I have seen this before in other nations enduring conflict: people preserve continuity by compartmentalizing. They create pockets of normalcy to shield their families, their children, and themselves from the constant strain of danger. Ukrainians do the same. They cling to routines not because they are blind to what is happening, but because this is how life goes on under extraordinary circumstances.

During the day, life unfolded with striking steadiness. Shops were open, schools held classes, and cafés filled with conversations. Nothing closed. War was present, but it did not dictate the cadence of daily life. People pressed on with remarkable resolve, refusing to let conflict consume their hours.

At night, however, the balance shifted. Air raid warnings pierced the darkness. Ambulance sirens cut through the silence. The curfew, from midnight to 5 AM, made those sounds echo loudly, a stark reminder of vulnerability as streets fell quiet. This contrast, between calm days and anxious nights, was a reminder that compartmentalizing is not the same as escaping. Shutting out “the other reality” allows life to go on, but it exacts a quiet toll. Beneath the surface of resilience, the weight of “what if” is relentless.

I recall when Ukraine’s major roads were narrow and potholed, marked by unofficial checkpoints and police randomly checking documents. Over time, they became modern highways, a symbol of progress and a nation moving forward. Russia’s invasion reversed that progress overnight. What had been a country pressing ahead was thrust back into a state of survival.

Before the war, Ukrainians knew Volodymyr Zelensky as the star of Servant of the People, a television satire in which a schoolteacher rants about corruption and becomes an unlikely president. It was comedy, but with an edge of truth. Today, in a cruel twist of fate, that fiction became prophecy. Zelensky is no longer acting out politics; he is leading a nation through crisis and resilience.

As I walked the streets this year, I noticed how persistence and resilience stand side by side. Markets were crowded with produce, yet older residents stood nearby, selling small baskets from their gardens to make ends meet. Soviet-era uniforms lay for sale on blankets placed on sidewalks, while new BMWs sped past rattling Soviet-era buses. In town squares, there were endless billboards featuring photographs of fallen soldiers, each bearing a QR code that linked to their stories. Schools mounted plaques on building walls to honor graduates who died in battle. I paused as a funeral procession passed, an ambulance leading with a soldier’s photograph in the windshield, shopkeepers leaving their stores to stand in silence. Grief is not an occasional occurrence here. It is part of the rhythm of life.

Living in this reality has unleashed a mental health crisis. According to Ukraine’s Ministry of Health, the number of people seeking psychological help in 2024 has more than doubled compared to the previous year. Antidepressant sales have surged nearly 50 percent since 2021. A Lancet study reports that more than half of Ukrainians, including refugees, live with PTSD. Twenty-one percent struggle with severe anxiety. Eighteen percent live with constant stress. And in 2023, more than one in four reported feeling depressed or very sad, up sharply from before the invasion.

These figures are not abstractions. They are lived experiences. Teachers steady students while suppressing their own fears. Parents comfort children when sirens interrupt dinner. Shopkeepers greet customers with smiles while wondering whether loved ones will return from the front. This is the cost of war: invisible wounds carried behind the routines of daily life.

Remember People’s Stories

Western headlines are increasingly focused on politics, with questions about whether U.S. and EU leaders will sustain aid, how long support for Zelensky will last, and what future negotiations might bring. These debates matter. But when politics dominates the narrative, the human story – our emotional connection – risks fading from view. The United Nations recently passed a resolution recognizing “the profound and long-lasting effects on the mental health of people, in particular children.” This acknowledgment is important, but it is not enough. Policies and political platitudes cannot replace storytelling.

The war’s reach was evident even at the border. My crossing into Moldova took five hours.  Two years ago, it was 30 minutes. Officials pried into spare tire hubs, emptied luggage, and rechecked passports repeatedly. For me, it was an inconvenience. For Ukrainian men between 18 and 60, it was absolute – they cannot leave. Guards studied every face, determined to grab draft dodgers. War demands not only weapons, but people.

Moldova itself carries the strain. Refugees continue to arrive, its economy is stretched, and its stability depends in no small measure on Ukraine’s endurance. Trauma does not stop at borders; it ripples outward, reshaping the region.

What impressed me most was the people’s adaptation. Ukraine is doing more than enduring; it is investing in its future. I saw new multilingual historic heritage signs supported by EU restoration funding, featuring markers that honor the intertwined contributions of Ukrainians, Poles, and Jews. Even if history is more complicated than the inscriptions suggest, these symbols point toward unity. They reflect a nation determined to acknowledge its difficult past while striving to shape a different tomorrow.

That is what struck me most this year. Ukraine is not allowing the conflict to dominate its aspirations. While global headlines debate the scale and length of Western support, Ukrainians are already laying the foundations for what comes next. Their resilience is not simply about surviving the present; it is about declaring that there will be a future, and they will build it.

Ukraine is more than a battlefield. It is a nation of teachers, farmers, doctors, and entrepreneurs who rise each morning to live, to work and build. The war, directed mainly at Kyiv and the East, has scarred Ukraine. It has not broken this nation. Instead, it has revealed a strength of spirit that unites remembrance with renewal.

That is why their stories must remain on our front pages, not only to remember their sacrifices, but also to honor their hope. Ukraine’s struggle is not just for sovereignty, but for the promise that even in the hardest of times, a nation can adapt, unite, and invest in a future worth both believing in and living.

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As winter approaches, the effects of the conflict will push Ukraine’s health infrastructure to the brink. With public works systems attacked, water supply systems damaged, food chains disrupted, and heating systems in disrepair, Ukrainians must contend with dual dangers — physical wounds and a looming public health catastrophe.

A Broken Health System

In addition to its borders, Ukraine’s health system is also under siege. According to the World Health Organization (WHO), nearly 1,000 health facilities have been damaged or destroyed since the conflict began in 2022. Hospitals struggle to operate with limited resources, a shortage of medical supplies, and overburdened staff. The lack of access to essential medicines, compounded by interrupted supply chains, means that essential health services are increasingly inaccessible to millions.

Since the war began, the Ukrainian population’s health needs have changed dramatically. War injuries, trauma, and mental health conditions are on the rise, while chronic diseases like diabetes, hypertension, and cancer — conditions that require regular treatment and medication — go unchecked and untreated. Patients are unable to receive the care they need while doctors are stretched thin, tending to the war-wounded, displaced, and people with long-standing health concerns. Under the best conditions, sick people get sicker when they lack access to care. What happens when care becomes nonexistent?

The public health toll is expected to skyrocket without access to quality care. The indirect consequences of this war — poor sanitation and lack of heating — add to Ukraine’s already precarious health situation, leaving millions vulnerable to illness and preventable deaths.

Public Works Under Siege

War doesn’t just target people — it targets infrastructure. Public works, the backbone of daily life, have been severely compromised. Cities across Ukraine — particularly on the Eastern front — have suffered the bombing of power stations, water treatment plants, and sewage systems. The assault on infrastructure isn’t just an inconvenience — it’s a public health time bomb.

Water quality, in particular, is a growing concern. Contaminated water sources have led to an increase in waterborne diseases, including dysentery, which are particularly threatening to the elderly and the young. Clean drinking water is becoming scarce in many regions, forcing civilians to resort to unsafe alternatives. The WHO has already warned of the potential for large-scale outbreaks if the water supply continues to degrade.

With sanitation systems destroyed, the spread of disease becomes even more likely. Waste disposal has been disrupted, and raw sewage contaminates streets and water systems in many areas. The health risks are immense, especially for children and those with weakened immune systems.

Food Supply: The Silent Hunger Crisis

War may not always bring immediate famine but plants the seeds of a silent hunger crisis. Ukraine, the so-called “breadbasket of Europe,” has become a nation where food insecurity is a growing threat. The conflict has upended agricultural production, destroyed farmlands, and blocked essential transportation routes, making it nearly impossible for many to access fresh food.

International relief organizations have warned that the food supply chain is on the verge of collapse. Farmers have abandoned their fields, both out of fear for their lives and because they are called to serve and defend. Crops have been left to rot, and livestock has been slaughtered prematurely due to a lack of resources to care for them. As food prices soar, more families cannot afford even basic staples.

Malnutrition is a natural and present danger, particularly for children. Without proper nutrition, growth and cognitive development are stunted, leaving long-term scars on the next generation. As winter approaches, the lack of food and energy shortages will only exacerbate this crisis, pushing more civilians into hunger and despair.

Meanwhile, the destruction of the Ukrainian agricultural sector has a ripple effect on global food security. Ukraine is a major exporter of grains and other essential food products. The disruption of these exports contributes to rising food prices and shortages worldwide, particularly in emerging nations that rely heavily on Ukrainian imports.

The Winter Threat: No Heat, No Shelter

In Ukraine, winter is not just a season — it can be a test of survival. For millions, the coming months will be defined by the struggle to stay warm in a country where the infrastructure that supports heating has been obliterated. With power plants targeted and fuel supplies dwindling, many Ukrainians will be forced to endure sub-zero temperatures without adequate heating or shelter.

The loss of heating is not just uncomfortable — it’s unbearable and deadly. Hypothermia, respiratory illnesses, and other cold-related conditions pose a significant threat. Hospitals, already overburdened with war casualties, may soon face a surge in patients suffering from the cold.

The mental health toll of enduring another freezing winter in a war zone cannot be understated. The constant strain of survival and the physical challenges of the cold erode millions’ emotional resilience. Anxiety, depression, and post-traumatic stress disorder (PTSD) are already widespread, and the coming winter will only deepen these psychological wounds.

Beyond the Battlefield: The Global Impact

While the immediate suffering is concentrated mainly in Eastern Ukraine, the war’s health implications extend far beyond its borders. The displacement of millions of Ukrainians has led to one of the most significant refugee crises in recent history, with neighboring countries — Poland, Romania, and Moldova — bearing the brunt of this humanitarian wave. Moldova, perhaps the poorest nation in Europe, has demonstrated how kindness and empathy are part of the healing process, going beyond merely opening its borders. It has made room in schools and public buildings to house, clothe, and educate new residents.

Refugees face a host of health challenges in their new environments, from urgent access to healthcare to the anxiety of overcrowded shelters. Despite best efforts, host countries struggle to provide adequate services to these displaced populations, putting further strain on their public health systems.

In addition, the war is exacerbating existing health crises globally, such as the COVID-19 variants. Resources and attention have been diverted to the conflict, undermining efforts to combat other health emergencies. The war’s strain on the global economy is also limiting the capacity of international organizations to provide aid, leaving millions in Ukraine and beyond in dire need of support.

A Call for Urgent Action

The war in Ukraine is more than a geopolitical conflict — it’s a humanitarian disaster with profound health consequences. As the world watches, the health of millions hangs in the balance. The international community must act swiftly to provide the resources and support necessary to prevent further loss of life — medicines, warm clothes, temporary shelters, and mental health support.

Humanitarian aid is desperately needed to repair the health infrastructure, restore clean water supplies, and ensure access to food and heating. Governments, NGOs, and private sector organizations must work together to deliver life-saving assistance before the full impact of winter sets in.

This war has shown us that health is not only a question of access to hospitals and doctors — it is intertwined with every aspect of life. From public works to food systems to mental health, the well-being of the nation’s civilians is inextricably linked to its survival. Beyond discussions of continued support for defense, health access must be prioritized. Lives are at stake, and time is running out as winter approaches.

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