LYUBA VOEVCHIK lives underground. Her neighbourhood, the Petrovsky district of Donetsk, is close to eastern Ukraine’s front line. When shells began landing on her street last summer, she moved to the dank basement of a local cultural centre, where she and her two youngest sons share a narrow bed with faded pink sheets. Frightened and exhausted, Ms Voevchik has not slept at home in nearly a year. The latest ceasefire has provided little solace. “They should hush up,” Ms Voevchik says with a sigh. “They promised.”

Those promises were the subject of high-level talks between Russia and America last week. John Kerry, America’s secretary of state, conferred with Vladimir Putin, Russia’s president. Victoria Nuland, another American envoy, shuttled between Kiev and Moscow, urging compliance with the faltering Minsk peace plan.

But as diplomats keep talking, the guns keep sputtering and civilians like Ms Voevchik keep suffering. The United Nations estimates that the war has left 5m people in need of humanitarian help. Of the more than 6,000 killed since last April, most have been civilians. Some 2m people have been displaced, and countless more reduced to lives of basic survival. Worst hit are the sick, the elderly and children.

The woes of front-line residents have mounted as the authorities who are supposed to succour them vanish. Ukraine’s government has stopped financing the separatist-held territories (including pension payments and doctors’ salaries), and has offered haphazard help to the internally displaced on its side of the lines.

The separatist leadership has proved capable of little more than waging war. Russia’s aid to the region has been heavy on guns and light on butter. “It turned out that nobody cares about the people,” says Evgeniy Shibalov, co-founder of Responsible Citizens, a volunteer-run humanitarian aid group in Donetsk. The outside world has ignored the plight of the Donbas region, treating war as a geopolitical rather than a humanitarian problem. Of the $316m the UN requested for aid to Ukraine this year, only a quarter has been pledged.

Humanitarian organisations and volunteers have stepped in. The International Committee of the Red Cross (ICRC) opened five offices in the area. Médecins Sans Frontières (MSF), a health charity, has sent dozens of doctors. During the heaviest fighting, Responsible Citizens delivered aid to “red zone” areas which others deemed too dangerous. Pomozhem, a foundation started by Rinat Akhmetov, Ukraine’s richest oligarch and a native of Donetsk, distributes monthly food handouts to over 800,000 people on both sides of the lines. More still sign up every month. The foundation’s 12kg package of essentials like salt, sugar, pasta and flour “helps us survive in this nightmare”, says one pensioner from Donetsk’s Kievskiy district, which borders the city’s heavily bombed airport.

When war was raging, aid workers focused on treating the wounded and evacuating civilians. Now, as fighting has ebbed (though not fully ceased), attention has turned to securing medical and food supplies and rebuilding damaged homes. Ukrainian government restrictions have exacerbated supply shortages, limited civilian access to aid and deepened resentment in separatist-held areas. Pensioners can only retrieve funds in government-controlled territory, and many are physically or economically unable to get there. To cross the lines, residents need a pass from the Kiev authorities; that can take months. The rebel authorities pay pensions sporadically.

Other problems will linger long after all fire ceases. “When the conflict stops, it doesn’t mean life goes completely back to normal,” says David Nash of MSF in Donetsk. Unexploded ordnance hides along country roads. Psychological trauma haunts daily life. At one school near the front, childish drawings adorn the wall. Subjects include two soldiers running through a field beside two tanks under a receding sun, an old woman and a boy huddled with their cat and dog in front of a burning home, and two children gripping their mother in candlelight, with the words, “Give us back the quiet!”