The bomb shelter birthday party: Mental health and resilience in Ukraine

Beneath the streets of Kyiv, the city's metro system has become a refuge for people escaping the terrors of the war. MSF psychologist Concetta Feo joins the team providing medical care underground...

My first night in Ukraine, I couldn't sleep. The cold wind and the sound of air raid sirens kept me awake. The next day, I was already on my way to my first assignment: Vinnytsia, a city in the centre of the country.

It was clear on the journey that people were prepared for the worst, with roads blocked by checkpoints and sandbags protecting houses and villages.

It was like holding hands as you waded through a river to withstand the raging current

The wounded hadn’t yet arrived in Vinnytsia and I wasn’t sure if this was good or bad. Instead, there were people who had fled the violence, mainly women, children and the elderly, who carried with them the memories of World War Two and the conflict of 2014.

I started to help the volunteers caring for the displaced people. The volunteers were of all ages and were involved in everything. Health workers were doing an extraordinary job. I don't think I've ever come across such comradery and unity. It was like holding hands as you waded through a river to withstand the raging current.

Kyiv’s metro stations

After Vinnytsia, I travelled by train to Kyiv to provide support to displaced people who had spent a month crowding into what was generally considered a relatively safe place to shelter: the city’s metro stations. MSF’s mobile clinic team was at work there, with a nurse, social workers and two psychologists – my Ukrainian colleague and I. We visited the shelters, we met people, we listened to their stories and we got involved in their lives.

One of the people I met was Helena, the young mother of Natalia, who had just celebrated her fifth birthday on the underground platform. A volunteer had arranged for a chocolate cake and some pink balloons to brighten up the grey, cold metro station.

Hiding in a car from bombs

Helena was suffering from severe symptoms of stress, which had stopped her sleeping for three whole days after the first bombings took place near her home. She had picked up her daughter and their dog and locked themselves in their car in the cold for three days. Then she had plucked up the courage to take the whole family to the metro station. ‘That night, I slept for six hours straight, I was so physically and mentally exhausted,’ she said.

Her story came flooding out. To interrupt it would have been tantamount to knocking her down. She clearly needed support, and we were offering it...

After a few days, she decided to face her fears and take Natalia to her grandfather's house, but the situation was still too dangerous and, after a few hours, they had returned to the shelter of the underground station. This had proved to be a good thing because a short time later the grandfather's building was hit by mortar fire. Miraculously, the grandfather survived.

Helena had endured weeks of fear and anxiety attacks, while doing her best to protect little Natalia. ‘When I heard about what had happened in Bucha, I collapsed,’ she told me. ‘I can't even imagine what I’d have done if that had happened to my daughter.’

An unusual birthday

A number of children of different ages were there to celebrate Natalia's unusual birthday. Nine-year-old Maksym was playing with Andrej, a 13-year-old boy with Down’s Syndrome, who taught him how to throw a bottle of water into the air so that it landed upright.

Maksym is a very intelligent, curious and courageous child. He spoke to me in English and laughed at my poor Ukrainian. He had been in the shelter since the early days of the conflict, when he and his mother, sister and aunt fled there in search of refuge. The war frightened him, said his older sister Oksana, who described their recent weeks and their fears. Maksym was sleeping very little, she said, and threw tantrums every time he had to go to bed on his makeshift mattress. He was sensitive to loud noises and, no matter how much time he spent playing bottle-throwing, his thoughts inevitably turned to war.

Unlike the previous conflict, she felt that this time she would not be able to take her life back and rebuild herself and her future...

Oksana was struggling too, and told me about her feelings with shyness, but also relief. Still a teenager, she feels the burden of responsibility for her brother and an immense sense of loneliness, aggravated by two years of pandemic and a war at home. Despite the late hour, her story came flooding out. To interrupt it would have been tantamount to knocking her down. She clearly needed support and we were offering it.

When I finished the session with Oksana, I realised that Maksym was still standing there, waiting to give me a very long, very tight hug.

A second trauma

I also met Masha, a 48-year-old from Donbas. Alone in Kyiv, she escaped the 2014 attacks and is now reliving the trauma for a second time. Her elderly mother is trapped in the area under occupation and Masha’s family have been trying for weeks to get her out. Masha's husband has decided to stay in Donbas, where their lives and jobs were. She is terrified that she will never see him again and resents her husband's decision.

Irina has sharp, searching eyes. She takes care of her husband as if they had only recently fallen in love.

Masha told me that she felt lonely and powerless; she didn’t know how to find a solution or where to go next. She wasn't having nightmares but was sleeping very little and badly. She had lost her appetite and winced at every noise. She cried often. Unlike the previous conflict, she felt that this time she would not be able to take her life back into her own hands and rebuild herself and her future. She looked at me with sad eyes that asked for my help.

Igor just wants to go back to school

I met Igor sitting on the steps down to the metro station. He watched me walk past and smiled shyly at my greeting. When I approached him, he sprang up like a cricket and came towards me. Igor is 13. He fled Hostomel with his mother, his sick grandmother and two cats. His home, which is in an area that’s been under heavy attack, had been bombed. He was waiting to be able to return home so that he could be comfortable again and go back to school.

Igor didn't talk much but he smiled a lot. He showed me funny videos on his phone of cats getting into trouble or making strange faces. This is how he spent his evenings: attempting to distract himself with his phone and trying not to think.

Gratitude and guilt

There was Maria, a young woman accompanied by her elderly parents. As we explored her fears, she said: ‘I can't help thinking that the people who died in Bucha saved our lives. They protected Kyiv and me with their own bodies and lives.’

She felt a mingled sense of gratitude and guilt, like several of the people I spoke to.

An invitation

Finally, Irina and Volodya are an elderly couple from Hostomel. Their only son is abroad and calls them every day. They have been in the metro station since the first week and are trying to survive this experience as best they can.

Irina has sharp, searching eyes. She takes care of her husband as if they had only recently fallen in love. Intrigued by my presence, she asked me many questions. I checked their physical and mental state and, despite their fatigue and various health problems, they were full of hope and a desire to return to their village.

Irina showed me photos of her house, which had been hit by bombs, while Volodya told me about the days spent in the shelter. They are just waiting for the green light from the army, who are busy clearing the area, so that they can return to the place where they had lived happily for so many years.

At the end of our meeting, Irina and Volodya invited me to visit them at home. They wrote down my name and address, insisted on taking a souvenir photo of us together, and repeated my name with big smiles.

When the time came for me to go, we said goodbye with a hug. They made me promise to visit them if I return to Ukraine.

I told them I would do so gladly.

Top image shows drawings at the mobile clinic in the metro stations in Kharkiv.


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