Recently when aid workers finally reached the besieged city of Madaya in Syria, they saw the horror of destruction and the desperation among the estimated 42,000 inhabitants. The sight of emaciated civilians, deprived of proper nutrition for months, brought tears to their eyes.
Aid workers are on the front line of disasters. They are the first responders who get deployed to some of the most inhospitable places on Earth. They are usually greeted by horrifying scenes, desperate people and the lack of essential services.
With modern-day emergencies becoming more complex and the working environment more dangerous, the toll on aid workers can be enormous. But this issue gets scant attention.
Indeed, a survey by the Guardian reveals what many of us in the development sector have long suspected: that an overwhelming proportion of aid workers suffer from mental health problems and little is being done to help them.
What’s astonishing is that almost 80% of respondents from the Global Development Professional Network said they had experienced some sort of mental health issue, with almost half declaring they had been diagnosed with depression. Previous research has indicated that 30% of those deployed on field assignments report symptoms of PTSD after returning home.
These findings should trigger alarm bells in the aid community, especially among leaders and donors. Stronger support, more resources and better access to treatment are needed. Understandably, aid agencies have to make tough decisions on where to allocate funding.
“NGOs struggle with making psychosocial support more than a tick-box exercise,” said an aid worker in an anonymous posting.
Former U.N. emergency coordinator Valerie Amos said the humanitarian system is overstretched and that many aid workers are being forced to stay in the field far too long due to regional insecurity or political deadlock.
Professional aid workers, of which there are about 450,000 around the world, are often expected to stay in difficult and complex field environments for months at a time with no break. The security environment puts many under curfew restrictions that limit their ability to exercise and socialize. And in the testosterone-driven environment of tough fieldwork, there’s an enormous stigma attached to declaring oneself unfit for duty.
When our U.N. team first showed up in areas of northwest Pakistan devastated by the South Asia earthquake of 2005, which displaced more than 3 million people, there were few functioning government offices in the hard hit regional capitals. Entire ministries had disappeared into the rubble. There was a lot of work to be done.
I’ve seen firsthand fellow aid workers reach the precipice and it’s not pretty. Telling a colleague or friend to seek help is often greeted with such responses as: “Oh, I’m OK, I just need some time off.” In the field, feelings of invincibility are extremely common. An almost incurable obsession can take hold. Oftentimes aid workers rush from one assignment to the next with little to no time off, which can be detrimental to their health.
There used to be a time when, as a humanitarian aid worker, one felt shielded by the U.N. or Red Cross flags. Not any more. After the bombings of U.N. headquarters in Baghdad in 2003 and Abuja in 2011, there’s a feeling that aid work, as with journalism, is a far more dangerous profession.
The numbers support this. In 2013 alone, 155 aid workers were killed, 171 seriously wounded and 134 kidnapped. Kidnapping has become the most common form of violence that affects aid workers.
In 2014, eight of my international colleagues from the Organization for Security and Cooperation in Europe were kidnapped in two groups and held for an entire month by rebels in eastern Ukraine. Four were held incommunicado the entire time, but fortunately, all were released unharmed and unconditionally. All were offered counseling by experts.
I recall breaking into tears on the tarmac of Islamabad Airport in 2012 when I spotted the coffin carrying the decapitated body of Dr. Khalil Rasjed Dale, a 60-year-old Yemen-born British national working for the International Committee of the Red Cross who was kidnapped by unidentified armed men and murdered after four months in captivity.
It’s not just international aid workers who suffer. Local aid workers often toil away even if they have lost their homes or loved ones in disasters. In 2013, the majority of aid worker victims in attacks and ambushes were staffers of national nongovernmental organizations and Red Cross/Crescent societies.l
If there’s one aid organization that seems to be doing many of the right things to protect its workers, it’s the one that has a reputation as “first in and last out,” the International Committee of the Red Cross.
The organization’s aid workers have been deployed to some of the most inhospitable places on Earth. They stay on the ground long after others have left. “Humanitarian work is inherently stressful and working for the ICRC is no exception,” the Geneva-based organization told me. When needed, external psychologists are provided. A round-the-clock health hot line and extra days off away from the work environment are part of its mitigation measures for staff in stressful environments.
Donors and investors need to press aid organizations for guarantees that they are willing — and able — to provide mental health support to their staff and contractors. A good venue for further discussion is the World Humanitarian Summit in Istanbul in May. One solution could be a sectorwide code of conduct outlining commitments aid organizations should follow, from screening of new applicants to predeployment training, post-deployment assessment and sharing of best practices.
At a time when emergencies are becoming more complex, require longer and deeper engagement, and attacks on aid workers becoming more frequent and violent, how can we expect this sector to deliver if the very people at the forefront do not receive proper protection and support?
