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Aged and Disabled in UkraineThe elderly population is the fastest growing age group worldwide, and two-thirds of its population lives in low-income and middle-income countries. Such geographic locations have greater likelihoods of humanitarian crises, and the impacts of humanitarian disasters in these countries are more severe. Research shows the aged and disabled in Ukraine also have higher rates of poverty than younger, non-disabled people, making them more vulnerable during disasters. More than one-fifth of Ukraine’s population (more than 9.5 million people) were over the age of 60 in 2018. The country also is facing one of the world’s most acute global crises today.

Increased Vulnerability and Disproportionate Effects

According to HelpAge International (HAI), marginalization is having greater effects on older individuals, especially older women and the disabled. Since 2014, older persons have constituted more than one-third of the conflict-affected population — equivalent to more than one million people. Many of them have fled their homes due to violence along the contact line — a line dividing government-controlled areas (GCA) from non-government-controlled areas (NGCA). The number of affected people continues to rise as the ceaseless fighting impacts the mental health of the aged and disabled in Ukraine. These populations must contend with widespread landmines and restricted access to nutrition, healthcare, housing, pensions, fuel and public transportation.

Residents living along either side of the contact line and in NGCA are among the most vulnerable in Ukraine because humanitarian access is severely restricted in these areas.

The majority of individuals residing in and displaced from NGCA collect pensions. However, they can claim their pensions only if they are registered as internally displaced persons (IDPs) in GCA. They must also undergo complex and discriminatory vetting for pension verification, including home visits, physical identification in banks and additional safeguards. This approach is riddled with liabilities and creates serious humanitarian consequences because pensions are the sole source of income for most pensioners in NGCA. If approved, administrative requirements demand the aged and disabled travel through five checkpoints along the contact line every few months to avoid pension suspension. These individuals spend 50 to 80 percent of their monthly pension on travel expenses. Consequently, many seniors are cut off from their pensions because they either are physically unable to travel to GCA or cannot afford the trip.

Pensions are not the only reason seniors cross the contact line. They also cross to visit with family, obtain documentation and access medical services. The many restrictions imposed on crossing result in older and disabled persons waiting at entry and exit checkpoints for extended periods of time without adequate facilities like toilets, drinking water or shelter. Red tape often prohibits them from crossing with necessary items like medications and food as these may not be permitted goods. People also must renew their electronic passes on regular basis if they plan to cross — a near impossibility for much of the senior population who has no computer or internet access. These conditions are detrimental to the well-being of the aged and disabled, creating a dire need for mental health services, psychosocial support and life-saving aid.

Forgotten in the Midst of Crises

Marginalizing the older and disabled during disasters is not unique to Ukraine. In 2015, HAI interviewed hundreds of seniors across Ukraine, Lebanon and South Sudan. In all three countries, there was evidence of neglect. Most interviewees said they had never met with anyone to discuss their needs nor did they have sufficient information about available assistance. Almost 50 percent complained that health services were not equipped to treat their age-related conditions, and nearly half said they suffered from anxiety or depression.

Humanitarian Relief for the Aged and Disabled in Ukraine

HAI has worked with the elderly in Ukraine for more than 10 years and has provided them with community safe spaces. The organization has also directed advocacy and coordination efforts with NGOs and UN agencies to ensure that seniors are not excluded from receiving services and psychosocial support. HAI has established support groups and provided home-based care activities, assistive devices and hygiene kits to those of advanced age. However, despite the organization’s humanitarian assistance, a survey they conducted in 2018 showed that those aged 60 and older are still suffering.

The findings were echoed at a 2018 conference organized by the European Commission and the UN Office for the Coordination of Humanitarian Affairs in Brussels. The conference highlighted the support that the WHO and partners have given Ukraine to help combat the devastating effects of the country’s ongoing crisis. During the conference, it also was noted that despite the efforts of the WHO and its health partners, Ukrainian health needs still are on the rise. Speakers attributed the lack of improvement to a weak health system, limited disease prevention and insufficient treatment for chronic illnesses.

The conference also confirmed that the European Union (EU) will provide an additional €24 million to conflict-affected persons in eastern Ukraine, bringing their aid total for Ukraine to more than €677 million. The money will be used to fulfill the essential needs of the most vulnerable populations along the contact line, including IDPs and those in NGCA.

With coordinated efforts and increased humanitarian funding, permanent change for Ukraine is on the horizon.

– Julianne Russo
Photo: Pixabay

Mental Health in LebanonIn 2011, it was estimated that approximately 17 percent of Lebanon’s population suffered from a mental illness of some kind. Among them, 90 percent of people went untreated. Mental health in Lebanon was not always a priority. However, with rising issues of mental illness, the Lebanese government is finding new ways to combat the misconceptions and stigmas surrounding mental health.

Role of Education in Understanding Mental Health

According to two researchers from the Holy Spirit University of Kaslik, Lebanon, there is a distinct difference in the perception of mental illness depending on education. People who had higher educational attainment, as well as higher socioeconomic status, were more likely to have positive attitudes towards mentally ill patients. On the other hand, people who lacked education due to lower socioeconomic status had a negative outlook towards mental illness.

According to the World Health Organization (WHO), mental health and socioeconomic factors cannot be separated from each other. Socioeconomic factors can hinder educational attainment, and this may limit the lack of awareness people have about mental health.

Lack of awareness perpetuates the stigma around mental illness which stops people from receiving treatment. It even prevents them from talking about their feelings as they fail to be validated by others. Another reason why mental illness goes untreated is that many cannot afford it.

New Programmes to Help Improve Mental Health in Lebanon

The perception of mental health in Lebanon is changing and getting better. Historically, mental illness was considered something that could be solved only by the private sector. This meant that mental health care was reserved for those that could afford it.

Over the years, the government has realized that any person in need of help should be able to access mental health care. So, while mental health care will remain in part in the private sector, the health ministry in Lebanon is creating various programmes to help those who cannot afford it.

In 2014, the Lebanese health ministry created the National Mental Health Programme. This programme works with WHO, UNICEF and the International Medical Corps in order to help those with mental illness in Lebanon. It aims to incorporate mental health into general medicine more completely. This will hopefully help eradicate some of the bias that exists. It will help make mental health part of the discourse.

The programme also aims to help vulnerable populations in Lebanon such as refugees, people in prison and survivors of war and torture. This will be a huge help to these communities because it will allow them to have access to mental health care which they did not have before. It will create the perception that mental health deserves to be taken care of.

The National Mental Health Programme organized events such as “Time to Talk” in 2018. It was a way to directly combat incorrect perceptions about mental health by simply talking about mental health under ordinary contexts. Another similar event was “Depression: Let’s Talk About It to Get Out of It”. It was held in 2017 in order to discuss rising depression rates and help people heal. “My Mental Health is My Right” which was organized in 2014 aimed to enforce the fact that mental health in Lebanon is important and that every person has a right to receive treatment.

Thus, with such advanced programmes and new developments, the future of mental health care in Lebanon looks bright. It is important to remove the stigma surrounding mental health to improve people’s well being and foster a healthier and happier society.

– Isabella Niemeyer
 Photo: Unsplash