial services). But together with similar initiatives, Lysikova is confident it will help get the ball rolling: “Our task is to help reduce the overall pressure in society.”
The center is looking to cooperate with another that was recently opened by the Kharkiv Renovation Fund, one of Direct Relief’s core partners in the city. The shiny new “Kimnata Pidtrymky” (Support Room) is located a couple of streets over. Offering free psychological services for children, it was also inundated with requests for sessions and expects to receive more than 1,000 clients a month at its 310m2 premises, as well as offering online consultations.
The city’s children present a huge emerging need for psychological assistance and speech therapy.
“These children were not socialized,” says the center’s project leader, Alla Roitblat, referring to the months the youngest Kharkivites spent at home or in shelters, rather than enjoying normal interaction with their peers. “Many children, especially those of IDPs, have aged beyond their years.”
Nationwide Mobilization of Psycho-Social Care
Related initiatives sprang up across Ukraine in recent months. Some 200km to the south, in the city of Dnipro, the Tragedy Assistance Program for Survivors (TAPS) embraced the same issue from a different angle by organizing camps for relatives of fallen service personnel.
So far, it has run two one-week camps at a wood cabin complex in the Carpathian Mountains in April and July for 54 children who lost a parent serving in the military since 2014. There was also a camp for 30 war widows. Described as a “synergy of fun and psychological work,” the events were funded by the US aerospace giant Boeing and will continue as finances allow.
“It’s something that is only happening now, that people realize they need to take care of themselves,” says TAPS project manager Liudmila Cherkez. “We want to normalize the act of going to a psychologist.”
This remains a challenge in many Western societies, too. But in Ukraine, which is still burdened by its Soviet past, people are especially wary of admitting anything that may be perceived as mental weakness, much more so among men. “We are already seeing the consequences,” says Cherkez. “And after victory and the soldiers come home, the need is going to be immense.”
In an online survey that TAPS conducted among 200 members of bereaved families in late August, only 16 people said they required psychological help. After follow-up phone calls by a psychologist working with TAPS, the number jumped to 80 who wished to talk at length to someone qualified.
Fortunately, the issue now has some high-level support behind it. Championed by First Lady of Ukraine Olena Zelenska, the “How are you?” nationwide mental health program has been promoted on billboards and in other spaces since 2022 to address the trauma of war in reluctant Ukrainians.
“They don’t want to upset their family, they are afraid of being excluded from the team, they are afraid of a diagnosis, they remember the negative years of the Soviet medical system of punitive psychiatry,” Zelenska said in September during a discussion in Kyiv on the issue.
“All of this needs to be overcome, this stigma needs to be overcome. And not only in our country, but in the world. Everyone needs to understand that taking care of yourself is not selfishness, it’s a responsibility,” the First Lady said.