Toronto Star

Ukraine hospital’s patients are waiting for the next explosion

- MSTYSLAV CHERNOV THE ASSOCIATED PRESS

HORLIVKA, UKRAINE— Whenever the bombs fell, the men and women in the psychiatri­c ward would huddle in terror around fellow patient Valentina Izotova, a stout, maternal-looking woman, and she would read to them from her favourite book. They hardly understood a word, but her voice soothed them.

The hospital in Ukraine’s war-torn east has been shelled eight times since the conflict started more than a year ago, blasting a huge hole in a wall, shattering windows and terrorizin­g patients. Long suffering from the trauma within their minds, they now suffer the trauma of war, abandonmen­t and a shortage of psychiatri­c medication.

“People lived so peacefully, there was at least some joy,” said Izotova, who teared up as she spoke. “And now we only wait for the next explosion, wait for someone to start shooting. We are disturbed and worried.”

The suffering is manifest even on days when there is no fighting. Patients wander the corridors aimlessly. Their emaciated faces stare out from beds. Endlessly, they mumble the same, incoherent phrases.

The staff — what’s left of it — face the crushing struggle of caring for confused and vulnerable charges with insufficie­nt manpower and constant anxiety about how to obtain the medication that can bring the patients a measure of peace, as fighting between Ukrainian forces and pro-Russia rebels gathers new force after a lull.

The hospital, like scores of others in the rebel-controlled east, is plagued not only by the bombs and bullets but by an effective government economic blockade. The government has stopped sending pensions and other social payment to the rebel-held territorie­s, and residents can get the money only by travelling to government-controlled areas. Getting the paperwork to do so is laborious. The trip itself can be stressful and perilous, and many of those in most need of money have mental or physical ailments that prevent them from travelling at all.

“When war started in July last year, our financing was stopped; no salaries, no drugs, no food. We had emergency rations, which every hospital had at the beginning of the war; that’s why we could survive a few months,” said chief doctor Tatiana Sergunova. In April, rebels began paying some pensions, but “it’s a blockade, it’s impossible to bring medicine here.”

The internatio­nal aid group Médecins Sans Frontières, or Doctors Without Borders, known by its French acronym MSF, said psychiatri­c patients across eastern Ukraine are suffering from a lack of basic care.

“The problem of drugs in psychiatri­c hospitals is a severe problem. So we visit these institutio­ns, find that they have a lack of drugs to treat all these patients,” said Franklin Friaz, an MSF medical co-ordinator; “for example antibiotic­s, painkiller­s, and most important for them is psychotrop­ic drugs.”

Even when it has money, the hospital can’t buy the required medication­s because pharmacies don’t have them in stock. Major humanitari­an organizati­ons such as MSF also have difficulty finding the drugs needed by the mental patients. That means there’s sometimes no respite from mental suffering even as war drives it to unbearable levels.

The Horlivka hospital itself is fitfully recovering. The broken windows have been repaired and some new staff has been hired, though they are inexperien­ced. “I have to work for two people now,” said one of the doctors, Evgeniy Menyaenko.

And more demands may be placed on its hardpresse­d staff. Loic Jaeger, Ukraine emergency coordinato­r for MSF, said requests for mental-health support are rising from people not afflicted by mental illness, but unable to shake the trauma of war.

That could strain the Horlivka hospital, which has only one psychologi­st to care for the 30 patients already there with serious psychologi­cal damage from the conflict. “Around 80 per cent of people who come to us now need help in dealing with losses, losses of family members,” said psychologi­st Victoria Yarotskaya. “They see the mutilated bodies of relatives, pieces of bodies.”

Among those who come are Tatiana Anatolievn­a, who gave only her forename and patronymic, and her 3-year-old grandson, Vadik.

She said her grandson was recently holed up in the family apartment for two weeks to protect him from shelling. One day, the family took Vadik outside for a breath of fresh air. A bomb fell, killing the boy’s mother in front of his eyes.

The boy screamed “unbelievab­ly loud,” clinging to a scrap of his mother’s jacket. These days, she said, he has withdrawn into himself: “He is like in a shell.”

Psychiatri­c patients across eastern Ukraine are suffering from a lack of basic care

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