The Crisis in Ukraine: Public Health Deteriorates in Warfare

The Crisis in Ukraine: Public Health Deteriorates in Warfare
Ukrainians were fleeing the city of Irpin (Northwest of Kyiv).

One of the most significant humanitarian crises is happening right now in Ukraine after the full-scale military invasion by Russia. Nations worldwide, especially Nato countries, have come together to intervene in the situation and address the public health crisis occurring to the rising demand for healthcare professionals, the increase in homelessness, or declining financial security that has impacted the whole country’s infrastructure (Patel & Erickson, 2022). 

On February 24, 2022, Russia bombed Ukraine in an act of warfare that is considered one of the most significant military aggression since World War II.  But this invasion was the turning point of an 8-year-long Russo-Ukrainian conflict that began in 2014, which included the annexation of Crimea and other incidents from naval warfare to battles near the border. The political tensions escalated violently when Russia launched a full-scale invasion of Ukraine. 

President Vladimir Putin questioned Ukraine’s right to their statehood and even falsely accused Ukraine of protecting neo-Nazis who persecute the Russian minority in Ukraine. Putin forced Russian troops into Ukraine for reasons to denazify and demilitarize Ukraine in large-scale military warfare, from air and missile strikes to besieging key settlements like Kherson, Kylv, or Sumy. The ongoing fighting continuously wears down Ukraine troops and soldiers with increasing civilian casualties each day (Scientific American, 2022). 

A therapist and refugee Kristina Shalashenko who lives in Odesa, Ukraine, said, “It’s very scary. Everybody’s terrified and in shock. The world [we’re] used to, it’s not there anymore.” The quote above was taken from TIME magazine. The violent injustice and atrocity behind Russia’s actions against Ukraine are unthinkable, provoking terror throughout the region (Ducharme, 2022). In a world of social media, the raw visual impacts of the Ukraine area’s photos, images, and news videos show a population full of fear and uncertainty, suffering what can be long-term psychological wounds. Several news articles from the NYTimes, The Conversation, and other news sites worldwide report that the civilian population is left defenseless from essential resources like food, shelter, clean water, and electricity. 

Wars and military conflicts are among the most traumatic life experiences in the world. The exposure to these events is pervasive to the mental health of those who experience these acts of violence firsthand. Many of these “survivors” endure excruciating pain both physically and mentally. Most deal with Post-Traumatic Stress Disorder (PTSD) which leads to symptoms like severe terror or flashbacks, nightmares, insomnia, paranoia, and hallucinations. The prevalence of these conditions continues on and off for years of suffering even with proper treatment. 9% of 720 adults in high-conflict areas of Nepal, predominantly married males, exhibited high rates of PTSD in which  27.5% for depression and 22.9% had anxiety (Suhaiban et al., 2019). In another research study, depression was recorded as high as 94.7% among 131 African torture survivors of high-crime regions, which was associated with a high demand for mental health services, but low public health means.  

There has been abundant research that such traumatic events can lead to severe and prolonged mental stress. According to the Conversation, almost 1 million Ukrainians have fled their homes for safety in nearby European counties and other refugees. One study has delved into how exposure to traumatic events can put someone at risk for a spectrum of mental health conditions like acute stress disorder, PTSD, depression, substance use, and increased risk of suicide; depending on the sampled population, about 30% to 80% of refugees exhibit high rates of PTSD (Suhaiban et al., 2019). Another study in 2019 focused on Syrian refugees in which a high prevalence of conditions was found like PTSD (32.2%), anxiety (40.3%), and depression (47.7%) (Javanbakht et al., 2019) were observed in adult Syrians. The years of conflict in Syria exposed millions to trauma and stress, including experiences of threats, torture, deaths of loved ones, lack of basic living needs, an extreme shortage of food and other resources.  

The human suffering was enormous in the face of such a calamity because thousands’ of livelihoods were lost in tragedy.  In the US, the mental health of veterans and service members has been a growing issue for almost two decades of continuous warfare. Some research has pointed out that 14%-16% of those in service who were deployed to Afghanistan and Iraq had exhibited high rates of PTSD symptoms and depression. These individuals in response to these symptoms would usually tend to negatively cope with suicide, substance abuse, domestic violence, alcohol abuse, and other issues (Inoue et al., 2011). 

War is a breeding field for pain, suffering, and violence which fuels the mental health crisis in the world. Furthermore in Ukraine because of the necessary deployment of soldiers, many Ukrainian combatants are separated from families and other social relationships. Many of them placed into combat roles have little to no training in these desperate situations. There is a need to emphasize the mental health crisis that grows in the civilian soldiers lacking in training, making them more vulnerable to tragedy and trauma and unprepared for stressful environments (Bryant et al., 2022).

The Russian-Ukrainian war is one of the worse humanitarian crises in history. The impact of the psychological wounds will result in severe long-term consequences of mental, physical, and emotional well-being. Trauma can be passed on throughout each generation like a heritable trait. A study has observed potential biological effects in the children of trauma survivors via subtle shifts in the heritability in the genome and high exposure to the parent’s anxiety or stress from their war experiences(Yehuda & Lehrner, 2018).  However, not all individuals who endured traumatic events will have PTSD. Still, many are influenced by their environments and undergo significant changes to recover and live out the rest of their lives. 

References

Image Source: https://time.com/6155630/ukraine-war-social-media-mental-health/ 

Abu Suhaiban, H., Grasser, L. R., & Javanbakht, A. (2019). Mental Health of Refugees and Torture Survivors: A Critical Review of Prevalence, Predictors, and Integrated Care. International journal of environmental research and public health, 16(13), 2309. https://doi.org/10.3390/ijerph16132309

Bryant, R. A., Schnurr, P. P., Pedlar, D., & 5-Eyes Mental Health Research and Innovation Collaboration in military and veteran mental health (2022). Addressing the mental health needs of civilian combatants in Ukraine. The lancet. Psychiatry, S2215-0366(22)00097-9. Advance online publication. https://doi.org/10.1016/S2215-0366(22)00097-9

Ducharme, J. (2022, March 8). Watching war unfold on social media affects mental health. Time. Retrieved March 23, 2022, from https://time.com/6155630/ukraine-war-social-media-mental-health/

Inoue, C., Shawler, E., Jordan, C. H., & Jackson, C. A. (2021). Veteran and Military Mental Health Issues. In StatPearls. StatPearls Publishing.

Patel, S., & Erickson, T. (2022). The new humanitarian crisis in Ukraine: Coping with the public health impact of hybrid warfare, mass migration, and mental health trauma. Disaster Medicine and Public Health Preparedness, 1-5. doi:10.1017/dmp.2022.70

Javanbakht, A. (2022, March 11). Ukrainians face lasting psychological wounds from Russian invasion. Scientific American. Retrieved March 23, 2022, from https://www.scientificamerican.com/article/ukrainians-face-lasting-psychological-wounds-from-russian-invasion1/

Javanbakht, A., Amirsadri, A., Abu Suhaiban, H. et al. Prevalence of Possible Mental Disorders in Syrian Refugees Resettling in the United States Screened at Primary Care. J Immigrant Minority Health 21, 664–667 (2019). https://doi.org/10.1007/s10903-018-0797-3

Yehuda, R., & Lehrner, A. (2018). Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World psychiatry: official journal of the World Psychiatric Association (WPA), 17(3), 243–257. https://doi.org/10.1002/wps.20568

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