“Our emotions go from here to here.” Nadiia stretched her arms out as wide as she could. “And,” she said, bringing her hands back together, with an inch of space between them, “this is the space we have in which we experience those emotions.”
Though this conversation took place between Emily and a friend in L’viv, Ukraine, in September 2024, we have both had this same conversation with Ukrainian friends and colleagues many times in the two-and-a-half years since the start of Russia’s full-scale invasion. Ukrainians have been forced to adapt to everyday war even as they simply live their lives and stand up to the invasion—whether on the front lines or through humanitarian and grassroots efforts elsewhere. That adaptation has been hailed by many scholars and commentators as the remarkable resilience that it is. But resilience always comes at a cost: the cost of daily life interrupted; of loved ones lost and injured; of families separated; of patience worn thin; of dreams put on hold.
Current estimates of war casualties among Ukrainian troops suggest half a million soldiers killed or wounded. Ukraine currently has 1.2 million people registered as veterans who will need services when the war is over, and the Ministry of Veterans Affairs estimates that this number could reach 5-6 million. In addition to the psychological impact of war, 30-50,000 Ukrainians have had one or more limbs amputated during this war. The need for physical rehabilitation competes for resources with the need for psychological diagnoses and treatment for soldiers and for many (if not most) civilians.
Further, many war-related deaths don’t occur near the battlefield. One study estimates that more than 4.5 million people have died “indirect deaths” as a result of the United States’ post-9/11 wars around the globe—deaths caused not by military violence but by famine, disease, and crumbling public health infrastructures. For instance, deaths from cardiovascular disease in Iraq spiked to five-times the normal rate among older adults following the 2003 US invasion. Today, war in South Sudan has led to more than 2 million people facing imminent starvation. Residents of the Gaza strip now face what a UN representative has called “catastrophic levels of hunger,” as well as an uncontrolled polio epidemic following the devastation of essential health and safety infrastructures in the region.
At the beginning of Russia’s war in Ukraine, experts sounded the alarm about the risk of respiratory diseases—COVID-19 and tuberculosis—in crowded bomb shelters, evacuation trains, processing centers, and way-stations for the displaced. Others stressed the urgent need to overcome disrupted supply chains that placed life-saving medications for HIV and opioid use disorder beyond the reach of those who need them. The full consequences of Russia’s war on these populations are still unknown, and conducting effective research on these topics in the context of war presents both institutional and personal challenges.
A critical scholarly approach to Russia’s war in Ukraine invites us to consider not only these material impacts of Russian attacks on civilian institutions—including maternity and children’s hospitals, healthcare workers, and other medical infrastructure—but also (as Nadiia so aptly illustrated) the deeply emotional, psychological, and symbolic toll of that violence. For example, it is widely understood among residents of Ukraine that many Russian attacks are designed not to gain military advantage, but to destabilize routines, create a sense of vulnerability, and maximize civilian stress. The deliberate targeting of energy infrastructure leaves millions of Ukrainians experiencing daily lengthy and unpredictable power outages, despite the effective surface-to-air defense systems that have helped protect some essential infrastructures in many cities. UN-donated generators help keep many schools and hospitals operational, but ordinary citizens must face life without air conditioners in the summer and without refrigeration for food and medicines, and are stuck in urban apartments that have been transformed by decommissioned elevators into 12-, 17-, even 20-story walk-ups. These difficulties hit the most vulnerable Ukrainians hardest of all.
As medical anthropologists, we know that the effects of such damages reverberate deeply into the political substrate. Social shifts occur as people are forced to adopt new roles: the soldier in the field; the veteran who returned; the mother who left; the parent who stayed behind. New hierarchies of resort emerge as healthcare systems bend and break under the pressure of Russia’s attacks. The boundary between “illegal drug” and “essential medicine” shifts as narratives coalesce into “crises” and new classes of deserving citizens emerge. Past and future take on new meaning as the war “steals time” from the lives that Ukrainians had planned. And the weight of all these transformations grows greater still when they are perpetually overshadowed by questions about the plausible (“how destructive can this war become?”) and the unknown (“when, if ever, will it end?”).
This special collection of essays from scholars of Ukraine—including several who are Ukrainians currently living through this war—offers readers unparalleled proximity to the tangible effects that Russia’s war is having on health in Ukraine. Maryna Nading takes us into a community of artisans who have turned their skills towards the weaving of camouflage nets – artifacts produced for the preservation of life and the enabling of death. Ivan Shmatko reveals the many uncertainties that wounded soldiers face in the Ukrainian medical system. Kateryna Dovhopola, Olha Nabochenko, and Tetiana M. Kostenko draw our attention to the experiences of disabled children in the context of Russia’s war. Alyona Mazhnaya examines how Ukrainians experience and process trauma amidst war while navigating compromised health care systems and the weight of historical and current injustices. Jennifer Carroll explores the positive and negative impacts of shifting drug policies in Ukraine. Dafna Rachok presents vulnerability is an always contextual embodied experience with that can forge communities through acts of care. Volha Verbilovich describes the health-care experiences of older Belarusian protestors’ who became political exiles after Russia’s full-scale invasion. Sarah Phillips introduces us to the tenacious Dmitrii, who makes us question how far the devastation of war can reach.
In response to Bruno Latour’s famous insights on modernity, Margaret Lock has argued that medical anthropologists “bring another insight to the table: that people everywhere are, increasingly, for better or worse, partially modern.” In other words, the symbolic work of maintaining scientific neutrality, epistemological boundaries, and stories about “what is objectively so” is ongoing. In this terrifying, extraordinary moment in Ukraine, the stakes of this work—and its success or failure—is dizzyingly high. But, like all good ethnography, these essays bring these realities to the page by documenting Ukrainian experiences at the ground level.
Jennifer J. Carroll is an Associate Professor of Anthropology at North Carolina State University.
Emily Channell-Justice is Director of the Temerty Contemporary Ukraine Program at the Ukrainian Research Institute, Harvard University.