The story of Natalia, Ukrainian combat medic
Article written by Jorge Aranda, founder and CEO of Hands With Heart.
I met her in Denmark, during the collaboration between Hands With Heart and Repower, in the organisation’s 15th programme. It was my seventh mission with them. The meeting brought together some 66 combat medics for a physical and emotional recovery programme.
Natalia was the last person I saw that day. It was around half past eleven at night. Ukrainian, 29 years old, a decade in the army. Brunette, hair tied back, slightly overweight. A phoenix tattoo on her left forearm. A slight gap between her upper incisors. Between 1.65 and 1.70 metres tall, with good posture.
During the initial interview, Olena, a Ukrainian translator with a good level of English, facilitated communication. Natalia kept her hands clasped, used frequent gestures when speaking and crossed her feet under the chair. Her tone of voice was loud and clear, almost powerful. She sought eye contact with Olena when expressing herself.
Natalia, a combat medic in Ukraine, was a prisoner of war for six months. She reported various ailments as a result of torture.
She recounted that she was beaten daily, including on her back and head… they used sticks.
Pains reported by the patient
(combat medic in the war in Ukraine)
Natalia said that her entire back hurt: cervical, dorsal, lumbar, sacral, and coccygeal regions. I explained that it was unusual to find significant injuries in the dorsal region without a specific cause and asked her if she had suffered any trauma that would explain it. She replied that she had: she had spent six months in captivity as a Russian prisoner of war.
Assessment of the patient as a prisoner of war
She asked me to ask her whatever I needed for the assessment. She reported that she was beaten daily, including on her back and head. She confirmed that sticks were used, but denied electrocution or damage to her fingernails. When asked about sexual assault or trauma to the pelvic or reproductive area, she replied with certainty that this had not occurred.
She added that, in addition to the beatings, she was forced to maintain uncomfortable positions for long periods of time. One position involved standing next to a wall without leaning on it, with her legs spread as wide as possible and her arms stretched above her head, hands together. Men were allowed to rest their hands on the wall, but women were not.
Another common position was sitting in a chair, hunched over, with her head as close to her knees as possible. Sometimes she had to maintain this position while standing. The arms were held behind the back, elbows bent, with a stick passing through the crook of one elbow, behind the back, and out through the crook of the other. Standing, the torso was bent at 90 degrees from the hips, with the gaze fixed on the floor, the spine in maximum lumbar, dorsal and cervical flexion.
He had to maintain these positions for hours, sometimes walking like this. He linked these postures to his current pain. He said he went hungry and cold, conditions shared by other patients who have suffered captivity. He pointed to the treatment bed—approximately 1.9 metres long and between 50 and 60 centimetres wide—to explain that three people slept sideways on a similar surface. The discomfort was compounded by the fact that, after the torture, rest was never restorative.
In similar cases, those released—often through prisoner exchanges between armies—show noticeable weight loss, with prominent ribs and weakened limbs. Subsequently, they tend to regain weight. Natalia, at that time, looked plumper.
The examination found palpable irregularities in the spine and rib cage, consistent with blows and possible rib injuries.
The treatment
Treatment began with cranial work, assessing possible injuries from repeated blows and seeking to determine whether they had affected the visual system and overall postural tension. The aim was also to offer gentle, controlled contact, after her previous experience of painful massages and unsuccessful medical consultations.
The abdominal region was treated, founding neuromuscular reflexes linked to chronic stress and anxiety. Self-care techniques were taught to promote self-regulation. Work on the sacrum and coccyx was postponed to a subsequent session, requesting that she wear shorts to perform more specific manoeuvres on the hips.
During the first session, an eye assessment was also performed, detecting double vision in a semicircular follow-up above the horizontal plane of gaze. At the end, after gentle cervical and dorsal manipulations, she reported relief and the double vision had disappeared. She left smiling.
The next day, at breakfast, she came over to say in Ukrainian that she was feeling much better, even though she knew I didn’t speak the language.
In the second session, she came wearing shorts, although they were made of stiff fabric. We worked on her lumbar, sacral and rib areas, and also used pinching and rolling techniques on her thighs and legs. The patient reported pain with this last manoeuvre and expressed concern about her chances of recovery. I explained that she would make a full recovery, that her pain threshold was altered by chronic stress, and that her biomechanics were not seriously damaged.
She understood that her symptoms were amplified by her current circumstances and that, with the end of the war and a period of relaxation, she would see a noticeable improvement. The patient expressed relief.
The next day, she came back to see me to say that she was feeling much better and to thank me for my work.
