People in the eastern Ukrainian village of Opytne are living without access to health care or essential medications. This village on the front line lies in Ukrainian government-controlled territory, opposite the destroyed Donetsk Airport, which is now in the self-proclaimed Donetsk People’s Republic.

Without transportation and isolated by poor weather, these mostly elderly villagers have no choice but to live with the constant stress of the conflict in the region. Nearby shelling engenders acute anxiety and depression, in addition to cutting off access to regular care for chronic conditions such as cardiovascular disease, hypertension, and diabetes.

In response, a Doctors Without Borders/Médecins Sans Frontières (MSF) mobile clinic team comprising a doctor, a nurse, and a psychologist began providing primary health care and psychological consultations to villagers starting December 14, using a resident’s home as a base of operations.

"Without access to a regular doctor, the villagers in Opytne practice self-care, measure each other’s blood pressure, and self-medicate," said Myriam Berry, MSF field coordinator for Donetsk oblast (province). "As there is no road, there are no cars in the village and residents are walking several kilometers to reach Avdiivka [a nearby city] through a field."

The MSF team found residents living in partially destroyed buildings and relying on international nongovernmental organizations for food, heating, and electricity. But despite the conditions, many residents are reluctant to leave their homes and flee.

"The proximity to the front line puts the population under daily stress with the nearby sound of shelling," said Berry. "It is, by far, the worst situation of despair I’ve seen in our project since I arrived in May 2017. From the ten patients we have already assessed, half had blood pressure measuring over 200, which indicates the constant stress they are under."

"We had tried to access the village for two months after our initial assessment," said Berry. Opytne is only reachable via a narrow dirt track along the front line, with other entrances possibly mined or restricted to use by the Ukrainian military. "Between security issues and poor weather, which turns the road into a mudslide, we struggled to get through. We now aim to assess all residents who need medical attention and provide medication which will last for two months, in case we experience access issues again."

MSF runs mobile clinics for those most in need of health care and psychological support in 28 locations in Donetsk oblast, with four teams based out of Mariupol and Kurakhove. Most patients supported by MSF’s mobile clinics are women over the age of 50 suffering from chronic illnesses.

To address the effect of the conflict on mental health, MSF psychologists conduct individual and group counseling sessions and mental health awareness education, offering coping techniques for those living in the conflict area as well as teachers and medical staff.