(Selection, training and support of relief workers: an occupational health issue)
Relief organisations are neglecting the psychological welfare of their field workers involved in complex humanitarian emergencies and therefore should develop a coordinated and cooperative approach to their training and management, says a report published in this week's BMJ. Dr Maureen McCall from the Red Deer Regional Hospital in Canada and Dr Peter Salama from Concern Worldwide, based in the Republic of Ireland, say that disregard for the psychological welfare of relief workers is commonplace and that this is harmful not only for their wellbeing, but for that of the populations that they are trying to assist.
The authors interviewed 12 of the leading international humanitarian relief organisations and found that most admitted that their psychological support mechanisms were underdeveloped. They explain that complex humanitarian emergencies generate more stress among relief workers than "natural" disasters (such as earthquakes). These relief workers are faced with the risk of violent personal assault; ethical dilemmas, such as having to negotiate with warlords; witnessing human rights abuses, but being prevented from responding by operational considerations, as well as having to deal with the concern that their assistance is perpetuating the conflict. These factors are notwithstanding the trauma of caring for people with serious injuries and handling dead bodies.
McCall and Salama have drawn up recommendations on how relief organisations could improve their practice of providing psychological support. These include standardising the recruitment procedure, including a means of ascertaining psychological resiliency of potential candidates as well as making candidates aware of the psychological risks they are taking. They conclude that greater research into this previously uncharted area is needed to obtain a greater understanding of the problem and how it can be countered .
Contact:
Dr Maureen McCall, Primary Care Physician, Red Deer Regional Hospital, Red Deer, Alberta, Canada or Dr Peter Salama, Emergency Medical Coordinator, Concern Worldwide, Camden Street, Dublin 2 Republic of Ireland peter.salama@concern.ie