Portrait of Tetyana

Ukraine: Living with the war and trauma

“I slept in our basement with my daughter for 70 days. We cried every day, because we were so afraid,” describes Tetyana, 33, she fled with her 12-year-old daughter from Luhansk region in Eastern Ukraine. They fled on May 8, on the last bus out of the region. “It was cold in the basement. The electricity was turned off sometimes, and we never knew when or if it would be turned back on. My husband went out to find food. Over the 70 days more and more shops closed, and the people left. When there was only one shop left, we knew it was time to leave,” reflects Tetyana about her time in the basement.  

While describing how that time has been for her emotionally and psychologically, she is calm and collected. That has not always been the case. “I came to Rivne totally broken. I needed help and someone to talk to. The first time there were air sirens in Rivne it was like something turned inside of me. I was so overwhelmed and there were too many emotions,” remembers Tetyana. She finds help with Tamara, 60, a psychologist who works for a local NGO that is supported by CARE. “With the psychologist I talked about what my primary fear was about. I had some practical exercises to control my negative thoughts, to stop and to turn it to the positive. Now I can deal with it better. I can talk about it. The sirens do not scare me as much,” describes the mother.   

Her daughter is also struggling since coming to Rivne. “While we were living in the basement my daughter helped me a lot. She was the one saying that all would be fine. When we came to Rivne, there was no more joy in her. She couldn’t smile anymore,” explains Tetyana. Her daughter also goes to talk to someone, and they recommend that she should go to a massage for her to relax and lose a bit of tension. “Now she is smiling again,” says Tetyana smiling herself. She is glad that her daughter is doing better. 

Tetyana, 33, who fled with her daughter, 12, from Luhansk region to Rivne, Western Ukraine.

Tetyana, 33, who fled with her daughter, 12, from Luhansk region to Rivne, Western Ukraine.

Tetyana and her daughter are just one case of many. “We have a lot more patients with anxiety and depression,” says Doctor Bulavina Olena, 29, who works as a family doctor in a health facility in Rivne. Many people have gone through a lot of trauma in their home or while fleeing to safer places. They fear for their own safety, that of their family, friends and relatives that they were forced to leave behind. Living with an active war just outside your doorstep is difficult on an emotional and psychological level.  

Doctor Olena Bulavina, 29, sitting in her office with patient Olga Gvozduk, 77, in a health facility in Rivne.

Doctor Olena Bulavina, 29, sitting in her office with patient Olga Gvozduk, 77, in a health facility in Rivne.

“Most of my patients either live in the past or in the future, but I help them to find their now and live in the presence,” explains psychologist Tamara. She works with internally displaced people who have fled from areas that have active fighting and now are trying to start a somewhat normal life. “I talk to families that arrived at the train station in Lviv when the missiles hit. I talk to children, that sing loudly when the air sirens go off in order to not hear them,” describes Tamara. It is very important to work through fear and anxiety. In the short term, anxiety increases breathing and heart rate, concentrating the blood flow to the brain, where it is needed. Long-term anxiety can cause the brain to release stress hormones on a regular basis. This increases the frequency of headaches, dizziness, and depression. The body never receives the signal to return to normal functioning and this can weaken the immune system and be more vulnerable to infections and illnesses. “Most of my patients are in stress and shock. I try and decrease their level of fear. I believe that it will get worse and that there will be a lot of cases of post-traumatic stress disorder (PTSD),” explains Tamara. PTSD can affect a person’s ability to work, perform day-to-day activities or relate to their family and friends. Tamara has worked with many people who have gone through a traumatic experience. “I normally start by letting them explain their fear, maybe let them draw it. Then together we try and find the negative and change it to the positive.” 

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Tamara, 60, is a psychologist working with internally displaced people in Ukraine.

However, not everyone wants to talk to a psychologist. Not everyone wants to seek for help. “There are some cases that refuse psychological support, because there is still some stigma against it. Some of the people believe they can deal with it by themselves,” reflects Tamara. For these cases, Olena, 33, psychiatrist in Lutsk has written a book. “I wrote a book that gives answers to the most common questions on how to live with the war, because it helps to keep clients confidential,” explains Olena. In 38 short chapters the booklet answers questions for example on how to communicate with relatives that have fled from ongoing fighting, on how to decrease stress in children, how to treat sleeping problems, how to overcome guilt, if it is okay to feel hate, what do to do when one feels helpless and how not to lose hope. With CARE’s support they were able to print 2,400 books in the first round. The books are distributed for free to internally displaced families but also sent to areas where there is still active fighting. 

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Olena, 33, psychiatrist in Lutsk

The feeling of guilt is a major problem for some. Volunteers and others feel that they are not doing enough. “I learnt how to rest and how to live with the guilt. I help where I can, but I have to stop myself before I burn out. I have to control my own fear and not panic. To be afraid is okay,” says Iryna, 31, is a volunteer in Lutsk. She collects humanitarian aid items and sends them to areas with active fighting. She is one of the recipients of the book. The advice in the book helps her to feel more relaxed and at peace with herself. She tries to stay strong for her 8-year-old daughter Victoria. 

Iryna, 31, volunteer, in Lutsk holding her daughter Victoria, 8.

Iryna, 31, volunteer, in Lutsk holding her daughter Victoria, 8.

Working through emotions and trauma is an important aspect of being healthy. CARE supports families, women and children who have gone through the extreme. Either through support sessions, by giving information on where to seek help, or anonymously through hotlines or support books.