Behind every budget shift lies a ripple effect, and today, global healthcare is at the receiving end. The result is shrinking access, rising costs, and widening inequities. The impact of geopolitical decisions is rarely confined to borders, it now extends into clinics, hospitals, and communities. What we are witnessing is not just a funding gap, but a structural shift in how the world values health.

The silent reallocation

Over the past years, global defense spending has surged to record levels. According to the Stockholm International Peace Research Institute (SIPRI), global military expenditure rose by 9.4% in real terms to $2718 billion in 2024, the highest global total ever recorded by SIPRI and the 10th year of consecutive increases. The total military expenditure accounted for 2.5% of the global gross domestic product (GDP) in 2024. These figures are expected to climb further following the June 2025 commitment by North Atlantic Treaty Organization (NATO) members to increase defence and security spending to 5% of GDP by 2035, more than twice the earlier 2% benchmark.

Meanwhile, public health budgets are being trimmed or stagnating. The World Health Organization (WHO) has raised serious concerns about the strain on global health systems, pointing to shrinking international aid and ongoing funding shortfalls. In February, Director-General Tedros Adhanom Ghebreyesus highlighted that abrupt and significant reductions in bilateral assistance have severely disrupted healthcare services across multiple countries, describing 2025 as “one of the most challenging years” in the organization’s history.

As per the WHO, an estimated 4.6 billion people worldwide still do not have access to essential health services, while around 2.1 billion experience financial strain due to healthcare expenses. Compounding this challenge, the global health workforce is projected to face a shortfall of 11 million professionals by 2030, with nurses accounting for more than half of this gap. When 4.6 billion people lack access to essential services, this is not only a development failure, but also a global stability risk – translating into fewer vaccinations, delayed disease surveillance, and weakened emergency response systems.

The global policy conversation increasingly treats defence spending as essential security investment. Health spending, however, is still framed as social expenditure rather than strategic infrastructure. This shift is particularly devastating for LMICs, where international aid often fills critical gaps.

Conflict and the collapse of care

Conflict has long been a stress test for health systems, but the consequences today are deeper and more far-reaching. As the Russia–Ukraine war entered its fifth year in 2026, Ukraine’s health system faced unprecedented strain, with attacks on healthcare rising nearly 20% in 2025 alone. Since the full-scale invasion began, the WHO has documented at least 2,881 attacks targeting hospitals, health workers, ambulances, and medical infrastructure, severely disrupting care delivery. Health outcomes have deteriorated sharply, with 59% of people in frontline areas reporting poor health, alongside surging mental health issues, cardiovascular conditions, and widespread lack of access to essential medicines. Intensified attacks in 2025, including a spike in strikes on medical warehouses, have further crippled supply chains.

In the aftermath of the war in Gaza, the region’s health system remains on the brink of collapse despite months of humanitarian efforts and intermittent pauses in fighting. Widespread damage to hospitals, severe shortages of medicines, and a surge in patients continue to overwhelm already fragile services. Many facilities operate at drastically reduced capacity, with critical treatments, including cancer care, meeting only a fraction of demand, while rising cases of skin and respiratory illnesses place further strain on the system. Healthcare workers, operating under extraordinary pressure and with limited resources, are struggling to manage overwhelming caseloads each day amid ongoing supply constraints and infrastructure damage. The crisis extends well beyond acute injuries, as patients with chronic illnesses face dangerous interruptions in care and deteriorating living conditions, turning access to healthcare into a daily struggle for survival.

Meanwhile, after three years of conflict, the Sudan war has evolved into the world’s largest humanitarian and health crisis, with 34 million people in need of aid and 21 million lacking access to basic healthcare. The system is collapsing under the combined weight of widespread disease outbreaks, acute malnutrition affecting over 4 million people, and relentless attacks on healthcare infrastructure—37% of facilities are now non-functional. As infectious diseases surge and funding falls short, Sudan’s health crisis continues to deepen, turning basic healthcare access into a matter of survival for millions.

What distinguishes the current moment is the scale of global interdependence. Earlier crises were largely contained within regions. Today, disruptions are transmitted across borders through tightly integrated supply chains, financing systems, and health workforces. The Ukraine conflict, for instance, has affected global pharmaceutical logistics and energy prices, indirectly increasing healthcare costs across Europe, Asia, and beyond. The result is not just localized breakdowns, but a systemic fragility in global health security.

Conflict as a cost multiplier in health delivery

Healthcare systems are tightly linked to global supply chains, making them highly vulnerable to geopolitical disruptions. When conflicts interrupt trade routes, restrict exports, or trigger sanctions, costs rise almost immediately, across pharmaceuticals, medical devices, and even basic supplies.

Energy shocks add further pressure. Hospitals, being energy-intensive, face higher operating costs as fuel and electricity prices climb. In conflict zones, even critical functions like vaccine cold chains and intensive care become difficult to sustain. The result is a steady increase in healthcare costs, one that is unevenly felt. While high-income countries may cushion the impact through insurance and subsidies, LMICs face a harsher reality, where rising out-of-pocket expenses can push millions into poverty.

At the same time, conflicts are driving up demand for care. Displacement, malnutrition, and infectious disease outbreaks are becoming more frequent, often compounded by climate-related crises. This creates a vicious cycle. Underfunded systems struggle to respond, outcomes worsen, and long-term costs escalate as preventable issues turn into full-blown crises.

Health communicators bridging gaps in a fragmented world

In times of systemic stress, communication becomes a strategic imperative. Health communicators are no longer just interpreters of science. They are interpreters of risk, resilience, and national preparedness. Their role is to translate complex realities into actionable understanding, to advocate for evidence-based decision-making, and to maintain trust in institutions. In today’s environment, narrative gaps are becoming policy gaps. When health is absent from security conversations, it is often absent from security budgets.

In the current context, communicators must:

• Elevate the narrative around health as a security priority, not a secondary concern.
• Highlight the human impact of budget cuts, moving beyond statistics to real stories.
• Counter misinformation proactively, especially in conflict-affected and resource-constrained settings.
• Support policy advocacy, ensuring that health remains central in national and global agendas.

Equally important is the need for communicators to adopt a more systems-oriented approach. This means connecting the dots between geopolitical decisions and health outcomes, helping stakeholders understand that these are deeply interconnected challenges. Investing in health is not just a moral imperative; it is an economic and strategic one. Strong health systems contribute to productivity, stability, and resilience. They are foundational to national security in the broadest sense.

Governments, multilateral organizations, private sector players, and civil society must come together to reassert the importance of health in the global agenda. Innovative financing mechanisms, public-private partnerships, and more efficient use of resources can help bridge funding gaps. But without political will, these solutions will remain insufficient.

If current trajectories persist, the consequences will extend far beyond strained health systems, they will reshape how societies absorb risk, respond to crises, and sustain economic stability. Healthcare cannot remain the residual line item in a world that is becoming more volatile, more interconnected, and more vulnerable. Narratives shape priorities, and priorities shape funding. If health continues to be framed as a cost rather than a cornerstone of resilience, it will keep losing ground to more immediate, visible threats. That framing must change urgently and decisively. Over the next decade, the countries that succeed in protecting population health will not necessarily be those spending the most on healthcare, but those most effectively integrating health into national security thinking. The real question before policymakers and global leaders is whether nations can remain economically stable, politically resilient, or socially secure while treating health as a

The post The Hidden Cost of Global Conflict: Why Health Security Is the First Casualty appeared first on Medika Life.

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.

The post Ukraine: Worn Hearts, Steeled Resolve appeared first on Medika Life.

Research over the years has shown the war’s far-reaching and current effects on those involved in war-torn areas. Living in conflict areas, being subjected to warfare, and being forced to migrate have all been repeatedly linked to increased dangers to one’s physical and mental health. Being in a combat zone has direct implications that can include physical harm, disease, psychological anguish, and even death. One of the most common and crippling effects is post-traumatic stress disorder (PTSD). In Kosovo, Iraq, and Lebanon, 87–97.5% of children affected by war have been reported to have PTSD.

How could children and adults not be so seriously affected? They can’t, and therein lie the issues that must be addressed now, not in the future when these disorders all manifest themselves.

Once the outbreak of war in Ukraine began, one study of Polish children had troubling results. According to the findings, children who are not directly involved in the conflict may also experience mental health issues. Polish youngsters had far greater rates of emotional difficulties and low self-esteem in the early months after the war began and in the early phases of the present refugee crisis. In addition, it seemed that the amount of time that had passed since the conflict began had an impact on how one saw the world and oneself.

Therefore, it’s not simply how they view the war, but themselves and their self-esteem and confidence. This corrosive effect needs attention immediately, but how do you do that while a war is still in progress? There are no simple answers, but aren’t some answers better than denying the existence of difficulties for these children?

The war in Gaza hasn’t resulted in the deaths of “civilians,” but of troubling numbers of children and created hoards of orphans who have had their parents killed in the bombing. How will they cope as they are moved as refugees without protection, perhaps to lands with foreign languages and cultures where they don’t fit in? We are looking at one or two generations that will be seriously impacted mentally by what they’ve seen and to which they have been exposed.

One thing I learned when I did intake interviews with children of Holocaust survivors was that no one wanted to talk about the horrors they’d experienced. But the mental effects were there despite this tendency to secrecy or to “forget” it all. Even when children wanted to understand and talk about it, they were shut down quickly or referred to others in the family who, similarly, refused to discuss it. They tried to seal the scar over with silence, and their children experienced the results of these efforts.

I only met one older woman who proudly discussed her experiences as a resistance fighter in France during WWII and how they killed Nazis with guns they’d never used before. She made it her mission to not only write a book about it but to travel to schools to give lectures and to try to provide answers to difficult questions.

Even children not exposed directly to war will need help in their psychological reaction to what they’ve seen or heard. Sitting safely in the United States will not ensure that they are untouched because we know that PTSD, surprisingly, can arise as a result of tangential exposure. UNICEF has eight suggestions for parents seeking guidance:

1. Find out what they know and how they feel
   Choose a time and place when you can bring it up naturally, and your child is more likely to feel comfortable talking freely, such as during a family meal. Try to avoid talking about the topic just before bedtime.
2. Keep it calm and age-appropriate. Use age-appropriate language, watch their reactions, and be sensitive to their level of anxiety.
3. Spread compassion, not stigma. Remind your children that everyone deserves to be safe at school and in society. Bullying and discrimination is always wrong and we should each do our part to spread kindness and support each other.
4. Focus on the helpers. It’s important for children to know that people are helping each other with acts of courage and kindness. Find positive stories, such as the first responders assisting people, or young people calling for peace.
5. Close conversations with care. It’s important to make sure that you are not leaving your child in a state of distress. Try to assess their level of anxiety by watching their body language, considering whether they’re using their usual tone of voice and watching their breathing.
6. Continue to check in. Continue to check in with your child to see how they’re doing. How are they feeling? Do they have any new questions or things they would like to talk about with you?
7. Limit the flood of news. Be mindful of how exposed your children are to the news while it’s full of alarming headlines and upsetting images. Consider switching off the news around younger children.
8. Take care of yourself. You’ll be able to help your kids better if you’re coping, too. Children will pick up on your own response to the news, so it helps them to know that you are calm and in control.

These are all good suggestions, and I would suggest you read the full page in order to get the full benefit of everything they are recommending. Our children are precious, and we must do what we can to help them in these times of serious crisis.

The post War Tears Children Apart in Invisible, Prolonged Ways Into Their Futures appeared first on Medika Life.

Viktor Frankl, a renowned psychiatrist, Holocaust survivor and author, draws from experiences in Nazi concentration camps to develop a profound understanding of the importance of hope called logotherapy. This psychotherapeutic approach describes the search for a life’s meaning as the central human motivational force. Frankel observed that people in Nazi extermination camps who found a shred of hope, even in the bleakest circumstances, were more likely to endure and survive.

Frankl later wrote in his book Man’s Search for Meaning that “Everything can be taken from a man but one thing: the last of the human freedoms – to choose one’s attitude in any given set of circumstances, to choose one’s own way.”

News reports of the Hamas attacks on Israel cover the unconscionable devastation of Israeli villages along the Southern border. An inhumane action directly almost entirely toward civilians, documented and shared on social media by terrorists not “caught in the act” but proudly sharing visuals online of their murder spree.  The media focuses primarily on geopolitical chaos and military response.  The human stories center around families searching for information about loved ones missing or the more than 100 civilians taken hostage to hostile territory – their destiny unknown.

The Biblical reading for Simchat Torah, the holiday marking the annual cycle of the conclusion of Torah readings, with which Hamas timed its well-coordinated attack, ends with a prophetic call from the Book of Joshua:  “Only be strong and resolute!”

The bigger story is to explore Israeli’s unwavering resilience in the face of so much horror.  Israel is built on “hope,” nurtured by hope, and resilient because hope is embedded in the people’s mental health psyche. Once the anguish and outrage are expressed, its citizens will turn to what they do best – rebuilding.  What of their neighbors? Will this successful blood-letting act be a catalyst for nation-building inspiration?

The Psychological Benefits of Hope

Psychologists have long recognized the vital role hope plays in people’s resilience. American psychologist Professor Charles Snyder defined hope as “a positive motivational state that is based on an interactively derived sense of successful agency (goal-directed energy) and pathways (planning to meet goals).” Snyder’s definition highlights the two critical components of hope: agency and pathways.

Agency is the belief that someone can initiate actions and make a difference. In desperate situations, this belief can be a lifeline. It fuels determination and empowers individuals to take control of their situation, no matter how hopeless and disappointing.

Pathways represent strategies and plans that can be developed to achieve those goals. Hope provides the internal flame framework for problem-solving and finding a way out of dire situations. Researchers emphasize that hope is intricately linked to a person’s problem-solving abilities, making it an essential psychological – even people-building – resource.

When Hate Defines Purpose

Hope is not just an abstract concept; it can be nurtured and cultivated. This is one of Israel’s and its people’s most significant resources – not oil, diamonds, or other precious natural resources.  Hope is a national treasure that can be mined and replenished. It is the micro-processor of the “Start-Up Nation” credited with countless innovations that are used in medicine, technology and auto GPS systems.

Right now, Israel must secure its borders and prevent nearby nations from taking advantage of the current instability.  That “hopefully” is in its neighbors – Egypt, Jordan, Lebanon, and even Saudi Arabia’s – best geopolitical interests.  Then, it must address painful steps to determine how low-tech terrorist planning overwhelmed the hi-tech intelligence system of one of the world’s greatest innovation engines. But those steps will not deter the nation’s simultaneous focus on healing and hope.

This national soul-searching is another painful chapter in the bigger saga – how will this mega terrorist war-level attack change its approach to the relationship with the Palestinians and influence Palestinian’s strategy to build a nation not based on hate?  Historically, Hamas celebratory events have not been rooted in establishing statehood-level institutions in Gaza that support culture, education, finance, health, and infrastructure. 

No one can account for the billions in regional and global aid directed to Hamas for infrastructure and refugee support. Where has it been spent? For tunnels or teachers?  For medical supplies or missiles?  Just the aid provided by Saudi Arabia alone to the Palestinian people during the last 17 years exceeded $6 billion. That does not include other United Nations members and institutions. But where is the ROI for these billions, and how does that massive investment kindle hope on the part of the Palestinian people when the fruits of the spending are invisible to the people?

As we’ve seen in the media during the past few days, Hamas invested mightily in this attack against Israel. An attack that is certain to be answered with a military response further setting back Palestinian citizens trapped in this hostile maze.  Finding hope through the possibilities of peace is almost impossible when encouraged public expression for success is in killing “the other.”

Hope is a Catalyst

Hope empowers individuals and acts as a catalyst for positive societal change. When people collectively hold onto hope for a better future, they mobilize their efforts to bring about that change: the Rev. Dr. Martin Luther King, Jr. had “a dream” driven by the hope for racial equality and justice. This hope – still burning in a nation’s heart – galvanizes millions of people to take action and continues to lead urgent changes.

The global response to climate change is fueled by hope for a sustainable and healthy planet. Swedish environmental and climate activist Greta Thunberg embodies the transformative power of hope. Her unwavering belief that change is possible has inspired millions of young people worldwide to demand action from their governments and advocate for a greener future. Her hope drives her to eyeball global leaders and demand urgent action. 

Thunberg scolded the world’s leaders in her speech at the 2019 United Nations Climate Action Summit by exclaiming, “How dare you” about their perceived indifference and inaction to the climate crisis. Her actions are a catalyst for young people worldwide to step forward and work toward a sustainable planet.

Israel and Palestine – Hope and Hate

What has happened during the past few days in Israel – brutal attacks against women, children, and aged citizens- is horrifying.  The visuals – well documented by the terrorists themselves and proudly shared – reinforce the energy that drives Hamas – a thirst for Jewish blood that seems impossible to quench.  

But what of the Palestinian people?  Is that their destiny? Their national desire? To endure endless retaliations that rekindle hate?  To change their future, they must find – or demand – capable, trustworthy leaders who inspire nation-building hope and abandon hatred as a preferred political path!  As Professor Snyder suggested, they must have people at the helm who offer agency and a pathway – a goal–oriented agency matched by plans to achieve that goal. 

And of Israel? For the rest of their lives, like countless generations, the memories of loved ones slaughtered helplessly will haunt family, friends, and the nation.  But that tormented energy and “how and why” questions will elevate the country toward agency and a pathway, as Snyder suggested:  “Now what and to where?”

Golda Meir, the Israeli Prime Minister, who shepherded a wounded nation through the surprise Yom Kippur War – another incredibly devastating, unexpected war that started 50 years almost to the day of this October 2023 Hamas attack – offered insight paralleling Professor Snyder’s insight. “Peace will come when the Arabs will love their children more than they hate us.”  Hate is a disease that must be overcome emotionally.

For all its generational waves of suffering, the Jewish people and the nation of Israel continue to draw upon the endless resource that will guide its collective next steps – faith and purpose standing on a foundation of enduring hope. That is the inspiring story of a people – as the Biblical Prophet Isaiah proclaimed, as “A light unto the nations” – with renewable positive energy to sustain itself and contribute to the world.

The post In the Face of Horror, Hope is a Vital Mental Health Resource appeared first on Medika Life.

No Military Value – Yet Still Struck by Missiles

Each year, I head to a small city of 90,000 residents called Uman– a community between Kyiv and Odesa. – two cities hard hit continuously by Russian targeting of civilian populations and the destruction of hospitals and schools. I’ve often written about my reasons for going to this distant town. This year, the motivation to share is different. Ukraine is in the second year of defending itself against a formidable aggressor in Russia. The ongoing conflict has resulted in the merciless bombing of Ukrainian cities and civilian infrastructure.

Uman has no military bases, yet Russian missiles have targeted this historic city. On April 28th, toward the end of the nighttime curfew, Russia launched more than 20 long-range missiles against residential buildings in Uman. Russia claims it was “aiming for the reserve units and used high-precision weapons” – but no soldiers were counted among the scores of civilians killed and wounded. There are no military or otherwise strategic targets within the city. Like the war, this attack was launched without rhyme or reason.

Not New to War and its Civilian Impact

I’m not new to war. I served for six years as a paratrooper and combat medic. I’ve seen how constant exposure to violence and desperate displacement impacts civilians. I’ve seen firsthand classic images of people pushing wagons with salvaged household possessions—mothers carrying their babies to safety. I’ve even seen the fronts of buildings peeled off, creating a dollhouse effect, and watched families in these apartments continue daily routines in this surreal setting.

Whenever I had time and permission – the latter always given – I joined other medics entering refugee camps to treat civilians – often women and children. Faces of gratitude are still etched in my thoughts. Decades afterward, those images are vivid.

Many years later and in Ukraine, I remain confused and troubled at how the world continues to let Russia brutally attack Ukrainian cities and issue outrageous statements that its targets are military and not civilian. In Uman, I saw firsthand that these missives are bald-faced lies.

When Shells Stop Raining – the Sewage Flows in the Streets

One evening, leaving a dinner gathering, I thought there had been a heavy downpour that escaped my notice while indoors. The main street had become a fast-flowing river – something I’d seen before. But the sidewalks were completely dry. This wasn’t rain runoff, and the smell confirmed it. This was backed-up sewage running down the street.

During my five-day visit, there were ample indicators of infrastructure buckling under wartime stress. The power was unpredictable. Streets were damaged. Refuse piled high. And all the while, air raid sirens warn citizens of risks – even in the still quiet that prevailed. People are on edge.

But I also saw remarkable resilience. The central marketplace was teeming with shoppers picking choice fruits and vegetables. Shopping bags were printed with words of encouragement – “Ukraine –Be strong and courageous.” The coffee shops were filled. As they have for years, people again welcomed me and were thrilled to see that the world stands with Ukraine and its struggle as a developing democracy to press forward. One man hugged me and said: “America,” – reflecting an appreciation for continued generosity.

War and Public Health Intersect

What is the impact of people fleeing, leaving behind loved ones, and being exiled, not knowing when it will be safe to return or if they’ll be able to at all? In these instances, refugees and internally displaced persons often first live in temporary housing with unsanitary conditions, making them susceptible to illnesses that range from flu to COVID-19. I helped people with primary health concerns resulting from stress and sanitary conditions.

While many men are mobilized or supporting the defense infrastructure, displacement disrupts access to education and care, particularly for women and children, contributing to long-term health disparities. In nearby Moldova, where I visited during the past two years on my way to and from Ukraine, I marvel at how a small nation – called Europe’s poorest – opens its borders and houses people not in tents but rather by ordinary citizens throwing open the doors to their homes. Places of worship have become free food centers for the hungry. I saw the power of kindness become an operational governmental guide and policy as Moldovan citizens rallied to help their refugee neighbors.

Physical and Mental Health Casualties

How will we measure and address the mental health needs of the civilian population? They are not warriors trained to fight. But they are certainly in the thick of a different battle. Hospitals and clinics are targeted and damaged, and healthcare workers are forced to flee or have joined troops at the frontlines. This lack of access and limited availability of medical care translates into diminished health of people whose conditions might otherwise be manageable in normal circumstances.

The news media may worry that their readers and viewers are growing weary of this war—ratings and viewership rule. In response to the numbers, they move on to other topics. That plays into the hands of the aggressor. That’s what Russia hopes for –the world’s attention will turn elsewhere, and Ukraine’s appetite for perseverance will wane, securing a dictated unjust victory.

Apathy is the Aggressor’s Ally

As my friend and teacher, Nobel Prize recipient, the late Elie Wiesel, said in his “Perils of Indifference” White House remarks: “The opposite of love is not hatred, it’s indifference… Even hatred, at times, may elicit a response. You fight it. You denounce it. You disarm it. Indifference elicits no response. Indifference is not a response. Indifference is not a beginning; it is an end.”

While I have returned from Ukraine, memories are vivid and will be shared. As I reflect on this visit and compare it to my others, I am already thinking about my next journey and the friendly faces that welcome me each time. I hope and pray they are safe.

For my part and for whatever difference I can make, I refuse to give in to apathy. The human cost has been and is too high. A just and enduring peace must be the outcome.

The post People Still Travel to Wartime Ukraine – I’m Among Those Who Do appeared first on Medika Life.

Some of you will talk about tucking under desks or lining up against walls for nuclear attack practice. Families with money and houses built bomb shelters in their back yards. Black and yellow signs on buildings and subways pointed to bomb shelter areas.

We took home large posters from my school that gave detailed illustrations regarding protecting ourselves if Russia attacked with an atom bomb. Yes, it was Russia even then.

We were all issued dog tags with our name, birthdate, and religion on them and always instructed to wear them around our necks. It never occurred to me that they would use it for identifying my dead body in the event of an attack. After all these years, I have no idea where mine is, but I remember wearing them.

Those were upsetting times that students tried to see as common as fire drills, but they weren’t; it was preparation for destruction, disappearing in a flash. We had so little concern (forget any fear) because our teachers modeled the calm behavior that we then incorporated into our thinking. If they weren’t afraid, why should we be, was our attitude. No parents in my neighborhood ever brought up the topic and dutifully hung up the posters as though they were artwork.

No one talked to us about death and destruction, only that we were expected to act a certain way and things would be OK. But, if they were going to be “OK,” why did we need those dog tags or the posters? The question never entered our minds, seemingly.

How many of you sat in your living room with all the drapes drawn, daring not to whisper a word as the local air raid warden made rounds? As a very young child, my family did, and I can still recall, what it was like to have a rudimentary, pump-action fire extinguisher in the hallway outside our apartment in a poorly constructed wooden building. Ironically, the “fire extinguisher” never contained water.

The invasion in Ukraine is disturbing to us adults, but for the children, what is it, and how will it affect them? I heard one little boy on TV say, “They’re going to kill us.” The saying we often use is only the strong survive, but overt survival doesn’t tell the deeper story and any damage done.

Incredibly, some research points toward children being more resistant to after-war effects. “Yet many practitioners recognized that even amidst armed conflicts or recent mass displacement, children and adolescents exhibit agency that is an important resource for coping, adjustment, and resilience.”

But as opposed to wars in the past where the military were the primary targets, wars now are considered low intensity where “under these…circumstances civilians, including children, as well as the infrastructure of the society become targets.” The entire social fabric of society is damaged in its entirety, leaving some of the citizens terrorized. How will this affect the future of that generation and the generation they are raising?

Exposure to war violence is viewed as intergenerational, and its effects may play out in many areas; violence, mental health issues, and physical health. Children enmeshed in the turbulence of a war zone may be desensitized or immune to violence. Can anyone dare to predict how they will be affected?

Much of the research has mentioned PTSD, primarily in domestic situations, but there is a lack of longitudinal study with children and war experiences at this point. We know trauma can affect brain development, and we might conclude that these children could have stunted growth in some areas of their brains, personalities, and ability to relate to others.

Right now, what would seem to be the one thing that may be most helpful for children in these situations? I think it might be what it was during our atom bomb drills; parental reassurance and support, as well as teachers who model appropriate behavior and provide extra help when needed.

We can’t stop unconscionable, murderous dictators, who are more criminal than politicians, but we can help our kids and adults. Continuing to plan for a more promising future, maintaining close social connections, and caring for each other are three means to a brighter future.

Holding a position of hope is one power we retain in the direst of situations.

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