Safeguarding the people of Ukraine

0:00:13.8 Oksana Federaq: I had a very narrow and specific thought. It was just like about my grandma. I mean, I have other family and friends and I care about Ukraine as a whole, but I remember like waking up and just thinking of my grandma. I had this intense sensation of wanting to like go get her and physically if I have to, carry her over the border to safety, 'cause she's deathly afraid of flying. And that's, honestly all I could think about. And I had no other thoughts. And obviously gradually as that shock came down, other thoughts came into my mind and contacting other folks and also speaking to my parents and seeing how they were doing 'cause obviously they were receiving all this information as I was and I wanted to make sure they were okay. And then I made sure my brother was okay and then we were calling our family members and obviously we called grandma and grandma is okay and she's doing well and she's stubborn, but healthy. I love her endlessly and I spent most of my childhood with her, at least the summers. But we were talking about, maybe we can take you somewhere else, bring you to safety. But her attitude is that she survived Russians before and she will again. And I love her for it, but I still have that feeling of wanting to just like pick her up and take her somewhere else.

0:01:42.0 Speaker 2: The Ukrainian people continue to suffer atrocities at the hands of Russian armed forces, which invaded Ukraine on February 24th, 2022. In this episode of Population Healthy, we'll hear from two members of the University of Michigan community with ties to Ukraine, they've dedicated their talents and lent their expertise to help safeguard its people. Public health is about listening, learning, and working in partnership with communities to come up with the solutions that are best for the people impacted. These efforts are especially critical in a time of war when people and the systems that keep them safe and healthy are most vulnerable.

0:02:18.0 S2: Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. Join us as we dig into important health topics, stuff that affects the health of all of us at a population level, from the microscopic to the macroeconomic, the social to the environmental, from cities to neighborhoods, states, to countries and around the world.

0:02:49.8 S2: We begin with Oksana Federaq a native of Ukraine who has lived in Michigan since she was 10 years old. Federaq is a second year master student working toward a degree in health, behavior and health education at the University of Michigan School of Public Health. She interned remotely over the summer with Health Right International, a global health and human rights organization. We'll hear about the courageous and important work she's done and continues to do to combat human trafficking and improve mental health care in her home country in the midst of the Russian invasion. The CDC considers human trafficking to be a serious public health concern both domestically and worldwide. And instability after a disaster can make people especially vulnerable to trafficking.

0:03:30.8 OF: Human trafficking is a highly prolific and very lucrative thing that happens around the world is essentially the coercion of another human being into either labor or sexual acts. And it could be done by threat of violence, it could be done because of finances. It could be done with coercion by drugs. So there are a lot of waste to be coerced into providing services for others. It's something that, a lot of folks talk about as this tragic, very dramatic thing that happens when you're abroad in Eastern Europe, but truly is happening here. Michigan itself is a huge hub for trafficking, so it's important to be knowledgeable about it. And it's also important to note that so far our way of dealing with human trafficking has been very reactive.

0:04:25.3 S2: What will life look like in a year or two for the Ukrainian people who've been displaced or survived gender-based violence? What will the public health system need to be able to respond to this invasion and what programs have been effective in preventing gender-based violence during the war? These are questions Federaq set out to answer through her internship by creating awareness of a public health emergency and applying scientific approaches and incorporating public health principles such as equity, participation and respect. She is working to improve lives in Ukraine.

0:04:54.2 OF: We are trying to help survivors. We are trying to make sure that they're okay and our prevention efforts have been really victim-centered and not in the good way. We're trying to teach victims how to not become victims rather than trying to teach people to not become traffickers. And that's a personal beef of mine that I constantly think about and hope to really affect in my career because I think that if we continue to focus on how the victim cannot be a victim, we are not going to get very far. I look at it as almost an analogy of looking at COVID. And if you look at all the people that get sick and their symptoms, that's great, but what are you gonna do if you're not studying the virus itself, is the virus people? Is the virus the symptoms that create those people? So what makes your average person go from average person to trafficker or not? It really made me think and it's given me a lot more fuel to keep going and I think I've made made a lot of really great connections and I hope that this carries me through to work into some of these larger systems and larger organizations that are affecting change in human trafficking as well.

0:06:09.5 S2: Combating human trafficking is an issue Federaq is passionate about. It was a problem. She came to understand better after working with Health Right International, shortly after the Russian invasion, she was looking for ways to help those experiencing the conflict. She began by offering her help in supporting Ukrainian College students with their mental health challenges.

0:06:28.4 OF: I believe that it was really within, I wanna say the first month because I reached out to the preceptor of the organization just to make sure she was okay because she lives in the capital city and the office of the organization is the capital city, Kiev. And so I kept in touch with her. She reached out to me via email and said, "Hey, there's this Facebook group not connected to the organization at all of psychologists and they're trying to organize some kind of aid for students that are experiencing mental health crisis in the moment. And they need someone that speaks English as well that has experience in mental health and you know, have had at this point, over a decade of experience in mental health and adolescent health specifically."

0:07:16.3 OF: So I was like, "Of course. Absolutely." At this point, I think the group is like over 150 different members. Within psychology space, and initially it was dumped through a Telegram channel. I helped them kind of curate the English side of things, and that specifically is because Ukraine is actually pretty common place to go to for other countries, for like med schools, you know, whether it's India or Nigeria. A lot of students come from around the world to go to the schools here. So, one common thread was that many spoke English, which is why I was asked to be involved. What was most amazing to me, I think, and this is kind of a common theme throughout my experience, during all of this time, you know, we'd be meeting in Dukes and kind of setting up the procedure for what we would want to be able to offer students, right? 

0:08:07.7 OF: And they would be sitting in dark rooms because they had to have their lights off in case there's a missile coming in. They would, you know, all of a sudden stop and have to go into a corridor because a missile might hit the building. But throughout the whole time, they were trying to keep going to set up this service, this help for others, and I found this quite inspiring.

0:08:31.0 S2: From there. Federaq's work with Health Right transitioned into a remote internship where she worked to help prevent human trafficking.

0:08:38.6 OF: I first met with Halyna Skipalska, the director of Health Right International in Ukraine. Initially, we spoke about utilizing those skills and past work with adolescent mental health to provide some feedback on developing programs that they had. There were also opportunities to interact with programs serving women with HIV and domestic violence survivors. And then another side I was honestly really interested in learning how international organizations work at the structural level. So who funds what, how do the country offices interact with the main offices? And I've done so much work within local organizations, including my current employer, and I've been fortunate to understand those and out of how well functioning orgs work. But now I really wanted to know how this happens and what happens at this higher level.

0:09:30.9 OF: So eventually in around end of May or June, Halyna reached out and asked if I was interested in doing the internship remotely, and I said, absolutely. I desperately needed something to do. I was ready to work on any way that I could be helpful, whether it was human trafficking or not. But Halyna had offered. And provided me with, I guess a list of the different projects that they had going on at the moment. And there was, I think, maybe even more than 10. Eventually, I chose to work with a platform project called Safe Women Hub. It specifically exists to help women and girls connect with psychological services, but also social programs, so housing, domestic violence issues, finding various international agencies and how they could be helpful when working in the country and also, they were developing informational posts and whatnot to provide people with warning signs when it does come to traveling abroad and where it concerns human trafficking.

0:10:38.5 OF: I spoke to the director and we sort of settled on the idea of, needs assessment that talked about structural infrastructure needs. And the mental health system as a whole, really in Ukraine. And what kind of things were gonna be important in long term? So we know that immediate needs are really, you know, food, shelter, and water and safety. So those are immediate needs, but what kind of psychological needs are people going to need, you know, a year down the line, two years down the line? You know, there is concern that when things stabilize and things are no longer in this crisis mode, will other international aid organizations pull out and that kind of additional buffer for psychological service go down? What kind of needs have to happen at the, you know, country level with the mental health system. That was something that came as a pretty repeated theme. I think several folks that I interviewed, we did one-to-one interviews, so we ended up talking about what their daily life is like, and it was sort of similar to the Facebook group, when I talked to them, they were doing these things mid siren, or if it was the different type of siren, they would have to go to a bunker and we'd have to, you know, talk later.

0:11:56.2 OF: One thing I remember that kind of came up in our conversations was that, you know, they're doing these very important things. They're trying to connect folks, women and girls, with as many services as possible but they're also human beings themselves, and they're thinking about safety and they have their own needs, which across the board, when I talked to everyone, they said that the project and platform was really good about supporting them as well in the psychological needs. The general attitude is, what else are we gonna do? We can help, we are alive, we can do something, you know, do they have a backpack full of their important documents and love things right by the door ready to go? Yeah. But are they going to continue their work regardless? Also, yes. I am almost a little bit afraid that the needs assessment won't do this organization justice but I will absolutely be trying.

0:12:49.3 S2: Like a lot of things in public health work in the context of war is inherently empathetic. It forces us to center the experiences of others for the sake of global public health. It's important to remember that all of the issues Federaq encountered, occur in nearly every war, and there are many ongoing conflicts around the world where people need similar support.

0:13:09.0 OF: My experience has been that the more concerned and hyper aware I became of what's going on with Ukraine, because, you're checking news outlets every day. But I also became more acutely aware of other things that are going on in the world, whether it's Palestinians or Afghans or Iranians. My mind is constantly wrapped around what they're experiencing, the harm they're experiencing, and the injustices that they face. And, they love their own, they wish to be free. That feeling is pretty universal. And having that freedom, so violently challenged as a Ukrainian has made me more vocal for others. I think I'll always be like this. I'm a little bit mouthy and slightly obnoxious in my endless need to support others but Ukraine will always be my home and my grandmothers there. Now, my grandfather is there, my cousins are there. Our lifelong family friends are there.

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0:14:13.3 OF: For my birthday, we were just connecting with other people via Skype or Viber, and we spent the day calling, catching up, is it quiet where you are? Are you safe? Will you be okay this winter? And I think it's this intense need for connection that reminds me also the panic of the first few days of war. I guess that feeling kind of sticks with you a little bit. And I guess I wanna say that Ukrainians are very resilient. They're very hearty, they're very good humoured. But I also think that the consistent need for resilience also means bitterness. It means we are in care of the human spirit. It means that there are going to be effects and impacts in which we can all only gasp at. How do you replace a home that you've lived in 50 years? And how do you replace the art in the museums of artists that are long dead and gone? And how do you replace, it's a year of school that children have missed and spent in bunkers. We as a people will stand as long as we have breath. And on the other side, I also hope that we also stand in solidarity with others around the world who are trying to figure out how to replace those very same things.

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0:15:38.7 S2: Now we turn to Geneviève Zubrzycki, professor of Sociology in the Department of Sociology in the College of Literature Science and the Arts at the University of Michigan. Dr. Zubrzycki is the director of the Wiser Center for Europe and Eurasia at the University of Michigan. The Wiser Center has partnered with the Reckoning Project: Ukraine Testifies to create a lasting memorial of Russia's war in Ukraine.

0:16:00.3 Geneviève Zubrzycki: The Reckoning project in Ukraine is constituted by a collective of journalists and first responders. These are local people who are spread throughout Ukraine, but mostly still in the east because this is, these are the occupied regions. They are local journalists with no prior experience really of of war and war reporting. They're documenting crimes as they are occurring. This is very important to have really on the ground reports from what is happening from the local experts. It's not journalists who are going to Ukraine to document, but really people who are embedded in different communities and not just in Kyiv or Kazan or, Zaporizhia, but also in smaller towns where a lot of the atrocities are actually being committed. And what we're doing is working with students and faculty that have specific expertise to provide support to that organization.

0:17:08.1 GZ: For example, we have a team of translators who are translating testimonies or summaries of testimonies. Then I created a course in the Department of Sociology, where I have students who are taking that course and provide research assistance instead of readings and exams, they receive course credit for research assistance. What they're doing is reading summaries of testimonies that have been translated, and they're coding them so that the reckoning projects data analyst can actually have easier access to the data and identify patterns of aggression against the Ukrainian people. And then a third part of our contribution is legal analysis. We're working with legal scholars and students in the law school to provide legal advice on different ways that those crimes could be prosecuted at the national level, but also at international courts. This fall, most of our work has been getting the summaries of testimonies and doing the translation and coding those testimonies. We expect to have coded over a hundred cases of potential crimes. Each case has most of the at time several testimonies, several witnesses or victims. It could, potentially be as many as 300 testimonies that we are reading and coding.

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0:18:44.3 GZ: It's too early to talk about trends, but we are seeing different types of crimes. Some of them have been reported in the news, a bombing of a train station, for example. But we're also learning about other types of crimes that we hear about that are actually more pervasive and perhaps less dramatic, but no less important. Kidnappings, for example, interrogations that are very violent cases of torture, cases of theft. Most testimonies are about that type of violence, beatings, executions or people who have witnessed executions. And this is what we're trying to do is also to eventually see patterns, but also compare what we're seeing, reading in the testimonies with what we know about the movement of Russian troops in Ukraine. And then what types of crimes are committed and in what fashion. The testimonies are very detailed because this is what will allow us to see patterns and whether specific forms of torture or aggression or persistent across different regions or in a given region so that we could suspect specific orders to troops.

0:20:07.0 GZ: And this would make it possible eventually to prosecute those crimes in courts like the Hague. It's important to hold Russia accountable as a regime, as a country to prevent more crimes of that sort, to prevent aggressions against other countries or continued aggressions against Ukrainians. In a way, it's not that difficult to prove war crimes when you see that that schools, for example, or hospitals are being targeted. The real challenge is proving basically where the orders came from and who was giving them.

0:20:42.8 S2: And in this way, sociologists are helping to ease the burdens of negative mental health and health outcomes post-war. They provide very specific skills that can really help multiple teams in Ukraine and other international organizations.

0:20:54.5 GZ: For example, what I'm doing with my students coding testimonies, the testimonies, they come to us in narrative form. That's very, very rich data, but we need to be able to extract specific information for that so that other social scientists then can identify statistically trends in crimes. Also have colleagues in political science who are working to geo map the crimes and to compare that with movements of troops in Ukraine so that we can see which troops were where when. So these are skills that actually academics and social scientists are providing for legal teams to build their cases. It's preparing very strong evidence for legal scholars and legal specialists to prepare cases and to basically bring perpetrators to justice, for our students. There's another issue. We brought this to the University of Michigan because we felt that the University of Michigan had the unique experts to provide assistance to an NGO like the Reckoning Project, but we also felt that this was important for our students to get training and to make a difference in something that's happening now that has tremendous importance, obviously for Ukrainians, but also for peace in Europe and the world and they're getting firsthand experience with a conflict that is occurring now.

0:22:26.8 GZ: And basically they're getting trained on how to treat sensitive data. They're getting trained on vicarious trauma, how to read these testimonies that are very difficult to read, when to step back from that and basically identify things that might cloud their judgment in how they're coding so our students are also getting extraordinary training in a project that has very important potential, real life impact so I think that this was really, a unique opportunity for students, and we have students who signed up for that course in the fall, we have a new crew of students signed up for the winter course, and those students from the fall are now volunteering because they feel really involved and they want to continue being involved in the project. It's very emotionally difficult work, and that's why we provide training for that type of work but it's also very rewarding because when they read the news, they know really intimately what people are experiencing, and they know that their work will have an impact down the road, even though they will probably have graduated by then.

0:23:38.3 S2: Zubrzycki has dedicated her efforts to help support people affected by the conflict abroad, as well as right here in Ann harbor.

0:23:44.3 GZ: Michigan is a powerhouse, so we have specialists in all areas. We have a lot of experts, or you know, in political science, in sociology, economics, law, who are specializing in Eastern Europe, public policy, business. Eastern Europe is really a place that is studied deeply at Michigan so the Weiser Center for Europe and Eurasia has a very place of honor basically to kind of coordinate our help to the Reckoning Project, but also in hosting Ukrainian scholars. Last spring, we got to work very early on in the war to raise funds and create partnerships to host Ukrainian scholars and we created a fellowship that allowed us to host seven Ukrainian scholars and they came with their families, their children, and they are here for a full year until August 2023. We're hoping that we can extend for another year, as the war is unlikely to be over next September and the scholars we're hosting here at Michigan are also deeply committed to also returning to Ukraine.

0:25:00.1 GZ: So they're acquiring skills that will be helpful for when the war is over, and they go back to reconstruct Ukrainian academia, but also provide expertise that they developed or deepened here in Ann Harbor. It is life changing. We provide a safe home and a very stimulating environment for these scholars to be able to conduct their research and to be safe. So there is no question that this is really a program that is lifesaving and that will have a very long-term impact on these scholars and their children. I'm hopeful, but it's unclear what lies ahead for Ukrainians. And I think that we need to brace ourselves for a conflict to continue for a while and to provide support to the Ukrainian people for a while. While Ukrainians are hoping for peace in 2023, they're hoping for spring to come early because it is very cold in Ukraine and power outages, no heat, very often, no water. The situation is really, really difficult in most part of Ukraine, including in Kyiv, for example.

0:26:13.0 GZ: What do they have to look forward to in 2023? It's difficult to say. They're certainly hoping for their loved ones to come back. Those who have left Ukraine, women and children, many had returned in the summer when it was clear that the war was concentrated mostly in the east and south and I know from my work in Poland that now refugees that had left Poland and returned to Ukraine because of power outages are leaving again, because it's very difficult for elderly people and for children to be basically in freezing temperature without electricity. So Ukraine is now really focused on defending its sovereignty and its territorial integrity, but they're also looking ahead for a post-war reconstruction process. This is what they're already doing even though it's unlikely that the war will finish within, you know, the next three months.

0:27:17.8 S2: On the next edition of Population Healthy.

0:27:20.8 Speaker 4: The public health consequences of Roe being overturned are infinite, and they can't be understated. We need to be clear about what the risks and the costs of this will be. We are talking about situations where people will not have lifesaving care, and I'm not sure that everyone understands that because we talk about abortion in this very simplistic way, but abortion care is quite ubiquitous. It's one of the most common medical procedures. One in four American women in their lifetime will have an abortion. It's gonna be devastating, these effects.

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0:28:00.8 S2: Thanks for listening to this episode of Population Healthy from the University of Michigan School of Public Health. We're glad you decided to join us and hope you learn something that'll help you improve your own health or make the world a healthier place. If you enjoyed the show, please subscribe or follow this podcast on iTunes, apple Podcast, Google Play, Stitcher, Spotify, or wherever you listen to podcast. Be sure to follow us at @UMICHSPH on Twitter, Instagram, and Facebook so you can share your perspectives on the issues we discussed, learn more from Michigan public health experts and share episodes of the podcast with your friends on social media. You're invited to subscribe to our weekly newsletter to get the latest research news and analysis from the University of Michigan School public health. Visit public publichealth.umich.edu/news/newsletter to sign up. You can also check out the show notes on our website, population-healthy.com. For more resources on the topics discussed in this episode. We hope you can join us for our next edition, where we'll dig in further to public health topics that affect all of us at a population level.

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