Search

Background Humanitarian aid workers are exposed to deployment-related health threats. Identifying subgroups at a higher risk of infection in this diverse population could help optimize prevention. Methods We carried out a retrospective study based on anonymized data of humanitarian aid workers that visited our clinic for a post-deployment visit between 1 January 2018 and 31 December 2021. We conducted a descriptive analysis of basic demographic data, self-reported risk exposure and health problems encountered during deployment extracted from a standard questionnaire. Results The questionnaire was administered to 1238 aid workers during 1529 post-deployment medical consultations. The median age was 37.2 years (IQR 31.7–44.3), and 718/1529 (47.0%) were female aid workers. The median duration of deployment was 6 months (IQR 3–12 months). Most deployments (1321/1529 (86.4%)) were for a medical organization and in Sub-Saharan Africa (73.2%). The most common risk exposures were contact with freshwater in schistosomiasis endemic regions (187/1308 (14.3%)), unprotected sexual contact with a person other than a regular partner (138/1529 (9.0%)), suspected rabies exposure (56/1529 (3.7%)) and accidental exposure to blood (44/1529 (2.9%)). Gastrointestinal problems (487/1529 (31.9%)), malaria (237/1529 (15.5%)) and respiratory tract infections (94/1529 (6,2%)) were the most encountered health problems. Fifteen volunteers (1%) were hospitalized during deployment and 19 (1.2%) repatriated due to health problems. Adherence to malaria chemoprophylaxis was poor, only taken according to the prescription in 355 out of 1225 (29.0%) of aid workers for whom prophylaxis was indicated. Conclusion Humanitarian aid workers deployed abroad encounter significant rates of health problems and report a high level of risk exposure during their deployment, with the risks being greatest among younger people, those deployed to rural areas, and those working for non-medical organizations. These findings help guide future pre-deployment consultations, to increase awareness and reduce risk behaviour during deployment, as well as focus on adherence to medical advice such as malaria chemoprophylaxis. [ABSTRACT FROM AUTHOR]

In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (N = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors.

This paper analyses the significance of specific ethical experiences for humanitarian aid workers' motivation. Following Emmanuel Levinas's understanding of ethics as arising from intersubjective face‐to‐face encounters, the study illuminates the experiential origins of the humanitarian commitment by analysing James Orbinski's memoir entitled An Imperfect Offering: Dispatches from the Medical Frontline. Orbinski, a former International Council President at Médecins Sans Frontières, was directly involved in humanitarian responses to several major crises during the 1990s, including those in Somalia, Afghanistan, Rwanda, and what was then Zaire. This paper explores three formative experiences from Orbinski's childhood and teenage years to analyse the personal ethics of humanitarian aid workers and to illuminate the intersection of the personal and professional level of humanitarian aid work. Illustrating that Orbinski's humanitarian commitment is a surrendering to the other's call, the paper argues for stronger inclusion of aid workers' lives and experiences to achieve a comprehensive understanding of humanitarian work. [ABSTRACT FROM AUTHOR]

In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (N = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors., (Copyright © 2024. Published by Elsevier Inc.)

Abstract The expanding use of IT has brought an increase in productivity to the world of business, industry and commerce. However, this is not mirrored by an equivalent growth in the use of IT by aid agencies in post-disaster situations. We report a pioneering two-stage study which tested the appetite for the increased use of computational IT tools in this sector, assessed their level of usefulness and whether they can be practically implemented. Thirty aid workers across nineteen countries were surveyed on their use of IT and computational tools in shelter design and provision. The key finding was that none of the participants used any building simulation tools or software packages in any of the design stages of shelter construction. Using this result, two example tools were created—one assessing daylighting and the other environmental impact. A second survey involving 48 aid workers was then carried out to record their experience of using the new tools and 97% of the participants identified a need for such shelter design tools. The majority felt that the new tools were useful and that they would like to use similar tools in their work, most of them preferring tools in the form of web applications. It is concluded that humanitarian workers in the shelter sector are very willing to adopt IT-based computational tools in their work and would appreciate doing so, but only if they have access to suitably simple tools which are quick to use and easy to learn.

International and national humanitarian aid workers were recruited for this study via purposive sampling techniques using social media. Eight interviews and one focus group discussion were carried out (n=13), and a survey disseminated (n=62), to garner a broad range of perspectives on barriers to aid workers seeking out and accessing psychosocial support. A thematic analysis was performed on the transcriptions of the interviews and focus group discussion. The hypothesis was that participants would describe a variety of personal, professional, and environmental obstacles, with 'tough‐guy macho culture' and/or 'martyr culture' being the strongest deterrents. Fourteen barriers in total were identified: accessibility; appropriateness; attitude; availability; confidentiality and trust; duty of care; guidance; normalisation; experience; repercussions; self‐awareness; self‐reliance; stigma; and time. It is recommended that organisations improve the provision of quality, appropriate psychosocial support for staff, and that it is communicated regularly, and they train staff in pinpointing when others are in need of assistance. [ABSTRACT FROM AUTHOR]

The history of humanitarianism has typically focussed on organizations or key players in establishing these organizations, with little attention paid to fieldworkers, ignoring what might be considered a "bottom-up" approach to humanitarian history. This article uses personal narratives of fieldworkers to analyze their actions through the lens of emotions, which allows their motivations to come to the forefront, rather than assuming they carry out actions to fulfil the orders of the organization for which they work. This article comprises four case studies (Esme Odgers, Audrey Russell, Richard Rees and Lilian Urmston) based on personal narratives covering the often overlooked period between the end of Spanish Civil War and the beginning of World War II, when half a million Spanish refugees fled into France in what became known as the retirada. It will explore how aid was given on an individual level and what this can tell us about the larger story of transnational aid movements. These personal narratives show that all of these four aid workers sympathized with a specific cause, while continuing to profess in public the neutrality and nonpolitical nature of their activities as expected of those engaged in humanitarianism. Their shared experiences culminated in feelings of solidarity and empathy with those they aided, rather than sympathy, compassion or pity – emotions often associated with humanitarianism. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the levels of anxiety, depression and post-traumatic stress disorder (PTSD) in national aid workers in Central African Republic as well as to evaluate the effectiveness of a stress management group in reducing those symptoms. Twenty-seven stress management groups were evaluated in two international non-governmental organisations in which 197 national humanitarian aid workers took part. There was a significant decrease in the intensity of every psychopathological variable tested despite a decrease in the sample between the pre- and post-tests. At post-test, 8.1, 5.1 and 11.1% of the participants had scores indicating anxiety, depression and PTSD compared to 25, 18.9 and 26% at pre-test. The group intervention has demonstrated to be a realistic, effective and cost-effective way to respond to mental health problems in national aid workers living in a context of ongoing violence and where access to specialised services is extremely limited. Key implications for practice Documenting the mental health of national humanitarian staff working in unsecure environment in Central African Republic A one session stress management group protocol can reduce the levels of anxiety, depression and PTSD in this population and hence demonstrating that it is feasible and cost-effective for organizations to honour their duty of care towards national humanitarian workers Further research is needed to confirm these preliminary results, especially in other cultural and humanitarian contexts.

In 2008, Taliban forces killed four aid workers in Afghanistan. Immediately afterwards, expatriate and national field staff undertook crisis management activities on the ground. While this was a devastating event, field and headquarters staff agreed that the organisational response to the crisis was positive. Nine months later, 19 expatriate staff members involved in the crisis response participated in an evaluation to reflect on personal and organisational factors that contributed to their post crisis resilience. Results suggest that clear security protocols, crisis simulation preparedness training, team cohesiveness, strong leadership, staff mobilisation, well timed psychological support and support from managers may all contribute to staff resilience in high stress environments. Recommendations are offered to the international nongovernmental organisation community seeking to support staff following critical incidents.

The expanding use of IT has brought an increase in productivity to the world of business, industry and commerce. However, this is not mirrored by an equivalent growth in the use of IT by aid agencies in post-disaster situations. We report a pioneering two-stage study which tested the appetite for the increased use of computational IT tools in this sector, assessed their level of usefulness and whether they can be practically implemented. Thirty aid workers across nineteen countries were surveyed on their use of IT and computational tools in shelter design and provision. The key finding was that none of the participants used any building simulation tools or software packages in any of the design stages of shelter construction. Using this result, two example tools were created—one assessing daylighting and the other environmental impact. A second survey involving 48 aid workers was then carried out to record their experience of using the new tools and 97% of the participants identified a need for such shelter design tools. The majority felt that the new tools were useful and that they would like to use similar tools in their work, most of them preferring tools in the form of web applications. It is concluded that humanitarian workers in the shelter sector are very willing to adopt IT-based computational tools in their work and would appreciate doing so, but only if they have access to suitably simple tools which are quick to use and easy to learn. [ABSTRACT FROM AUTHOR]

Background: Humanitarian aid workers are likely to be exposed or witness complex emergencies. Posttraumatic stress disorder (PTSD) is one of the most widespread and most commonly studied mental health problems after exposure to adversities and trauma. However, face-to-face treatment has limited utilization in the resource-constrained settings where humanitarian aid workers often operate. Internet-delivered cognitive behavioral therapy (iCBT) is a treatment option with the potential to improve the access to evidence-based care for humanitarian aid workers. Until now, only a few studies have evaluated iCBT in the treatment of PTSD. No studies have yet explored the feasibility of iCBT for humanitarian aid workers with PTSD. The aim of this study is to investigate the participants' experiences and progress with the treatment, in order to determine whether TELLUS is acceptable for humanitarian aid workers. Methods and design: A pilot feasibility study will be conducted with 20 humanitarian aid workers with a full or subclinical PTSD diagnosis according to DSM-IV criteria. The intervention used is TELLUS, which is a therapist-assisted Internet-delivered treatment program based on trauma-focused CBT components for individuals with PTSD. It contains eight text-based modules, where each module is expected to be completed within one week. Discussion: This study may set the ground for a large-scale randomized control trial that would test the effectiveness and cost-effectiveness of the program. The study may contribute to the better understanding of PTSD treatment and increase the availability of evidence-based treatments in resource-constrained settings.

Abstract Humanitarian aid workers experience adverse mental health effects from their work at higher rates than the military, police and other emergency service personnel. Whilst there is considerable literature investigating risk and resilience factors for workers within this field, little is known about the status of such factors among individuals prior to their joining the profession. Semi-structured interviews were conducted with ten commencing undergraduates of a Bachelor of Humanitarian and Development Studies course to explore their aspirations and resilience factors regarding future work. Thematic analysis identified that whilst there was a high level of reported altruism among trainees, these perceptions appeared to constrain individual use of social support networks and help-seeking behaviours. Education and training appeared to shift future work preferences from humanitarian relief work towards development-related roles. The findings suggest that humanitarian aid trainees exhibit known risk and resilience factors before they enter the profession, whilst highlighting practice expectations and personal support perceptions that are amenable to positive change through training.

The authors of this qualitative study explored the perceptions and concerns of Liberian RNs who work for international nongovernmental organizations in Liberia, yielding insights on how to improve collaboration between national and expatriate nursing staff. Purpose: This qualitative study was conducted to explore the perceptions and concerns of Liberian RNs who work for international nongovernmental organizations (NGOs) in Liberia, and to elicit insights and suggestions about how to improve collaboration between national and expatriate nursing staff. Methods: Five focus groups involving 19 nurses and an individual interview with one nurse were conducted. A semistructured interview guide was used to gather perspectives and garner suggestions. A phenomenological approach was used to identify emergent themes. Results: Regarding positive experiences, participants from all 10 NGOs reported that working with expats gave them opportunities to be mentored, learn new skills, and try out new techniques and equipment. Negative experiences included problems with disrespect and expats' lack of cultural competency. Participants spoke of adverse patient outcomes that resulted when expats made assumptions and wouldn't listen to national staff. Conclusions: The findings indicate that changes are warranted in the current work culture between national and expatriate nursing staff. Improving collaboration between national and expatriate RNs could lead to higher-quality care and better patient outcomes. Predeployment training for expatriates that incorporates the voices of national staff is recommended; this would raise awareness of the realities of nursing in low-resource settings and promote respect for national staff. [ABSTRACT FROM AUTHOR]

Background: Most people with disabilities the world over can be found in the Majority (or ‘economically developing’) World. This is also where most of the world’s hungry and malnourished are found. We argue that the intersectionality between disability and nutrition may best be understood through a food security framework, and we position all people living with disability, including those experiencing feeding and swallowing disabilities, as at risk for food insecurity, especially those living in humanitarian emergency contexts. Objectives: This study aimed to explore and describe the knowledge and experience of humanitarian aid workers (HAWs) and health care professionals (HCPs) in food assistance contexts with regard to the nutrition and food security of people living with disabilities. Method: In this exploratory, descriptive study, 16 participants with experience in sub-Saharan Africa and Southern Asia participated in an online survey. Three survey participants with extensive experience were also interviewed. Data analysis involved descriptive statistics and thematic content analysis. Results: Results revealed that participants had generally low levels of exposure to and experience with disability, including swallowing and feeding disorders. Conclusions: Reduced knowledge of HAWs and HCPs regarding disability and the lack of professionals such as speech–language therapists, who manage disability-specific issues such as feeding and swallowing disorders, may affect the food security of people living with disabilities in food assistance contexts.

Responding to the impact, community and individuals during a crisis is demanding for humanitarian workers. The need for resilience is crucial for the delivery of effective humanitarian aid and staff long-term emotional endurance. This article describes an arts-based approach aimed at enhancing the resilience of 53 World Vision (WV) staff in Asia at a weeklong Regional Disaster Management Team (RDMT) workshop. The purpose was to introduce responders to embodied artful experiences to develop coping skills and enhance their personal resilience to the impact of the response before, during and after deployment. The arts-based experiential sessions were embraced by the participants, with many acknowledging that they will engage in the arts as a reflexive practice during deployment. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the levels of anxiety, depression and post-traumatic stress disorder (PTSD) in national aid workers in Central African Republic as well as to evaluate the effectiveness of a stress management group in reducing those symptoms. Twenty-seven stress management groups were evaluated in two international non-governmental organisations in which 197 national humanitarian aid workers took part. There was a significant decrease in the intensity of every psychopathological variable tested despite a decrease in the sample between the pre- and post-tests. At post-test, 8.1, 5.1 and 11.1% of the participants had scores indicating anxiety, depression and PTSD compared to 25, 18.9 and 26% at pre-test. The group intervention has demonstrated to be a realistic, effective and cost-effective way to respond to mental health problems in national aid workers living in a context of ongoing violence and where access to specialised services is extremely limited. [ABSTRACT FROM AUTHOR]

In 2008, Taliban forces killed four aid workers in Afghanistan. Immediately afterwards, expatriate and national field staff undertook crisis management activities on the ground. While this was a devastating event, field and headquarters staff agreed that the organisational response to the crisis was positive. Nine months later, 19 expatriate staff members involved in the crisis response participated in an evaluation to reflect on personal and organisational factors that contributed to their post crisis resilience. Results suggest that clear security protocols, crisis simulation preparedness training, team cohesiveness, strong leadership, staff mobilisation, well timed psychological support and support from managers may all contribute to staff resilience in high stress environments. Recommendations are offered to the international nongovernmental organisation community seeking to support staff following critical incidents. [ABSTRACT FROM AUTHOR]

Humanitarian aid workers experience adverse mental health effects from their work at higher rates than the military, police and other emergency service personnel. Whilst there is considerable literature investigating risk and resilience factors for workers within this field, little is known about the status of such factors among individuals prior to their joining the profession. Semi-structured interviews were conducted with ten commencing undergraduates of a Bachelor of Humanitarian and Development Studies course to explore their aspirations and resilience factors regarding future work. Thematic analysis identified that whilst there was a high level of reported altruism among trainees, these perceptions appeared to constrain individual use of social support networks and help-seeking behaviours. Education and training appeared to shift future work preferences from humanitarian relief work towards development-related roles. The findings suggest that humanitarian aid trainees exhibit known risk and resilience factors before they enter the profession, whilst highlighting practice expectations and personal support perceptions that are amenable to positive change through training. [ABSTRACT FROM AUTHOR]

Purpose Altitude illness can be a severe to even life-threatening condition for individuals ascending to altitudes higher than 2,500 m without proper acclimatization, a process that requires at least a couple of days. Considering disaster scenarios in high-altitude settings where humanitarian aid workers need to be deployed immediately, altitude illness may pose a relevant risk factor. The paper aims to discuss these issues.Design/methodology/approach Population data on people living in high-altitude risk areas worldwide were matched with data on natural hazards in these areas.Findings Globally, more than 140 million people live in the risk zone for altitude illness and at least 19 cities with a population of more than 100,000 people exist above 2,500 m. These cities are situated in countries that are highly vulnerable to various natural hazards, and most of these cities have already been affected by hazardous events in the past. The relevance of considering altitude illness is underlined by a report on the emergency operation after the 2010 earthquake in Yushu County, China, where at least 200 aid workers had to be withdrawn due to this condition.Originality/value There are possible disaster scenarios where altitude illness can become a serious issue for aid workers, however, the only available preventive measures are not feasible with proper acclimatization requiring a couple of days and chemoprophylaxis not being 100 percent efficient. Therefore, this work intends to raise awareness within the humanitarian community for and to proactively engage with the topic of altitude illness in order to ensure the security and well-being of staff. [ABSTRACT FROM AUTHOR]

A small group of humanitarian aid workers travelled to Port-au-Prince, Haiti six months after the 2010 earthquake to assist in recovery efforts at an orphanage. This study explores the experiences of these workers and how they coped with the challenges in Port-au-Prince. Participants kept a journal to record their daily experiences. A phenomenological methodology was used to analyse the data in this study. Themes included relationships and connections, faith/perspective, care of self and others, purpose, and perspective. Researchers concluded relief workers need more preparation and support during and after humanitarian trips as experiences significantly impact workers perspective of themselves and others. [ABSTRACT FROM AUTHOR]

The mental health consequences of exposure to traumatic events and the risk factors for psychological morbidity among expatriate and Kosovar Albanian humanitarian aid workers have not been well studied. In June 2000, we used standardised screening tools to survey 285 (69.5%) of 410 expatriate aid workers and 325 (75.8%) of 429 Kosovar Albanian aid workers from 22 humanitarian organizations that were implementing health programmes in Kosovo. The mean number of trauma events experienced by expatriates was 2.8 (standard deviation: 2.7) and by Kosovar staff 3.2 (standard deviation: 2.8). Although only 1.1% of expatriate and 6.2% of Kosovar aid workers reported symptoms consistent with the diagnosis for post-traumatic stress disorder, 17.2% and 16.9%, respectively, reported symptoms satisfying the definition of depression. Regression analysis demonstrated that the number of trauma events experienced was significantly associated with depression for the two sets of workers. Organisational support services may be an important mediating factor and should be targeted at both groups. [ABSTRACT FROM AUTHOR]

The testimony method was found to be an effective tool for helping a group of humanitarian aid workers, injured in a bomb blast and undergoing treatment in a medical facility in the first few days following the event, to begin to access and process traumatic memories. The testimony method provided a safe structure to recall the traumatic event, while assisting in the reconstruction of the traumatic memories and associated emotions, and offered an acceptable motivation to do so. The testimonies proved to be of further use to family members and colleagues of those directly affected by the blast. [ABSTRACT FROM PUBLISHER]