Written by: Robert McAlister, Executive Contributor
Executive Contributors at Brainz Magazine are handpicked and invited to contribute because of their knowledge and valuable insight within their area of expertise.
Over the last four years, I have been involved in various long running training and development projects associated with Ukraine. During that time building up relationships with individuals and teams located and working across the country.
I was last in Kyiv back in late 2018 planning further visits which unfortunately got postponed due to the COVID pandemic, not realising that those visits would be postponed for far longer than anyone expected.
Once the war started and many of those I knew scattered, some leaving Ukraine and others being internal displaced I was left as many of my other colleagues were too, with a very real feeling of helplessness.
Whilst the Ukraine projects continued, moving from normal programme mode to a more crisis management footing, this personally still left me feeling I could and should do more. Listening each week to their emotional updates and seeing their resilience was very moving but also inspiring.
So, when an opportunity arose which provided me with the chance to get involved however indirectly in their overall plight, I immediately seized upon it.
From February to May I have had the unique opportunity to observe first-hand the Ukraine refugee crisis and gain valuable insights across 3 frontline cities that closely border Ukraine or are used as critical escape routes.
Rzeszow ‒ Poland
Kosice ‒ Slovakia
Iasi ‒ Romania
These and many other first contact cities have faced the brunt of the Ukrainian refugee crisis over that time and have had to adapt and adjust accordingly.
Whilst there are many similarities across the locations and the way they have tackled these impacts; there are also many differences and challenges as you may imagine.
There is nothing quite like getting the ground truth by being there and experiencing things first hand such as, speaking with the volunteers and responders, witnessing the affected individuals being treated and the day-to-day operational level activities.
Many watching the media may believe that the war is over as the fighting appears limited to the east of Ukraine and talk of many Ukrainians thinking of returning home, but each day across Ukraine there are reminders that this war is far from over.
While border crossings such as Medyka which I visited whilst in Rzeszow have grown less busy, officials are wary that any intensification of the fighting in Ukraine could trigger a new influx.
Changing Picture
As the dynamics, locations, and duration of the war in Ukraine have changed, so too has the ripple effect and impacts faced beyond its borders. Ukraine’s neighbours are having to remain aware, agile, and adaptive in their crisis management strategies and approaches.
An example is:
The first wave of refugees fleeing Ukraine was made up of people with resources and means such as those with contacts in central Europe and beyond, allowing them to move on. However subsequent waves are more traumatised, leaving without any resources. These groups are very vulnerable and need more direct support, many more are infirm, for example the elderly, the grandparents who people have left behind because they are not able to move around very easily.
Hence, the response and support requirements are different and to some degree increased but have become reduced and diluted due to the period in which they have been operating, reduced in capability or financing, creating a new and interesting challenge for Ukraine’s neighbours offering means of assistance.
My observations have very much been a snapshot in time and dare I say history, but the war evolves repeatedly and so do the challenges and required responses.
Whilst I have gained many insights across varied themes as part of this work, this article will focus on only one, that of the impact on mental health of those escaping the war and the challenge for those first contact cities seeking to support.
Common Thread
Firstly, let me say straight away I am not a psychologist or psychosocial expert, but I’ve been around conflict and crises for a long time and try to apply a common sense and emotionally intelligent approach to this subject matter.
“One aspect that is common across all areas is the impact of trauma on those fleeing”
The Author
Trauma is a huge effect of war not only on physical health, which is more easily visible, but also the mental health consequence, which may remain hidden. Many require specialist help to come to terms with the displacement and deal with anxiety, depression, and post-traumatic stress disorder (PTSD). For the ones who have lived through fighting the demand for this type of support is even greater.
However, these neighbouring countries often lack capacity and specialists to offer the types of counselling and support required with mental health infrastructures that are under financed and now overwhelmed. Whilst The World Health Organisation is at work trying to quickly build up capacity, creating “psychological first aid” toolkits — informational materials for schools and social workers to help provide an initial buffer but there are still extremely limited resources available.
Hidden Crisis
It is no surprise then that for the millions on the move from Ukraine, whose lives have been thrown into turmoil since the war started, the immediate fight for survival centres on the most basic needs of food, shelter, and medical aid, reminiscent of Maslow’s model.
But the history of mass trauma suggests the need for psychiatric support will inexorably grow after the acute phase of the emergency subsides. While it is painful to see the direct impact of this war on human lives and livelihoods, this invasion will also produce less visible psychological wounds that could linger for generations.
There is abundant research that such difficult experiences can lead to severe consequences including PTSD, depression, and anxiety. PTSD symptoms include terrifying and realistic flashbacks of war scenes, intrusive memories of the trauma, panic, inability to sleep and nightmares, as well as avoidance of anything that resembles the trauma. Prevalence of these conditions is higher in human-caused catastrophes than, for example, natural disasters.
Children exposed to war manifest the highest rates of mental health problems compared to children in the general population, complicated by difficulties in communicating or articulating their traumatic experiences. Although children are extremely resilient, war and conflicts have devastating long-lasting effects on children impairing their ability to engage in daily life, focus on school, form relationships and attachments and to feel safe ‒ all of which we take for granted.
The needs of those fleeing shelling and missile attacks, bearing harrowing memories and the pain of separation from family, stretch well beyond education. The International Organization for Migration (IOM) has organised psychological first aid training near the Polish border with Ukraine to help volunteers provide care for the many struggling mentally.
Who’s Helping the Helpers?
Police, firefighters, paramedics, and volunteers face first-hand the ugliest results of wars. They endure long hours of physically and emotionally intense work and frequently see scenes of death and suffering, while having the same concerns of other civilians about their own families. Research shows that PTSD affects between 15% to 20% of firefighters and other first responders during peacetime.
The volunteers in these frontline cities are also experiencing similar effects based on their contact with traumatised refugees, those daily interactions, mental images, and inescapable emotions take their toll. A recent report suggests many mental health workers, like their medical colleagues, are already suffering from burnout and overwork related to the coronavirus pandemic and are now faced with this new and prolonged crisis.
Shame On Them!
Many Ukrainians who have been able to flee are facing the daily battle with survivor’s guilt as the war in their country rages on whilst they watch from safety.
Survivor’s guilt has been well documented in those who lived through the Holocaust, the 9/11 terrorist attack, or, more recently, the COVID-19 pandemic. It’s also seen in combat soldiers, first responders and humanitarian aid workers, and it can affect regular people who have survived mass shootings, traffic accidents, natural disasters, and other traumatic situations.
Against the backdrop of increasing numbers of displaced people in the world, experts argue that survivor’s guilt should get much more attention. But it is a vicious circle. Because survivor’s guilt is linked to shame, those affected often don’t share their thoughts and feelings.
Frying Pan to Fire
Many who successful escape from the most dangerous locations and reach safety, now face other less visible threats one of which is people traffickers. Remember many of the refugees are vulnerable females and children and are therefore stereotypical targets for criminals. There have been many reports of people traffickers preying on individuals as soon as they cross border checkpoints, offering kind assistance, such as food, transportation, and accommodation. Therefore, safeguarding becomes a huge priority to those local authorities who have a duty of care responsibility. These authorities are producing awareness campaigns and materials to raise awareness of such threats.
Uncertain Futures
For the many Ukrainians who have reached safety, remaining abreast of the news — watching video after video of shelling and breathlessly checking in with people who stayed behind may well be more harmful than helpful.
“They may well have reached safety, but they are certainly not settled nor sound’ ‒ Author
According to latest reports many Ukrainians are now planning to return (thousands over the last month alone) but many have no idea what they are returning to or what reception will await them which is creating its very own unique stressors and subsequent mental health issues and even deeper trauma.
I would like to pay tribute to all the municipalities, responders, and volunteers on the frontline daily, but most of all let us spare a thought for all those (Ukrainians and others) who have lost everything and now continue the unknown and perilous journey to safety, wherever that may be or whatever that may look and feel like.
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Robert McAlister, Executive Contributor Brainz Magazine Robert’s mantra is ‘think differently’ and he certainly walks that talk in everything he does. Certainly not one for taking the easy path, he thrives on a challenge and the words ‘the most tenacious person we know’ are a major understatement. He is a recognized leader in the field of leadership and team coaching. and is the Director and driving force behind Glenbarr Coaching, who offers a very different coaching experience. For over 30 years he has worked globally with a diverse range of high-profile clients from Governments to NGO’s, Private Sector Corporates to Public Sector Agencies. Celebrities and Senior Executives who have all benefitted from his sought-after talents. Such a wide portfolio and body of work has provided him with very unique insights and approaches to training and coaching strategies that work and are sustainable. The central theme to Robert’s career has been people development and growth. Specialising in mindset, behaviours, and team dynamics to effect positive outcomes and increased performance. Equally, at home in the boardroom or challenging field environments getting his hands dirty, Robert’s real magic is bringing the best out of individuals or teams to achieve their goals. If you are looking for a truly transformational experience that is remembered and relived long after any official training or coaching session, then Robert is the guy to talk to!