Kurakhove is doomed. If not to immediate capture, then the kind of battlefield demolition inflicted upon Mariupol, Bakhmut, Vuhledar and any other Ukrainian community that has found itself in the path of Russia‘s ambition.
Since we were last here, in January, the front line has crept several miles closer. The Russians can now hit the centre of this Donbas ghost town with small-calibre mortar rounds, rather than relying on the longer range rocket artillery which greeted us when snow was on the ground.
Then, the only civilian we encountered was a drunk trying to direct military traffic. This time, as we prepare for the final, high-speed dash into the hot zone, we overtake a local council worker riding a motorised road-painting trolley, upon which he is renewing the white markings on the centre of the highway.
Keeping pace on foot behind him – at no more than 3mph – is a colleague wearing a hi-vis yellow jerkin. Hi-vis! Ukraine has health-and-safety rules, too, you see.
Such a vignette, played out on a road under threat of Russian drones, artillery and encirclement, is either an exemplar of magnificent sangfroid or incipient madness.
Suggesting the latter isn’t merely being flippant. After nearly three years of total war, mental health issues are almost as big a concern among Ukrainians as the situation on the battlefields.
Mail cameraman Jamie Wiseman and I have lived alongside this country’s soldiers and civilians since the first days of the full invasion.
Much blood has been spilt over that time. One recent report suggested the battlefield casualty total, that is losses on both sides, has passed one million.
Often though, the wounds are not visible. A study by the Lancet medical journal suggested 54 per cent of all Ukrainians are suffering from some kind of PTSD.
Serious, stress-related ailments, such as high blood pressure, depression and heart disease have also increased dramatically, I’m told by doctor friends here.
The impact of the war could affect the country’s physical and mental wellbeing for generations to come.
The question in Kurakhove and many other places not even on the front line is often this: how much more can I take, before I break?
The heaviest burden falls upon the fighting soldiers, of course. Particularly the wartime recruits, volunteers and conscripts.
Earlier this year, I spent an evening with the soldiers of the 1st Mechanised Company
of the 21st Sarmatian battalion of the 56th Brigade. What was left of them, at least. They are the Mariupol Cossacks, made homeless by the Russians, and fighting on the Chasiv Yar front line.
With his curled moustache, Kos, the company commander, has a touch of Errol Flynn about him. Unlike most company commanders, who are from Generation X (in their 40s and 50s), Kos was just 25.
Outside, the temperature was sub-zero and the artillery grumbled. Inside the abandoned cottage that was now their company HQ, all was warm and jolly. Up to a point.
The unit’s home city had been Mariupol, where many of the men were recruited and where their families lived.
But it was destroyed in 2022 after a long Russian siege. The area is now under occupation.
The vast majority of the company’s original personnel have become casualties. Those who survived laboured under an intense mental and physical strain. But they had to carry on.
‘Since the start of the war, we had great losses,’ Kos told me.
‘And we were replenished and replenished. But there were also very large losses among the young replenishments.
‘In general, the losses are very large and very scary. Those who survive, you can count them on your fingers. Only a few of old professional soldiers, with a slightly unstable psyche, remain.’
Platoon soldiers with an 82mm mortar on a combat mission as Ukrainian soldiers hold their positions in the snow-covered Serebryan Forest in freezing temperatures in 2022
The weather is warmer but the battles still rage for the Ukranian soldiers on the front line in August 2024
They were positioned in the meat grinder Donetsk village of Pisky when the full invasion began in February 2022.
‘The Russians were very dominant there, in terms of artillery,’ he said. ‘We simply could not oppose them – we had nothing to answer. They could throw 6,000 shells at a defence area of 1km by 2km. They levelled everything to the ground.
‘After that, we could no longer hold the defence because we had no more men to do it.’
They were then sent to Chasiv Yar. Of the 100 or so men who arrived there, only a couple of dozen are still alive or unwounded this autumn. The psychological impact on the survivors is inescapable. ‘Such a moment comes for every person,’ said Kos.
‘When, for example, you sit under shells for a week or if you encounter a Russian in a trench every other day and shoot him right in front of you, seeing all the gore, then of course you will start losing it [mentally]. It’s obvious.
‘And most of the servicemen, the longer they serve, especially in such infantry units, they start going crazy. It is 100 per cent inevitable.’
Dr Viktor, the Sarmat battalion’s chief medical officer, is also in his 20s and he admits that the strain has almost become too much for him. ‘This is a great psychological pressure,’ he tells me. ‘Sometimes I want to give it all up and say: ‘I’m fed up, I want to go home!’
‘I’ve not been at home for eight months, I’ve not seen my family.
‘Psychologically… I don’t know… everyone has a limit and I can say with confidence that I am already on the verge of a crisis.’
Oleksii lost his ‘peace of mind’ defending Kurakhove. We meet him six days after he had been withdrawn from one of the most bitterly contested front lines, suffering from combat-related stress.
Before the full-scale Russian invasion, Oleksii was a packer in a furniture factory. Since joining 33rd Brigade he had been in the same exposed firing position for 64 days without rest or rotation.
He tells me what finally broke him. ‘There were these two already killed comrades,’ he begins. ‘And just so that you understand me, it took us three weeks to reach and drag their bodies [from the location they fell] to the evacuation point. It took that time just for us to cover 1.5km [with the bodies].
‘Upon my return from that combat mission, my [comrade who] was responsible for moral and psychological support saw and understood what had happened to me.
‘He asked if I needed to get help and I said: ‘Yes, I think I need it.’
He said of the symptoms of his condition: ‘There was an anger, some kind of hatred. Not necessarily towards the enemy, but in general, some kind of hatred appears in oneself. It’s like a lump inside you.’
We are introduced to Oleksii at a pioneering rehabilitation centre, set up by 33rd Brigade, deep in the eastern Ukraine countryside, where front-line soldiers suffering from combat fatigue are given respite and a chance to recover.
In Kurakhove in January, we were surprised to find that a quote by the British author Neil Gaiman had been translated into Ukrainian and painted under a bucolic mural on the exterior wall of an angling equipment shop next to the town’s reservoir.
It read: ‘It’s not the fish you catch, it’s the peace of mind you take home at the end of the day.’
The mural remains intact, albeit obscured now by a blast wall. The quotation, as far as Kurakhove is concerned, becomes more darkly ironic by the day.
But on this picturesque rural smallholding, its message is made real. The September sun is setting over a small lake where two men fish. Dogs bark, a cockerel cries and an autumnal wind is moving through the trees.
It has to blow a little stronger and in the right direction in order for you to hear the pounding of artillery on the front line, just 20 miles away.
Most of the time it doesn’t and that is just how these mentally bruised fishermen like it to be. Here, amid the calm, Oleksii tells me, ‘you can come to your senses’.
The 33rd Brigade was formed just in time to be thrown into last summer’s unsuccessful Ukrainian counteroffensive.
Now, in the autumn of 2024, they are helping hold the line against relentless Russian ground assaults around Kurakhove. The cost, both physical and mental, has been high. But here, up to seven soldiers who have been identified by comrades in the front line as suffering severe psychological distress can spend a week recuperating under the care of a team of counsellors.
Yulia, from Kupiansk in Eastern Ukraine, fights back tears as she describes the effects of war on her and her family
Smoke from a recent missile strike shrouds the main road between Kramatorsk and Slovyansk
Kos, commander of the 1st Mechanised Company, of the 56th Brigade, puts his head in his hands as he describes the trauma suffered by his men
There are any number of indicators that a soldier is on or past the brink, I am told by a carer who goes under the call sign Godzilla.
‘The signs of an acute reaction to stress are not immediately visible,’ he says. ‘Sometimes a certain time passes and then the serviceman realises what he has done.’
Godzilla adds: ‘A person can return from a combat position high on adrenalin and everything seems to be
fine with him, but then the adrenalin goes and he starts having hallucinations, disorders and other reactions. A lot of different reactions.’
Triggers can range from the sound of artillery or jets and, most commonly, the death or injury of close colleagues, to the particular colour of a shirt or the smell of gunpowder.
Ukraine’s Generation X is carrying the burden of fighting this war and that middle-aged group is most vulnerable to such psychological reactions, says Lieutenant-Colonel Ruslan, deputy commander of 33rd Brigade.
‘The average age of a patient here today is 45 and severe combat stress is suffered by those aged 40 to 50 more often than not. That said, all military personnel who perform tasks on the very front lines are mentally affected. In other words, they are all sick, roughly speaking.’
The rehabilitation team eat and sleep alongside the men. No alcohol is allowed. There are alfresco film shows every night. Physical and mental rest is given priority.
A German teacher before the war, Lieutenant Andrii is now in day-to-day charge of the rehab centre. He explains why there are so many cats and dogs on the property. Damaged soldiers don’t speak to each other, but a cat or dog can come to a soldier and make contact with him.
‘This is the first very important thing. The soldier trusts the animal. This animal is not dangerous. Secondly, it’s very important that soldiers can speak some difficult words or thoughts to a cat that he cannot speak to another soldier.
‘A cat or a dog cannot betray these words to other people or to their commander.
The aftermath of Russian attacks on the city of Lviv in which several people died
A man tries to direct traffic in the town of Kurakhove in Eastern Ukraine, a town expected soon to be over-run by advancing Russian forces
‘He trusts the cat and the dog and that is very important.’
Soon the 33rd will also begin equine therapy – horse riding and management – for their battled-shocked men. They claim that after seven days at the centre, around 90 per cent are fit to return to their front-line units.
Trauma among the civilian population here is just as big a problem. Everyone knows someone who has been killed, injured or displaced. Everyone is a target.
Our latest month-long trip has been a journey through Ukraine’s mental anguish. Nowhere is safe. We arrived in the western city of Lviv – some 800 miles from the fighting in the east – in time to witness a night-time missile attack on a residential block that killed a mother and her daughters, leaving a wounded and distraught father to follow their bodies being stretchered to the ambulances.
At the other end of the country, in Kramatorsk, an industrial city next to the Donbas front line, our temporary home was shaken when a Russian Tornado S missile carrying cluster munitions, landed in a nearby residential street, next to a playground. A 16-year-old girl was left with critical injuries.
The following day we saw the tell-tale contrails of a Russian jet launching yet another huge glide bomb towards the city. The air-raid sirens wail almost relentlessly.
How much more can the people take?
We met Yulia at a psychological rehabilitation and counselling centre in Kyiv run by the Mercy Health Foundation.
Aprecious period of calm for Oleksii (in red) and his comrades at the pioneering rehabilitation centre 20 miles from the front lines in Eastern Ukraine
She is a refugee from Kupiansk in Kharkiv Oblast, along with her two daughters, Victoria and Milena, aged seven and nine. Her soldier husband Oleh was captured in 2022 and remains a prisoner in Russia. She has received just one letter from him, via the Red Cross.
Yulia breaks down into tears as she tells me she can’t bear to tell her daughters that their father is a captive.
‘I just say to them that the phone connection is bad on the front line so he cannot call us,’ she says. ‘It’s very hard and often I want to scream and cry. But I know I must keep those emotions hidden and be strong for them. Knowing Oleh is out there somewhere gives me strength.’
Winter and the third anniversary of the full-scale invasion is approaching. Russia is expected to redouble its missile blitz on Ukraine’s power stations. Millions of homes will no doubt go without light or electricity again in the coldest, darkest, most bitter months. It is deliberate psychological warfare.
Kurakhove might fall but, like those road painters, embattled Ukraine must not lose its determination to endure.
Additional reporting: Oleksandr Kostiuchenko