Volodomyr Kucherenko’s problems with post-traumatic stress began not with the 2022 Russian invasion of Ukraine, but eight years ago when the war began in the Donbas. In the midst of what was supposed to be a truce, he was resting with his unit, which included his brother-in-law, when they were mortared in the yard of a village house.
Injured in the leg during the first strike, his brother-in-law threw himself over Kucherenko to protect him from shrapnel as more rounds came in. The wounds he sustained protecting his comrade would prove fatal.
Kucherenko’s experience is far from unique. After more than a year of brutal and continuing combat, Ukraine’s wounded – both physically and psychologically – have become an inescapable fact in a horrific war fought often a close quarters under shell fire, and where the home front is also under fire from missile and drone attacks.
Kucherenko’s symptoms since have been complex. He says he still feels his dead friend speaks to him, sometimes offering advice, sometimes remonstrating with him for a promise he made about scattering his ashes.
There has been anger too, he says. Other feelings came when columns of Russian armour descended last year on the region – about an hour’s drive from the capital, Kyiv – where he lives in a village outside Borodianka.
Kucherenko took up arms in a volunteer defence unit and was sent to ambush Russian forces around Makariv as they pressed on with their unsuccessful effort to capture the capital. Injured again, he was demobilised.
Sitting in a workshop area of his horse farm, whose farmhouse was destroyed last year, Kucherenko is chatting to Iryna Nyzovets, a therapist from a nearby centre in Borodianka involved in the psychological rehabilitation of soldiers and civilians.
“Since that first incident, I feel my brother-in-law is still talking to me,” he says. “When I need advice, I sometimes talk to him. It feels like it helps. The other thing is that I don’t dream. Or at least I can’t remember dreaming.”
Kucherenko says that being with his horses helps him, as do his sessions at the centre. But he says he felt like a “fish in water” when he returned to soldiering last year, and his demobilisation after his second injury has made him feel anxious and worthless.
He says it is a problem felt by many soldiers. “We fought because it was our duty. But now we don’t know what’s expected of us. Part of it is feeling that we need to be heard.”
He continues: “It’s worst when I’m in the house on my own. I feel anxious and guilty because the army didn’t want me any more. But when I feel nervous now I go to the centre in the Borodianka and talk to them. And I always feel better.”
While it is too soon to know the scale of the issue in Ukraine, the National Center for PTSD at the US Veterans’ Affairs Department has estimated that at “some point in their life, seven out of every 100 veterans will have PTSD”, compared with six in 100 of the general population.
However, levels of experience of PTSD are also known to vary by conflict, with figures suggesting that up to 29% of Iraq veterans have experienced it at some point in their life, compared with 10% who served in Vietnam.
At the centre in Borodianka, housed in the offices of the town’s football stadium after its own offices were destroyed, the centre’s head, Lyudmila Boiko, and her deputy, Tatiana Soshko, describe working with soldiers – some of whom go back to the front – families and children, all psychologically affected by the war.
“Some of the soldiers feel lost and very sensitive to information about people dying. They have flashbacks or dream constantly about what they have experienced,” says Boiko. “Others have difficulty sleeping or use alcohol as self-medication. Usually they have some treatment then go back to their unit.”
“Another problem,” adds Soshko, “is when people are trying to be sympathetic, saying that they understand. They don’t want to hear it.”
They tell the story of one veteran, a businessman who had returned to his family after escaping from a burning tank. At night in bed, his wife would see him fighting in his dreams. The man denied he was having violent dreams, until his wife videoed him sleeping. Shocked and frightened that he might hurt their son, he took to sleeping in his car.
“We worked with soldiers before 24 February last year [when the full-scale Russian invasion began.] But it is much worse now,” Boiko says. “We are seeing civilians who were caught up in the fighting and lost everything. At the moment we are seeing 1,500 people every month.
Soshko says: “For children whose homes have been burned, it’s very hard. They want to know what’s happened to the things they had, their toys or cats and dogs. They’ll say: ‘My dad is at the front and he didn’t call us yesterday.’ It’s very hard, and it is hard to say how long the impact will be.
“Then there is the trauma for wives and mothers whose men are on the frontline, sometimes in circumstances where they will have lost their jobs.”
Conscious of the scale of the task they will be faced with when the war is eventually over, the therapists in Borodianka are planning new strategies for treatment, including a nature-based centre for patients to visit.
On his farm, Kucherenko has his own ideas. “A lot of people are going to need help when the war is over and we’ve won,” he says. “The soldiers coming back will need help from people who really understand what they’ve been through. It needs to be integrated in the military.”
