Category Archives: Research

Stress in the Aid Sector: Who Suffers Most and Why?

Something in my heart snaps. My hands tremble and my eyes burn. For the first time since arriving here I cry. I cry for the dead boy buried in the cornfield. I cry for the hungry man beaten by the police. I cry for the little boy whose hopes of living with family have been shattered. I cry for the woman who will never recover from the wounds inflicted by her husband…

Miranda Gaanderse, relief worker in Rwamanja refugee camp, south-western Uganda (from Chasing Misery, ed. Kelsey Hoppe, 2014).

Why do some aid workers suffer from stress more than others? How do they cope with their emotional difficulties and what does this tell us about who they are and why they are doing this work? These are some of the questions I will be considering as I conduct field research in Kenya for my doctorate.

My research is inspired by my own experiences and those of my colleagues in the aid sector. Having worked in many different roles and in a variety of contexts – from villages at risk of demolition by Israeli authorities in the West Bank, to communities recovering from conflict and the tsunami in Sri Lanka – I’ve realised that stress and burnout is more complicated in this sector than one may originally assume. It is not merely the consequence of working in emergency or crisis situations, nor is it solely related to insufficient institutional support or the difficulties of working in unfamiliar settings, far away from family and friends. As mentioned in a previous blog piece there is a wealth of literature addressing the possible causes and symptoms of stress and burnout. However, whether it be in academic literature or in NGO/aid agency policy papers, we are told little about who it is specifically that suffers from stress and why. In particular I have found that there is an emphasis on the experiences of people operating in emergency settings – primarily relief workers – and on expats; with little attention paid to the reality that stress and burnout are also problems for other types of aid workers – such as development professionals or human rights activists, and nationals operating in their own countries.

The fact that there are so few studies about national aid workers is of particular concern, given that they make up approximately 90 per cent of the workforce.  They are often at the most risk from the work they do, due to their social proximity to the victims and perpetrators of human rights abuses and the state authorities responsible for addressing such abuses. They are also usually on lower salaries, with less benefits than their expatriate counterparts. They cannot simply leave the country when times get tough, nor do they have the same luxuries as many of their expat colleagues in terms of living arrangements and housing allowances.

Recent, and now increasing, reports of female aid workers being sexually harassed whilst on the job also highlights that women are at times faced with specific challenges and risks that are not fully recognised and no doubt are a serious source of stress.

Although these issues are receiving growing attention, this is not yet being translated into providing better advice and support that acknowledges the complexity of aid workers’ experiences. My research is thus aimed at highlighting that stress among aid workers can only be fully addressed by examining the diversity of personalities and identities within the sector and the influence of these elements on behaviour and experiences.

Motivations are particularly important here; I believe a deeper understanding of these may shine some light on why some people suffer from stress more than others. It is common for aid workers to be perceived as purely altruistic (particularly in the media and indeed by our own family and friends), or the complete opposite; in other words, motivated by what they may gain in terms of personal or professional development and status. Aid workers increasingly try to debunk the image of the altruistic hero by emphasising their primarily selfish motivations. My feeling is motivations are more complicated than this, and may be influenced by one’s background, upbringing and political beliefs. I’m interested to find out what role these motivations play in how aid workers approach and deal with the pressures of their job.

I also hope to reveal how one’s identity – whether this be class, gender, race, sexual orientation, culture or religion – influences the aid worker’s experiences. Whilst aid workers themselves share their experiences of the specific challenges of being, for instance a woman, or gay, far more analysis is needed to understand how these challenges contribute to stress and burnout in the sector.

It is my belief that understanding these issues is vital if organisations are to provide better staff care, and if aid workers are to make sense of the emotional upheavals associated with their jobs. I hope that my research, as well as this blog site, will provide opportunities to share experiences and reflect on how as aid workers we can understand ourselves and each other better.

Burnout in the Aid Sector: Debates and Emerging Issues

Burnout is a term that has become increasingly popular among the helping professions. Described by its key researchers as the emotional exhaustion and development of negative attitudes towards oneself and others that occurs among individuals doing ‘people work’  it is now increasingly recognised as a widespread problem within the aid sector. Within this sector, burnout is equated with mental and physical exhaustion, emotional detachment and insomnia arising from operating in challenging environments, heavy workload and insufficient social or organisational support. Concern has also been raised over its impact in terms of high staff turnover and absenteeism.

However the causes of burnout among aid workers are not clear or straightforward. There is a misguided assumption in much of the academic literature and public debates on this issue that chronic forms of stress such as burnout and post-traumatic stress disorder are associated with working in insecure or dangerous environments. This assumption fails to capture who exactly the aid worker is and how their unique circumstances – the personal values, choices or expectations that influence their work – may have an effect on their experience of stress. In addition, the humanitarian workers featured in most of the studies of stress and burnout in the sector are expatriates, whose emotional challenges are often associated with the specific pressures of living away from home in unfamiliar settings. Only a limited number of studies examine stress among national aid workers operating in their own countries (for some exceptional examples read Ager et al, 2012, and Cardozo et al, 2005).

A recent online consultation by PHAP (Professionals in Humanitarian Assistance and Protection) was a promising step towards putting the issue of stress and burnout and improving staff welfare in the aid sector firmly on the agenda of the UN at the World Humanitarian Summit next year, alongside a petition calling for the same. Among the rich and impassioned debate among approximately 170 aid professionals who joined the consultation online, a couple of issues emerged that reinforce the concerns I’ve outlined above. One is that we need to recognise that the emotional difficulties of this work do not only affect those doing the frontline interventions. Aid work means many things to many people; within my own professional experience this has included being a programme officer, human rights defender, researcher and campaigner. None of these roles fit traditionally within the humanitarian worker mold, but the emotions they provoke are not dissimilar due to the implications of repeatedly bearing witness to immense suffering and the horrors of mankind.

Not only is the call for better staff welfare too often focused purely on those working in emergency settings, it is also focused too often on expatriate aid workers. Yet, as acknowledged at the PHAP consultation and by others, national aid workers make up approximately 90 per cent of people operating within the aid sector.  They are often the ones exposed to more danger and risk due to their social proximity to communities their organisations are assisting and the fact they receive less security benefits and privileges – such as R&R packages and evacuations – than their expatriate counterparts.

Another important issue to emerge from the PHAP consultation is the aid sector’s organisational culture, which prevents the issue of staff welfare being widely discussed. In a sector that is constantly battling to get funds for its programmes, and where the public image is so focused on helping others, staff care costs are seen as a luxury. The fact that many organisations are not providing enough support or services for people suffering from chronic stress or burnout is obviously a major concern. However, so too is the fact that staff themselves are not admitting they are having difficulties. It’s quite possible that as aid workers, we all know someone who has suffered from chronic stress. But the signs are not always obvious. Aid workers and others within the helping professions are quite good at their emotional labour – a term described by Arlie Hochschild, the person who coined it, as ‘the management of feeling to create a publicly observable facial and bodily display’. In the case of aidworkers, amidst witnessing and responding to human rights violations and humanitarian catastrophes, showing one’s own vulnerability at times feels self-indulgent, or a sign of weakness amongst one’s far tougher colleagues and managers. Marianne Elliott provides some good examples of this in her account of her experiences working for the UN in Afghanistan. As does Kathleen Rodgers in her research into staff at Amnesty International.

Where there is a culture of suppressing difficult emotions it’s hard to know what the best response or form of support can be. Self-organisation among aid workers – seeking out support groups (please refer to my Resources page) – and opening up the discussion among colleagues, is in my view as important as putting pressure on  managers to take more responsibility in duty of care. As another humanitarian blogger has noted, we need to bring our burnout and our breakdowns out of the closet. Staff support and welfare interventions should certainly become more of a priority for aid organisations wishing to address staff burnout and turnover. But we as aid workers should also be willing to engage more directly with our own emotional needs and those of our colleagues. After all, this is part of the compassion that lies at the heart of all humanitarian work.