Mass. Doctor Helps Bring Medical Care To Elderly In War-Ravaged Eastern Ukraine

A physician from Arlington makes a living going to some of the most dangerous places in the world to provide medical care.

Dr. Deane Marchbein is now in eastern Ukraine with Doctors Without Borders, which is known internationally as Médecins Sans Frontières (MSF). The Donbass region of Ukraine has been wracked by conflict for almost five years. Ukrainian forces are fighting pro-Russian separatist forces. Russia wants to control the country.

More than one million people have fled. But there are still pockets of mostly elderly people in villages in the conflict zone. Some have been without electricity for years. The fighting has destroyed local clinics, and left people in dire health.

Marchbein coordinates Doctors Without Borders' medical care in 28 villages. She sends out medical teams to set up mobile clinics in people's homes.

Marchbein spoke with WBUR's All Things Considered host Lisa Mullins. Hear their conversation above.

On why people stay in war-ravaged eastern Ukraine and what medical issues they face

Dr. Deane Marchbein: Sometimes the answer is, 'This is my home. I have lived here for my entire life. I have no place to go. I do not have the money to go.' People on fixed pensions really cannot afford to leave.

We are treating people with chronic non-communicable diseases. So, high blood pressure, cardiovascular disease and diabetes. Additionally, since Ukraine has no system of ambulatory mental health, there is a psychologist with every team that goes. And they're dealing with people with anxiety because they're listening to shelling — sometimes every day — depression, grief, loss. What they express is a kind of shock that they live in Europe and how could this be happening. And they express sadness, and just surprise, that this is what their life is in their older years.

Lisa Mullins: When you visit them, can you hear the shelling? Are you anywhere near the line of fire?

We go to a great deal of care to make sure that our teams are not in harm's way. My assistants make calls in the morning before the mobile teams leave to make sure that there is no active shelling going on. I can say that I have heard distant shelling, but never anything close. In one community that we have not been able to get a mobile team because it gets shelled so regularly, I went to do an evaluation — I'm trying to find a way for our teams to be able to safely get there. And I talked to one elderly woman who lives there with her 50-year-old mentally disabled son, who cannot leave her home because if she does — and he's afraid to leave home — he will wander off looking for their old home. They have moved three times. Their house has been destroyed three times by shelling ... there is no other place for them to go.

When you offer psychological help, or the team does, this is not a culture that's used to the idea of psychotherapy. How did you get them to trust you? How did the team members gain their trust?

I think that people have such great needs. And when you have a team, a medical team, that comes to your village week after week, month after month, and they are the only people who are coming, you feel that they understand your humanity and that they are standing with you, and somehow that trust grows.