Tag Archives: national aidworkers

What do Stress and Wellbeing mean to Aid Workers?

In the last few weeks I’ve been engaging in discussions that have put the question of how aid workers interpret stress and wellbeing at centre stage. In August I ran a stress management workshop with an Italian NGO in Kenya which was attended by Kenyan, Somali and European staff. Aside from that, I’ve been talking to various people who have an interest in or are working on providing stress relief for aid workers and social change makers.

The question of how stress and wellbeing is understood by different people is important because in a world that is flooded with information about ‘alternative therapies’ such as yoga and meditation, as well as the western psychotherapy models, we can forget the hundreds of cultural traditions around the world that have handled emotional difficulties and mental health problems in their own, localised way. We can also forget that what works for one culture or society may not work for another. And in the aid sector, where the majority of staff are nationals from the southern hemisphere, we perhaps therefore still have a lot to learn about what interventions (if any) are appropriate for dealing with work-related stress.

The tendency is to assume that standard psycho-social models are a sufficient mechanism for addressing staff mental health. But there is a counter-argument that suggests that Western models of trauma healing are not always appropriate, nor healing, for some individuals from post-conflict countries. This has been argued in various literature (for instance, here) and was a point made by an Italian doctor I met recently who was conducting a training for humanitarian workers in body, mind and spirit practices for stress, trauma and compassion fatigue. During the training she related how in previous trainings in Rwanda and Burundi, some of the participants had commented how traumatising they had found the counselling given by Western psychotherapists.

’Stress’ and ’counselling’ are pretty familiar terms in European and American societies. Whilst there is still stigma around issues of mental health – people don’t talk openly about their depression, for instance –  there is an assumption that stress is part of everyday life, and that chronic forms of stress affect some of us and require clinical intervention in the form of one-to-one counselling.

The personal perception of stress and the way one deals with it is, in many ways, culturally and socially rooted. Whilst many NGOs provide some form of counselling for their staff, it would seem that ‘talking therapies’ are not necessarily the answer for a lot of aid workers.

Here are a couple of quotes from my data:

“There are those of us like me who come from nomadic background which thinks that talking about it is…is being a bit of a sissy. But, there are those of us that come from that culture of expressing yourself and you can see that people do grieve with each other, with different cultures.”

Somali UN worker (male)

“They pay for our counselling…but since it’s not so African to go for such things, most people don’t go for…debriefing. You can go during your R and R but nobody seems to ever get to it […] We as Africans we handle our stress differently – everyone has their own issues so why do you think yours is bigger? […] I think people just learn to handle their stress on their own, in case it’s there. Because for one we don’t open up that much, and especially here in Kakuma who would you open up to, especially if stress is work-related [….] basically you have to learn to handle your stress by yourself.”

Kenyan humanitarian NGO worker (male) (Kakuma)

Stress is not only culturally rooted; it is a gendered concept too. In the stress management workshop I recently ran, the Kenyan women remarked that stress in their society is largely seen as a women’s issue and associated with marital pressures, and with being of the ‘weaker sex’. This not only denigrates stress to the female experience, it also sends out the message that men do not suffer from stress, and therefore should certainly not talk about it.

I have been wondering about self-care practices too. ‘Self-care’ is in itself a dirty word for some aid workers. If it’s not seen as a bit ’new age’ or ‘hippy’, it’s seen as self-indulgent and completely at odds with a sector supposedly focused solely on helping others, not oneself.

There is a growing interest in yoga, meditation and similar self-care practices as a means to relieve stress, build resilience and encourage deeper self-awareness and compassion among aid workers and other social change makers. Regular yoga and mindfulness practices have certainly helped me in the last few years; the way I approach my work as a human rights defender has been transformed by following a daily practice that cultivates presence and a more mindful response to my own emotions and to the challenges around me.  And I continue to explore these further as a means to engage more fully in the world as well as to bring inner wellbeing.

But can these sorts of practices be adapted, and adopted, in African cultures? Are there traditions within African cultures which in fact use some of these practices already but give them a different name? I’m conscious that here in Kenya, for instance, trying to impose yoga or mindfulness as a stress relief tool may be seen as an effort to convert people to Hindu or Buddhist religions. Yet some of the techniques used in both these practices can probably be found in many other ancient cultures, including in Africa.

There are examples where the use of yoga and mindfulness have been introduced in different cultures, among aid workers and the communities they serve, with positive results – as this video from a woman who worked in Afghanistan suggests. Capacitar training also uses yoga, tai chi and other practices for trauma healing in communities that may be otherwise unaware of these traditions.

Self-care needn’t require a commitment to these increasingly popular practices however. As this blog by an Afrofeminist writer eloquently describes, there are many ways of practising self-care without having to devote oneself to yoga, and without necessarily having to completely change one’s lifestyle. Spending more time with family and loved ones is  important for aid workers and any other social change makers; because one of the big symptoms of stress and burnout is social detachment and disengagement, triggered by repeated exposure to the brutality and injustice that represent the darkest elements of human behaviour.  After such exposure, it is vital to seek out community and friendship. This can restore one’s faith in humanity and help cultivate compassion in a working environment that can be susceptible to ‘compassion fatigue.’ This video by the Headington Institute provides some advice to aid workers on how to maintain relationships with loved ones as a means of self-care.

Stress and how one responds to it is in some ways a complex matter. In the aid sector, both the individual and the organisation need to listen more – to themselves, to their staff, and what forms of support and healing are appropriate. It could take some time before aid agencies  go beyond a ‘one size fits all’ approach to staff care, but in the meantime there is a lot aid workers can do to help themselves. The starting point is that old adage, ‘Know Thyself’. What is your body trying to tell you and are you willing to stop and listen?

 

 

Finding Purpose and Managing Expectations in Aid Work

There’s been a fair amount of debate recently regarding people from the western world who travel to the developing world (particularly Africa) with high ideals of saving lives and leave feeling disappointed or worse, depressed. First there was the ‘Linton Lies’ debacle where a white British woman’s published book describing her experiences as a volunteer in Zambia, and the neo-colonial language she used in the book, were challenged through the social media hashtag #LintonLies.

Then this week an anonymous aid worker wrote about the depression they suffered after working for an international NGO in an unnamed African country. Both individuals have drawn criticism for having white saviour complexes. Their stories also raise important issues about whether aid organisations – working with volunteers or paid professionals – make the appropriate decisions in who they send on these ‘missions’ and whether the people sent are sufficiently prepared for the working environment they will find themselves in. The criticisms levelled at these individuals, and the concerns their stories prompt about institutional responsibilities – whilst certainly worthy of attention – are not the focus of this blog post.

There is an overriding theme that emerges from the stories of these individuals which I find particularly interesting right now, and that is expectations. How do personal, organisational and societal expectations feed into aid workers’ sense of, or indeed loss of, purpose? This question is as legitimate for national aid workers from developing countries as it is for western aid workers from privileged backgrounds.

Aid workers often enter the sector with high morals and ideals about saving the world or humanity. And there is certainly nothing wrong with wanting to play a role in improving the lives of others, or ending social or economic injustices. The reality of the work though can be far from what aid workers had in mind. Not only this, but aid workers are often juggling the huge expectations from their organisation, from their organisation’s donors, and from the populations receiving the organisation’s assistance. Feelings of guilt and shame arise when as an aid worker you realise that organisational policies, poor management or insufficient – or worse, wasted – resources, mean that some of the communities you are assisting will not actually receive the help that is so urgently needed, and their lives will not change for the better through your interventions. Under these circumstances it is not difficult to wonder whether your efforts were worth it, or even necessary in the first place.

Kenyan aid workers I’ve spoken to have told me of how one of their major challenges is responding to the expectations of the communities they are assisting, particularly in poorer regions such as Turkana in northern Kenya where the needs are greater.  An organisation’s mandate to work solely on human rights protection, for instance, means little to someone in urgent need of food and water.The chances are that as an aid worker you will have to get used to saying no to requests for help far more than you can say yes. And the justification for saying no can at times seen unethical, unfair or unjust.

As noted in the Guardian’s Secret Aid Worker article, there are also work pressures that are not envisaged when entering into this sector; tasks and responsibilities that go beyond your job description. This includes the unspoken expectation that you will check your e-mails regularly outside working hours, including weekends. Or being told that it would be better if you delay your R and R (rest and recuperation) because you’re needed in the office, thereby resulting in you not seeing your family for another few weeks after having already been away for 2 months.

Much of what I’m talking about here has nothing to do with western aid workers with white saviour complexes. National aid workers are just as likely to have these same challenges; indeed many Kenyan aid workers I’ve spoken to have referred to them. One Kenyan female humanitarian worker told me how she travelled to Dadaab to conduct a training in the camp, 33 weeks pregnant and on a bumpy and unsafe road, because the colleague who was meant to be going had fallen sick and couldn’t make it. Another Kenyan woman working for an international humanitarian agency told me that she had to work over much of the Christmas period in response to a string of natural disasters and conflicts occurring in the region, requiring an urgent response. Her exhaustion from this episode resulted in what she called a ‘burnout’. This was dealt with partly by establishing a more disciplined working pattern, where at a certain time outside working hours she would stop checking and responding to e-mails and be called by phone only in an emergency.

But what I find particularly relevant for aid workers – and perhaps this is also the case for others in the ‘helping professions’ – is the role of personal expectations in one’s experiences. Many aid workers are driven by a shared experience of injustice, or by a desire to help others less fortunate than themselves. Their expectation is that they can make a tangible difference to people’s lives. Indeed this is also backed up by the agendas of their organisations, so often popularised through the media images of aid workers feeding hungry children or building shelters for refugees.

There is thus an emotional investment; a sense of responsibility – rightly or wrongly – for the wellbeing and survival of others who are suffering. There is also an expectation – again at times reinforced by one’s employers – that this responsibility towards others comes before responsibility to oneself. One Ethiopian UN worker I spoke to went as far as to say, ‘if I don’t go through what I’m going through, some boy or girl somewhere will either miss their meal….or some boy or girl somewhere would not have education…or kids will miss their vaccination or immunisation and these are the vital services that children need….’

Perhaps what is important in all of this, if aid workers are to continue their efforts without burning out, is for them to find purpose in what they do. The recent Secret Aid Worker’s story, along with many others from aid workers, highlight that loss of purpose is often a trigger for depression and burnout. But what is also important is having realistic expectations about one’s purpose in the first place. This requires aid workers to engage in some self-reflection about their role in helping others – and this should certainly include a willingness to recognise their privileged position and skewed view point in relation to the populations they are assisting, something that Louise Linton in particular was accused of failing to do. But aid workers should also acknowledge, accept and work within their limitations – whether these are down to organisational policies, the environmental context or simply being human.

 

 

 

 

 

 

Aid Workers in Turkana: Outsider Lives and Compound Lifestyles

For the last couple of weeks, I’ve been up in Turkana county, in northern Kenya. This is one of Kenya’s poorest counties; dry, arid and hot, it is not an easy life up here. Rural and pastoralist communities are spread out throughout the county, struggling to survive with a scarcity of water and relying on their cattle, goats and camels and various Food for Assets and Credit Transfer programmes; since the devolution process started in 2013, the county government is now leading many of these development initiatives in the area. Meanwhile, the refugee community in Kakuma in Turkana West sub-county is struggling to survive on the handouts of humanitarian agencies, with everyone waiting to find out if the camp – home to around 185000 refugees – will be closed following the Kenyan government’s announcement to this effect a few weeks ago.

It goes without saying that this is a very different context for aid interventions than Nairobi, where I’ve been most of the time whilst conducting field research in Kenya. In Nairobi aid workers are either based in national offices where they travel out to the field every few weeks, to their programmes dotted around the country (this of course includes Somalia for a lot of organisations, who cannot be based in the country permanently due to security risks); or they are based in the regional offices where they may be travelling even less, playing an administrative or supportive role to the staff based in countries such as South Sudan or Uganda.

Here in Turkana you can find aid and development workers who have barely travelled to Nairobi; some who are from Turkana and have rarely left the county. The air conditioned, bustling offices and plywood desks and swivel chairs of the INGO national headquarters in Nairobi are a long long way away. Here in Turkana most INGO offices are on sandy, dusty compounds with few trees or foliage, and a slow, sleepy atmosphere permeates with only fans and an occasional breeze to cool people down in temperatures of 35 to 40 degrees.

Most of the people I’ve spoken to here, whether programme directors or field officers, are Kenyans. This would not have been the case 10 or 20 years ago. The expat aid worker presence, both here and in Nairobi, is falling year by year as Kenyan expertise increase and the restructuring of INGOs leads to more operations being managed and implemented at local and national level rather than from Europe. This reality, which can be seen across the globe as well as in Kenya, makes the need for greater recognition of the specific challenges faced by national aid workers even more crucial if we are to fully understand aid practice.

And here I outline some of those challenges that I’ve noticed as I spend time in Lodwar, the main city in Turkana and the local base for development INGOs including Oxfam, World Vision, Child Fund and Save the Children among others; and Kakuma, the base for humanitarian INGOs and UN agencies providing assistance to the refugee camp.

  • Many of the Kenyans I’ve spoken to are not from Turkana; their families are in another part of the country and they are visiting them every 2 or 3 months when they are on R and R (rest and recuperation). This is not the sort of place to bring your family, I’ve heard a few people say. So they must make do with speaking to their loved ones on the phone – provided they are not right out in the rural areas, where phone network may not work – or on skype – provided there is internet network, which is very intermittent here. And after 2 months, they spend what can be a day or more travelling to their family homes, for what may only be 5 days if they stick solely to the R and R they’re entitled to.
  • For most of Turkana county, you can find aid workers staying in guest houses or local accommodation, some in remote villages with no electricity or internet, and some in Lodwar and other large towns. In Kakuma, you can find them in one of the UN or INGO compounds. These are self-contained areas housing offices and staff accommodation, some of them small prefab units for people passing through for a short period of time. When not in the camp, humanitarian workers are confined to these compounds – it is where they work, eat and socialise – and are expected to return there when the curfew begins in the refugee camp at 6pm. Whether in Kakuma or other towns and villages in Turkana, there is not much to do outside office hours. None of the fancy restaurants found in Nairobi. No yoga classes or parks to walk around. And no supermarkets selling luxury items. In these circumstances, the social structure of one’s organisation is often all that exists in terms of support and social interaction. But on some weekends people travel out of town, to their homes or on R and R. So the humanitarian compound can be a quiet, uneventful place. Although some compounds, particularly those housing the UN staff, are better than others – one here has a gym and tennis court as well as cafeteria and bar.
  • One is very aware here of being seen as an outsider. In Lodwar, aid workers from outside Turkana told me of how they find the culture very different from their own; characterised by the diet – a lot of meat, mainly goat – or by the perceptions of women, for instance. One African expat in a senior position at an INGO told me of how she found the local authorities very reluctant to meet her when she arrived to introduce herself and make herself known to the community. She suspected there would have been a very different welcome if she’d been a man. Several others I spoke to in Lodwar commented on how the local community had seemed very suspicious towards them at first. This is partly a throwback to the derogatory treatment they were subjected to in colonial times, I was told; but also part of their guarded attitude as pastoralists defending their small communities and livestock, and their disillusionment with INGOs coming and going with endless surveys and overambitious or unfulfilled promises of development assistance.
  • In Kakuma, mistrust plays out in a different way. There is hostility particularly from the host community, who are tired of seeing the plethora of aid agencies turning up in their four wheel drives, hiding behind huge compounds just beside the refugee camp, and assisting the refugee community whilst apparently ignoring the abject poverty of the local population; although a number of organisations are trying to address this disparity with development interventions with the host community as well. One American expat told me of how she’d been attacked twice whilst going for a run in the area outside her compound, although she escaped largely unharmed on both occasions. Refugees too are also at times unhappy with the insufficient assistance received from the aid agencies here, occasionally protesting outside the agency compounds.

What is important to most aid workers I speak to in Turkana is having some form of social support network to turn to. Sometimes this may only be friends and family back home. For others, who are stuck up in a remote village for two months, it may be just one other colleague who is there with them. And for the expat humanitarian workers here in Kakuma, friendships are challenged by the continuing turnover of staff, as people finish one humanitarian posting and move on to another.

Life isn’t all bad of course. Staying in a quiet town with few ways to pass one’s time means money is saved, and for Kenyans this is particularly important when there are likely to be several relatives from the extended family expecting support. Expat aid workers have their supplies of luxury items such as olive oil, muesli, cheese and wine they’ve brought with them from Nairobi to keep them happy. And in the humanitarian compounds there is usually a party or gathering to go to at a neighbour’s house; one aid worker described his life there as ‘a bit like summer camp’.

Few aid workers have complained directly about their work with the communities. Those that have refer to the difficulties of meeting people’s expectations, particularly in what is often referred to as a very aid-dependent community. Most love the work they do, and feel a sense of fulfilment from the impact it has. The greater challenges often relate to what can at times be unbearable heat; the rough terrain throughout Turkana which can halt transport plans, particularly in the rainy season, leaving aid workers stranded in one place with few provisions; and the insecurity in certain areas – particularly on the borders with West Pokot county, where cattle rustling occurs between the Pokot and the Turkana pastoralists.

It has been an insightful time up here, exposing me far more directly to the realities of aid and development work than what I’ve witnessed so far in Nairobi. No doubt what I have described is familiar for many development and humanitarian workers. But outside the sector, these small but significant nuances are not always acknowledged in debates and analysis of what ‘aid work’ entails.

With only a few months left of my field research, it will soon be time to make sense of all of this and draw some conclusions, which I hope will be of value to the aid sector and to the many and diverse professionals working within it.

Aid worker motivations: more than escapism or altruism

Motivations remains a big topic in the ongoing debates and reflections on why aid workers stay in their jobs and why they leave. A few days ago, the Guardian published a piece by the author of a recent survey that investigated, among other issues, aid worker motivations.

The article itself is only a brief reflection on what is clearly a fairly extensive survey of over 1000 respondents from around the world, and which covered a range of topics including how aid workers describe their jobs to others, why they leave their jobs, the reasons why aid workers are rarely fired, and what people like and dislike about being in the sector. I look forward to when the data – available on the Aid Worker Voices blog site – is fully compiled and further conclusions and recommendations are published.

In the meantime though, the published data thus far raises some questions for me. The Guardian article certainly touches on some important challenges faced by aid workers on a day-to-day basis. For instance, how they relate to their friends and family back home who have little understanding of the work they do. And their sense of belonging in and loyalty to the communities they work with in developing countries. But I do wonder are these actually motivating factors we are talking about – the main drivers of why people chose to stay in their particular jobs? These may indeed be the reasons why aid workers put off leaving a country and returning home. I know of a few people myself who feel an increasing disconnect with what they see as the privileged and humdrum lives of their family and friends back home. But I’m not sure this has anything to do with why someone choses to stay in a job where they are fighting a particular cause, often with little reward in terms of meaningful change to people’s lives.

A glance on the Aid Worker Voices site where the survey’s initial findings are, offers greater insights into motivating factors, but I would still love to find out more about the survey respondents. What drove them to enter the aid sector in the first place, or to work in their particular roles? I know I’ve repeated this point over and over in this blog, but that’s because it is the rationale and basis for my own investigations into aid worker wellbeing: the personal matters if we are to understand how aid workers perceive and respond to the emotional challenges of their work. Whilst self-development of one sort or another may be one reason why people enter and stay in this sector, I feel the motivations behind choosing to be a gender specialist, or an advocacy officer, or a country director are more complicated than that. These career decisions may be economic as much as political, and may also be extremely personal and related to an aid worker’s direct experiences of injustice.

Another issue repeated throughout the Life in Crisis site is that we need to identify more closely who exactly we are talking about when we refer to ‘aid workers’. Too often the focus is on expats, when the majority within this sector are nationals operating in their own countries. Likewise, too often the expats themselves are assumed to be from countries in the northern hemisphere, ignoring the increasing number who are from the global south. It is not clear from the survey cited in the Guardian who all the respondents are, but I suspect they are mostly Americans and Europeans. A survey on aid worker motivations that focuses more on aid workers from the global south may have brought up very different responses. I speak from experience, given the data I have collected so far during my field research in Kenya. For instance, unlike western expats who talk a lot about family and friends back home not understanding their work but nevertheless applauding them as heroes, national aid workers often do not receive this sort of praise. Kenyan aid workers I’ve spoken to here refer to how their families generally disapprove of what they’re doing, questioning why they have to travel so often and why they don’t get a ‘proper job’. This is particularly hard for women in societies that expect them to stay home and cook and clean for the family. Furthermore, expats may complain that their families think they are doing low paid voluntary work, but for nationals working in the aid sector, the opposite is often true; family members assume, sometimes incorrectly, that aid workers have lots of money and thus their relative can afford to help more towards schools fees and medical care.

This relates also to another distinction between expat and national aid workers experiences. Whilst expats may eventually leave their jobs because they want more financial security – one of the findings emerging from the Aid Worker Voices data – nationals may stay in their jobs for that very same reason; because for them, a job in the aid sector provides a stable income that they can’t afford to let go of, even if they find the job extremely demanding and stressful. Indeed it is assumed by many expats I’ve spoken to that most national aid workers are motivated primarily by financial factors.

An interesting point made by someone I spoke to recently is that it may be a healthier attitude to have to one’s work – to see it purely as a job like any other, that brings a monthly salary, and which one will do to the best of one’s abilities. It is perhaps the ideological factors underpinning many aid workers’ motivations – both expats and nationals – that create the disappointment and disillusionment that can eventually lead to burnout. This is because the aid sector is full of unrealised hopes and unmet expectations about what we can achieve. The survey respondents acknowledge this in the Aid Worker Voices blog, and in my own research I am investigating how people experience and respond to what they feel are personal or organisational failings. Such insights can tell us a lot about why people struggle with aid work, and why some people cope better than others in managing its demands.

Aid worker salaries and meanings for motivation

Last week my blog post on motivations in aid work was published at the same time as the spotlight was once again shone on aid worker salaries and benefits disparities. The Guardian’s Secret Aid Worker piece which questioned why expats receive as much as three times more compensation for their work than their national counterparts, was followed by another Guardian article summarising what continues to be a polarised response from the aid worker community.

Some would argue that the discrepancies in compensation – with expats often entitled to regular R and R, flights home, housing and hardship allowances and the payment of school fees for their children – create divisions within the workplace and fail to recognise the distinctive expertise of national staff that should also be rewarded. Some expats are quick to defend the higher salaries and allowances afforded to them due to the sacrifices they make in moving from their home country, usually taking a drop in salary to do this sort of work, and often still having to cover housing, school or family costs back home.

This debate is an important one – you can add your voice to it in a survey posted via the Evil Genius site  – and is happening on a regular basis within aid organisations, although often in hushed tones. The very fact that there is this disparity, and sometimes glaringly so, is likely to create tensions between national and expat staff. I often wonder myself what it must feel like for Kenyans here to see their colleagues driving to their homes six kilometres away in their four wheel drives while the Kenyan staff queue for a matatu to take them on what can be a two hour journey across town to an area where rent is more affordable. Or what it feels like to know that as a Kenyan you are treated as a ‘national staff’ in a place like Somalia or South Sudan, and thus paid less and not protected by the same security procedures as the European and American aid workers doing the same job. I think Western expats should at the very least acknowledge these differences and how they feed into a neo-colonial narrative that assumes white people are more deserving of certain privileges because of their backgrounds, expertise and experience. The uncomfortable truth that even African expats are likely to be treated differently from their white counterparts is highlighted by Crewe and Fernando:

Is it an unreasonable jump to have argued that the expatriate versus national opposition is linked to white versus non-white? The correlation is far from exact. But when people from the South take jobs in Europe or America they are not considered ‘expatriates’. It is often taken for granted that ‘expatriates’ means Euro- American experts whereas expatriates from elsewhere are given a specific identity (the ‘Ghanaian consultant’ or ‘consultant from the South’). So the jump is more reasonable than it appears at first.

(Crewe and Fernando, The elephant in the room: racism in representation, relationships and rituals, Progress in Development Studies 6, 1, 2006; 51)

Putting this particular hot potato aside, I also think we should be reflecting on what role adequate compensation plays in doing our work well. I’m aware of some NGOs – both national and international – where there are very few benefits for expats and salaries are so low that although you may be able to afford a modest apartment in the country you’re working in, you certainly couldn’t afford to live anywhere back home. The thinking behind this a lot of the time is, ‘we hire people because of their dedication to the cause – a quality that loses legitimacy if rewarded with too much compensation’. The assumption is that a desirable income suggests motivations of self-interest that go against the noble intentions associated with aid work. For a young aid worker who is new to the industry this arrangement may seem morally correct; but realities and attitudes change once you consider how you’re going to pay for a flight home, or for rent or daily living when you get there. Your dedication to the cause eventually has to be weighed against building a future and a settled, financially secure life for yourself. And aid workers want and need this like anyone else does.

Aid work is now increasingly seen as a professional role like any other; it is not driven purely by altruistic values. In Kenya, it is in fact a fairly lucrative profession in many instances – for both nationals and expats. This is partly why so many will not leave their jobs, no matter how much they struggle with it or how mean their boss is – they do not want to let go of the benefits that come with it.

We should not therefore discount the possibility that aid workers stay in their jobs because of the income and benefits they receive; but we should also not assume that this completely undermines any suggestion that aid worker motivations are, or should be, moral or altruistic. Perhaps, as one study of Bangledeshi NGO workers suggests, these sorts of intentions should be rewarded if staff are to remain committed to what they do. This should apply none more so than to national aid workers. They are often operating in difficult, sometimes highly dangerous settings, and their close proximity to the communities they assist may bring specific challenges; for instance, they themselves may be exposed to the same health or security risks as these communities, or they may become a target of government surveillance or harassment. Yet these national aid workers rarely have the same privileges of R and R, evacuation, or being able to easily find a job in another country, as their expat counterparts. These distinctive circumstances demand greater recognition, and reward.

 

Unpacking the Personal in Aid Work

A six week break in the UK has meant the Life in Crisis blog site has been a bit neglected lately. Meanwhile, debates and discussions concerning aid worker wellbeing continue to grow and have become more widely recognised, thanks partly to the spotlight shone by the Guardian and by new blog sites such as Christopher Hensch’s Support for Humanitarian Aid Workers. Aid worker wellbeing is now so prevalent a topic within aid circles that it’s being satirised . It remains to be seen how far this growing recognition will translate into better policies and approaches by aid organisations, or contribute to a change in an organisational culture that continues to stigmatise the vulnerabilities and mental health needs of aid workers. Encouraging steps are meanwhile being taken by others such as International Location Safety and Interhealth to integrate this issue into the trainings and preparation of humanitarian workers entering the field.

Amidst this heightened interest in aid worker wellbeing I find myself still asking the same questions that I started out with three months ago when I began my field research in Kenya: why is it that some people suffer from the challenges of this work more than others? And what do we understand about the specific challenges and difficulties faced by national aid workers? It still feels that in many of the findings of recent surveys (such as the Guardian’s, which I commented on in my previous blog post) we are not getting the full, and complex, picture. Expatriate – and of these, mainly American or European – aid workers dominate the discussions. And although their concerns – about security risks, about living in unfamiliar and at times hostile environments, about the difficulties of articulating experiences to friends and families back home, to name a few – are legitimate and understandable, I’m still left wondering how national aid workers relate to these concerns.

Furthermore, I’m not fully convinced that it is the security incident, or the suffering one witnesses on a day to day basis as an aid worker, that is the direct cause of all the stress and anxiety within the sector. We have to understand what else is going on in a person’s life if we are to fully understand why they are struggling with their work. The degree of support provided by their employers, and to what extent they feel able to ask for it, are obviously important issues. But whether an aid worker is experiencing particular challenges may also be related to their gender, sexuality or nationality. We are seeing already that being a woman in the aid sector, for instance, has had unpleasant and discriminatory repercussions for many (if you can relate to this, you may wish to fill in this survey aimed at highlighting the extent of sexual abuse and discrimination in the sector). More generally, the aid worker’s personal landscape – how they understand their feelings, how they are able to communicate these feelings with others and express themselves – are factors which will make one person’s experience in the sector very different from another.

This has led me to wonder how stress – and more generally, the emotional impact of aid work – may be a relational issue; something that is determined by our relationship to others around us. How do aid workers articulate and talk about their emotions? What role do friends, family and loved ones play in helping or hindering one’s capacity or willingness to express difficult emotions associated with aid work, such as guilt, fear, anger or sadness? To what extent do aid workers feel able to reveal these emotions when in the company of those they feel are far worse off than them, or among their colleagues? And does the suppression of these emotions prompt the detachment and disillusionment that so often arises after years of working in difficult environments?

I find these questions interesting as my own experiences in the aid sector have shown me that it can be very easy to spend years concealing the most difficult emotions that arise, even from oneself. Likewise it can take years to realise that such emotions, if buried and unprocessed, can become your demons one day. In my case there was no ‘critical incident’, no specific traumatic event that prompted my emotional bloodletting. What happened was far more ambiguous and cannot simply be explained through the narrow focus of working conditions or challenging environments.

The questions I’m considering do not point directly to the external factors such as security and levels of institutional support which are so often referred to as indicators of stress in the sector. Instead they highlight how the challenges of aid work can be a deeply personal, and complex, experience requiring self-reflection and care as much as gentle, open-minded support from others. Emotions may ebb and flow according to specific social norms, interactions and memories. I wonder also what role cultural values and assumptions have to play in how one deals with difficult emotions. These issues are important to the aid sector as they highlight there is no easy, one-size-fits all answer to addressing aid worker health and wellbeing. Uncovering and untangling the complicated, emotional aspects of aid work isn’t easy, and I wonder myself what success I’ll have in the remainder of my field work in Kenya; but this work, and the questions I’ve raised, are an essential element in the ongoing efforts to highlight and respond to aid worker stress and burnout.

Aid Worker Wellbeing: Reflections on the Guardian Survey and Steve Dennis case

This past week has seen a real shake-up in the aid sector. First last Monday the publication of the Guardian’s survey on aid worker wellbeing, which found that 79% of its 754 respondents claimed to suffer from mental health problems, including diagnosed depression, anxiety and post-traumatic stress disorder (PTSD). Then on Wednesday came the news that an Oslo court had found the humanitarian organisation Norwegian Refugee Council guilty of ‘gross negligence’ in the treatment of former employee Steve Dennis and others who were kidnapped by armed groups in Dadaab refugee camp in Kenya in 2012. Steve Dennis was awarded $500,000 in compensation plus costs.

Both pieces of news point to the same issue – that aid organisations are not giving nearly enough attention to the wellbeing of their staff, particularly those who are doing the frontline relief work in emergency areas, and that individuals are not getting the support they need when they experience serious stress and mental health conditions such as burnout and PTSD.

But before aid organisations quickly rush to demonstrate that they have all the right policies and structures in place to support their staff (I’m sure this is happening already, particularly given the legal implications of the Steve Dennis case) it’s worth reflecting on a few issues that are relevant but have not been so highly pronounced or exposed in these two pieces of news.

Which aid workers are being referred to in the Guardian’s survey? We are given little detail about who the 754 respondents are, except that most of them were female and expatriate. This in itself is hardly an accurate reflection of the broader aid sector, in which approximately 90% are nationals. I am also interested to know who these ‘aid workers’ were exactly. Only those working in disaster areas? Or development workers? They may not be exposed to the acute suffering that one witnesses in a disaster area, but are certainly likely to witness the human misery that arises from extreme poverty. Or human rights workers? They too are bearing witness to ongoing injustices. The survey did not make clear what jobs these 754 respondents were doing. For me this is of interest because the assumption is often that it is humanitarian workers who suffer the most from the work they do. And yet my own research is already demonstrating that you don’t have to be on the frontlines of war and disaster to suffer from burnout or post-traumatic stress disorder.

Can the causes of mental health problems be so easily defined? The main factors contributing to serious mental health conditions according to the Guardian survey were security incidents and the witnessing of human tragedy. Yet it is also becoming clear, in the Guardian’s own reports and elsewhere, that different people – women and nationals in particular – experience different challenges in this work. Given the Guardian’s own reporting on sexual assaults within the aid industry, a question we should be asking when addressing aid worker wellbeing is what specific challenges have women faced and what sort of support do they need? The same could be said about nationals. It is quite possible that some nationals are directly affected by the issues their organisations are working on; perhaps they are refugees themselves, or they or their family have been victims of domestic violence. These factors are important as mental health conditions cannot be fully understood unless we consider the individual’s background and identity and how these impact on their experiences in the workplace.

What are aid workers doing to address their challenges and difficulties? Both the Guardian survey and the Steve Dennis case may provide damning evidence that aid organisations need to be doing more to support their staff. And certainly the survey findings are pretty critical about the insufficient response given by aid organisations to staff who have suffered from mental health issues. But tightened security procedures, regular debriefings and staff counselling are not the only solutions aid organisations should be seeking. Staff themselves need to be considering what they must do to address the challenges they face in their work. As aid workers, we all like to moan about how our managers don’t have time for us and aren’t supporting us enough – and this may well be accurate a lot of the time – but are we also giving time and support to ourselves? In a culture that can often seem competitive and macho in its pressure to work the longest hours and be the most dedicated, what role can we play in caring for ourselves and stepping back, or seeking help, when we need to? With any big emotional challenges in our lives, it can be far easier to point fingers and blame situations or other people. It is harder, but just as important, to reflect on who we are and how we approach our work as possible factors in why we struggle in certain ways. As aid workers, our personal motivations, expectations and approach to work may say a lot about whether we eventually suffer disillusionment, guilt or burnout. And likewise reflecting on these and what needs to change within ourselves may help overcome some of our darkest moments.

These comments are not seeking to belittle individual experiences, nor undermine the serious mental health conditions that many are suffering in this work, including the staff of Norwegian Refugee Council who were kidnapped and those who responded to the Guardian survey. But I do believe we need a more nuanced approach to aid worker wellbeing that recognises that the challenges of this work are not simply related to security incidents and operating within conflict settings; I believe the experiences within the sector are far more complex. Nor are better security procedures or counselling services the only solutions. As the Guardian survey recognises, the culture within aid organisations must change. This not only means creating a space where it is safe and acceptable to admit you are struggling or not coping; it also means cultivating an environment in which people continue to feel valued and maintain a sense of purpose and meaning in what they do. This is the work of everybody – organisations and staff – who have an interest in reducing serious mental health and stress conditions and the resulting staff absenteeism and turnover; and who wish to encourage a spirit of humanity – not only in the field but also in the office.

 

 

The Role of Staff Welfare in Improving Humanitarian Practice

Yesterday saw the launch of three reports on humanitarian practice in Nairobi, and also saw me presenting on a panel for one of the reports. The panel was organised by the CHS (Core Humanitarian Standard) Alliance, a network of around 260 humanitarian organisations operating in 160 countries worldwide.   Its work focuses on ensuring the core humanitarian standards – nine commitments on quality and accountability – are mainstreamed throughout all humanitarian operations.

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A photo on display at the conference: MSF workers deliver food parcels to a remote mountain region in Nepal (Tatiana Kotova)

The CHS Alliance’s Humanitarian Accountability Report is entitled On the Road to Istanbul: How can the World Humanitarian Summit make humanitarian response more effective? In its 13 chapters, written by different experts from the humanitarian sector, 5 key themes are addressed, which the panel members, including myself, spoke to in our different capacities:

  • the role of principled humanitarian response in building trust and facilitating access
  • how standards can drive appropriate, effective and timely aid
  • strengthening national capacities in aid delivery
  • collective accountability and transparent decision making
  • good people management practices

This report launch coincided with two others – ALNAP’s State of the Humanitarian System report 2015 and Quality and Accountability Initiatives by the Inter-Agency Working Group on Disaster Preparedness in East and Central Africa. Whilst the content of these reports and the presentations given by the different speakers at yesterday’s event are all very relevant to the debates around improving humanitarian effectiveness, I will only touch here on the issue which concerns me most within my own area of interest – staff welfare. This was what I was discussing on the panel in the morning, and is an issue which was hotly debated on the margins of the global consultations for the World Humanitarian Summit happening in May 2016.

Sadly, I did not see these debates being addressed or given much attention in yesterday’s event, which was attended by around 80 regional and country directors and managers from various aid agencies, including UNOCHA, World Vision, Save the Children, Oxfam, Action Aid, Red Cross and Danish Refugee Council. The tendency of staff security, safety and welfare to be sidelined by what are seen as the bigger priorities of meeting the growing needs of populations living in crisis situations is nothing new. And certainly given the reality of today’s world crises and conflicts – creating higher numbers of refugees and populations in need of assistance – it is no surprise that humanitarian decision makers find it hard to consider their own health when having to make what often amount to life or death decisions affecting thousands of people.

Yet one issue highlighted in the ALNAP report on the State of the Humanitarian System  – the threefold increase in attacks on humanitarian workers since 2002 – demonstrate the huge risks, and the implications of these risks, for people working in emergency settings. In 2013, 151 humanitarian workers were killed, 171 wounded and 134 kidnapped. The majority of these were national aid workers, operating in their own countries. The increase in attacks are partly down to the changing nature of global conflict, with humanitarian workers now often being specifically targeted by non-state actors and armed groups. But as we’ve seen with the case of the MSF hospital blown up in Kunduz, Afghanistan, Western states are also responsible for flouting the laws governing armed conflict, directly affecting those engaged in humanitarian operations.

A photo on display at the conference: humanitarian workers on their way by helicopter to an IDP camp in South Sudan (Andrea Contenta)

A photo on display at the conference: humanitarian workers on their way to an IDP camp in South Sudan (Andrea Contenta)

As security risks to humanitarian workers are on the increase, so too is the likelihood of chronic forms of stress, such as post-traumatic stress disorder, for those working in the midst of crisis. My presentation at the CHS Alliance report launch highlighted two distinct issues arising from this reality, to be considered by humanitarian organisations. One was the need for organisations to understand the different cultural interpretations and ways of dealing with stress.   Staff welfare strategies, in terms of addressing problems such as stress, burnout or post-traumatic stress disorder, must acknowledge the diversity of the sector if they are to be effective. What is seen as stressful or traumatic for a white expat worker may be very different from what a Kenyan worker feels and experiences for instance. From the data I’ve collected so far in my research I’ve found that addressing the mental and physical health needs of national humanitarian staff is a major challenge. This is partly to do with inadequate support structures that privilege the expat staff, and partly to do with the very different cultural understandings of how personal emotional difficulties are talked about and dealt with. One important way of addressing this is to consider the right language to be used for addressing these difficulties. Trauma, for instance, or the more general term ‘mental health’ are still stigmatised words, not only in Kenya but in many other contexts.

Another issue I touched on in the panel discussion is related to the structures and culture of aid organisations. Some people, particularly national aid workers, have told me that there is a resistance to openly discussing vulnerabilities or difficulties in coping because people fear losing their job. This macho culture of working long hours, not really looking after yourself and not admitting that you’re not coping is so common in this sector and having the right support mechanisms in place is not enough to change this.

Instead, both managers and staff need to be asking themselves, how can they break down the stigmatisation around seeking help? How can they open up the space to allow for people to share their vulnerabilities and their personal insecurities? A major element that drives humanitarian work is compassion – compassion for the community in crisis. That same compassion can be lost when it comes to individual staff members looking after themselves or their colleagues. So a change in culture means cultivating an environment where staff can reflect on their emotional challenges and those of their colleagues, where they can realise they are not alone in the difficulties they face with this work, and where their personal problems are met with sensitivity and understanding.

These issues are of the utmost importance to people working in the humanitarian sector, as evidenced in various online discussions happening at the moment in the run-up to the World Humanitarian Summit next year. Yet so far there has been little recognition of the centrality of staff wellbeing to improving humanitarian practice; hence why it is not seen as a key theme to be addressed at the World Humanitarian Summit nor as an issue to be followed up in discussions such as those taking place in yesterday’s report launches in Nairobi. This is not to say that individuals, including those in the conference room yesterday, are not concerned about staff welfare. But addressing this part of humanitarian work remains far down the agenda of most aid organisations, and even more so for the donor agencies supporting those organisations. Humanitarian workers must continue to push the agenda of staff welfare within their organisations, and also at the World Humanitarian Summit in 2016. It should be an essential component in understanding how to make humanitarian action more effective and sustainable.

 

 

The Realities of a Life in Crisis

Watching Living in Emergency, a documentary film about doctors from the humanitarian agency Médicins Sans Frontières (MSF) operating in Congo and Liberia, reminded me of the profound emotional challenges and difficult decisions that are part of everyday life for many aid workers. The film tracks the lives of several doctors working in post-conflict Liberia and war-torn Congo, some of them located in remote areas with few resources to treat the hundreds of sick and wounded people who come to them for assistance. It addresses many of the issues I’m grappling with as I conduct my field research on stress and burnout among aid workers in Kenya, and which are important factors in remembering the human behind the humanitarian.

  • MotivationsThese are complex and not always what may be assumed. Whilst it’s easy to think that aid workers have purely altruistic motives – the wish to help others – sometimes they are fighting their own personal demons or pursuing a form of happiness they never achieved back home. In the film, one MSF veteran of 9 years mentions that some people do this work to run away from something, as was the case with him and his escape from life back home in Australia. A doctor who gave up his comfortable life in the United States to work in a hospital in Liberia claims, ‘It ends up being a selfish thing. Somehow fixing other people fixes yourself’.
  • Disconnection with home. The longer that aid workers are working in foreign lands, far away from the comforts of home, and the more they are exposed to immense and at times relentless suffering, the harder it becomes to relate to friends and family thousands of miles away. The Australian doctor in Congo claims he is essentially ‘homeless’ after moving around for so many years. The American doctor in the only free emergency hospital in Liberia’s capital Monrovia at the time, says, ‘If you’re going to talk to some of your friends about some of the stuff you saw, and you can’t describe the smells, the feeling of the heat on your body, the sweat running down your back, the smell of the pus that hits your nose and the unwashed bodies in a closed room…the smell of your own panic when you’re not sure what to do…you can’t share that stuff.’
  • Tensions between expatriate and national aid workers. Expat aid workers can often forget the privileges associated with their position, particularly in relation to their national counterparts. In the aid sector, the term ‘expat’ is often assumed to refer to a white person from the global north. Furthermore, the term ‘expat’ is conflated with ‘expert’ in the language of the aid industry. These assumptions are problematic for the aid worker from the global south, who is left on the sidelines of dominant white expat approaches to aid. In Living in Emergency, these roles are played out between the expat staff and national staff at MSF. In one scene there is an altercation between a Liberian doctor who is accused of being arrogant by his Italian colleague after disputing treatment being recommended by one of the expat doctors. In front of the camera he tells his Italian colleague, ‘Tell your doctors to talk to me like a doctor and not like a small boy. And don’t tell me I’m arrogant because I disagree with the diagnosis’. The different experiences of national and expat aid workers are highlighted again when some of the expat staff prepare to leave the country. A national staff member comments to his colleagues, ‘don’t get used to any expatriates. As they go, other people come’.
  • Inability to meet expectations of populations in need. As an aid worker, you can at times feel that people are depending on you massively to save their lives. Indeed sometimes this is the case – you are their only hope. What you decide may affect whether that person survives. And sometimes you have to say no, because you can’t meet everyone’s expectations – perhaps because of lack of resources, or because of the limitations of your organisation’s mandate. In my own experience, people have sought my help and I have not been in a position to give them the assistance they need. In one case, the person died as a result of not accessing the required treatment. Doctors at MSF have to accept this reality all the time. As the American doctor says, ‘you have to be able to live with wrong decisions. That’s really hard to do.’ An Italian woman working for MSF in Liberia comments, ‘I think we all have the same question and that is, what is our limit?’ A young Australian doctor on his first MSF mission and working in a remote village in Congo says, ‘I compare myself to others and I wonder whether another doctor in the same setting would have had the energy….to spend longer with that patient, sleep less that night, and got more work done the following day than I got done.’
  • Loss of idealism. Many aid workers start off their career with a determination to put an end to some of the injustices that they have seen on the news or read about during their studies. When they travel to the field they face realities that challenge the noble intentions to simply do good and help others. In the face of war or extreme poverty, and limited by lack of resources, the sort of help they had envisaged giving may not be possible. As an Italian woman working for MSF in Liberia says, there is a loss of innocence: ‘At the beginning I was feeling good about everything I was doing. Now I’m not feeling good anymore’.

These are some of the realities of a ‘life in crisis’, whether working for MSF or another humanitarian agency. They are also the experiences at times of development and human rights workers, who aren’t necessarily operating in emergency settings but who on a daily basis are faced with immense suffering and expectations that they are unable to meet. The guilt associated with these realities is felt by many and may linger for a long time.

And while for expats there are undoubtedly significant challenges to working far away from one’s home country, and at times it can feel like living in two very different and disconnected worlds, the national aid worker has their own unique struggles. They have no choice to leave the country after a year. The suffering they witness is part of their own society, perhaps their own family and friends, and will not end when the expat finishes their mission.

These realities have emotional consequences. How do aid workers maintain a sense of hope in the face of the struggles they encounter as they carry out their work? What is important and gives meaning in their lives when confronted on a daily basis with so much suffering and so many challenges? Searching for the answers to these questions is a part of my research and should also be considered by aid organisations and staff alike in the quest to address stress and burnout in the aid sector more effectively.

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.