Humanitarian agencies should not ignore mental health of their staff

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Brendan McDonald :
Aid worker casualties are horrific: 2,913 nationals and 544 internationals were affected by attacks since 2000. Regrettably, there will be more. After my 16 years of aid work it is not remarkable that I know colleagues who have been killed.
Hidden behind these numbers are the families of aid workers who have been killed. What happens to them? Many of them disappear from our collective consciousness. Many aid workers who are harmed, especially nationals and volunteers, don’t have insurance or invalidity coverage. If they do, I doubt it is adequate.
Recently, a colleague approached me with a yellow envelope collecting donations for a UN contractor who had been killed, leaving behind a wife and children. Contractors are not insured, hence the envelope. On one hand I was glad that we were doing something; on the other hand I was stunned. Really? The welfare of a widow and her children depended, in part, on my generosity, a UN staff member?
Casualties are just part of the problem. What happens to the thousands of aid workers exposed to the stress of humanitarian work? For every aid worker casualty, there are many more near misses. And, if we’re not exposed directly to the trauma of conflict, aid workers experience it through our daily work. Victims transfer this trauma to colleagues. Walls are built; emotions suppressed.
The Antares Foundation found that 30% of aid workers report symptoms of post-traumatic stress disorder (PTSD) after field assignments. A 2013 study by UNHCR showed that 47% of staff experienced difficulty sleeping; 57% reported symptoms of “sadness, unhappiness, or emptiness”.
Another study by the Antares Foundation shows that 46% to 80% of national aid workers experience symptoms of distress. In northern Uganda, over 50% of national aid workers experienced five or more categories of traumatic events. Respondents reported symptoms associated with depression, anxiety disorders, and PTSD.
Studies of soldiers show that post-traumatic stress can be cumulative and manifests itself years later. Aid workers can experience similar levels of stress to those of soldiers; without the support some forces provide.
Before I went to Iraq the UN checked my physical health, but not my mental wellness. Few aid agencies test the mental fitness of their staff; fewer have a comprehensive approach to wellbeing and senior managers rarely acknowledge the stress of aid work. We never talk about suicide rates among aid workers.
A colleague told me he felt isolated after being wounded in an attack a few years ago. There were no messages from senior managers; no acknowledgment of what he had gone through.
Human resources advised him not to tell anyone about his depression, and to make sure that his medical certificate was from a GP, not a psychiatrist. Better to be hurt on the outside, where people can see it.
Sadly this story is not an isolated one. Post-traumatic stress and depression are reality for many aid workers. When I experienced burnout a few years ago, I did not tell my employer. I felt at the time it would have ended my career; much better to have leukaemia.
The humanitarian sector has not been entirely idle when looking at this issue. Ten aid agencies signed up to the People in Aid Code, and another 40 stated a “desire to continuously improve their HR and people management skills”. However, this represents but a fraction of the aid world. Research has found that even when aid agencies establish wellness mechanisms, many aid workers find the care inadequate. A real concern of many is the fear that if they report their mental health issues, it will harm their careers and reputations.
In a recent Irin article about aid worker casualties Ben Parker asks “how do you honour the sacrifices of aid workers without appearing to value them more than those they serve?” Maybe the answer is to recognise that people are central to the achievement of our mission.
The May 2016 World Humanitarian Summit presents aid agencies with a unique opportunity to recognise that investing in their staff will reshape aid. I am petitioning the summit, calling on the UN to prioritise staff wellbeing in five ways:
1. Invest systematically in caring for the physical, mental and psychological welfare of their staff.
2. Establish a mechanism to ensure all aid workers have access to adequate support in the event of illness or injury, particularly for national aid workers.
3. Support the Core Humanitarian Standard.
4. Support the establishment of a Global Humanitarian Association to advocate for the rights of aid workers and their families globally.
5. Establish a mechanism for tracking the well being of current and former aid workers, including contractors and volunteers and national staff.
Improving the wellness of aid workers is a pressing task. No matter what aid commitments emerge from the World Humanitarian Summit, aid workers cannot serve well unless we are well.

(Brendan McDonald works for the United Nations Office for the Coordination of Humanitarian Affairs.)

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