What now? Stress for humanitarians in transition
by Mark Bradley - Trauma Consultant & Trainer
For many in the humanitarian sector the pandemic’s challenges are ones we have faced before. Lockdowns and curfews are common. Working with vulnerable populations who are susceptible to diseases, a lack of resources and supplies, illness, death, and the stresses of a quickly changing environment are all part and parcel of many aid workers lives.
I’ve worked with NGOs – such as MSF and VisionQuest – as a psychotherapist and counsellor for many years now, blending a mix of academic training and practical work in the NHS. I specialise in hostile environments and critical incidents working with NGO’s, conflict journalists to develop the best support they, their families and colleagues need during stressful times and incidents. I know that humanitarians bring passion, skills and resilience to their work, but they can also be tempted to believe that the pandemic won’t affect them as much as others.
This pandemic is new and has had massive impact on our lives – even if we’re accustomed to change, disease and living under lockdown. It has created a hyper-anxious environment with accompanying overwhelming thoughts and feelings. How we react as humanitarians will be a very human reaction. A pandemic is a traumatising event. Trauma causes powerful emotional, mental and physical reactions. As a pandemic continues, intense feelings will compound over time affecting our mental, emotional and physical wellbeing. Our morale will be affected as will our physical wellbeing. Having reactions like not sleeping, being tearful, ruminating over worst-case scenarios, having headaches or suddenly forgetting how to do simple tasks are all completely normal.
"This pandemic is new and has had massive impact on our lives – even if we’re accustomed to change, disease and living under lockdown. It has created a hyper-anxious environment with accompanying overwhelming thoughts and feelings. How we react as humanitarians will be a very human reaction. "
For aid workers there are some specific issues that will arise. If our work involves travel it might mean some period of quarantine, where we sit idly by, possibly in comfort, near to our work that is being done by others. Or we may be stuck at home, with our deployment delayed indefinitely.
Isolation from friends and family is an understood and accepted part of the job; now though this may extend to colleagues. New measures will reduce contact and simple human responses like a hug from a friend are gone for a while. In some case you may worry you may carry the virus into communities you are there to help or that those communities will avoid you because of fear and stigma.
At the moment, well-resourced and experienced health professionals are feeling despair, hopelessness and overwhelm as a result of COVID. If we assume that these same feelings will be felt in already resourced-stretched environments – such as a refugee camp or field hospital it is likely that humanitarian workers will be struggling.
Working with vulnerable communities can greatly increase this stress and the consequences; however, our inbuilt resilience and compassion can also, once harnessed, greatly increase our ability to cope.
So how can we put our colleagues and ourselves in the best place to continue working?
Much of what we’re experiencing now is about control and the lack of it; control of our lives, our work, our mission and outcomes for the people we want to support. Underlying this anxiety is a need for certainty and a belief that more information is the answer. Stress and anxiety are natural reactions to pressure and not signs of weakness. When you feel stress or anxiety take them as signs that you’re being challenged and put in place some strategies to cope with these challenges.
Life is uncertain and unpredictable – especially now. Letting go of the belief that we can control or fix everything is important during the pandemic, so we don’t become overwhelmed. Try adjusting your focus to smaller tasks, things you can control and engaging with activities that support your emotional and mental well-being.
This is part of the idea of ‘graded' response. We feel anxiety when we: 1) overestimate the challenge and threat ahead; 2) underestimate our ability to deal with it. We mistakenly fling ourselves at tasks hoping to force our way through the anxiety. Stopping, letting go, stepping back and working on smaller tasks makes anxiety more manageable allowing you to overcome and rebuild confidence in your abilities. We are still capable; we are still supported by those around us and we can prevail.
"This is part of the idea of ‘graded' response. We feel anxiety when we: 1) overestimate the challenge and threat ahead; 2) underestimate our ability to deal with it."
It might also be helpful to spend some time reflecting on what aspects of the coming period trigger stress, fear and anxiety. Is it whether you will have a job? Deploying with, or without, PPE? Insecurity? Unknowns about travel and separation from family? The pressure to overwork? Simply recognising our stress triggers can help us develop strategies to deal with them.
In all of this we need to practice self-compassion. We often find we extend compassion to others. We care for, and listen carefully, to others much more readily than we do ourselves. The next time you criticise or have negative thoughts about yourself think whether you would say the same to a friend or colleague in the same situation. Then, think about what you would say to a friend or colleague and say that to yourself.
Other self-care exercises have been well covered, but we can’t be reminded enough to do them. Practicing gratitude in a journal. Reconnect to your personal mission and ground yourself in the ‘why’ of what you do. Take time to notice small, positive things about your life, smile as much as possible because it changes both your physical and emotional states. Look for humour – whether in a meme, a fun chat with friends or colleagues, a favourite scene from a film or show (mine is one from the Simpsons Movie). Humour dispels fear and worries and laughing provides physical and emotional stress relief. Take time to connect with others – especially if they are in, or have been in, similar situations. These moments can get us through our work – day by day.