EmergencyAIDio Interview - Wellbeing of Aid Workers

Mental Health & Wellbeing of Aid Workers: My Emergency AIDio Interview

A few weeks ago I had the pleasure to be interviewed by Nuran Higgins on Emergency AIDio, the first independent international broadcasting community for aid workers. Here is the transcript of the interview, edited slightly for clarity.

Nuran: Hi, everyone. This is Nuran Higgins, and you’re listening to Emergency AIDio. A community space that’s all about connecting aid workers to discuss real issues that shape our lives. I hope wherever you are tuning in from around the world that your week has been filled with lots of positive vibes and not too much stress. As you know, our last week’s show of Emergency AIDio featured the first of a 2-part series which is focused on the Mental Health and Well-Being of Aid Workers. 

Today, we’re going to continue on with this important topic by diving deeper into the second part of the series. Now, on today’s show we’re going to hear from Brendan McDonald who will share with us his critical views surrounding staff welfare, as well as a recent online petitionthat is circulating widely across the sector which is calling on the United Nations Secretary General and Emergency Relief Coordinator to recognize and invest in the mental, psychological, and physical welfare of aid workers.

Nuran:  Welcome Brendan and thanks for joining us here on Emergency AIDio.

Brendan: Pleasure to be here.

Nuran: Now over the last 15 years, there has been a significant interest and commitment by many individuals and organizations to address the issue of mental health and well-being of aid workers. This is an issue that leaves no stone unturned affecting every one of us. Either on a personal level witnessing a friend, or colleague, or even indirectly through the lives of our family and friends that are often left feeling a sense of helplessness not knowing how to help us. In spite of such efforts and commitment made by many over the years, one would expect with this being an area studied extensively that the statistics around the effects for aid workers when it comes to mental health and well-being would decline to some degree. In fact, that’s not the case. Now, in July you wrote a number of articles around this issue yourself which was shortly followed by the launch of an online petition.

Can you share with us what was the turning point for you in making the decision that you needed to take action, in raising the issue of staff welfare and launching the petition to the United Nations, to include staff welfare as a key issue to be addressed on the agenda of the World Humanitarian Summit in Istanbul 2016?

Brendan: Thanks. I guess the key turning point for me was in July this year. Ben Parker of IRIN, wrote an article called Memento Mori, which looked at this issue of aid worker casualties and the dilemma of how do we honor and acknowledge those who were being killed, or wounded, or kidnapped without appearing to value them more than the affected populations. 

Aid workers are reticent to promote their own issues, their own wellness, their own agenda because they feel it somehow detracts from the people we help. Parker finishes the IRIN article with the sentence, “How do you honor the sacrifices of aid workers without appearing to value them more than those they serve? I thought about that question. I felt that maybe the answer to that question is to recognize that people are central to the achievement of the humanitarian mission, which is not just the people we serve, but the people who are serving. That they’re equal. To invest in aid workers, does in no way shape or form, detract from those we are helping.

After watching that article, I’ve been in conversation with The Guardian and I wrote an 800-word article for them on this topic. Very quickly that article reached over 4,000 shares and generated a lot of conversation and dialogue on Facebook, on Twitter. So, in consultation with some similar colleagues who asked me, "How to take this agenda forward? I said, "Well, the World Humanitarian Summit is the most appropriate spot right now.” That is when I launched the petition.

Nuran:  With the petition that’s circulating widely across the globe currently. It stands at 1,426 signatories, which is fantastic, I had to look at it today. The petition calls on both the United Nations Secretary General and the Emergency Relief Coordinator to address five key points. Can you share with listeners a bit about the five key points and why in particular they have been singled out as fundamental in raising this issue of staff welfare?

Brendan: First of all, for those less familiar with the process, the World Humanitarian Summitis an initiative of the Secretary General. That’s why the petition is addressed to that office. The Emergency Relief Coordinator is the official charged with making the Summit happen. 

I think the five key points reflect cross-cutting issues around the whole topic of staff welfare and staff wellness. The first one, invest systematically in the physical, mental, and psychological welfare of aid workers. All too often people view this conversation through the lens of critical incidents and post-traumatic stress disorder, rather than saying actually, the stresses, the trauma of aid work has to be addressed holistically from how we recruit our staff in terms of the psychological testing. How we invest in them in terms of training? How can we create a healthy work environment in headquarters or in the field, in terms of something that’s free from discrimination, free from sexual harassment, that is free from abuse and bullying; so that when the staff goes to the field, they are fully prepared for that assignment.

When something does happen in the field, we make sure that we fully invest in the security aspects to make sure that we mitigate as many the risk as possible, so that we’re only left with the residual risk, which we accept. Then of course, if harmed, we then look after them until they no longer need our care. On the second point, which is to establish a mechanism to ensure all aid workers have access to adequate support in the event of illness or injury. 

What prompted this point was many years ago in New York. We learned of colleagues who were contractors to the UN, who were killed. A staff member came around to my office with a yellow envelope asking me if I could donate cash for the person’s children and widow. On one hand it’s like great, were doing something. Then also, how terrible is that some young kids depend on my generosity in New York. What happens to their future? You have a huge number of volunteers, particularly I’m thinking of national staff for NGO’s or the UN who I don’t think have adequate insurance.

I also realized this for my own kids, where I investigated a little while ago that if I had been seriously hurt, perhaps made a quadriplegic or paraplegic as a result of my work in the field, I didn’t have adequate insurance to adapt my house and get the care I would need. Imagine how horrific it is as for a volunteer working in Sierra Leone in the Ebola response, and you get sick and die? There is nothing for your family. 

Now, if you look some solutions, from purely a business perspective, there’s a massive economy at scale. For example, UN needs to have a harmonized insurance, we don’t, we have separate insurance policies, which is ridiculous. Secondly if the NGO’s would collectively, say 20 of the world’s biggest NGOs, and bargain for one comprehensive insurance package, or perhaps set up a global trust, where we cover the needs of those staff who is not on contract. So this point is about looking after these people, which we don’t normally think about.

Nuran:  It comes back to the issue around equity too, which when we talk about humanitarian principles in the way in which we act. We’re kind of hypocrites in that sense, where there is inequity in this perfect example. We need to be accountable for that. 

Brendan:  Yeah. What is a red flag for me is I do have friends and colleagues who had been hurt in terrorist attacks in Baghdad, in Afghanistan. They’re in the UN, which probably provides some of the best coverage and support, in theory. All of them had been aggrieved in how they were treated and the battles they fight. The lack of support or insurance coverage for them in their illnesses. If the UN, which has a policy that is committed to aid worker wellness isn’t delivering, what are the smaller NGOs doing?

Nuran: Nothing.

Brendan: Nothing.

Nuran: Exactly.

Brendan: Definitely, this is equity issue. Also the … I’ll use the word hypocrisy, but I don’t think it’s intended to be that. If you’re injured in Australia or the UK for example, you have a legal duty of care. If a volunteer helps you and they’re hurt, you have to cover them.

Nuran: Exactly.

Brendan:  You have to look after them, right? You have to provide a safe working environment. In the field, they don’t do that, right? This is why the case of Steve Dennis, suing NRC for an incident in Dadaab, who is going through the Norwegian courtsm is fascinating. Because, you, as an employer under law, certainly in most European countries, US, Australia have to provide a duty of care and ensure foreseeable risks are mitigated. That is in Dadaab, in Kabul, or when you’re in Baghdad. If you fail to do that, you’ve broken the law because as an international staff member, my redress will be through my national courts. Anyway, my second point will help you address this. 

My third point was to support the new core humanitarian standard through the CHS Alliance. I really thought the People In Aid Code of Good Practice was excellent. The more I researched it, very few organizations had actually said, “Yes, we’re doing this. We’re committed to make that happen.” 

A lot of organizations I think were trying. Only a handful were delivering, which beg the question is, either “It was too hard” or people were not engaged in the topic. People in Aid Code perhaps wasn’t allowed enough voice to get noticed. I’m not sure. We have to get people to say, “This is the common standard of how we look after our staff, get everyone to sign it, and then it becomes the industry standard.”

Nuran:  Do you think that there will be a shift in that because it’s changed, or do you think that it will be pushed under the table as with the People in Aid Code has? Ultimately as you said, organizations have signed up to it, but the commitment has been very much on the superficial level; if we look over the last 15 years in addressing some of the fundamental flaws that should be in place as basic element.

Brendan:  I don’t think any organization, or the system as a whole will address this, unless it’s forced to do so. Similarly, we have people who don’t adequately look after their staff in terms of pre-deployment, deployment, post-deployment work. Yet donors will still fund them. I would rather donors turn around and say, "Sorry NGO, UN Agency, if you don’t meet the standard, if you aren’t investing and looking after your staff appropriately, in accordance with best practice, we’re not going to give you any money.” Again, it’s this idea of a hierarchy that the people we help are more important than us. This is also another topic, which links to this. It’s the professionalization of humanitarian work.

Nuran: Yes. That’s where my concern with this comes because we used the same word around humanitarian effectiveness and with that. All of the debates and discussions that have evolved around this issue, it links very closely to professionalization. Already, there is enough stress and expectations that we place on humanitarian leaders in the field to deliver without even thinking about the fact that these people are human beings, beyond the responsibility of managing a complex emergency. They have personal lives as well. Are we actually putting more, demanding more pressure than on practitioners because we’re requesting or demanding what should really be in place to begin with? With that squeeze coming from the donor organizations, again it comes down harder then on practitioners to say, “Well, if we’re going to invest in you, rather than it being a mentality of what we should be doing anyways, we expect more in return.”

Brendan:  Which is why this third point to me makes sense. I like the way that People in Aid Code is being merged as part of the CHS Alliance, is that all of the standards do support each other. To deliver effective aid, you have to be looking after your staff. I think that’s the more coherent approach. That’s the fourth point, I think PHAP is a very good example of this. Perhaps you can even build on what they’re doing. There needs to be an external independent entity that represents the interest of aid workers. If you think about in professions in a lot of countries, you had guilds. For example, if you’re a plumber in the UK, he’s got the guild to look after that. If you are a doctor in Australia, you belong to the Australian Medical Association, which is free you from issues with your employer, who might be the hospital. 

We need an independent body that aid workers join up to. That’s able to coherently solicit the views of aid workers and advocate for them. This is on things whether it’s about insurance, whether it’s about professionalization. Anyone can call themselves a humanitarian, not anyone can call themselves a lawyer. What would make somebody humanitarian, or maybe make a distinction, what would make someone an aid worker? Also to the lobbying on this issues, both improves security, etc. because when an agency does it or when staff union does it, in case of the UN or UN agency, it always comes with a particular bias or particular agenda, that’s about the institution, not the system. The fifth point, is to establish a mechanism for tracking the well-being of the current and former aid workers, including contracts, volunteers and national staff.  And there are two elements to this. Humanitarian Outcomes has the Aid Worker Security Database that records major incidents of violence against aid workers.

Nuran: And inside in security as well. 

Brendan: Yes. That database is only comprehensive in the sense of reporting. It probably underestimates the toll. That’s one issue. Secondly, as we know certainly from emergency services and defense personnel, a lot of the issues related to well-being and health, happen many years later. You could be involved in a critical incident, walk out and say I am perfectly fine. Then five or six years later, you’re back in Australia, or you settled somewhere else, and PTSD starts manifesting itself or the lesser forms of burned out, depression, etc., can emerge. Once you’re off contract, you’re on your own.

Nuran: Exactly.

Brendan: How do we know the scope of the problem if we don’t have the data? That’s the other issue. We have various studies that had been done on over the years, but there has never been as far as I can see, either a meta analysis of the studies, or a proper valid survey or study of this topic. That’s what I would really like to see, for a donor to get behind this survey. It is a problem, let’s go and find out what it is. Then we talk about the solutions based on the evidence. 

Nuran:  For me, one of the constants that I’ve seen over many years both upwards institutionally and then downwards to aid workers is, there’s always this push back. What I like to call the blame game where no one wants to take responsibility, because the reality is this is not going to be an easy fix. It’s going to require a fundamental shift in our culture and long-term commitment in how we see ourselves, the system, and the world around us. The question is, how are we really ready to commit, to tackling this issue together? Recognizing that it requires a shared level of responsibility with a view to investing long term were needed to really see and be the change we know should be in place. Reflecting on this, what words of advice would you give to those in positions of leadership across the sector and humanitarian practitioners in being active agents for change as a result of your personal experience of working in the sector for the last 15 years?

Brendan: I think, humanitarian leaders need to set a vision and inspire people to follow them to achieve that. Often in the UN and the humanitarian community we have great managers, bad managers, average managers. But a real leader that says:

“I know you don’t want to go to this destination, but I’m going to inspire you and you’re going to want to travel there with me. We’re going to change things together.”  

In terms of this issue of staff welfare, we need to see a senior humanitarian stand up and seize the issue and lead from the front. There is only so much change that can be driven from the grassroots level to fill the momentum, but at the end of the day to execute that, courage and leadership is required. The courage to listen and to realize that if we do invest in staff, not just in terms of their welfare, but in terms of the training and professionalization of what we’re doing, we will have a much better humanitarian system. We will overcome the inertia, we will overcome cynicism, we will drive change, because people will know there valued. People think they’re not valued, and that they simply functionaries. If organizations treat them poorly, you’re never going to reshape aid.

Nuran: On that note, I’m going to say, Brendan, thank you so much for taking time to share your critical reflections with Emergency AIDio listeners on the current challenges and dynamics surrounding mental health and well-being for aid workers. It’s been really great to listen to your journey and commitment to raising the issue of staff welfare. It’s not an easy battle, but it’s great to see people like yourself that are getting behind and are committed to try and make a change in this space. Thank you.

Brendan:   Thanks very much. It’s been a great conversation, very stimulating, and I look forward to talk to you again. 

Nuran:  Thank you. Now, I really want to stress that there are very few moments in time like this right now to make our voices hard as a collective community. Don’t let this opportunity pass you by. We all need to take responsibility to ensure that the environment we work is safe, and values us as human beings by investing and prioritizing in mental, physical, and psychological welfare of staff and volunteers. Make sure you sign up to the petition. The link to the petition will be posted on thehealthynomad.org website under the Emergency AIDio page. You can also follow the great work that Brendan is doing by hitting over to his website, http://7piliers.com.

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