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Desperate shortages leave Ukraine ill-prepared for trauma of war
by Staff Writers
Kiev (AFP) Dec 13, 2014

NATO says Russia not discussing military activity
Brussels (AFP) Dec 12, 2014 - NATO said Friday that Russia showed no interest in talking about its increased military activity, adding there had been no contact between their armed forces since May amid the Ukraine crisis.

The US-led alliance has reported an upsurge in Russian military flights, especially near its Baltic state members, but also further afield around Norway, Britain and far south into the Atlantic.

"It takes two to have a dialogue and until now, Russia has not demonstrated any interest in genuine dialogue," NATO spokesperson Oana Lungescu told AFP.

"Nor has it returned to compliance with international law and its international obligations and responsibilities. So I would refer you to the Russian authorities for any further questions."

She recalled that NATO foreign ministers had agreed at a meeting in Brussels earlier this month that regular communications between NATO and the Russian military were needed "to avoid any incidents", and for NATO to "keep channels of military communications open."

In response to Russia's intervention in Ukraine and its annexation of Crimea in March, NATO suspended all cooperation with Moscow but said diplomatic channels would remain open.

Another NATO spokesman, Dan Termansen, separately confirmed the long gap in talks with the Russian military.

"There has been no conversation between the NATO military authorities and the Russian Chief of Defence Staff since May, but the lines of communications are open," Termansen said.

NATO's comments came a day after Poland's defence minister said he was concerned by the "unprecedented" increase in Russia's military activity over the Baltic Sea.

Estonia's defence minister also said on Friday that a Russian plane had violated its airspace over the weekend.

Alliance chief Jens Stoltenberg has said there have been around 400 intercepts of Russian military flights near its member countries this year, 50 percent more than last year.

The alliance has repeatedly complained that Russian aircraft do not communicate their positions or provide flight plans, putting other air traffic at risk.

Early last year, NATO and Russia's top brass launched a 'hot-line' aimed at enhancing cooperation and said generals would stay in touch on a regular basis.

Russian intervention in Ukraine has sparked the worst crisis with the West since the end of the Cold War, and fears in eastern Europe about the Kremlin's territorial ambitions.

In response, NATO has boosted its military readiness, seeking especially to reassure its eastern allies that it will stand by them in face of a more assertive Russia.

Russia in turn has increased its military activity, launching high-profile aircraft sorties to test NATO's defences and deploying naval units far from home seas.

With Ukraine still trapped in a Soviet-era approach to mental health and psychiatric hospitals so under-funded that some have less than 10 cents a day to feed patients, the country has been left ill-prepared for the trauma of war.

As with so many aspects of its sudden descent into conflict, Ukraine has turned to volunteers to help deal with post-traumatic stress among soldiers.

Psychologist Tetyana Nazarenko, who works with a volunteer group, recalls her toughest task to date: dealing with a frontline brigade that had just lost 12 men in a single battle.

The body parts had been gathered in only a few bags and were mixed up with pieces from 13 other soldiers.

"The guys had to go to the morgue and identify their friends from small things -- tattoos, birthmarks -- as best they could," she said.

"Some were left in a terrible depression, others in acute stress."

Another volunteer, Uliana Fedoryachenko, has been helping at the Central Military Hospital in Kiev.

"One man just lay for three months in bed, silently staring. He had no serious injuries -- just shock. I shudder to think what he saw to leave him unable to talk," she said.

- Desperate shortages -

Such trauma is common in any country at war.

But for Ukraine, where psychiatric care is hobbled by corruption and antiquated methods, the crisis is acute.

Basic resources such as food, water and electricity are in desperately short supply at hospitals.

"We have a very serious situation with food. There is a budget of only 1.5 hryvnias ($0.09, 0.08 euros) per person per day here," said Semyon Gluzman, one of the country's leading psychiatrists who works at the IP Pavlov hospital in Kiev.

"There is real starvation."

The broader problem, he says, is a Soviet-era approach to psychology in which anyone with trauma or stress is immediately admitted to hospital, when often they just need social care or family comfort.

"It's a very primitive system -- keep invalids out of sight," he said. "Obviously, some people need real psychiatric care in hospital, but most just need support in their ordinary lives, from their families.

"And of course there is so much corruption. People are given any old drug because it's a business. It's a mafiosi structure."

Post-traumatic stress from the war in the east is a time-bomb for Ukraine for which the government is not prepared, he adds, because of this focus on doctors rather than social workers.

"It will be a very serious problem for us in the coming months. When people come back from the war, they drink, and we already have a problem with alcoholism in our culture."

- Five phases of shock -

Nazarenko says her group is overwhelmed with cases of alcoholism, sleep and eating disorders and depression among returning soldiers.

Ukraine's lack of experience with war, and its sudden and unexpected onset in April, has made it tough for society to adjust, but she takes a hard-headed view.

"Many are tormented by the people they killed. Our society has to learn to replace the term 'homicide' with 'destroying the enemy'," she said.

"That is correct from the point of view of military psychology. Ukrainians find this difficult to understand because we have never fought."

She says the toll from PTSD may not be as bad as people expect.

"We hear about 'Afghanistan syndrome' and 'Vietnam syndrome' but those were completely different situations because the wars were fought on foreign soil and the reasons were not clear.

"Here, we know why we are fighting -- to defend our territory -- so to speak of terrible consequences is still premature."

The United Nations Development Programme is not so confident. It is racing to train social workers and implement systems to help returning soldiers as well as the thousands of civilians fleeing the war zone every day.

"Ukrainian society was not ready for all the trauma of the past year," said Inita Paulovica, deputy representative for the UNDP in Kiev.

"It is going through the five phases of shock. By August, it was still in denial. It is only just reaching anger. There is a long way to go before it reaches acceptance."

A few glimmers of hope make the task for volunteers more bearable.

Fedoriachenko recalls a very young amputee in the military hospital.

"He kept to himself, he never spoke to anyone. But day by day, he got used to me and even began to smile. It was amazing."

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