Perhaps there is no lie more white than that of a woman who hides brain cancer from her mother. Even less so in the middle of a war. The daughter’s name is Inna Kochenko and she is 30 years old. She is large, serious, and has a noble gaze. It’s obvious she suffers for her mother, Lubov Uzhishchenko, 49, bedridden with her brain severely damaged, with no hope of recovery, in a small house in a rural area of Nizhin, in the Ukrainian province of Chernihiv. Experts say that the stress of war can awaken illnesses, exacerbating them, precisely when loneliness increases, the possibility of being left hopeless while your loved ones flee or die. “The explosions and bombings greatly affect my mother’s condition,” Kochenko laments, “and I can’t avoid them because we don’t have a shelter nearby.”
According to data collected by the Ukrainian office of the UN Development Programme (UNDP), some 500,000 people in the country require palliative care. More than ever, and with greater needs. Among them are the elderly, the disabled, wounded war veterans, and patients who, like Uzhishchenko, have an incurable illness. This is why her daughter receives regular visits from Alina Kazalap, a 30-year-old oncologist who heads a mobile palliative care unit at Nizhin Central Hospital.
Their relationship is almost familial. The specialist admits that a disease like cancer “spreads more quickly due to the stress and sleep deprivation” that daily violence causes in patients. Kazalap also acknowledges that, given Uzhishchenko’s fear of the word “cancer,” her daughter is right to lie. Her mother knows it’s a tumor, nothing more.
The impact of barbarism
Russian barbarism has elevated the suffering of an entire population to unprecedented levels, forcing them to make giant leaps in their access to psychological treatment and palliative care, which were almost nonexistent in the past. There is still work to be done. “Limited financial and human resources, which affect the availability of services, especially in remote areas, remain a problem,” says Dmytro Kushch, an analyst with the UNDP, the agency that is funding the mobile unit. The UNDP also notes that “in the context of war, ensuring access to adequate pain relief is not only a medical issue, but also a human rights issue.”
The requirements of war wounded are vast, so chronic illnesses are left behind, despite accounting for 80% of deaths before the Russian invasion, according to the World Health Organization. Chronically ill patients also suffer from the destruction of hospitals, being forced from their homes, financial hardship, and poor air quality caused by the war machine.
The oncologist adds another revealing fact: her greatest challenge is convincing families that the lives of patients still matter. “Before, perhaps because of Soviet heritage,” says Kazalap, “only those who were healthy were considered useful.” Kochenko knows her mother’s life is valuable, but she is exhausted. She cries as she describes having to bathe her, feed her, move her, monitor her blood sugar levels so she doesn’t lose consciousness; with an 18-month-old daughter and a husband who works away most of the day. “With all that, plus the attacks, the civilians who die, how can I take care of myself?” she asks, distraught.
Nizhin was occupied by Russian troops for just over a month after the invasion in February 2022. The war there, despite being far from the front, is still felt daily. A few minutes after noon, a Ukrainian helicopter pulverized a Russian drone circling over the town, easily visible from the hospital entrance, with a tremendous, somewhat frightening roar.
Mikola Panasovich, 83, remembers how the Russians arrived and killed some of his neighbors. “Russia has done many bad things to us, and I don’t understand it. We had a relationship,” says this smiling, kind man with large, weather-beaten hands. Tears flow when he talks about why he lives on the outskirts of the city. “My wife died six years ago,” he says. “I miss her a lot because she was my companion.” He is sad, but his gaze is grateful.
The elderly, the most-affected
Those aged over 60 represent 25% of the Ukrainian population. However, due to their health or their own choices, they are the ones who stay and suffer most from violence or loneliness. A study by HelpAge International, a nonprofit organization specializing in analyzing the difficulties of the elderly, revealed last July that 44% of those over 70 in Ukraine live alone and without family support.
Before sitting down to chat, Panasovich is given a checkup by several doctors from the mobile unit, lying down. He is suffering, above all, from the consequences of a prostate tumor that he underwent surgery for. He has a delicate heart, high blood pressure, a hernia… “But I’m fine for my age,” he says, although the war, he knows, is taking its toll on his health. He continues to grow grain to feed the chickens and ensure they produce good eggs. He has two children. “My daughter visits me every week,” he continues, “but my son moved to Kyiv and doesn’t come because he’s afraid of being mobilized.” He is referring to the possibility of being forcibly recruited by a conscription unit to join the army.
This man is a good example of what Oleg Kacher, 65, general director of Nizhin Central Hospital, explains. His 40 palliative care beds are always occupied: “People are very lonely, especially the elderly, and they need more care because many of their relatives left during the war.”
Maria Oliinik, 87, carries a double sorrow: not only did her husband die, but also her son, at the age of 45. Wearing a burgundy headscarf tied around her neck and with the small eyes of old age, Oliinik refuses to sit down and prefers to chat leaning against the wall. She worked as a cook in kindergartens. She had lived alone for six years, but developed kidney disease and had to ask for help. She now lives in the Nizhin nursing home, where she is cared for. “It’s better to live here than at home,” she says. Her house is only a couple of kilometers away.
Zoria Harda, 57, one of the nursing home managers, says that in recent years the number of single people seeking care has increased, most of them elderly and unable to care for themselves. The youngest patient is 48; the oldest is 92.
Oliinik becomes emotional when she talks about those weeks when the city was occupied. “I’m afraid of explosions,” the old woman says very softly. She speaks generously, even though her hearing is failing. Her grandson’s name is Dima and he’s 31 years old. He emigrated to Poland before Moscow launched its invasion and hasn’t returned. He’s all she has left. “He calls me a couple of times a month,” she says. “I want the war to end so he can come back.”
Dima tells his grandmother on the phone that he misses her a lot. The violence worsened their loneliness. Fortunately, Oliinik says, their old neighbors still visit her at the nursing home.
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