The hospital where Dr Olga Milinchuk works has no sign outside and no waiting rooms. The address is a closely guarded secret, as are the identities of her patients. With a team of 18 specialists, she spends every day repairing the shattered lives and minds of victims of Ukraine’s longest-running crisis – endemic human trafficking.

When Milinchuk opened this rehabilitation centre in 2002, under the auspices of the International Organisation of Migration (IOM), it was dealing almost exclusively with young women who had returned home after escaping sex trafficking. Today, her patients are men and women of all ages who crossed a border on the promise of a job, but found themselves on a journey into forced labour, abuse and debt bondage.

Milinchuk, who has treated about 2,000 people at the centre, estimates that 95% of her patients are victims of labour trafficking. They come with gastric and intestinal diseases from malnourishment, sexually transmitted diseases, and psychiatric problems such as post-traumatic stress disorder.

“The youngest was three years old, trafficked to Poland for work begging with her mother and five-year-old sister,” she says.

Forced labour is difficult to detect. Traffickers deceive victims into travelling without valid visas, keep workers trapped in debt bondage and reliant on their employers for food and accommodation, or stop unpaid workers from leaving through violence and intimidation.

Dr Olga Milinchuk Photograph: IOM mission in Ukraine

“They take a mother with two children, then lock one child away so that when the mother is out begging, the traffickers know she will return for the other,” she says. “The mother had been promised a job in agriculture and was told to bring the children for kindergarten.”

Trapped in conflict with Russia and weakened by decades of government mismanagement, Ukraine is suffering a deepening economic malaise. It is the second poorest country in Europe by GDP; only its tiny neighbour Moldova is poorer.

“The economic crisis is now so deep we see so many people are willing to accept any offer, risky offers, just for the chance to work abroad,” says Hanna Antonova, the IOM’s counter-trafficking programme coordinator in Ukraine.

The country has long been a regional trafficking hub. The IOM estimates that more than 160,000 people have been trafficked from the country since independence in 1991.



“Ukrainians have traditionally used migration as a survival strategy. You can make more as a nanny or a construction worker in Russia than as a teacher or doctor in Ukraine,” Antonova explains.

An estimated 2.7 million people have fled their homes to escape conflict with pro-Russian separatists (pdf). Traffickers prey on them, with police intercepting dozens of displaced people in the hands of traffickers en route to Germany, Russia, Belarus, Poland and Israel. The inflated currency is pushing millions of people into destitution. Thousands are trying to find work abroad – by whatever means possible. According to a 2015 survey commissioned by the IOM, 41% of Ukrainians working abroad are doing so illegally – compared with 28% in 2011. That puts them at the mercy of criminals.

Milinchuk says she has treated a 21-year-old daughter sold by her mother to a Turkish brothel and a 50-year-old mother with disabilities sold by her son to beg in Russia.

Former patients say the hospital saved their lives. Olya, a 52-year-old survivor from a small town in central Ukraine, travelled to Moscow with a friend in 2013 on the promise of a job selling Chinese products in a market. The salary seemed credible – $600 (£410) a month plus room and board.

On arriving, Olya says they were met by a man named Rahid, who took them to a warehouse where they were asked to sort clothes. He took their passports “to copy them” and introduced them to their employer.

“When we saw the conditions, we were shocked,” Olya recalls. “He locked us in the warehouse and we ate only doughnuts and fried hot dogs. We slept there on sacks and bags. There was no fresh air, no place to wash ourselves.”

The group told their employer they wanted to leave and asked for their money.

“He drove us outside the city,” she says. “There was an abandoned territory – I guess it had been a factory, surrounded by a fence with barbed wire. The gate was closed but when the bus arrived, two guards came out. They were huge and had guns.

“The first night we didn’t sleep. The guards said we had to go with them. They took me and another girl. We didn’t want to go but they forced us. We were powerless before such huge men.”

Art work created by residents of the IOM hospital in Ukraine. Photograph: Maxim Tucker/The Guardian

For almost two months Olya says she worked 18-hour days, bottling, packing and loading vodka from the plant’s illegal stills. “There were moments I asked for vodka. I drank it to relieve the stress,” she says.

Eventually, police raided the factory and the guards told them to run. Olya fled into a forest and spent the next few weeks hitchhiking and hiding on trains. When she finally arrived home, all she could bring herself to tell her husband was that she hadn’t been paid: “I wanted to tell him but I was afraid of consequences. … I just prayed to God that I didn’t have any diseases.”

A local NGO put her in touch with the IOM hospital. They treated Olya’s stomach and back problems, and her depression.

“This rehabilitation really helped me. I don’t know how my life would [have been] if I had stayed at home, shut in and thinking about that all the time. I think I would [have gone] mad,” she says.

Nadia, another of the centre’s patients, also credits the hospital with saving her life. She was recruited by a trafficker on the promise of work caring for an elderly woman in Moscow. Nadia and the three women with whom she had travelled were kept in a house, beaten, underfed, sexually harassed and forced into domestic servitude.

“We worked there for six months until we were too thin and worn out. Then they said that we were ‘used goods’,” she says. “They gave us 2,000 roubles [£18.70] to get home.”

“I had grey hair when I came back,” she says. “Then … they examined me, treated me and now I feel better. I thought it was heaven after hell … they just dragged me out of that depression.”

The patients are usually from the most vulnerable sectors of Ukrainian society – with limited education and few opportunities. The rehabilitation centre not only treats their trauma, but trains them in vocational skills to make them more employable.

“Sometimes I see a person in the street and they recognise me but I don’t recognise them,” Milinchuk says. “Even if I’m related to a difficult experience for them, they’re happy to see me and say some warm words. That’s a great source of support.”