‘It’s like survivor’s guilt’ – one dentist on the emotional impact of the Russia-Ukraine war

'It's like survivor's guilt' – one dentist on the emotional impact of the Russia-Ukraine warDentist Myroslav Goncharuk-Khomyn talks to Leo Jurkiw about the realities of life in western Ukraine and how he is contributing to the war effort. 

First of all please tell us a little about yourself

I am originally from central Ukraine, but when I began my dental education I came to the western city of Uzhhorod. This is the most western city in Ukraine, right on the border with Hungary.

My speciality is prosthodontics and endodontics and the subject of my PhD was paediatric dentistry and orthodontics. Most of the time I treat patients. Although part of the time I am lecturer at the Uzhhorod University teaching both Ukrainian and foreign students.

I have not heard of Uzhhorod being referred to in our news here. Please could you tell me and our readers if the war has had any impact on your city?

The impact of the war here has been quite unique because of the city’s location at the border with the European Union. This has resulted in us receiving the largest number of refugees from the rest of the country.

Our city is not large – its population normally is only about 120,000. But in the last five weeks the same number or an even larger number of people fleeing the war have arrived. Consequently, we have many problems with regard to humanitarian and medical care because the city is overcrowded.

Uzhhorod is also unique in Ukraine in that it is the only city which has not so far been bombed by the Russians. Some of these new people are looking to stay in the city. But the majority are using it as a transfer point on their journey into the Slovak Republic and Hungary, or further into Europe.

In addition, again because of its location, our city is one of the prime recipients of humanitarian assistance from the west and its distribution throughout Ukraine.

With so many refugees have flocking to your city, when working as a clinician, could you describe some of the problems that particularly illustrate what you have faced?

You must understand that most of the refugees are women and children. The men have either stayed at home or have been included in the general mobilisation by the army of the male population. So consequently most of the refugees are children.

After weeks of being bombed and days – sometimes weeks – of travel to an area of relative safety, many are in need of not only humanitarian, but also medical and dental aid.

While doing my PhD I specialised in paediatric dentistry, so now because I have that experience because there are such a large number of children to be seen. For the last weeks I have exclusively been doing paediatric dentistry in the clinic.

At the beginning it was very difficult because you are aware of what a child has endured. So I endeavoured to be super gentle with them. Most of the population now have an app on their phones, which warns of air raids or missile strikes. When the sirens are activated, you can see that the children who have already been bombed are really afraid.

We have tablets in the surgery for the children to watch cartoons while having their treatment. When the sirens go off, they often ask for the volume on the tablet to be turned up to drown out the sound of danger.

In contrast, it is noticeable that if you are treating a child from the west of the country who have not undergone bombing. You can see that they are just irritated and distressed that the sirens are disturbing them, but they do not exhibit the same degree of fear.

It is noticeable that the children who have come from the east are so very brave – they aren’t afraid of the dentistry, they are afraid of the danger.

That is in my opinion quite a profound but disturbing observation, which I doubt has ever been previously reported. It’s hard to even conceive of such a thing. To move on, I presume you are extremely busy at work at the moment?

Now, my days are divided into four separate portions. The first involves treating patients. In the second part of my day I help at a volunteering centre to find out what kind of help the refugees need. It might be money, food, shelter or any medical treatment.

The third part of my day is taken up by driving people. You see some people come to the train or bus station. They are so afraid that they immediately want to be taken to the border. So I usually get a call and then take, usually families, to the Hungarian or Slovakian border.

I make sure they have something to eat and drink and enough clothes. In the first weeks of the war, there was a huge number of people waiting to cross. Sometimes you were waiting for ten or twelve hours, although now it is much quicker.

My final duty is the find medical materials because I have contacts in Ukraine, in active war zones and on the front line. They contact me with lists of drugs that they need. These are easier to obtain in the west of the country and I send them to hospitals or military divisions. So that’s basically it: treating, volunteering, driving, and sourcing medicines.

Myroslav, when you get a request for materials from, for instance, Kharkiv, let’s say for dental anaesthetics, is there an established mechanism for getting it there from Uzhhorod?

That’s a really good question, because the mechanism in every single case is different. Sometimes, I send things via Kyiv by train and I get it transported on from there by car with other humanitarian aid. Sometimes I send it by post to the nearest accessible town and they arrange to have it collected. Every single case is different and logistically dependant on the city or town in need.

But remarkably, I’ve never had a case when the delivery did not get there because every time there are always people who agree to help. The only exception are the cities which are totally occupied, but in those places when they are asking for help it is for other things, dental materials are not a priority.

Can you tell me, are there dental distributors in Uzhhorod where you can obtain materials if you have the funds?

Certainly you can get dental materials here but also in other western Ukrainian cities like Lviv, Ivan Frankivsk and Chernivtsi, perhaps not the full range. You can certainly the basics: anaesthetics, needles, composites, scalpels things like that.

And in your case, where do you get the money from to pay for the materials you are sending on?

Well, our clinic donates materials, but also I have a few international friends in the UK, Turkey and Lithuania who have been helping me by transferring money.

But it is all completely transparent and I supply invoices and evidence of dispatch and receipt of goods. The entire system depends on only using people you know and trust.

Although the government of Ukraine does its best, I must say that volunteers are having a huge impact in all aspects of humanitarian aid. I know of instances where the government was trying to get something and were unable, but the volunteers have so many contacts that they were able to do so very quickly.

Just one final question – what are your hopes and wishes for the future?

I just want the war to end, but I have one additional dream. Even with the winning of this war, I know there will be a large number of personal tragedies – I don’t even think about the material destruction. What I hope for is that the war finishes as soon as possible and with minimal personal tragedies.

I would just like to add a couple of sentences about myself. Living here in western Ukraine, far from active war zones, and when you know people are dying over there, you adopt a sort of syndrome where you always want to do more and you can do more and you must do more.

At the beginning I was volunteering and treating children and it’s like survivor guilt. But now my colleagues and I realise that we must just do the best that we can to help and that at times we do have a physiological need to sleep.

So my objective is to help every day as much as I can. But I just live one day at a time and it’s easier for me not to think too far into the future.

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