Oksana Dutchak says in the face of war, crisis and neoliberal policies, struggles for care need to be supported in Ukraine
For years Ukrainian society has faced challenges of care gaps, due to socio-economic instability and poor policies, resulting in degradation or dismantling of social infrastructure and support. Russia’s large-scale invasion in 2022 worsened the situation with thousands killed and wounded, millions displaced internally and across borders, breaking of care support networks, spiralling demographic crisis, destruction of facilities and insufficient or shrinking funding for public care infrastructure.
I have observed these processes as a woman living in Ukraine with children, who has older relatives requiring care, as well as being a left feminist and researcher, focused on care. I’ve witnessed shifting political discourses – from child, medical, geriatric, disability care as social rights (however poorly realized after Ukraine’s independence) to “social services” which can either be delivered or not, depending on the “capacities” and political will of local and central authorities.
This shift was manifested first in radical austerity measures, a response to socio-economic downturn after 2014, and later as consolidated and holistic sectorial reforms, supposed to deliver better quality of care more “efficiently”. The reforms started with healthcare in 2018 and continued (to a lesser extent) in childcare and education, finally penetrating social policy reform in 2020. The underpinning idea was “money following people”, financing basic services instead of infrastructure, introducing official payment for “non-basic services” and the creation of quasi-market settings where “providers” compete for funding.
The motto of efficiency and the new funding structures led to closure of many healthcare centres, schools and other facilities, predominantly in rural areas. People living in those areas, as well as in territories close to the then frontline in Eastern Ukraine, often had problems physically accessing care. This was recognized by mainstream international organisations like UNDP.
None of the reforms introduced direct mechanisms to address poor wages in care sectors. Taking into account that almost a quarter of Ukrainian women work in care sectors, the reforms were therefore ignoring both workers’ and gender inequality issues. The predominantly female workforce of the many public care facilities often came close to achieving minimum or rather poverty wages (currently €142 net per month). These facilities were also chronically lacking personnel with high rates of labour turnover. Meanwhile the situation of nurses, kindergarten staff and social workers were beyond the focus of the reformers.
Russia’s large scale invasion of 2022 brought a new crisis of unimaginable scale. The Russian army has been occupying cities and villages, targeting ambulances, using double-strikes to kill rescuers and medical workers, destroying and damaging hospitals, schools, kindergartens, residential care centres and other facilities. While some territories remaining extremely dangerous with care workers struggling to address local needs, others host increasing numbers of people fleeing the war, and struggle to address their needs with insufficient resources. There are territories where public schools and kindergartens are basically closed or have been teaching online since February 24th 2022.
As elsewhere, care gaps are managed by families. Triggering severe economic crisis in Ukraine, the Russian invasion pushed many families into poverty, where increasing care obligations of (predominantly female) family members restricts job options in the shrinking labour market, and skyrocketing inflation limits possibilities for privately funded care. The war brought another dramatic change whereby previously established care support networks (families, friends, neighbours, communities) have often been broken by displacement both inside the country and across borders. For instance, I became a refugee and an enforced single mother of two, without my husband and relatives to step in with childcare support when needed. It was one of the hardest experiences in my story of motherhood.
Struggles for care were developing in Ukraine before the Russian invasion. And most prominent is the movement of nurses #BeLikeNina which emerged as an informal network in the midst of healthcare reform and on the eve of Covid-19. It gradually developed into a large-scale movement and later trade union mobilisation of medical workers for better wages and working conditions, effectively campaigning for increased wages. The campaign continues to struggle for improvements in healthcare systems and labour conditions, despite the challenging circumstances.
In the dire situation created by war, economic crisis and neoliberal policies, one should remember that the need for care support in Ukrainian society has increased due to the war and related rapid and ongoing demographic shifts. With increasing numbers of injured and disabled civilians and military personnel, an urgent structural change is needed. Childcare support remains essential despite a slowing birthrate. Meanwhile, the proportion of elderly has increased with many working-age people leaving the country, making elderly care support crucial for the society’s future.
Some care issues are present in Ukrainian public and political discourse, except for elderly care which is barely discussed, and virtually absent in the visions and programmes for post-war recovery. The interests of carers and workers in public care facilities are rarely mentioned. In such a situation self-organised, grassroots movements such as #BeLikeNina are those which should be supported and whose voice should be reinforced, both at national and international level by those who care for the future of Ukrainian society.