There are two things that Ukraine needs now. First, this deadly war of attrition and destruction must end. Secondly, the younger generations of Ukrainians must be healthy, educated, resilient and ready to take on the formidable task of rebuilding their country.
I cannot comment on what it would take to achieve lasting peace in the region, although my friends with relevant experience say that it is at least possible. But I know a lot about what the children and youth of Ukraine will need, starting now.
The harsh reality is that the region’s health care and rehabilitation systems, schools and social support capacities, which were depleted before the war, are struggling to keep up with needs.
Almost since the war began, UNICEF estimates that thirds Children of Ukraine have been evacuated from the besieged eastern cities to relatively safe havens such as Lviv in the west of the country or outside Ukraine entirely in the host countries, mostly Poland.
I traveled to the region in April and May, and I am eager to see for myself what the situation on the ground would be like in this very serious crisis for millions of Ukrainian children.
First on the agenda in Lviv was a visit to a hospital for the care of children victims of the war. Even being the director of a pediatric intensive care unit early in my career didn’t quite prepare me for the level of pediatric trauma I’d seen within several hours at that facility.
I saw a 10-year-old girl with severe shrapnel in her head and right shoulder. Her physical recovery was progressing, but she saw her parents murdered by Russian soldiers outside their apartment building in an Odessa suburb. I can’t begin to guess how and when her psychological recovery will take place.
Then there were 11-year-old twins, beautiful children who were among the dozens who were injured or killed when a Russian missile hit, according to Ukrainian officials, Train station In Kramatorsk while people waited for evacuation. The boy went to get snacks on the flight and was unharmed, but his sister lost both of her legs. Their mother had lost her leg and seriously injured her arm.
These stories are heartbreaking, but outside the hospital walls there are a different set of challenges for child survivors of war that could destroy Ukraine’s long-term future. Many children are stressed, sad and confused, and many have not been to school since the invasion began.
Shelters for refugee children and families in Warsaw, Poland, and internally displaced children in Lviv are filled with children languishing in unfamiliar places. Most fathers stop fighting, leaving mothers struggling to maintain morale and figure out how to provide for basic necessities over the long term, knowing that many of the cities they fled may be uninhabitable for years, if not decades.
To be clear, the employees serving these families in both cities are superbly caring, but the inner strength is inexhaustible for even the most resilient mothers and children. Time eventually erodes nearly anyone’s ability to deal with constant adversity.
The harsh reality is that the region’s health care and rehabilitation systems, schools and social support capacities, which were depleted before the war, are struggling to keep up with needs. Lviv region now needs savings Nearly 2 million internally displaced people Children and adults who have taken refuge there since late February. At least I welcomed Warsaw alone 300,000 UkrainianThis has inflated its population by 17% in the past three months.
While I hope the immediate priorities of food, acute healthcare, protection and shelter will be taken care of, thanks to humanitarian response organizations like UNICEF, Save the Children, International Medical Corps and the like, how and where displaced Ukrainian children will get the mental health care they need is unclear. What about educational continuity? Can Lviv or Warsaw schools and other host communities accommodate the hundreds of thousands of children who have arrived from eastern Ukraine?
In refugee havens outside Ukraine, language barriers, not just available classroom space and the number of teachers, pose another challenge. Internet-based distance learning systemsWhich children were using during the war, can definitely help. But many kids don’t have access to tablets or laptops. Even for those with the devices, there is little evidence to document the uptake and effectiveness of distance learning as an alternative to learning in the classroom.
In terms of mental health support, every teacher, health care worker and political leader I spoke to in Lviv expressed concern that many of the internally displaced children now sheltered in the area have experienced psychological trauma. The children had fled in fear for their lives from Russian brutality, lost loved ones and friends, and lost parents who were out of combat.
Although the challenges facing the children of Ukraine are enormous, it is worth reminding ourselves that they are not insurmountable.
And at a high school in Warsaw, I met Ukrainian teenagers who were clearly suffering in silence, and were already showing evidence of PTSD, such as difficulty sleeping, detachment, and depression.
The big problem with the inevitable disruption caused by war is that children who lose ground academically or suffer persistent, unaddressed trauma (or both) may face significant challenges to the possibility of leading productive and successful lives in the future.
This is a concern because once the war is over, in addition to the enormous and costly need to actually rebuild Ukraine, all Ukrainians must be willing and able to take responsibility for its recovery.
Although the challenges facing the children of Ukraine are enormous, it is worth reminding ourselves that they are not insurmountable. new organization Ukraine Child Labor Projectwhich I co-founded with my wife, Karen, works with leaders in Warsaw and Lviv to think through strategies that can make a difference for children who, through a lack of choice on their part, have been driven into a world of confusion, fear and stress.
But I must stress that these challenges must be faced by international organizations cooperating with local efforts. I met extensively with the mayors of Lviv and Warsaw, as well as members of their departments. Lviv Mayor Andrey Sadovy is working on a large number of impressive plans to accommodate displaced Ukrainians who have taken refuge in his city. And Warsaw’s dynamic mayor, Rafal Trzaskovsky, is determined to provide adequate support to Ukrainian refugees – especially children – who have settled there.
So here’s what to do to move forward.
First of all, there is broad agreement that more teachers and mental health professionals should be identified and hired. However, all these professionals need to master the Ukrainian language and specially trained to deal with traumatized children.
Secondly, every displaced Ukrainian child of school age must be enrolled in a school or in a good quality distance education program. The Ukrainian Child Labor Project will support the development of private schools in Warsaw and Lviv designed to provide a full range of “comprehensive” support (social services, counselling, nutrition, etc.) to displaced children.
In addition, supportive summer programs with the same mission as specially designed schools will benefit many children.
Finally, many children who have been evacuated to safe places from war zones may have undiagnosed or treated health problems that interfere with learning. These concerns include visual problems, behavioral issues and even hunger.
The good news here is that the programs used for the Child Labor Ukraine Project are among the programs Karen and I have developed over 35 years as part of the Children’s Health Fund. In other words, we already have initiatives designed to identify and mitigate “health barriers to learning.”
But is this still an ambitious agenda? yes. However, as the most urgent needs of Ukrainian children are prioritized, addressing their mental health and access to education will be critical. Ukraine cannot afford to lose a generation of children if it is to secure a post-war future full of hope and potential.