Tag Archives: Mental health

Bringing sexy back to resilience and well-being of aid workers

By Nuran Higgins

Have you heard about Emergency AIDio?

If not, now’s the perfect time to tune in and sign up. It’s an independent radio show for aid workers, presented by Nuran Higgins. Emergency AIDio is all about creating an accessible and safe space that connects aid workers, by bringing issues of aid worker health and well-being to the forefront of people’s minds. Nuran Higgins shares the impetus behind the show and why you should tune in.

The Why behind Emergency AIDio?

Over the last 15 years I’ve been in the sector, what’s become more and more evident from my own personal experience, and also through listening to and observing colleagues and coaching and mentoring aid workers, is that an epidemic has been quietly living amidst us. It’s an epidemic that has resulted in our human dimension being lost as aid workers.

The humanitarian landscape is changing and has become increasingly dangerous over the last decade. Aid workers are now faced with working in environments that are more complex and multi-faceted than ever before. Growing recognition, both in the aid sector and in evidence-based research, has shown an increase in the prevalence of aid workers suffering from stress, burnout and other health and lifestyle issues. I have always been a strong advocate that prevention is the best medicine, and am hoping the radio show will have an impact in some way, by providing a space whereby we can openly have the conversations needed to bring about change related to aid worker health and well-being.

When reflecting on aid worker health and well-being  over quite a number of years now, there have been a few key areas that have essentially been the catalyst behind moving forward to get Emergency AIDio up.

The first area has been related to aid worker health and well-being and its connection to resilience.

Now for the majority, this issue will probably come as no surprise, given the extant literature that highlights some of the common issues that affect aid workers, from burnout, PTSD and vicarious trauma to anxiety, depression and even self-harm practices.

Yes, we are aid workers, but it’s also important to remember that, inside the role you carry out every day with passion, there’s a human being. A human being who has feelings, emotions and desires. A human being who is supported and connected to family and friends. And a human being who is worthy of receiving and giving love.

When we refocus discussions related to aid worker health and well-being to take into account the whole person rather than just the role, at individual and organisational levels, we are far better equipped to strengthen our overall level of resilience.

The second area has been related to the disconnect often found between academic institutions, humanitarian organisations and practitioners.

Over recent years, we can see that efforts have been made to bridge this divide. And, having been in the fortunate position over the last year to move into the world of academia as a Lecturer in Humanitarian Assistance and still remain connected to the field with short deployments, I have seen some of the innovative progress being made. However, there’s still more work to be done.

It doesn’t matter where or what level you are coming from; we all hold a unique piece of the jigsaw puzzle that brings together the full picture. What’s often missing is communication and a space to have such discussions that are not dominated by one party or another.

I do believe that if we really want to be able to influence organisational change and the direction the humanitarian sector is going, then as aid workers, we need to first and foremost be part of the discussion, even if it means sometimes taking that leap of faith to drive the discussion ourselves.

And the last area has been really about the importance of remaining connected with our inner selves, being gentle with ourselves and comfortable with the feeling of  just chilling out, having a bit of  fun.

We all have our own unique story of why we’ve chosen the path of wanting to serve humanity. But, somewhere along the journey, this often gets put to the side, against other competing priorities to keep the ball rolling. Yes, we are very good at helping others, but we’re not as good at finding a balance and redirecting the compassion and love inwards to ourselves.

Which is Why we need to shift this mindset.

Choosing to redirect some of the altruism that drives us back to the self doesn’t mean you can’t still be just as professional or hard working. The whole superhero/superheronine culture of aid workers is so 1990s; we’re living in 2014, which is all about bringing the sexy back into the resilience and well-being of aid workers.

You can check out the latest episode below, sign up at The Healthy Nomad and stay tuned on Facebook.

Nuran is an expert in conflict, post-conflict and disaster contexts, working extensively in Africa, Asia, the Pacific and the Middle East in various technical, senior leadership and operational roles. She holds academic credentials in Public Health and International Community Development, and has researched and written on Afghanistan, women, peace and security and operational humanitarian health interventions. She is also a public speaker on humanitarian issues, women and leadership, resilience and well-being. She is a lecturer in the Master of Humanitarian Assistance at Deakin University in Australia and is a member of Professionals in Humanitarian Assistance and Protection (PHAP).

Featured image is Nuran Higgins, host of Emergency AIDio.

Your organisation isn’t going to help you, help yourself.

This post originally appeared at How Matters

Generally speaking, it doesn’t matter how large or how small the organisation you work for is. If you work in aid and development, it’s up to you to look after yourself. Sure, there are exceptions out there. Anecdotally, Save the Children and MSF are both large organisations that are investing time and money into the mental health of their staff. But the reality is, for the bulk of them, the onus is still on the individual to take care of their emotional and mental wellbeing.

A volunteer in a large government volunteer program was working in an area of considerable stress, dealing with victims of sexual violence on a daily basis. She had put in an application to continue her association with this small local organisation, through another volunteer scheme managed by the same company. After she experienced mental health issues, she informed her employer that she was struggling and needed help.

The response that she was given was that she was jeopardising future placements through this company by requesting help. Quite simply, she was showing that she was not of the right fortitude to deal with the requirements of the job. They did however tell her that she was entitled to three hours of free counselling services. Over the 12-month period of her contract.

We put people in places where we demand a great deal from them, and expect our pound of flesh. But rather than give them the tools to do the job that is needed, we treat them with suspicion that they are incapable or weak when they need help.

How did it get like this?

Two years ago, WhyDev ran its first pilot program into peer support, aiming to match isolated aid workers around the world together, to support each others mental, emotional and professional well-being. Back then, the idea that aid workers were able to reach out for this kind of support was something of a novelty in itself, even more so than it is now.

An older man who had worked in the aid and development sector for a couple of decades felt the urge to write to me out of the blue. His email started politely, though (unsurprisingly perhaps) condescendingly.

“I am sure that you are a nice and well intentioned chap”, he wrote, much like the old uncle with a pipe in one hand and a cricket bat in the other, poised to strike you on the bottom just as you think you’re getting off with only a verbal warning. He continued to tell me how in his considerable experience working in conflict and post-conflict areas, he was yet to meet anybody who could benefit from this kind of support. What we were doing at WhyDev was, in his own words, “creating yet another coffee-club for people who ought to pull themselves together and stop whinging.” He urged that I “should put my considerable energy and brainpower into something worthwhile.”


It speaks volumes about the capacity of someone to provide empathy when their solution to a problem is to grin and bear it. It also says more about the aid and development sector when people who we can assume are in higher management positions have this attitude. When they were our age, they toughed it out, and learnt how to “stop whinging”, the younger generation simply needs to do the same.

It is for this very reason that progress from organisations towards true comprehensive mental and emotional support for aid workers is slow. Look at an example of who is green-lighting them (or not, in this case).

I have two simple suggestions on how we can start to improve the situation from an organisational point of view. The first is employ more women in management positions. The science has shown again and again, that on balance, women have more characteristics than men that are suitable for management. Humility, sensitivity and emotional intelligence, just to name a few. Surely these sorts of characteristics, not the overconfidence that male managers tend to display in their own opinions, are more likely to result in organisations that know how to care for their employees’ mental and emotional health. Not only care, mind you, but give them the right tools to do the job.

The second comes back to title of this piece. Realise that, for now, organisations are generally not going to provide staff with the sort of support that they need. This doesn’t exonerate them of their responsibility to do so. It means individuals who work in aid and development need to let them know that it is something valuable to them. And support each other. Changing the perception of mental and emotional needs of aid workers will take a long time. But collectively, it is possible.

John Steinbeck’s quintessential bromance novel, Of Mice and Men, contains one of my favourite passages that encapsulates what working in isolation feels like.

A guy sets alone out here at night, maybe readin’ books or thinkin’ or stuff like that. Sometimes he gets thinkin’, an’ he got nothing to tell him what’s so an’ what ain’t so. Maybe if he sees somethin’, he don’t know whether it’s right or not. He can’t turn to some other guy and ast him if he sees it too. He can’t tell. He got nothing to measure by. I seen things out here. I wasn’t drunk. I don’t know if I was asleep. If some guy was with me, he could tell me I was asleep, an’ then it would be all right. But I jus’ don’t know.

Crooks, a black, stable hand with a physical disability, is always someone who is on the periphery of everything. He has no measuring stick to which he can exist in his life. It’s just him. But we can help each other, by first helping ourselves.

DevPeers: Improving aid through peer support from Weh Yeoh on Vimeo.

Early results of the largest survey of humanitarian workers ever show that burnout is a key issue already. At WhyDev, we are raising funds for the next iteration of their peer support program: DevPeers.

We are currently halfway to what we need to get the program launched. Without it, we cannot support the hundreds and thousands of aid workers out there. All help is appreciated.

You can also register your interest in DevPeers as a participant.

Burnout and its causes

Burnout is a problem many aid workers face. In this post, psychologist and organisational consultant Alessandra Pigni discusses the causes of burnout and how it differs from stress or PTSD. A follow-up post will appear next week and will look at what (aid) organisations can do to prevent burnout.

Why does burnout, rather than PTSD, seem to be more common among aid workers?

We need to make a clear distinction between the psychological conditions aid workers may experience following traumatic events, and the distress they experience in their day-to-day work. Both can lead to psycho-somatic suffering, but the causes and remedies are different. Aid workers do not experience burnout following the exposure to a traumatic event, but they may experience trauma-related conditions including (but not exclusively) post-traumatic stress disorder (PTSD). Instead burnout is related to a way of working and to a particular type of organisational culture that I shall describe.

Research suggests that 5% to 10% of aid workers suffer from PTSD. Between 30% and 50% suffer from moderate to severe levels of emotional distress, and 40% are at high risk of burnout. What we need to understand is that given adequate support, most people have the strength and resilience to overcome a traumatic episode without developing PTSD.

This means that aid organisations need to provide tailored support to those professionals who may need it, offering a range of options and not exclusively trauma counselling. The work of trauma therapist Babette Rothschild is excellent if we want to understand PTSD: the author warns us about avoiding the common mistake of thinking that exposure to a traumatic event equals PTSD, and consequently rushing people into counselling.

Burnout is a different issue and unlike PTSD it is a widespread problem across the aid sector. Burnout is a “man-made” condition over which individuals and mostly organisations have a high degree of control. As burnout experts Prof Maslach and Leiter illustrate, burnout is a condition caused by being exposed to an unhealthy work environment, meaning the internal organisational environment.

So while people need to figure out what they can do on an individual level to prevent burnout and, for example, keep their perfectionism and workaholism in check, change will be limited without a shift in organisational thinking.

Aid workers have a pretty good idea of the challenges that they will face in a humanitarian/developing context: power cuts, at times violent and insecure surroundings, gunshots, checkpoints, etc. Place a group of aid workers around a table and you can almost feel that there is a sort of pride in how much they have endured, they always have a story to tell about showering out of a bucket and having to negotiate with the rebels the access to remote areas!

While these though conditions are far from easy, aid workers make an informed career choice. They know that these ‘rough edges’ come with a job that they expect to be meaningful, and full of action, a job that will allow them to experience the world, while being part of a community of people driven by common values. This is where burnout comes in because often these idealised expectations are betrayed by reality.

In order to understand how burnout is not simply a stress problem over which a single individual can have full control, let me go back to the research by Maslach and Leiter who clarify that “while most people think job burnout is just a matter of working too hard, that’s not necessarily true.”

Stress is to burnout what feeling a little blue is to clinical depression. “Burnout is when you feel overwhelming exhaustion, frustration, cynicism and a sense of ineffectiveness and failure.” The authors list six areas that can result in burnout:

  1. work overload;
  2. lack of control over the work;
  3. insufficient rewards;
  4. workplace community problems, such as incivility and a lack of support among co-workers;
  5. a lack of fairness, such as inequality of pay, promotions or workload;
  6. and a conflict between one’s personal values and the requirements of a job.
If this sounds familiar, that is a bad sign.

Do you recognise any of these traits in your organisation?

This evidence-based understanding of burnout and of its key features is essential to appreciate how this condition is an organisational challenge. Most aid workers do not simply overwork, they may also be immersed in an organisational culture that resembles the points highlighted by Leiter and Maslach. It is not unusual for aid workers to experience a sort of ‘cognitive dissonance’ between what they thought it was going to be and what it is.

This gap between expectations and reality, the mismatch between official mission statements and work on the ground, a defensive culture of overwork and sacrifice, and the lack of rewards and fairness is what leads aid workers to burnout. Burnout feels like falling out of love with your job.

If you are just tired, a break and some self-care will do. Burnout requires a different kind of approach, and the best approach is preventing it at the organisational level by strengthening a supportive and respectful work environment.

[Ed. note – participants in WhyDev’s pilot peer coaching program indicated a range of benefits to participating in the program, including feeling less stressed and isolated. We’re currently fundraising to launch DevPeers, the next iteration of this program. 

For more information and to support our campaign, visit http://www.startsomegood.com/devpeers.]

Are aid workers more ‘maladjusted’ than others?

Are aid workers more ‘maladjusted’ than others – or does our work just make our maladjustments more obvious?

“According to the General Health Questionnaire (GHQ), a staggering 50% of aid workers could be classified as non-psychotic psychiatric cases. The authors offer three possible reasons for the result, the third being the most intriguing: the tendency of maladjusted individuals to choose to become aid workers.” (Brendan Rigby, WhyDev)

I first came across this notion of “maladjustment” many years ago in a study on what motivates international volunteers, and I was curious – was it my “issues” that motivated me into volunteering and aid work?  Certainly I felt like the choices I was making brought out my insecurities, but on the other hand everyone else I knew had their own issues, and most of those people hadn’t gone into aid work.

As I considered this question further in subsequent years it also occurred to me that the aid worker experience often cuts quickly through the superficial.  Any demons, vulnerabilities or insecurities you have will be exposed by the emotional, physical and intellectual pressure-cooker of aid work – particularly humanitarian work.

The authors of the paper referenced above speculated that their results could be explained by “a high incidence of people with psychological problems choosing to become aid workers.”  But the study did not compare pre- and post-mission data to check this hypothesis or provide other evidence to support it.  Another well-known study that did involve longitudinal research found on the other hand that aid workers with experience of severe childhood stress seemed less at risk, and postulated that this may be because their earlier experiences had helped them develop more effective coping strategies. This is intriguing, because exposure to early life stress is often considered to predispose a person to greater vulnerability later in life, not less.

So I was very interested to hear psychologist Carla Uriarte’s opinion about this.  She has been working in aid worker psychosocial health for more than a decade and in a recent interview about a new aid worker resilience training program she is co-teaching for the Garrison Institute in New York, she said:

“I’ve been intensively working with aid workers for the last eight years. Many aid workers, from a general perspective, show an exceptionally good resilience capacity.  I’ve worked with people who have better personal coping mechanisms than the majority of people, but they are confronted with very extreme experiences, which overwhelm in some cases, some instances, some moments, those coping resources.  [I think it is also true that] very stressful experiences bring out our vulnerabilities in a more clear way.”

She points out that when you put all of these individual cases together, the effect intensifies: “Now when you’re working with a team of people who don’t know you, and are trying to cope with their own difficulties, then it’s a lot more difficult for those issues to calm themselves.  So I think what happens is they get more acute.”

In her chapter on aid worker safety and security in the anthology Workplace Violence, Ros Thomas draws on research done with mental health workers to assert that: “…when aid workers experience trauma it brings to the surface uncertainties, fear and vulnerability in colleagues who have contact with them.”

But the same characteristics that the stresses of aid work bring to the fore may also motivate and equip people to do the work.  Aid workers “seek adventure, travel and to engage in something different,” says Thomas, but they are also “motivated by a wish to engage in meaningful activities that contribute to securing a better life for those in distress.” The constant change and adaptation aid work demands are known to be stressful, Uriarte argues, but they also attract people to it.  Other research indicates a strong sense of empathy often motivates people to get involved in helping or caregiving work, even while potentially making them more vulnerable to empathic distress.

So it does seem fair to suggest that rather than being less well-adjusted than the general population, we aid workers are equally maladjusted, but have chosen a line of work that makes it harder to mask or ignore our weaknesses and vulnerabilities.

If that’s true, the relevant question becomes: how do we maximise the way the “maladjustments” each of us brings to aid work make us particularly suited for it, while minimising the negative consequences?

As Uriarte points out, some claim people who choose to train as psychologists are similarly maladjusted.  But unlike aid workers, the connection between the individual’s own process and the work he/she does with others is explicitly recognized in the training of psychologists and social workers.   They’re required to maintain some kind of peer supervision and self-reflection process as part of their professional practice.

What might happen if that also applied to aid work?  The need for continuing “organisational learning” through reflection is a given (though not necessarily done well) in humanitarian and development best practice.  Systematic practice of reflection and learning at the individual level, going beyond the traditional work-output focus of an aid worker’s performance appraisal, might be equally valuable.

WhyDev piloted a Peer Coaching program for aid workers last year with a lot of success and is currently fundraising to launch a refined version of DevPeers.  For me yoga and meditation have been key in the process of self-reflection at both a mental and physical level and I recently partnered with Marianne Elliott to offer an online yoga course ’30 Days of Yoga’ targeted for Aid Workers.  The Contemplative Based Resilience Training offered by the Garrison Institute, for which Uriarte is part of an expert faculty, brings together meditation and yoga-based practices with psychosocial education in a multi-faceted resilience training program.

Heart of darkness: The psychology of an aid worker

The research on stress and mental health problems afflicting aid workers is fragmented and scarce. Those that exist are alarming. They identify a number of health and psychological problems among both national and international aid workers from Sudan to Kosovo: physical illness, distress, alcohol abuse, anxiety, depression, PTSD, risk-taking behaviours, nondirected anger and secondary traumatic stress. (Aka, compassion fatigue).

One study in particular sticks out.

The researchers look at the mental health of 53 aid workers representing 11 NGOs in Darfur. According to the General Health Questionnaire (GHQ), a staggering 50% of aid workers could be classified as non-psychotic psychiatric cases. The authors offer three possible reasons for the result, the third being the most intriguing: the tendency of maladjusted individuals to choose to become aid workers.

Jessica Alexander’s story, Chasing Chaos, is both a cautionary tale and a memoir, one that I imagine she would have liked to have read before setting off for Sudan. It is almost laughably typical; a story that is the genesis for stereotypes. A privileged, white American girl goes to Africa to do aid work, (on the most recent episode of the brilliant satire Ja’ime: Private School Girl, Ja’ime, played by Chris Lily, declares that she will take “my gap year to focus on modelling and I’m gonna do aid work in Africa”) falls in love with a black man, returns briefly home, hates questions about her work and her friend’s naive attitudes, goes back to Africa. I almost put the book down at this point, but was both surprised and pleased I didn’t.chasingchaos

It is a deeply honest memoir of the personal and the professional; at times patronising and self-deprecating, Jessica demonstrates both self-awareness and a superiority complex. At times it reads like a giant resume, as she regales the reader with accounts of each of her postings like she is competing with a fellow aid worker in a game of  “Who’s got the Bigger Aid Balls?”. The beginning of Chapter 5 starts with, “I signed my contract to work in Darfur shortly after an American woman stationed there was shot in the face”. Can you beat that?

This type of bravado is contrasted with refreshing honesty. On the night before leaving for Darfur, reflecting with her best friend, Jessica reveals a universal truth of aid work. “Right then, I didn’t feel compelled by them. I didn’t necessarily feel connected to the plight of Darfurians, either. This was what I needed to be doing for my career; it just happened that Darfur was the place I would be doing it” (p.93). Jessica, like all aid workers I believe, is searching for something deeply personal, burrowed somewhere within. Our own heart of darkness. This Personal Truth is in everyone, and each of us takes different paths to try and find it. The maladjusted among us drive that PT boat down the river into aid work. (Or dentistry).

It is never entirely clear what Personal Truth Jessica is searching for. It is not clear what her motivations are, but I suspect it is connected to her late mother. Aid work is essentially about the ‘I'; the ‘You’, the ‘Me’. The effectiveness of aid work, that global catch-word of the next five years, is personal and individual. As Jessica spins the reader through the number of agencies crowding the field and the Discourse of aid work, she nails a key assumption and barrier of program and project success: “It really just depended on who was there” (p.105).

I think that is what Jessica does so well: puts a human face on aid work. And not just her face, but the faces of her international and national colleagues. It is easy to forget amongst all these declarations, international days, proclamations, targets, goals and agendas that at the heart of the international aid and development architecture are humans. Not just on the receiving end, but also on the sending end. Humans Use & Make Aid work Necessary & Successful. HUMANS. Many who are young, unprepared and given a great weight of responsibility. “So maybe we got pissed off and yelled at drivers and ran over people’s possessions, but we were just human, we were good people, some of us too young to know how to deal with what was going on around us” (p.203).

Jessica reveals the inconsistencies, the ambivalence of aid work as she takes us to Sudan, Sierra Leone, Sri Lanka, New York and Haiti. But, she also offers valuable lessons for the next generation. (And the current). As she was struggling with the decision to leave an Internally Displaced Persons camp in northern Darfur, Jessica’s colleague rebuffed her self-indulgence when she asked: ‘”What about the camp?!” He laughed. “You think being here is going to change that camp? I’m sorry, my dear, but that camp will be here no matter if you are or aren’t”‘ (p.213). Although aid work is about humans, it is also about systems and structures that no amount of one person’s willpower can change. The role of the aid worker, as Jessica puts it, is to “move the bar a mere two inches” (p.217).

Chasing Chaois an enjoyable read; a POV of the subculture that is aid work and a must for any student or early career professional who wants to journey into the heart of darkness. It is also a call for the urgent need for organisational change when it comes to supporting the well-being and health of air workers. Organisations are failing those who put the well being health of others ahead of their own.

“My own stress was starting to show, too. The loneliness of the place was what really had startd to strip me of my sanity…I could feel myself slipping, my irritation mounting, my mental strength withering. I hadn’t actually thrown rocks at children that one morning walk to the office, but that seemed like a trivial distinction: just wanting to was bad enough. I was on the edge of – something – and for what?!” (p.203).

I give it three-and-a-half Blue Helmets.

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I received a free copy of the book, and was under no obligation to write a review.

Telling the difference between a bad day, a run of bad days, and burnout

How do I tell the difference between a bad day, a run of bad days, and burnout? 

And what can I do about if it’s the latter?

This week and next, WhyDev’s blog posts are focussing on self-care. You can read the previous post by Marianne on finding the sweet spot for self-care, and another post by Narayani Berkowitz on when she realised self-care was vital for her as an aid worker. 

For more on self-care, join WhyDev and Marianne for a Twitter chat on self-care on October 15 at 9 pm EDT/October 16 at 12:00 pm AEDT. Follow the hashtag #WhySelfCare. 

When I was working in Afghanistan, I woke up one day and realized that I had lost the motivation to go for a run, do a yoga practice, eat a healthy meal, or even – most shocking of all – go to work.

Somehow I hadn’t noticed my descent into a grey fog of fatigue and despair while it was happening. I had noticed some of the signs, but I hadn’t been paying attention to what they added up to.

One sleepless night here and there is to be expected, when you spend your day interviewing people who are reporting their experiences of rape, torture or violent bereavement, right?

Some days feel like this.

One day of lethargy, or frustration, or even apathetic despair, is normal when your daily work resembles Sisyphus’s daily roll-a-rock-up-a-mountain effort, right?

So how can we tell when the occasional moment of fatigue, despondency or frustration has begun to transform itself into the larger pattern of what could be called burnout, or depression, or simply overwhelm and despair?

For me, this required first getting to know myself well enough to register what was ‘healthy’ for me. Next, I needed to become sufficently self-aware to notice when my behaviour, choices and daily or weekly patterns began to deviate from that healthy baseline on a regular basis.

Get to know your own healthy baseline

‘Normal’ for me might involve getting at least eight hours sleep, eating mostly fresh vegetables, doing an hour of exercise every day, doing at least 20 minutes of meditation, catching up with friends a few times a week, having a glass of wine most nights and spending at least three nights a week at home with a book – recharging.

For someone else – equally healthy and balanced – a ‘normal’ baseline might involve getting six hours sleep most nights, doing 30 minutes of gentle exercise three times a week, praying every morning, eating meat regularly and meeting up with friends most nights.

What matters is not that we all confirm to one idea of what ‘healthy’ looks like, but that we each know what healthy looks and feels like for us.

This can be as simple as getting yourself a notebook (I call mine ‘The Book of Me’ and it’s my real self-care bible) and keeping a note of some simple measures of what life looks like for you when you are feeling balanced and healthy. For example:

  • how many hours of sleep do I generally get?
  • how often do I eat, and what kinds of food do I choose to eat?
  • how much water do I drink?
  • how much alcohol do I regularly drink?
  • what kinds of exercise do I do, and how often?
  • how often do I choose to spend time with others?
  • how much time do I enjoy spending alone?
  • what sorts of things do I do purely for pleasure, how often do I do them?
  • how often do I communicate and/or connect with my family and friends?
  • if I have a spiritual practice (like prayer), how often do I pray?
  • how often do I laugh?
  • how often do I cry?
  • how often do I lose my temper?

If you are already feeling off-balance, it might help to remember a time when you were feeling healthy and make a note of what your usual habits were at that time. If this approach is very new, you might like to keep track of these measures over a period of time to see if they remain reasonably consistent, and to get a good idea of your own ‘healthy baseline’.

Track changes in your mood, habits and patterns

Once you have a good idea of what your healthy baseline looks like, you’ll have a better chance of noticing when things start to stray significantly.

In my case the big changes were:

  • I stopped sleeping. Over the course of several weeks I found I was regularly getting 3-4 hours of sleep rather than my usual eight.
  • I stopped exercising.
  • I started drinking more, more often.
  • I stopped cooking meals, and survived on snack food.
  • I stopped trying to explain how I felt, or what I was experiencing, to friends and family back in New Zealand – because they could never understand; and
  • I lost my motivation at work – and found it hard to concentrate on even the simplest daily tasks.

One of these changes might not have been cause for serious concern, but if I had been tracking them as they started to add up – and to be sustained over time – I might have noticed my downward spiral in time to get the support, and make the positive changes, I needed.

Call a friend

Sometimes it can be very hard to see changes in ourselves, especially if we are already beginning to experience the effects of chronic stress or trauma. Which is why it can be very useful to have someone on hand who you know and trust enough to tell you when you are deviating significantly from your healthy norms.

This is much more likely to work if:

  • You’ve had a conversation about what your respective healthy baseline looks like – so that you know you are being witnessed on your own terms, rather than on the basis of someone else’s ‘normal’; and
  • You’ve both agreed in advance that you have permission to tell each other if you notice a pattern of changes that deviate from your ‘heatlhy’ baseline.

What can I do when I notice a worrying trend?

It’s one thing to notice that my ‘well-being’ indicators are trending downwards, but it’s something else to know what to do when that happens. So here are some of the most, and least, useful things I did when I realized I was not doing well.

Not so useful strategies

My first instinct was to ignore the signs: ‘Head down, tail up Marianne’, I thought, ‘just keep working and hope things get better.’ That didn’t work.

Once I couldn’t ignore the situation any longer, my second instinct was to beat myself up about it: ‘What’s wrong with you Marianne? You have nothing to complain about. Everyone else is coping, why can’t you?’ That didn’t work either.

My third, not very useful, impulse was to ask for help from the wrong places, and in unhelpful way. I turned to a friend who, had I been paying attention I would have seen, wasn’t doing so well himself.

Useful strategies

The first useful thing I did was accept that I was struggling, and the next – and maybe most important – thing I did was start being a bit kinder to myself.

Accepting that it was okay for me to be struggling under the circumstances, and finding a way to meet myself with compassion even in my messy state, opened the door to every other useful thing I did for myself, which included:

  • Seeking help from a professional. When the staff counselor in Kabul said, ‘Honestly, I’d be surprised if anyone who had been through what you’ve been through wasn’t struggling’, I felt reassured by her expertise in a way no one else could have reassured me in that moment.
  • Letting some trusted friends (who were feeling at least reasonably stable themselves) know that I was struggling and asking for their support.
  • Taking a break – I took my scheduled R&R break and went on a retreat in Thailand, instead of rushing to visit family or postponing my break to get more work done.
  • Adding some core practices for emotional and physical resilience into my daily routine. For me, they were meditation and yoga.

Look after yourself (and each other) out there

The biggest lesson I learned from my experience of personal burnout in Afghanistan was this: only I really know how I’m doing, so it’s important that I know what healthy looks and feels like to me and I know what to do when the signs start pointing in the wrong direction. A trusted friend, however, can be a really useful support both in telling the difference between a bad week and a more serious situation and in getting the help we need to return to full health.

Aid worker self-care, community and sacrifice: finding the sweet spot

Let me make this declaration upfront: I’m extremely wary of ‘self-improvement’, as a goal or a genre. I’m always a little horrified when anyone suggests my book, Zen Under Fire, falls into the category of self-improvement. It’s a memoir, a story of humanitarian work, impotence and despair and the path I found from there back to health, and hopefully to being of service. It’s not a story about self-improvement.

But it is about self-care, at least in part. It’s partly a story of what happens when we try to serve others without taking care of ourselves, and the toll that can take on our physical and mental health, our work and our relationships.

It seems so obvious as to be trite – each of us is responsible for taking care of our own basic needs. But it seems to bear repeating, over and over again. I certainly need to be reminded of it, regularly.

In life, self-care is rarely as simple as putting on your own oxygen mask first.

If only it were this easy.
If only it were this easy.

There will be times when the needs of others require that you sacrifice something of your own comfort, perhaps even your own well-being; times of crisis, emergencies that call on all of us to assess honestly what we are willing to give up, and how far we are ready to go to serve and protect the people we love – or the people we have chosen to work with.

In so many ways, this willingness to put ourselves out for others, because we know the benefit to them will outweigh the inconvenience to us, lies at the heart of what it means to be part of a community. Our impulse to build community through these small (and not so small) acts of sacrifice is both the glue that connects us too each other and the greatest challenge to our ability to take good care of ourselves.

As a humanitarian worker, I found myself sacrificing my own well-being not only in the interest of meeting the needs of the community I was supposed to be serving, but also to meet the needs of my colleagues and employers – who often take on some of the role of community, in the absence of friends and family.

Because we care, and because we are wired for connection, we agree to do more than we can really afford to do. We commit more time, more energy, more resources than we really have to spare. The scales tip out of balance very quickly, too, when the willingness to make sacrifice, to build trust and connection, is not reciprocal. As is often be the case in humanitarian settings.

The Sweet Spot

My personal path as an aid worker, and as a yoga teacher, has been a search for the sweet spot – the place where I take care of myself, know my limits and set up some boundaries that keep me from overstretching myself repeatedly, but without switching off my impulse to serve, to help, and to create community and connection through personal effort and yes, even sacrifice, for the good of the whole.

What does this mean for aid worker self-care?

Firstly it means self-care relies on connection, or community. One of the key resilience factors for aid workers is a strong network of social connection – isolation makes self-care and self-regulation more challenging.

Meaningful connection requires some degree of vulnerability, which can be difficult in humanitarian settings. One of the key factors for my own mental health while in Afghanistan was finding a small number of colleagues with whom I felt I could speak freely about my anxieties and fears.

True self-care calls for a willingness to be vulnerable, to form meaningful and supportive connections, and to experiment with the balance between our personal needs and the needs of the community or collective.

Making the world better does not make you better

Things No One Told Me

There is a lot (a LOT) of discussion out there right now about how to do aid work. You can get an advanced degree in International Development, or Humanitarian Aid, or a hundred permutations, all of which somehow revolve around make you a professional aid worker. There are organizations like ELHRA dedicated specifically to professionalizing the humanitarian sector; Harvard (among several others) is trying to crank out uber-aid workers via its Humanitarian Academy, Tufts U. has got a whole center devoted to humanitarian studies; not to mention a gamut of formal and less formal organizations from ALNAP to HAP to The Sphere Project, all focused on telling you (along with the rest of us) how to do aid work: how to do a proper community assessment or how to run a proper NFI distribution, and certainly how to think about important-sounding topics like “neutrality” or “impartiality.” All fair enough: the move to professionalize the humanitarian sector* is decades overdue. It’s possible to do aid wrong, and we (including you, if you aspire to the role and title of “humanitarian”) have the responsibility to do aid right.

But as I talk to up-and-coming younger colleagues, or as I eavesdrop on conversations at the expat bar, or read the email coming from some of you, I begin to get the sense that while there is plenty of guidance out there for you about how to do your job properly – how to do aid work – I begin to get the sense that no one has had a straight conversation with you about how you should live the life. I get the sense that no one has talked to you about how to be an aid worker.

It’s important to understand that these are different things, doing the work and living the life. The demands and the ideals of the work frequently pit us against ourselves. And this in not at all unique to the humanitarian sector: it is precisely the tension between doing the work and living the life that makes the majority of television worth watching, whether it’s Law & Order or MI5 or Grey’s Anatomy or [INSERT NAME OF FAVORITE PRIME-TIME DRAMA]. Although there has thus far not been a convincing television drama show about aid work, it’s still important for you to understand that this tension exists, and how get a grip on how to manage it. I’m not saying that this is the end-all, be-all. But, after looking back at those times when I personally have struggled, and after to innumerable late-night talks where other aid workers, old and young, shared their struggles with me, maybe these would be a place to start:

Get a Life.

Simple as that. Get a life. Get a life outside of the aid world. Maybe those working in other fields are the same – I really can’t say. But I do know that aid workers are horribly prone to letting aid work and the aid world consume them. Sometimes we revel in it. Maybe we revel in being a workaholic or being an aid nerd. Sometimes we truly allow ourselves to be consumed by it. Many see humanitarianism as a higher calling or a life mission or a destiny and willingly allow themselves to be taken over by it.

But, even if for no other reason than bald self-interest, get a grip, have a life. Get a hobby not related to aid work (I brew beer); have friends who are not aid workers; be a tourist; see a movie; have a beer with someone who is not an aid worker. Join a reading group. Take yoga. Have a network outside of the aid world. Find balance.

Making the world better does not make you better.

For as much energy as we all invest in self-deprecation, explaining ad nauseum that we’re contingent, subjective knowers……………we basically think we’re better than everybody else. Yes, I know, you’ll all get indignant at reading this, especially the older aid workers. But it’s true. It’s true that we all think it, but it’s not true that it’s true. Being an aid worker, dedicating your life to eradicating extreme poverty or reducing human suffering or speaking truth to power on behalf of the helpless, all the while enduring harsh conditions or low salary, does not make you a good person.

It sounds harsh, but it has to be said. It’s important to understand that doing good things does not make you good. It is important to understand that good people can and frequently do do bad things. Not all good doers (confession: I positively loathe the term “do gooder”) are nice. You need to enter the aid world understanding that you will have to work and deal and maybe even share quarters with some truly nasty individuals. You need to understand that you, too, may do things that are not nice, things that you’re not particularly proud of. And you need to understand that this is nothing at all about your competence as a humanitarian. Being deeply committed to reducing the amount of injustice in the world, and expending great amounts of energy and personal resource towards that end in no way precludes you from treating your staff unjustly. It’s the opposite of “but he/she/they mean(s) well…” argument, all too frequently used to justify everything from poor individual performance to ridiculously reasoned startup NGOs.

You can be a basically good person and do bad things; just as a bad person can also do good things.

Be an aid worker if you want. Try to be a good person, regardless of your profession. And understand that in no way does one predetermine the other.

Make Peace With Reality that Your job is about bringing change…

One of the great paradoxes of the aid world is that on one hand we want to right wrongs, level playing fields, reduce inequity, empower the marginalized, above all make the world better. While on the other hand we have a deep conviction that we must always appreciate all things “local”, we must listen to beneficiaries, we must go to great lengths to understand “our” “beneficiaries” on their terms and not judge them and not make pronouncements about their values and choices. I can remember a number of specific occasions when the lights came on for me, when it suddenly clicked: the thing I’d been missing was a local perspective, a local sensibility.

Yes, of course – of course – local matters. We have to listen to people, include them in design and strategy discussions, involve them in evaluations. If aid doesn’t work for the end-users, recipients, beneficiaries, or whatever term you prefer, then it doesn’t work. Full stop.

But I think we make a dangerous mistake by trying to hide or downplay or shy away from acknowledging the simple fact that as aid workers it is our job to bring change.

It is. It just is.

We think that things are not as good as they could be. Or maybe we can see objectively that they plain suck. We think we have answers or knowledge or skill that could be used to make things better. We believe that we have something to offer. Acknowledging this does not make us arrogant or know-it-all. Acknowledging that we think we know a better way does not preclude us from being humble or open to new learning. It doesn’t mean that we cannot be wrong or get it wrong. It simply makes us honest.

And while it may seem cool (in an older aid worker kind of nerdy way) to ramble on about how “the longer you’re in the game the less you know…”, you’d better understand and make peace with the reality that it is your job to bring change. Whether you’re local or expat, whether you’re on the tail end of the cold chain, injecting babies with live vaccines all day or, or whether you’re sitting in a cubicle editing the notes from life-saving meetings, you need to understand that you’re part of a machine that makes changes in other people’s lives. It can be intrusive. It can be invasive. It is audacious.

Have your moments of doubt, your crises of faith. Wax melancholy into your Grenache or your craft beer with your trendy friends at happy hour. But your job is about taking change from here and applying it over there.

Make peace with this reality.


Bringing sexy back: the state of HR in development work 2013

By Tobias Denskus & Brendan Rigby

In some ways, reading People In Aid’s latest report on ‘The State of HR in International Humanitarian and Development Organisations’ reminded us of going shopping at a local organic grocery store: great local food, friendly staff who work in a cooperative way, making the right choices for ourselves and the environment even if the carrots are not perfect and the potatoes seem a bit overpriced. But, then you pass by the big box store of a global supermarket chain where a full parking lot indicates that shoppers are taking advantage of those low, low prices. The organisations who take part in the report and discussions seem a bit like the local grocery store, but we were also left with a feeling that the big and powerful multinationals of the aid industry are represented less when it comes to best HR practices, critical self-reflections and sharing new ideas to make humanitarian aid work ‘better’ for everybody involved – at least that often seems the case when we speak with friends who work for the ‘global supermarkets’.


One of the biggest challenges that the report tries to address is that it shares best HR practices and presents humanitarian HR as a professional managerial discipline within the aid industry. When it comes to teaching, training and mentoring (see for example the case study on Save The Children’s cooperation with executive management coaches for new country directors, p.15) humanitarian HR certainly tries to look at ideas from other sectors, and an important aspect of the report is that it shares case studies that may raise the bar for the whole industry as people learn what good employers and employees can and should offer.

But, the report also highlights that some metrics, e.g. the cost of security per humanitarian worker or days spent on learning and development, are still largely absent (p.10). On the other hand, the managerial approach is often faced with the political realities of humanitarian situations and can lead to a “high level of disillusionment from longer-term staff” as indicated by studies in the aftermath of the Haiti earthquake (p.17). This reminded us of Jonathan Katz’ book on this subject that found political dynamics in post-disaster situations seem to be unchanged, which could sideline well-intentioned HR efforts.

The most interesting aspect, and probably most relevant in the WhyDev context, were the reflections on the “rise of Generation Z” and the prediction that “HR professionals are going to have to employ some very different recruitment tactics if they are to harness the enthusiasm and technical abilities of this new group in the marketplace” (p.22). We think that the challenge will go beyond the ‘espressos & cool food’, but also beyond the “creative, fun and inspirational environment” that the report identifies (pp.23-24). J.’s recent post on ‘Hands-On’ experience is a good example that professionalised, office-focussed humanitarian work may offer neither espressos nor the thrills of ‘making a difference’ – in the traditional sense of the ‘hands-on’ work of helping people and rebuilding schools. But, there is a deeper level of misunderstanding in this paragraph on who the ‘Generation Z’ is, how they communicate and, most importantly, what they are looking for career-wise.

We have doubts that the authors really understand how ‘Generation Z’ engage and use social media, not only in their personal lives, but also in their professional lives for communicating, learning and networking. Just being “open about social media, don’t ban Facebook, LinkedIn etc.” (p.23) may only scratch at the surface. In addition, the paragraph is quite presumptive about ‘Generation Z’, suggesting that they will be less loyal, unfocused and uninterested in building a career. “These people do not stick around and build a career…information security issues, such as loss of trade secrets” (p.23). Not only are we a little offended, but think this shows a gross misunderstanding of the nature of humanitarian work and what it takes to build a stable career in the sector (particularly during an ongoing economic downturn, which is the focus of the report). One of the few avenues to a stable career is through the international civil service. We are not sure the authors know what an uncertain, competitive and fluid marketplace and environment it is, nor what Generation Z really wants.

Another issue that is absent from the report is the lack of linkages back to higher education for skill development and learning for future professionals. Many of the skills identified as lacking or being under-represented and under-addressed – teamwork, leadership, professional management, etc. – are those that can be facilitated and nurtured in higher education programmes. There is a proliferation of courses, both undergraduate and postgraduate, around the world offering ‘International Development Studies’ (IDS). Yet, the current state of higher education for development is perhaps not well-known or understood, nor are IDS teachers and organisational HR engaging with one another. We do not think that many of these courses adequately prepare graduates for working in the sector/s, and open debate around the ‘vocationalisation’ of IDS have not really emerged yet. If we need to address many of the areas identified in this report, then it should start in the emerging university courses being offered.

The report and subsequent discussions also help to shine a light on the importance of good HR in general, rather than perpetuating the stereotypes that The Office’s own HR officer, Toby, represents.

‘The State of HR’ shares some interesting, best-practice case studies on how the aid industry’s human resources can be valued and managed better, but it doesn’t really manage to think outside the box, especially when it comes to engaging with Generation Z and higher education. Furthermore, the report mentions work-life balance, but we were surprised that it did not go into more detail regarding psychological wellbeing, burn-out or PTSD. Although it is tacitly acknowledged under ‘Duty of Care’, there is a distinct lack of recommendations or a way forward offered.

You need only to take a cursory look at research into stress, isolation and burnout in the sector to realise two important things: it is highly under-researched and understood; and as a result, we know very little about the well being of humanitarian workers or how to care for their health. There is still a pervasive attitude, particularly from more experienced professionals, of fatalism. That this is the nature of the work, and we must just ‘suck it up’. The well being of humanitarian aid workers is not taken seriously, and it is time for a culture shift in understanding the mental health needs of humanitarian workers (which a few are coming together to do outside the formal structures of organisational HR: Amanda Scothern, Zehra Rizvi, Marianne Elliot and one of the authors of this post).

There are certainly some areas where the debate needs additional momentum, particularly in: how to engage and cater for the next generation of humanitarian workers; how to creatively and practically address HR issues during a time of budget cuts and restraints; how stronger linkages can be developed with higher education institutions to better prepare students for the workplace; and the recognition of and engagement in mental health issues. In a supply-driven labour market with politically fragile humanitarian situations, and some traditional debates (e.g. about expatriate remuneration or local talent), there is a risk that good aid HR may be for some time remain the equivalent of your local boutique grocer – although we always wish that more of us would spend more money in the them.

Tobias Denskus is a post-doctoral development anthropologist interested in peacebuilding, the ritualisation of aid professionalism & the impact of social media on policy-making and reflective writing.


Last chance to be part of the Peer Coaching Pilot Program!

The response has been overwhelming. As of Thursday 28 November, over 285 people have registered to be part of our Peer Coaching Pilot Program.

Today, we will close registration and begin matching people one-to-one and get them started on their peer coaching partnership. Just to give you an idea of who has registered, here is a snap shot of the peer coaches:

  • Over 70% are women
  • Just shy of 58% are aged between 26-35. Only 17% are older than 36 years of age
  • Almost 75% have 5 years or less experience working in aid/development
  • And, a whopping 91% indicate that they want to be matched with someone in the SAME sector

If you are young and just getting your career moving, then this program is for you. At the same time, we have a small, select group of very experienced professionals who are looking for a peer coach of similar standing. This program is open to everyone working in aid and development and neither age nor experience should discourage you.

In addition, it is not limited to ‘being in the field’ or even in the traditional aid sector. You could be working at community-based organisations in regional Australia or at a social business start-up in Kolkata. If you are working towards social justice, human rights and a more peaceful world, then peer coaching will work for you.

Although we encourage more men to apply (as with dating in the aid world, there seems to be a noticeable lack of men), gender is not an important determinant.

It is also shaping up to be a truly global network of peer coaches. Participants are living in the U.S, Haiti, China, Cambodia, Kenya, Ghana, Laos, Solomon Islands, Belgium, Niger, Uganda, UK, Madagascar and Nicaragua to name just a few.

This is your last chance to be part of this innovative, experimental and career-changing program. You will be matched with a peer of similar professional background and experience, and given extensive support from the team at WhyDev on how to get the most out of your peer coaching partnership.

Don’t miss out. Register here.