Belgium, (Brussels Morning Newspaper) As the anniversary of the outbreak of war in Ukraine comes and goes, we are reminded daily of the immense human suffering.
Images of Bakhmut, the embattled regional city in the Donetsk Oblast, show it transformed into a bleak, frozen landscape of collapsing tenement housing, scarred with the tracks of tanks, charred with soot, and cratered out from relentless artillery barrage.
From further behind the front lines, we hear from Ukrainian soldiers who had spent months fighting in the same damp trenches where they slept. These are some of the many who have developed PTSD while fighting.
“Shell shock” is a term we most closely associate with the trenches of the First World War. It endured as a defining injury of the war through poets like Wilfred Owen, with references in popular culture continuing to this day. According to historians, 65,000 British troops were still suffering from PTSD even 10 years after the end of the war. At their peak, there were reportedly 19 military hospitals dedicated exclusively to treating the “shell shocked”. Many never received any form of treatment and died whilst still suffering from the disorder.
It isn’t just artillery and trench warfare that can cause PTSD. Survivors’ guilt, sleepless nights, flashbacks, and physical injury are common triggers that can develop into the disorder.
The implication of this wave of mental unwellness is enormously significant not just for military capacity, but for the future well-being of Ukraine. With around 10,000 soldiers estimated to be suffering from the condition, it represents a serious thorn in the side of the defending forces, removing several battalions worth of soldiers from the fight at any given time. Moreover, once the war finally ends, Ukraine will have to rebuild not just the bricks and mortar of their country, but the broken minds neglected during the war.
Ukraine only has one military rehab center dedicated to the treatment of PTSD. Located in rural Kharkiv Oblast, several thousand soldiers have reportedly been treated there. Colonel Oleksandr Vasylkivskiy runs the facility on charitably donated funds alone – no funding is coming from the Ukrainian state. Despite that, at a cost of only around €140 a week, soldiers are normally fit to return to active service within a week.
Whilst this level of provision is clearly inadequate, it is nonetheless a remarkable turnaround for a country like Ukraine where mental health services are still viewed with suspicion. Patients fear being ostracised by their families or seen as “crazy”. Even before the war, Ukraine suffered from the highest rates of suicide and alcoholism in Europe.
On the home front, which stretches from the fortress cities of Ukraine through the refugee camps of Poland and into Western Europe and the UK, thousands of displaced families face anxiety, bereavement, and PTSD in their own right. While many are able to effectively access the mental health resources of host nations, others, especially those in the camps in Poland, are facing a scarcity of treatment options. People are left to battle mental demons and trauma with only the very basics provided for them.
Some charitable movements have taken it upon themselves to promote self-care and mental health routines which are still possible in the limbo of a refugee camp. Alysha Tagert, a US-based mental healthcare provider, has advocated for low-cost mental health “toolboxes”, assembled by Ukrainians to include personal items which can help them control their anxieties. These can include diaries to write down their thoughts and “name and tame” their anxieties, or items such as stress balls or sugar-free chewing gum to increase mindfulness and calm their unrest by focusing on their own chewing and movement. While these approaches are trying to make the best of a bad situation, even their most formidable advocates would never argue that they can replace professional help.
The level of human suffering in Ukraine continues to shock western observers. This suffering continues to motivate significant effort and military and economic aid. Most European nations have committed to providing state-of-the-art Main Battle Tanks (MBTs) such as the Challenger 2 and Leopard 2A6, something unimaginable only a year ago.
Yet, as Western governments rally behind Ukraine, they still ignore the question of mental health, even to the great detriment of the war effort.
