While it is important to note that hundreds of millions of people who need humanitarian and protection assistance[1] around the world deserve to be at the forefront of our prioritization for better health support and holistic care, often those that strive to support them in some way possible largely overlook their own well-being and self-care too, and are expected to be ‘resilient’ by the organizations that employ them with minimal actual, practical support. However, it is evident that self-care is not the solution, rather, while we are working, organizations have the primary responsibility to ensure for our health[2], well-being, welfare and safety. Self-care is only one part of integrated and holistic care, but until organizational culture within the sector entirely shifts its paradigm (this includes the patriarchal, macho environments and positions of often male leadership towards staff vulnerability), along with a plethora of other changes that are required in the system to ensure that there is a shared responsibility for promoting staff welfare and well-being, there are some ways to find and access support from others, our support networks, our faiths and belief, and various other tools or practices. We must also acknowledge that people cope differently with hardship and stress and may have different understandings of what stress or mental health comprises – this is either because they have had different life experiences and cultural perceptions around ‘resilience’ and stigma related to stress; have had limited access to internal or external support structures of healthcare services; or, they do not trust them for fear of retribution; or, have their own more appropriate support mechanisms. National staff and marginalized groups in most contexts where there is some form of humanitarian assistance often do not have the choice, freedom or ability to seek external support and/or are not provided with any tailored, contextualized support by their organizations (e.g. health insurance, extra medical support and other benefits).
Notwithstanding, humanitarian aid workers and other professionals working in hardship duty stations, difficult circumstances away from family and friends, or who have experienced some form of personal or work-related trauma often require time off to recuperate and/or escape. Some people persist through adversity and others escape through their own means, healthy or unhealthily! According to a mental health and wellbeing survey initiated by the Global Development Professional Network[3], 79 per cent of the 754 respondents stated that they had experienced mental health issues. The overwhelming majority, 93 per cent, believe these to have been related to their work in the aid industry. Three quarters of those that took the survey were female and the majority of participants identified as international staff working at an international NGO. In 2019, another survey of the charity sector in the UK produced equally troubling findings, with 42 per cent of 850 respondents claiming that their jobs were detrimental to their mental health[4]. Other revelations by humanitarian aid workers through the Guardian Development Professionals Platform[5] and the Facebook group ‘Fifty Shades of Aid’[6] have pointed to poor management, bullying, discrimination, unfair dismissal and various other health problems related to humanitarian work. Additionally, surveys within the humanitarian and broader humanitarian sector suggest that the risks of burnout increased as a result of the added pressures, and loneliness, related to COVID-19 and the associated lockdowns (Alliance Magazine; CHS Alliance, 2020). The pandemic, specifically, and studies arising from it[7] has shown that no one is completely free of mental suffering. It is a positive development that the World Health Organization (WHO) has released guidelines on mental health at work, which provide evidence-based recommendations to promote mental health, prevent mental health conditions, and enable people living with mental health conditions to participate and thrive in work[8].
Often an overlooked population, humanitarian aid workers, as a group, still experience an industry-wide failure to adequately address psycho-logical health issues. The suspected numbers of death by suicide, diagnosed post-traumatic stress disorder (PTSD), depression, anxiety disorders, hazardous alcohol and drug consumption, emotional exhaustion, and other stress-related problems are impossible to quantify but are considered endemic[9]. Our organizations formulate policy, frameworks, provide counselling and other options, but really rarely admit the fact that we are expendable manpower in largely bureaucratic institutions. The systemic failure to address this is not negated and collective changes are required, which cannot negate inclusivity and community to ensure shared purpose and humanity. As there are no available or trusted institutional systems or practices made available to us to pause to breathe, to share and be honest with each other, most humanitarian aid workers learn to bury emotions and continue working[10].
At the same time, this so-called ‘duty of care’ does not substitute for the decisions we can make as human-beings for own well-being, health and wellness, despite the importance of it not being an individualized approach rather a collective one. Aid workers still fear seeking help because of the stigma associated with mental illness or substance abuse and the potential negative impact on career. As a community we must hold our employers and donors to account by advocating for change and transparency, and taking ownership when it comes to mental health and well-being. So, by and large, despite the responsibility of our employers to provide us with a suitable, healthy and safe working environment, our healthiness is still in our own hands, will and strength of mind.
For more information as to how you can contribute to change, some very pertinent and applicable possibilities for change are documented by various thinkers and practitioners, listed in the resources on this website and in others also referred to.
[1]https://gho.unocha.org/
[2] As per Core Humanitarian Standard (CHS), established in 2014, Commitment 8: ‘staff are supported to do their job effectively, and are treated fairly and equitably.’
[3]https://www.theguardian.com/global-development-professionals-network/2015/sep/23/share-your-stories-mental-health-and-wellbeing-in-the-aid-industry
[4] Unite the Union, 2019. https://www.unitetheunion.org/news-events/news/2019/may/charity-workers-suffering-an-epidemic-of-mental-health-issues-and-stress-survey-reveals/
[6] Fifty Shades of Aid is a Facebook support group with over 25,000 members – https://www.facebook.com/groups/1594464844163690/
[7] https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide
[8] https://www.who.int/publications/i/item/9789240053052
[9] Humanitarian Aid Workers: The Forgotten First Responders, Robert I.S. Macpherson & Frederick M. Burkle, Jr. 2020
[10] Gemma Houldey, ‘The Vulnerable Humanitarian – Ending Burnout in the Aid Sector’, p.7, Routledge 2022