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A psychiatrist unpacks her relationship with driving, and her dad.
I remember vividly the night I came home with my newly obtained driver's license. I was 18 years old.
My mother congratulated me. Papà, on the other hand, took the document from my hands and said: "You will only get this back when you pass the most important test. Mine."
Despite my protests, a challenging period started for me — surely tougher than my driving lessons.
My father loved driving but he did not tolerate any distractions or triviality in the car.
In particular, he said, "When you drive, always think about what is behind you. It could be you in their place. Behave accordingly."
Finally, one morning, I found my driver's license waiting for me, on the nightstand beside my bed.
It meant that I had passed the exam — even if my father hadn't said a word about it.
More importantly, it meant that I had earned his trust.
Years later, when my father could no longer drive, he would only let me drive him to his chemotherapy.
I remember our conversations when we went to the hospital.
Never another critique of my driving.
As if that personal test of his had sealed a pact for life between us.
Then his earthly life came to an end, but that unspoken alliance lives within me every time I drive, and fits perfectly with my being a psychiatrist.
And because of that, I can't get angry when I'm in the car.
I think of him and I watch others as they drive.
And the highway in my mind turns into a diagnostic manual of nostalgia and psychopathology.
A psychiatrist unpacks her relationship with driving, and her dad.
I remember vividly the night I came home with my newly obtained driver's license. I was 18 years old.
My mother congratulated me. Papà, on the other hand, took the document from my hands and said: "You will only get this back when you pass the most important test. Mine."
Despite my protests, a challenging period started for me — surely tougher than my driving lessons.
My father loved driving but he did not tolerate any distractions or triviality in the car.
In particular, he said, "When you drive, always think about what is behind you. It could be you in their place. Behave accordingly."
Finally, one morning, I found my driver's license waiting for me, on the nightstand beside my bed.
It meant that I had passed the exam — even if my father hadn't said a word about it.
More importantly, it meant that I had earned his trust.
Years later, when my father could no longer drive, he would only let me drive him to his chemotherapy.
I remember our conversations when we went to the hospital.
Never another critique of my driving.
As if that personal test of his had sealed a pact for life between us.
Then his earthly life came to an end, but that unspoken alliance lives within me every time I drive, and fits perfectly with my being a psychiatrist.
And because of that, I can't get angry when I'm in the car.
I think of him and I watch others as they drive.
And the highway in my mind turns into a diagnostic manual of nostalgia and psychopathology.
The country's worst economic crisis in decades has toppled the government and led to soaring prices. Pregnant women struggle to access essential supplies.
Kirushna Sutharshan separates a basket of wild greens she has gathered forher family’s lunch.
INUVIL, SRI LANKA — At sunset, as her young son plays nearby and her husband has yet to return from work, Kirushna Sutharshan forages for edible plants near her home.
She bends carefully over her expanding belly — her second child is due in August — but ignores the discomfort. The prices of milk, eggs, spinach and other foods recommended for healthy pregnancies have tripled since January; the once-free iron supplements are no longer available at prenatal checkups at public hospitals; and she cannot afford vitamins at private pharmacies. Even Thriposha, a corn-based nutritional supplement usually distributed to pregnant women for free, is no longer available.
“What can I do?” Sutharshan says, adding that her doctor has warned her that her iron levels are too low. “In the current situation, I cannot afford to buy iron-rich spinach from the market.”
Sri Lanka has worked hard to improve its maternal and infant mortality rates, through advancements in sanitation and health care access. In 1950, a year before free health care was nationalized, 10% of newborns didn’t survive past their first birthday; in 2020, the first-birthday survival rate had reached 99%. But as the country dives deeper into economic turmoil — with the president agreeing to resign, according to a statement by Parliament’s speaker, after thousands of protesters stormed his home — public health experts warn that these gains will be reversed. Foods, vitamins, medicines and medical supplies needed for safe, healthy pregnancies have become unaffordable and inaccessible.
In June, the United Nations Children’s Fund, known as UNICEF, issued a $25.3 million fundraising appeal for Sri Lanka, including funding to provide 122,000 pregnant mothers with cash or voucher assistance. “All essential health services have been severely impacted by critical shortages of medicine,” according to a UNICEF statement. There are ongoing stockouts of essential medicines affecting pregnant and lactating women and children, which are likely to continue for several months.”
For decades, Sri Lankans could obtain free medications from government hospital dispensaries or at affordable prices from private pharmacies. But in March, the National Medicines Regulatory Authority approved a 29% price increase for all medicines, followed by a 40% price increase for 60 medications in April.
Murali Vallipuranathan, a Colombo-based community physician, confirms that imported medications and equipment for cesarean sections and other fetal and neonatal surgeries have become more expensive and difficult to procure. Due to power outages, pharmaceuticals that require refrigeration end up having to be thrown away, he adds.
Physicians, nurses and health associations are campaigning for more attention to the growing crisis, including circulating a list of supply donations requested by the Sri Lanka Medical Association.
Balasubramaniam Manikandan, a Jaffna pharmacy owner, says business has slowed as the prices for vitamins recommended for pregnant women, including folic acid, vitamin C, iron tablets and calcium, have skyrocketed. Black market sellers are also buying and hoarding the supplies, then selling them at even higher prices, he complains.
“Because of the economic condition of the nation, some medicines are not at all available. There is a general shortage of medicines for people from all walks of life, including pregnant women, diabetics, cancer patients and children,” he says, adding that he has gone from restocking his shelves twice a month to once a month.
In May, Japan donated $1.5 million, through UNICEF, in medicine for Sri Lankans, including 53,000 pregnant women and nearly 122,000 children in immediate need. Since then, pledges of aid and loans have also come in from Australia, China, India, the Asian Development Bank, the International Fund for Agricultural Development and the World Bank.
Sri Lanka’s annual drug purchasing costs are $268 million, says Keheliya Rambukwella, the minister of health. The country’s existing stockpile and the anticipated foreign aid should be enough to last until 2024, he says, but “we will have a tough time until August,” and the “priority now is to make all medicines available to the people rather than affordable prices.”
Dr. Asela Gunawardena, director general of the Ministry of Health, says discussions are also ongoing with the World Food Programme and UNICEF to provide corn, so the country can produce more Thriposha for pregnant women.
Humanitarian aid may help Sri Lanka recover, but Selvarathinam Santhirasegaram, an economics professor at the University of Jaffna, says the country needs better leadership, less corruption and more long-term investments to become less reliant on imports for food, medicine and other health care needs.
“It’s a common saying that ‘we want to taste the fruit before planting the tree,’” he says. “We need to create large-scale farms, plantations and large-scale business ventures.”
Midwives write prescriptions for pregnant women at Primary Medical Care Unit in Jaffna, Sri Lanka.
Vijayatharsiny Thinesh, Global Press Journal Sri Lanka
Malnutrition is also a growing concern. A UNICEF survey in Sri Lanka in 2021 found that 43% of families were eating less than before the coronavirus pandemic, and that nearly 80% of families who qualified for therapeutic food aid for severely malnourished children hadn’t received the aid for over two months.
To combat these challenges, the former minister of finance, in his 2022 budget speech, expanded a nutrition voucher program for pregnant and lactating mothers from 10 months of aid to 24 months of aid. But as the economic crisis has persisted, this plan has not come to fruition, and the existing program has been suspended.
More than 80% of households are eating cheaper foods or limiting portion sizes, fueling higher rates of malnutrition, according to a joint survey by the World Food Programme and Sri Lanka’s Department of National Planning.
Vallipuranathan says he has observed more signs of malnutrition among pregnant women, as they prioritize feeding their husbands and children over themselves. He worries that the economic crisis will exacerbate the fact that 1 in 7 women in Sri Lanka is already reported to be malnourished during pregnancy and 1 in 8 children will be born with malnutrition, according to 2021 data from the Ministry of Health.
“What we are seeing now is just the beginning, and if this situation continues, the health sector could get worse. The next biggest problem we would face is malnutrition,” Vallipuranathan says. “This economic crisis may further affect middle-income pregnant women in the future.”
One such woman, Tharsini Ariharan, 36, a preschool teacher from Inuvil, and her husband, a management assistant at the state timber corporation, are expecting their third child this month. They have been spending her entire monthly income, 10,000 Sri Lankan rupees ($27.86), on the medicine and supplies she needs, she says.
“Currently, I have diabetes and high blood pressure during pregnancy, so I can see the expenses outweighing the income,” she says.
At her last prenatal checkup, her fetus was underweight and she was advised to eat more grains. These types of foods are expensive, but Ariharan says she is trying to budget for small quantities.
For Sutharshan’s family, the 2015 government program that provides pregnant women 2,000 rupees ($5.58) per month in food assistance for 10 months had been a lifeline. But due to inflation, she was getting fewer food products for the same amount during her second trimester — and since entering her third trimester, the program has been suspended.
“I do not know whether to buy things needed for me or for my elder son or the food products needed to prepare the daily food,” she says tearfully.
Her husband can’t find more work, and her iron deficiency is not improving. Fuel shortages have also made transportation difficult, so they have decided to move in with her parents to combine resources for the sake of their child and his new sibling — due in a matter of weeks.
“I’m with my parents now,” she says, “and they are feeding my family.”
The country's worst economic crisis in decades has toppled the government and led to soaring prices. Pregnant women struggle to access essential supplies.
A psychiatrist unpacks her relationship with driving, and her dad.
Venezuela is to create free economic zones to attract foreign capital into the Venezuelan economy, but who would take "clean" money to a lawless land run by rapacious revolutionaries?
Bot did you get it?
Central to the tragic absurdity of this war is the question of language. Vladimir Putin has repeated that protecting ethnic Russians and the Russian-speaking populations of Ukraine was a driving motivation for his invasion.
Yet one month on, a quick look at the map shows that many of the worst-hit cities are those where Russian is the predominant language: Kharkiv, Odesa, Kherson.
Then there is Mariupol, under siege and symbol of Putin’s cruelty. In the largest city on the Azov Sea, with a population of half a million people, Ukrainians make up slightly less than half of the city's population, and Mariupol's second-largest national ethnicity is Russians. As of 2001, when the last census was conducted, 89.5% of the city's population identified Russian as their mother tongue.
Between 2018 and 2019, I spent several months in Mariupol. It is a rugged but beautiful city dotted with Soviet-era architecture, featuring wide avenues and hillside parks, and an extensive industrial zone stretching along the shoreline. There was a vibrant youth culture and art scene, with students developing projects to turn their city into a regional cultural center with an international photography festival.
There were also many offices of international NGOs and human rights organizations, a consequence of the fact that Mariupol was the last major city before entering the occupied zone of Donbas. Many natives of the contested regions of Luhansk and Donetsk had moved there, taking jobs in restaurants and hospitals. I had fond memories of the welcoming from locals who were quicker to smile than in some other parts of Ukraine. All of this is gone.
According to the latest data from the local authorities, 80% of the port city has been destroyed by Russian bombs, artillery fire and missile attacks, with particularly egregious targeting of civilians, including a maternity hospital, a theater where more than 1,000 people had taken shelter and a school where some 400 others were hiding.
The official civilian death toll of Mariupol is estimated at more than 3,000. There are no language or ethnic-based statistics of the victims, but it’s likely the majority were Russian speakers.
So let’s be clear, Putin is bombing the very people he has claimed to want to rescue.
Putin’s Public Enemy No. 1, Ukrainian President Volodymyr Zelensky, is a mother-tongue Russian speaker who’d made a successful acting and comedy career in Russian-language broadcasting, having extensively toured Russian cities for years.
Rescuers carry a person injured during a shelling by Russian troops of Kharkiv, northeastern Ukraine.
Vyacheslav Madiyevskyy/Ukrinform via ZUMA Press Wire
Yes, the official language of Ukraine is Ukrainian, and a 2019 law aimed to ensure that it is used in public discourse, but no one has ever sought to abolish the Russian language in everyday life. In none of the cities that are now being bombed by the Russian army to supposedly liberate them has the Russian language been suppressed or have the Russian-speaking population been discriminated against.
Sociologist Mikhail Mishchenko explains that studies have found that the vast majority of Ukrainians don’t consider language a political issue. For reasons of history, culture and the similarities of the two languages, Ukraine is effectively a bilingual nation.
"The overwhelming majority of the population speaks both languages, Russian and Ukrainian,” Mishchenko explains. “Those who say they understand Russian poorly and have difficulty communicating in it are just over 4% percent. Approximately the same number of people say the same about Ukrainian.”
In general, there is no problem of communication and understanding. Often there will be conversations where one person speaks Ukrainian, and the other responds in Russian. Geographically, the Russian language is more dominant in the eastern and central parts of Ukraine, and Ukrainian in the west.
Like most central Ukrainians I am perfectly bilingual: for me, Ukrainian and Russian are both native languages that I have used since childhood in Kyiv. My generation grew up on Russian rock, post-Soviet cinema, and translations of foreign literature into Russian. I communicate in Russian with my sister, and with my mother and daughter in Ukrainian. I write professionally in three languages: Ukrainian, Russian and English, and can also speak Polish, French, and a bit Japanese. My mother taught me that the more languages I know the more human I am.
At the same time, I am not Russian — nor British or Polish. I am Ukrainian. Ours is a nation with a long history and culture of its own, which has always included a multi-ethnic population: Russians, Belarusians, Moldovans, Crimean Tatars, Bulgarians, Romanians, Hungarians, Poles, Jews, Greeks. We all, they all, have found our place on Ukrainian soil. We speak different languages, pray in different churches, we have different traditions, clothes, and cuisine.
Like in other countries, these differences have been the source of conflict in our past. But it is who we are and will always be, and real progress has been made over the past three decades to embrace our multitudes. Our Jewish, Russian-speaking president is the most visible proof of that — and is in fact part of what our soldiers are fighting for.
Many in Moscow were convinced that Russian troops would be welcomed in Ukraine as liberating heroes by Russian speakers. Instead, young soldiers are forced to shoot at people who scream in their native language.
Starving people ina street of Kharkiv in 1933, during the famine
Diocesan Archive of Vienna (Diözesanarchiv Wien)/BA Innitzer
Putin has tried to rally the troops by warning that in Ukraine a “genocide” of ethnic Russians is being carried out by a government that must be “de-nazified.”
These are, of course, words with specific definitions that carry the full weight of history. The Ukrainian people know what genocide is not from books. In my hometown of Kyiv, German soldiers massacred Jews en masse. My grandfather survived the Buchenwald concentration camp, liberated by the U.S. army. My great-grandmother, who died at the age of 95, survived the 1932-33 famine when the Red Army carried out the genocide of the Ukrainian middle class, and her sister disappeared in the camps of Siberia, convicted for defying rationing to try to feed her children during the famine.
On Tuesday, came a notable report of one of the latest civilian deaths in the besieged Russian-speaking city of Kharkiv: a 96-year-old had been killed when shelling hit his apartment building. The victim’s name was Boris Romanchenko; he had survived Buchenwald and two other Nazi concentration camps during World War II. As President Zelensky noted: Hitler didn’t manage to kill him, but Putin did.
Genocide has returned to Ukraine, from Kharkiv to Kherson to Mariupol, as Vladimir Putin had warned. But it is his own genocide against the Russian-speaking population of Ukraine.