Four years of conflict have severely altered the lives of people living in eastern Ukraine. More than a million people have been forced from their homes by a lack of security, loss of livelihoods, and damage to their property. Partially abandoned villages are now home mostly to elderly people living in relative isolation, struggling to afford daily necessities as they cope with rising prices and insufficient pensions.

Many of these people are in desperate need of medical care to treat chronic diseases and psychological support to help them cope with their stress and loneliness, which are exacerbated by the conflict. Unfortunately, health care is often out of reach both physically and financially. Most medical personnel have fled the fighting in the region, and many hospitals and medical clinics were damaged or destroyed.

Doctors Without Borders/Médecins Sans Frontières (MSF) runs mobile clinics in 28 locations across Ukraine’s Donetsk region from bases in Mariupol and Kurakhove. The clinics provide primary health care and mental health consultations. Teams also supply medical facilities in the area with drugs and equipment and conduct mental health support training for teachers and government health care professionals still living or working in the conflict zone.

It is clear that some medical conditions—such as hypertension and diabetes—are related to the stress people are experiencing due to the conflict. Accordingly, MSF has bolstered its medical services with mental health support ever since it began working in this region. Among the patients receiving care from MSF, more than half are affected by anxiety. Other common conditions include psychosomatic disorders and depression.

The greatest challenge for MSF’s mental health team gaining the trust of people living in the region. Most had never spoken with a psychologist and did not understand how the consultations could help them. MSF’s team explained about psychological care and how mental health is linked with physical health. They focused on stress-related problems and the symptoms that indicate when someone needs help. Gradually, the team earned trust in the areas they visit.

People began to share their feelings and experiences more readily and started to come to MSF mental health consultations regularly. Those who had been helped through the mental health consultations began to share their experiences with others. Step by step, the trust between MSF and the communities has grown.

Here, MSF patients and staff share their experiences coping with the mental and physical effects of the ongoing conflict.

MSF doctor Sergienko Iryna