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Managers must help aid staff cope with stress

14 Feb 2002

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Tony Vaux: It's easy to put the cause above the people.

Tony Vaux has worked in disasters and development for nearly 30 years, most of that time with Oxfam GB. In his book "The Selfish Altruist", he analyses the dilemmas -- personal and institutional -- of aid management in humanitarian emergencies. In this edited extract, which first appeared in People In Aid News in January 2002, he reflects on how to cope with the problem of stress inherent in relief work.
Aid workers often talk about "demanding" situations. However, the greatest demands are not for goods but for emotional sympathy -- first because the demands are limitless and second because such feelings may be tinged by a sense of hypocrisy.

There are different ways of coping with, or limiting, the response. Some concentrate their emotional energy in short bursts. Others try to remain detached. Aid staff tend to overwork -- work becomes a drug to quiet the human response.

Aid workers are beset by a constant sense of failure. If organisations claim to save lives, this implies that they can fail to save them, too. For an organisation, this is a theoretical problem that can be lightly dismissed, but for aid workers in the front line it is a serious worry.

They can become more and more embedded in the problem of limiting their own sense of responsibility. They may hate the idea of compromise and yet find that neither complete commitment nor complete detachment is actually possible. They must learn to live with a constant sense of having never quite reached the ideal.

At different points in the experience of aid workers, human suffering becomes an issue in its own right, rather than as an intellectual problem.

"If organisations claim to save lives, this implies that they can fail to save them, too"

Yet such a process can involve too much introspection. An organisation tends to push the issue of personal responsibility away from the centre and out to the "edges". Canteen helpers sometimes end up as counsellors.

In aid organisations the field workers are left with the full emotional impact of problems that central managers only dimly perceive. This is not necessarily bad, but is rarely recognised. As a result, no one knows when the limit is reached or what personal sense of responsibility, including inevitable failure, people build up inside themselves.

EMPLOYERS KNEW LITTLE
Most expatriate staff members working for Oxfam in Bosnia during the war sought counselling on their return. For local staff, the stresses may have been greater. But their employers knew very little about it, and perhaps preferred not to know.

Aid managers need to recognise that stress is a constant factor in humanitarian work and that a supportive system is important. Stress-driven activity is dysfunctional.

Those who are unable to cope may rush around in pointless activity, taking on more and more responsibility and becoming suspicious of the efforts of others.

Such people often hide their anger, only to let it out when least expected and causing the most confusion. They can build mistrust of their colleagues and seek to undermine them. They can show cynical disregard for those whom they are trying to help, treating them as incapable victims rather than as people whose greatest wish may be to recover their capabilities. Failed idealism easily turns to bitterness.

"Those who are unable to cope may rush around in pointless activity, taking on more and more responsibility"

It may be helpful to recognise that these problems arise from deep contradictions in the notion of humanity -- which is, in sense, a selfish desire to assuage our own feelings of compassion for those in need as well as a desire to be altruistic.

It involves a combination of personal emotions and societal norms. Organisations cannot fully resolve these uncertainties. In the end, they are dealing with public emotion that varies according to a host of factors.

The more they try to impose or develop norms, the more they risk the possibility of losing the emotive force that underlies the human response.

The results of this tension are felt by those who have to translate the overall confusion into actions that may involve life and death. In other words, distress and suffering are the outcome of aid work, as well as its inspiration.

OBLIGATION TO SET LIMITS
Managers in emergency operations have an obligation to set limits for their staff. Staff must know what they supposed to be doing so that they are not accused -- or do not accuse themselves -- of failing to respond.

This boils down to dull but accurate job descriptions and clear instructions, good briefings before the job and excellent debriefings afterwards, and listening to the painful experiences of staff.

One of the worst scenarios for an aid worker is to return from a stressful situation for a serious discussion or a final debriefing, only to find that the manager has rushed out because of some new crisis.

The impression given is that no one cares about aid workers, even though the truth may be that people are concerned but busy. Because they do not have time and are stressed themselves, they cannot always fully understand another person's experience or needs. They may feel undervalued themselves and therefore unwilling to support anyone else.

"Managers in emergency operations have an obligation to set limits for their staff"

Humanitarian organisations have a tendency to be inhumane. It is easy to put the cause, or crisis, above the people who serve.

If we treat ourselves in an inhumane way, as if we need only food and water, we may be more likely to think that other people can make do with the same. Instead of expressing concern about human capabilities, we may become involved in problems of our own guilt and self-esteem.

The words of a psychiatrist about people in distress during the Balkan wars apply equally to aid workers: "It is important to allow intense emotion to be expressed without a sense of shame. Issues around helplessness and low self esteem may emerge as well as anger and guilt, which are inherent in the grieving processes. People may need realistic assurance that their feelings are normal responses to extraordinary events beyond their control and do not reflect personal weakness."

"The Selfish Altruist: Relief Work in Famine and War" by Tony Vaux is published in Britain by Earthscan (www.earthscan.co.uk) at £17.99 ISBN 1 85383 776 8

To find out more about People In Aid visit its website: www.peopleinaid.org.uk

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