To mark World Refugee Day, WHO spoke with mental health volunteer Oksana Vitvitska, herself a refugee and one of 3.5 million Ukrainian refugees now in Poland.
On this day, as we commemorate and honour the strength, courage and resilience of millions of refugees around the world, Oksana tells us of her plight and the importance of mental health and psychosocial support (MHPSS), highlighting how central this year’s World Refugee Day message is: “Whoever. Wherever. Whenever. Everyone has the right to seek safety”.
A 32-year-old psychology student from Kyiv, Oksana receives her master’s degree this month. She spoke to WHO/Europe about her experience working in a makeshift shelter in Kyiv, where, under heavy bombardment, she provided psychological first aid for a month before fleeing to Poland to seek safety and protection.
She was forced to flee her home with the rest of her family and her beloved parrot Freya.
“I always wanted to be a psychologist. Years ago, my relatives had some difficulties and I wanted to help them, so I started reading scientific articles, immersed myself in professional literature and decided to change my career,” she says. “In February, I was finalizing my thesis in Poland, but then my mother suffered a heart attack and I immediately decided to go back to Kyiv to look after her and to help my dad.”
Like many others, when the war in Ukraine started, Oksana was doing her best to succeed in life: she was pursuing her dreams, looking after her family and focusing on her master’s thesis until the war upended everything.
“On the 24 February, I didn’t sleep; I was finalizing the last chapter of my thesis and watching the Security Council meeting on Ukraine on TV,” she says. “During one of the speeches rockets and bombs started to hit my neighbourhood. It was around 4 or 5 am.”
“It was terrible, my parents woke up and were very stressed and disoriented. I immediately started packing the most necessary things: documents and medicine for my mum. With only a few belongings and with my parrot, we went underground to the overcrowded makeshift shelter where more than 100 people, mainly women with kids and the elderly were hiding from the artillery fire.”
A fitness room becomes a temporary shelter
They did not know that the overcrowded basement, which usually served as a fitness room, would become their shelter for a month and a half. They needed to arrange everything from scratch: from sourcing first aid kits, food provisions and water, to reinforcing ceilings and organizing security protocols and duty hours between themselves. And most importantly, they needed to manage the severe panic attacks and stress that many of those in the shelter experienced.
“For the first 5 days I slept only a few hours. I was going from corner to corner trying to calm down and comfort people who needed psychological help. I had extreme cases of elderly people who suffered from severe stress and psychological withdrawal, children who were crying, their pet dogs barking and mothers who felt helpless.
“Some of the cases were so difficult that I needed to consult with my professors from university in Poland, who via mobile phone supported me with their professional knowledge. The worst was that our fear was growing each day. We heard stories about Russian saboteurs committing crimes on civilians and disinformation about collapsing Ukrainian defences and Russian tanks on the streets. You cannot even imagine the level of fear and anxiety when every hour you hear the frantic sound of sirens and loud explosions around you. After constant shelling you even learn how to recognize the specific sounds of various armaments: artillery, missiles, mortars, even your own anti-aircraft systems,” says Oksana.
With weeks underground, her mother’s health began to deteriorate and they started to think about fleeing their homeland. Kyiv in early April became one of the biggest evacuation hubs in Europe since the Second World War. Millions of women, elderly and children from hundreds of Ukrainian towns were escaping death and violence. The only means of transport to Poland was by train.
“We could not leave earlier, I was the only psychologist in the shelter and I could not abandon my people; I felt responsible for them. But with the temporary withdrawal of the Russian army, things started to improve so many people began leaving the shelter. Two days before I left the shelter I said to everybody that my parents and I were going to Poland and I would no longer be able to provide psychological aid. It was heart breaking but at that time, the number of people in there had decreased to only 20. Before we embarked on our unknown journey to Poland we needed to wait for hours at Kyiv central station, and that was when I met a young girl from Mariupol.”
The girl’s story has stuck in Oksana’s memory ever since.
“She came up to me because of my colourful bird, and I immediately recognized the profound sadness in her eyes. She was only 6 years old, and to cope with the enormous stress, her mind subconsciously developed a mechanism involving the sharing of a surreal fairy tale. She was describing the death of her grandmother, her pets and friends as if it was a fairy tale. It was both heart-breaking and frightening,” says Oksana.
Welcomed with open arms
After a perilous journey, Oksana and her family arrived at 03:00 at the Polish-Ukrainian border. She recalls the warm reception by the Polish border guards and humanitarian volunteers, and the enormous generosity provided by a young Polish couple who picked them up from the border and invited them to their house.
Today, Oksana volunteers in the Polish city of Przemyśl, where she provides psychosocial support to Ukrainian refugees in one of the main humanitarian hubs. She is aware of the challenges related to mental health and believes that international humanitarian actors should provide more MHPSS training and coordination, and that volunteers need technical supervision too, because of the war’s effect on the mental health of refugees arriving from places like Kherson and Mariupol. She also stresses the importance of establishing special mental health care centres for long-term patients.
“Most people affected by humanitarian emergencies will experience signs of distress, such as feelings of anxiety and sadness, hopelessness, difficulty sleeping, fatigue, irritability or anger, and/or aches and pains. This is to be expected and will for most people improve over time. But future cases of post-traumatic stress disorder are very likely and I would like to help those in need, to coordinate the actions. Like yesterday, when I went with an old Ukrainian lady to the psychiatric hospital in Zurawica, nearby Przemyśl. But sometimes, you must also think about yourself and take a break to avoid burnout, and have a good supervisor with whom you can share experiences. I was lucky that one of my friends Joanna, who started working with WHO’s country office in Poland put me in touch with a Ukrainian expert who lives in the United States of America. It helped me a lot to mitigate the effects of having to deal with the most severe cases. It is a huge relief when you can share your difficult experiences with an older colleague,” explains Oksana.
Oksana also shared a message to other refugees around the world.
“If they feel that they need psychological help and they cannot cope with their memories and emotions, they should ask for assistance from volunteers at psychological support centres. Mental health is very important because it affects physical health. If they work through their memories now, it will be easier later on. Many people have the impression that they can cope on their own, and that they should not trust strangers. Do not be afraid to ask for help,” says Oksana.
WHO’s Country Office in Poland has set up a Mental Health and Psychosocial Support Technical Working Group in Poland for coordination of MHPSS services to help understand the needs, provide guidance, translate resources and give technical support to partners.