Battles beyond bombs: Health plight of older Ukrainians

Zhanna and her husband moved to western Ukraine in 2022 during the initial weeks of Russia’s full-scale invasion. At 76, this marks the second time she has been displaced from her home. She was forced to leave her native Donetsk back in 2014 and a few years later, in 2022 the war forced her out of Mariupol.  

Zhanna does not like to talk about their time in Mariupol – a city now levelled to the ground that buried her friends and neighbours in the rubble. Those months of intensive fighting were a heavy physical and psychological burden on the city’s residents. But Zhanna and her husband have additional health problems that have only been aggravated by the war.  

“I am battling cancer, and my husband suffers from Parkinson’s. We fled Mariupol carrying only our backpacks full of medicines. The stress has made both of our health conditions worse. Now he cannot walk at all anymore – I have to carry him to the bathroom every time.” 

Unfortunately, Zhanna is but one example of how the war has exacerbated the situation of older Ukrainians who make up over a quarter of the country’s population. While younger people have sought safety abroad, most of the nine million Ukrainians aged 60 and over have remained in the country. 

As the war rages on, the situation of older Ukrainians is challenging both at home and in displacement. Apart from the direct threat of mines and missiles, they face difficulties accessing health and care services. Since the onset of the full-scale war, at least 16% of public health facilities have been damaged or destroyed. At the same time, the country is seeing a steep rise in disability rates – by about 300,000 since February 2022.  

The war has also disrupted treatment of life-threatening health conditions such as Zhanna’s. In areas of active hostilities, care has completely stopped for oncological diseases, while the healthcare system in the safer regions struggles with the influx of displaced people.  

Each month, 64-year-old Liudmyla must travel over 500km to Kyiv for her treatment. “My cancer is quite advanced, and it has metastasised. I’ve started to experience some new symptoms, which means it is progressing further.” 

Moreover, the economic decline driven by the war has rendered millions jobless and eroded social contributions. As a result, about 80% of older Ukrainians live below the poverty line and 90% of them are unable to pay for even basic medical needs.  

Rising inflation has also reduced the income they have available to cover their basic needs. 

“It is not just my cancer, you know,” Tetiana, 64, tells HelpAge. “I have an array of different diseases. I need cataract surgery, but I don’t want to spend any money on it unless I go blind. The rent is the largest share of my expenses. I also have a bank loan from before the full-scale invasion. I receive allowance for displaced persons and a pension – a total of about 6,000 UAH (£130) but it’s far from enough.”  

HelpAge International has been supporting older Ukrainians since 2014. As part of its efforts, thousands of them have received aid such as cash assistance to allow them to decide their own priorities, vouchers for medicines, devices to monitor blood pressure and blood sugar, wheelchairs, canes, and walkers. HelpAge has also been using its robust cooperation with state institutions and partners to develop a referral system which ensures that older Ukrainians’ needs are met in ways that go beyond HelpAge’s remit. HelpAge’s physiotherapist provides regular meetings and training for older people and their carers, while also offering community safe spaces where classes are hosted to help improve overall fitness.  

“I could be feeling unwell, and still haul myself to the fitness classes,” Tetiana laughs. “It helps a lot, not just physically but also mentally. Being able to move about is not something you take for granted in this condition.” 

Mental health is another frequently overlooked impact of the war. According to HelpAge’s research, 55% of older people said that the war had impacted them emotionally because of separation from their loved ones, loneliness or isolation, disagreements with relatives or friends, and loss of loved ones. In the last month about 42% of them said they have difficulties performing even daily tasks.  

HelpAge’s community safe spaces across Ukraine provide not just a place for older people to receive information, acquire new skills or engage in physical activities, but also somewhere they can speak to a psychologist for group and individual sessions.  

“We had to leave everyone behind – friends, neighbours,” 68-year-old Tetiana’s voice is filled with regret as her eyes go unfocused for a second before, she visibly pulls herself together. “It’s painful but I can’t just sit at home and wallow in sorrow. At these group sessions you realise just how many people are going through the same.” 

A missile strike on Lviv earlier in summer triggered some of her unhealed traumas. Shaken up from the strike, Tetiana started having nightmares and panic attacks: “The psychologist has been a tremendous help. She taught me how to tame my stress and avoid falling back into depression. Hobbies are one way to do it. I love sewing, my husband likes fiddling with electronics. That’s how we try to cope.” 

“I take it one day at a time. It’s best this way – things are complicated, the family is scattered all around, and we don’t know where to go from here. But as I said, one day at a time.”