There is a hidden secret that everyone working on the front line in Ukraine knows: the use of prostitutes is rife. When I first arrived in Ukraine I worked undertaking civilian aid supplies in the Zaporizhzhia, and I slept on the floor in the office of a brothel just opposite a military base. I saw different men go in, with the same two girls, to the various rooms every day, as their girlfriends for a couple of days. Denied alcohol, the soldiers resort to other pleasures that are not banned. Smoking is one of them, and sex is another. These girls would come out from their experiences with each soldier utterly exhausted, as the soldiers had taken out all their stress and frustration in having sex with them. The sound of sex was everywhere as I slept in this office. Every bedroom was heaving with grunting and groaning; and in Ukraine (as in Russia) there is a curious stigma against the use of condoms. The reason I had to sleep in the office, by the way, was because the other rooms for the most part came with a girl for a heavier price and you couldn’t take a girl to the office because the sofa I was sleeping on was at best a single bed. There was a shop next door to the brothel where the proprietors of the brothel would quietly buy beer for the soldiers, so this was their vacation, because they were in Zaporizhzhia and far from their families and friends in the west, in a peculiar city surrounded by Russians on all but one side and it is 26 hours by train to Lviv.
The same soldiers would come in and out of this brothel pretending to be a hotel, where I had the distinctive displeasure of staying, smiling as they left their girlfriends and went back to the barracks. Then the girl, in some cases quite exhausted, would have a new boyfriend, possibly within half an hour, and this routine would begin all over again. The room with the girl was about 50 Euros a night, if I remember correctly; you will understand that I did not participate myself. Those soldiers who did not want to have a girlfriend instead bought dogs and walked them lonesomely around the city during their time off, because they are not allowed to go to the bars and Zaporizhzhia’s de facto curfew means that everything closes gloomily early so all there is for the soldiers to do is to have sex with prostitutes. Which they do. I think that hotel cum brothel was struck by a Russian missile recently but I haven’t checked as it’s a place I never intend to go back to. Those dank, dirty rooms with soiled sheets and endless soldiers having sex with the same girls rather disgusts me. One of my colleagues laughingly described them as patriots but I don’t think that’s an appropriate way to deal with the situation.
Prostitution is the world’s oldest trade, as it is often said, and particularly in times of war it is particularly common as soldiers, surrounded exclusively by other males (or almost exclusively so), miss female company and are therefore prepared to pay for it. But the scale upon which this is taking place all along the front line in Ukraine is extraordinary.
When I went to Kherson I was offered an erotic massage around the back of a car repair workshop. Again in Kherson everything closes gloomily early (apart from the shelling) and there is no alcohol so the soldiers resort to this kind of thing. I don’t know what you get for your erotic massage but I passed on the offer; it is one of the few things you can do in Kherson after 6pm at night. Apparently the cost is 30 Euros. I imagine it involves unprotected sex, because there really is an aversion in Ukraine to the use of condoms and that is all very well but where you reach high levels of promiscuity such as in situations of prostitution, and indeed the same girls having multiple partners each day over an extended period of time, condoms really are essential to prevent the transmission of sexually transmitted infections.
Before we come to the issue of sexually transmitted infections, let me say a little more about brothels and prostitutes on the front line. These organisations are invariably organised by elderly women who exploit younger women. There is no shame involved in quietly saying you would like a girl for the night, and I have quoted you the sorts of prices that you may pay. Sometimes there are offers where you get a bottle of whisky or vodka including with your girl, and for a soldier that is a real advantage so you might pay 100 Euros in total for the girl and the bottle of alcohol. When I tried to book a hotel in Kramatorsk (I will not name which one) I was told that the room only came with a girl and a bottle of vodka; I couldn’t have the room on its own, and the price was 100 Euros a night. In other words the room was essentially free, as long as I took the prostitute and the vodka. Kramatorsk is a front line city in Ukraine where soldiers go to “relax”; again there isn’t much to do in Kramatorsk, an empty industrial city even before the Russian invasion of Ukraine. There are some bars that don’t sell alcohol (including a “pub” that serves no beer) and everything closes by 8pm. So the town is full of prostitutes, and if you want one you just ask around. Kramatorsk is possibly the prostitution capital of Ukraine at the moment. These girls are typically dotted around specific establishments and again they receive a lot of customers, not all of whom treat the girls kindly, and contraception is not used. Also the girls may try to steal from the soldiers, so the entire phenomenon is risky, dangerous and unpleasant for all parties.
Izium and Kharkiv are also both centres for prostitution. They are outside Donetsk oblast where alcohol is officially banned and therefore more relaxation options come with the cities. However they both close early, in particular Izium, but the prostitution continues after hours. Prostitutes also enter military bases across the Donetsk and Kharkiv regions, and nobody really seems to consider this a problem. They enter and leave those bases without any control, and it is understood that they just exist to please the specific men and then they may come back the next day. Sex in these circumstances is about 30 to 40 Euros a night, depending on the standards the soldier is asking for. It is all so natural that nobody bats an eyelid and if you want this service you just ask for it and it will be given to you.
Now the practical consequences of all this is that sexually transmitted diseases are rampant along the front line because the soldiers have all been sleeping, unprotected, with the same women who have been transmitting diseases between the soldiers. The principal infections inflicting soldiers are HIV, Hepatitis A, Hepatitis C, syphilis, gonorrhoea and urinary tract infections. And because of the stigma associated with sexually transmitted diseases in Ukraine, these problems are not talked about and the soldiers are not tested for these diseases nor are they treated. Most sexually transmitted diseases can be dealt with using medications, if caught early enough. But because there is no routine testing for sexually transmitted diseases, the soldiers suffer the symptoms (most STD’s have no or few symptoms initially but serious potentially life-threatening symptoms can occur later) without complaint or without even knowing they have the conditions in many cases. And they continue to spread them through the use of prostitutes, until soon virtually everyone has some STD or other. Hence for the medical staff treating wounded soldiers, one of the biggest risks that they must take care to prevent is the transmission of STD’s from soldiers to medical personnel.
Unfortunately the facilities in stabilisation points and front line field hospitals, where wounded soldiers are first treated, often lack the basic equipment needed to prevent the transmission of sexually transmitted diseases. Gloves are obviously the first thing any medical staff needs when treating a patient all of whom on the front line must be presumed to be potentially carrying a serious sexually transmitted infection. But there can be shortages even of gloves; this author has been given gloves far too small for him on several occasions with the result that they snap. Loose sharps (needles) are everywhere because elementary hygiene standards are not observed in these field hospitals and stabilisation points. The situation is ghastly and medical staff are taking serious risks contracting sexually transmitted infections from their patients because STD’s are transmitted in the blood and wounded soldiers tend to be covered in a lot of blood.
Most sexually transmitted diseases, if identified early, can be treated easily, some as simply as with a course of specific antibiotics. Syphilis can be be treated with penicillin, the most elementary antibiotic. A non-specific urethritis can be treated with medicines as simple as doxycycline or erythromycin. Gonorrhoea is slightly more complicated to treat and requires a dual antibiotic regimen of ceftriaxone and azithromycin. HIV treatment is more complicated with sophisticated antiretroviral medications that can be expensive but it is treatable and it should be treated; it is life-threatening if left untreated for years (as indeed are many sexually transmitted diseases). There is no discussion of this problem and soldiers need education both on safe sex and on the importance of recognising and treating STD’s rather than ignoring pains in the genital area, pains when urinating and all the other signs that you may have an STD.
Ukraine has one of the highest HIV rates in Europe, with an estimated 1% of the population being HIV positive most without even knowing it. That is because promiscuity is common, particularly amongst soldiers who are separated from their wives, girlfriends and other social circles; use of condoms is scant; attitudes towards sex education are insufficient; and the appropriate medical treatment and expertise is not available in sufficient supply, particularly on the front line. Therefore Ukraine proliferates sexually transmitted diseases and this is one of the hidden problems facing Ukraine that it absolutely has to stand up to if the country is to progress towards Euro-Atlantic integration. There is probably no way of eliminating the exorbitant levels of front line prostitution, given the long tours of duty soldiers are subject to and there being little else for them to do in the way of recreation. You could put bromides in their tea but I doubt the central command of the Ukrainian Armed Forces is sufficiently far-sighted to do that. However all soldiers must be educated about condom use and sexually transmitted infections, and hospitals and other medical facilities along the front line need to be stocked with testing kits for STI’s and with the appropriate antibiotic and other treatments. Otherwise we are facing a pandemic, that will result in still more suffering and dying.