This led Mazhak to Ireland, which would lead to an interesting interdisciplinary research project with Ukrainian female refugees. “Compared to the Czech Republic, in Ireland, there’s a different culture, different social policies. There are also socio-demographic differences between the refugees that came to Ireland and went to the Slavic neighbouring countries.”

Mazhak discovered that her research was addressing a vital and under-explored area. The novelty of the research is obtaining through interdisciplinary methodology to provide evidence-based health profiles and identification of health needs for female refugees settled in the Czech Republic and Ireland during the process of forced migration, adaptation, and integration into a new environment.

Her research has a concurrent mixed methods research design where both quantitative and qualitative data are collected and analysed at the same time. The main objectives are to document the self-reported physical health of Ukrainian refugees, including any changes since the Russian invasion of Ukraine; to identify specific aspects of mental health and coping strategies; to assess how separation from family and loved ones influences social health: defined as the personal ability to interact with others and adapt in variable social situations; to examine how physical, mental, and social health statuses are associated with coping strategies; to explore Ukrainian refugees’ health care needs, and access to health services in host countries; to develop Ukrainian female refugees’ health profiles through the synthesis of such indicators as physical, mental and social health status, determinants of health, behaviour risk factors, health care needs and utilisation; and to assess common and different aspects of health profiles and coping strategies of Ukrainian female refugees settled in the Czech Republic and Ireland.

To collect quantitative data she designed an online survey asking participants questions in the areas of physical, mental and social health. This survey also incorporated five psychological instruments to measure perceived stress, depression, anxiety, post-traumatic stress disorder, and coping strategies. These psychological instruments were translated from English to Ukrainian, and validated in the Ukrainian female refugee sample. The reliability of the tools was measured by Cronbach’s alpha. To evaluate the construct validity of the scales as well as reveal factor structures and correlations among items, confirmatory and explanatory factorial analyses have been used.

Researchers from other countries have already reached out regarding the Ukrainian version of psychological instruments, interested in speeding up their research time: “I always say, you are welcome to use it because if we collect this information from refugees in different cultures in different countries, it will be very interesting to compare results.” She cautions that, while it is good to see a lot of interest in researching the Ukrainian refugee crisis, it is very important that it is done in a historically, socially and culturally aware manner.

Dr Mazhak’s qualitative study included a social media analysis of public groups’ posts and comments where refugees participate in the Czech Republic and Ireland. “As the researcher who belongs to the refugee group, I am included in social media groups where the topics of health care needs, access, and usage in the host country are widely discussed. Nowadays, little is known about how social media groups are used to provide and share information about the healthcare system and perceived issues with it”. Moreover, she is conducting semi-structured individual in-depth interviews to explore respondents’ self-reported physical, mental, and social health during the main periods: pre-migration, transition, settlement, and post-migration as well as coping strategies and assessment of their and their children’s socio-medical needs. There is an advantage because “I have a similar experience with participants, we share cultural background, I have a good understanding of circumstances, also the trust between interviewer and participant is very important”.

Then combined qualitative and quantitative findings from the Czech Republic and Ireland will be analysed and compared using the social-ecological model as a framework for the interpretation of integrated data at individual, interpersonal, organisational, and community levels.

“It’s no secret that Ukrainian refugees have problems with access to healthcare systems in most host European countries,” Mazhak notes. “No one expected 5 million additional people to join the population all at once, and 80% of them are women with children, which means they require a lot of access.” How could these challenges be addressed? According to Mazhak, by employing more Ukrainian medics in Ireland. “There are a lot of Ukrainian female doctors in the Czech Republic, who started working from the beginning of the war as assistants to Czech doctors to help with communication issues.” Now in the second year of the war, this problem remains in Ireland. “There are many doctors with good backgrounds and education who could be employed in Irish healthcare. There are a lot of dentists’ offices here, with a straightforward procedure to enable Ukrainian dentists to become certified in Ireland. It makes a lot of sense to employ Ukrainian doctors as family doctors, especially when you have 200 Ukrainians living in one place.”

Throughout all this, she is keeping up the considerable challenge of teaching in Ukraine, coordinating modules in her two home universities. These courses are being conducted online: many Ukrainian students are, like Mazhak, elsewhere in Europe. “When you teach online, it's very important to remember who is still in Ukraine, particularly during times of shelling to tell them to go to a shelter. I had a group where we couldn't hold classes for two months because of constant shelling. We record all classes so they can watch them at home when it's possible. It’s been a big problem because of the electricity shutdown and Internet access for students.”

Despite these almost insurmountable challenges, however, Mazhak believes in the human ability to adapt to different situations. According to her “The preliminary research outcomes from the Ukrainian female refugees sample in the Czech Republic showed that refugees more often used effective problem-focused coping strategies. Moreover, it was proved that ineffective coping strategies of self-blame and behavioural disengagement were associated with poorly reported general health/psychological status and effective coping strategy was positively associated with the better-reported psychological status of female refugees.”

“The MSCA4Ukraine Program gave me the ability to plan my life, in times of uncertainty, for the next 24 months, to conduct research, and continue to teach students in Ukrainian universities. I hope that RCSI will give me opportunities to establish collaborations with Irish researchers in my field. I’m especially interested in developing cooperation with researchers from migrant health studies”.