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Rising mental health issues among humanitarian workers

ECHO | Association ECHO's mobile library.

Mental health issues among humanitarian workers are worryingly high, reports show, so why are NGOs still not prioritising their staff’s well-being?


In November 2016, at the wheel of their mobile library, post-graduates from King’s College London, Laura Samira Naude and Esther ten Zitjhoff, left Britain and headed to Greece’s refugee camps.

Armed with compassion and educational books in Arabic, English and Farsi, the duo travelled from camp to camp in their library on wheels, attempting to bring the hope and resources to the refugees as they prepared for their future in Europe. Thus, their project, the NGO ECHO Library (Education Community Hope and Opportunity) was born.

But as winter came, facing the many pressure that all NGOs in Greece face, Laura and Esther began to lose hope themselves: “Everything you try and do is met with obstacles, we didn’t have a huge support group and so after a while we just couldn’t cope, physically or mentally.”

Aid workers and volunteers in the humanitarian sector face traumatising situations that have been proven to cause them to experience anxiety, burnout, secondary traumatic stress, depression or PTSD, explains Matthew Saltmarsh, spokesperson for the United Nations High Commissioner for Refugees.

However, sometimes the lack of structure and support can be just as dangerous as the harsh environments these workers are facing.

“I received zero training at any time as an aid worker,” says Brendan McDonald, former aid worker at the United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA). McDonald highlights the lack of support and protection provided and admits he gets “very angry” when remembering his experience and what he was exposed to.

McDonald says when he ‘burned out’ and had to be prescribed with medication, it was not just because of what he had experienced in Syria, but also the “horrifically bad management”.

The former aid worker recalls how when asking his staff councillor for advice after a particularly traumatic experience in Syria, he was only sent a pamphlet on yoga.

A report conducted by the Antares foundation in 2013, found that 30% of aid workers had experienced PTSD, compared to 11% of US veterans who participated in the war in Afghanistan according to the US Department of Veterans Affairs.

Where are we going wrong?

Dr Idit Albert, a clinical psychologist specialising in anxiety disorders and trauma, believes that one of the problems is the stigma of mental health in this sector. She points out that, “you wouldn’t send firemen into a fire without the right equipment or training, it’s like in any other profession of care; we’re not talking about providing people with lavish lifestyles but what they need to be able to carry out their work, cope with the situations and be able to resume their lives when they return home.”

Dr Albert remembers feeling real concern about some aid workers who, “clearly shouldn’t have been facing these challenges at this point in their life”. She argues that that screening could cut risks dramatically.

However mental health screenings among large NGOs like the UNHCR, the Red Cross and Doctors Without Borders (MSF) are not mandatory, nor a criteria for employment and this, Dr Albert says, “is a call for concern”.

The problem it seems in the humanitarian sector is the difficulty of transforming that raw compassion into the practical skills necessary, which in turn puts those who may not be fully prepared in a vulnerable situation.

The culture of silence

Despite NGOs recognising the mental health issues plaguing humanitarian workers, speaking up can sometimes be hard.

“Self-care is a very easy to say, but very hard in practice.”

Michael McHugh, a nurse and child protection officer who was one of the first to volunteer in the camps in Calais, feels his training as a nurse gave him those “professional boundaries” necessary that some younger volunteers without training couldn’t seem to grasp, from fear of not being a “true humanitarian”.

For Laura and Esther there is an unsatisfying feeling of not having done enough, and McHugh agrees: “When I left Calais, I left Calais. But I know that some people feel like their fates are entwined with that place.”

“Mandatory breaks became an actual thing. People were struggling to look after themselves because their focus was outwards, but when people burnout, they can become destructive, which can affect those in their care.” This feeling of compassion is what drives aid workers and volunteers, but if the worker becomes unbalanced, they can be a danger to themselves and those they are trying to help. It can even lead to “compassion fatigue”, where even the most compassionate can “lose sight of their end goals or become cynical and detached”, Dr Albert explains.

This fatigue, according to Dr Albert, should be a primary concern for NGOs and push them to change their practices. “What is it that caused people who went into this line of work, with what I would assume to be altruistic values, to end up in a situation where they’re behaving so differently. What happened there?” she points out. Doctor Albert is referring here to the Oxfam Haiti sexual abuse scandal that rocked the humanitarian sector back in February. The British NGO, after multiple requests to comment said they had “no information on the psychological state of the aid workers found guilty of sexual abuse in Haiti”.

A need to rethink the humanitarian sector and its actions

At the 2016 World Humanitarian Summit, Brendan McDonald, along with other colleagues, attempted to petition the summit, calling on the UN to “prioritise staff well-being”.

“I was told by UNOCHA senior management not to pursue the matter; it was basically not seen as an issue.”

While this interaction has left McDonald with “zero faith in the system”, Amjad Saleem, manager for the Volunteer section of the IFRC believes this summit was an attempt to rethink the humanitarian sector and its actions and open a dialogue on mental health.

For McDonald, working in countries where there is often no rule of law, aid workers struggle to find someone to turn to, and in one of the world’s largest unregulated sectors, “the bullying, the harassment, the poor leadership, the arbitrary dismissal of staff, the inherent racism, misogyny and sexual harassment are very present”.

MSF, UNHCR and IRCR aren’t oblivious to the issues within the sector and through the use of workshops on resilience, secondary trauma, burnout and PTSD or even Twitter, they have been trying to start a conversation. And for Matthew Saltmarsh, the future of a safer workplace will depend on the organisations’ willingness to show the new generations of aid workers that “[they] are better prepared to protect and support them”.

This article was adapted from the original in French

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