The well-being of aid workers has become a hot topic of discussion in recent years, but it seems much of the talk has yet to translate into meaningful actions.
During a meeting with colleagues at the START Network five years ago, Action Against Hunger Partnerships Program Manager Hitendra Solanki suggested the idea of introducing mindfulness meditation in the humanitarian sector as a means to prevent stress, which can lead to burnout, depression and post-traumatic stress disorder.
Solanki was referring to a practice in which individuals cultivate a sense of awareness about their own thoughts, emotions and bodily sensations. With time, meditation can help practitioners better relate to these thoughts and emotions and catch early signs of stress before they worsen.
“It means you can be aware of things building up before they get out of control or in a more acute stage. If you can catch the subtle signs of stress — tensing up in your body, feeling tight or sick in your stomach — at the earliest indications of that, it means that you then have the ability to take steps to mitigate it [from] getting into a full blown panic attack for example, or stress accumulating until you’re physically sick or you’re mentally ill,” he told Devex during a visit in Manila early this year, where he conducted a mindfulness meditation training to a group of aid workers, psychology students and personnel at the Ateneo de Manila University.
The practice has its roots in Buddhism, but Jon Kabat-Zinn, a professor of medicine at the University of Massachusetts, developed a program called Mindfulness-Based Stress Reduction that draws on the scientific evidence of the impact of self-awareness on people’s mental well-being.
Several universities, such as Oxford and Bangor in the U.K., offer courses on MBSR and mindfulness-based cognitive therapy, which is focused on helping individuals overcome depression. But there remains limited understanding in the humanitarian sector of what it is, what it’s not and what its potential benefits are.
The majority of Solanki’s colleagues to whom he initially proposed the idea rolled their eyes and associated the practice with “hippie” culture, he admitted.
But the U.K. Department for International Development agreed to fund the project — a component of the Transforming Surge Capacity project under the START Network — for three years through its Disasters Emergency Preparedness Program. This allowed Solanki to introduce the practice on a wider scale in the nonprofit sector. Since 2015, the project has engaged an estimated 180 individuals — both in person and through audio- and video-based trainings — in Pakistan, the Philippines and Thailand. Now Solanki wants to get the evidence base for the practice’s feasibility, outcomes and impact.
The challenge of evidence
Mindfulness as a practice is not new; a number of high-profile individuals, such as Ohio Congressman Tim Ryan, Huffington Post co-founder and former Editor-in-Chief Arianna Huffington, and CNN Senior Correspondent Anderson Cooper have all embraced the practice.
But most of the available literature that looked into its impact on a larger scale for those who underwent the training has been limited in the corporate sector, where mindfulness has received considerable attention and interest from companies such as Google, Intel and General Mills.
Inspired by the practice, Google launched SIY, or Search Inside Yourself, in 2007, a program spearheaded by one of its engineers, Chade Meng Tan. The program has since rolled out of Google and is now a nonprofit, but it remains a popular training program at the tech giant. An estimated 2,000 Google employees have already gone through the course, and a number of them — at least anecdotally — have reported changes in their focus, relations and how they handle the pressures of working in such a demanding, fast-paced setting, according to a 2012 article in The New York Times.
Getting that evidence base is what Solanki hopes to achieve in the project’s third year, but there have been setbacks and challenges, he said. Plans for an app that participants can use to input data about their experience in practicing mindfulness fell through. Aid workers’ availability has also put a strain on his evidence-gathering efforts.
“How do you bring in an experiential training that takes time to develop in a sector where everything needs to be done immediately?” he said. “Most people in the sector don’t even have time to go for a 5-day training course because they could be pulled away into an emergency. Even when you can afford a time, a person will still be busy worrying about getting back to their inbox because the work is building up.”
MBSR developed by Kabat-Zinn was for eight weeks, but to accommodate aid workers’ erratic schedules, Solanki had to develop a course fit for a five-day, one-day or even half-day trainings where he introduces the basics of mindfulness meditation. This allows aid workers to have a feel for the practice, which is helpful for them to decide later on whether they’d want to continue and deepen their understanding of how mindfulness works and how it can benefit them.
But another challenge is that not everyone is open to the idea, either out of lack of interest or deep-seated preconceptions on meditation being linked to religious pursuits. Some think meditation is about reaching a certain state of bliss, or being freed of negative thoughts. There remain individuals who, after an eight-week course on MBSR, still don’t quite get it, said Solanki.
“Just imagine you’re sitting there, saying ‘OK, I want to achieve a state where there are no thoughts.’ So every time a thought comes into your head, as it will inevitably do as that is the nature of the mind, you’re going to be sitting there getting more and more frustrated and stressed because, ‘oh God, I’m thinking again,’” he said.
The pervasiveness of stress in the aid sector
The aid sector does not currently have a system in place to get a full picture of how much work-related stress is affecting aid workers’ mental health and performance. But the few statistics available that tried to capture a segment of the aid worker population revealed worrying numbers.
A Guardian survey in 2015 revealed 79 percent of 754 aid workers admitted to experiencing mental health issues: anxiety, depression, panic attacks and post traumatic stress disorder. Approximately 20 percent of international staff from Europe and the U.S. that are part of moderate-to-large-sized NGOs also reported “clinically significant levels of depression” following deployment, based on research conducted by the Centers for Disease Control and The Antares Foundation, a Dutch nonprofit providing staff care and psychosocial support to development and humanitarian organizations. Almost 12 percent also reported high anxiety three to six months after returning from mission. National staff from Jordan, Uganda and Sri Lanka who took part in a similar survey also reported significant levels of mental challenges: More than half of the close to 1,000 national staff showed significant levels of depression, while half showed significant signs of anxiety. About one-quarter showed symptoms of PTSD.
“We can call it an absolute disaster or crisis if you want to, because that’s exactly what it is,” Solanki said.
The problem is that most aid workers would rather not talk about it, for fear of judgment and potentially losing their jobs, and aid organizations don’t have an overarching policy to deal with their staff members’ well-being, including consultants on short-term contracts.
This is reflected in an online survey Solanki conducted in October 2016 among some members of the U.K.’s START Network. It was meant as a general well-being survey to get a glimpse of aid organizations’ well-being practices, and consisted of two sets of questions, one for aid agencies’ human resources, one for aid agencies’ staff. But it revealed some trends in the sector: Despite increasing calls for organizations to put in place policies that ensure their staff members’ well-being, very few organizations allocate sufficient budget and have distinct policies in place for this purpose.
Eleven out of 19 aid agencies that took part in the survey apportion little of their budget for staff well-being and support — a fraction of the 10 percent allocated for training purposes. Much of that support is focused on security and first-aid training prior to deployment, and only 38 percent of 184 aid workers answered “yes” to a survey question on whether they received specific training on self-care and stress management — revealing differences in how well-being advocates and aid organizations define and understand the scope of well-being.
The survey didn’t have data on how many of its participants have or are experiencing some form of stress, anxiety or depression, which several statistics suggest are pervasive in the sector. But the survey did reveal aid workers’ perceptions on mental health, from how comfortable they were in discussing it with different members of their organizations to what impact they thought opening up would have on their work and their colleagues’ perception of their abilities. Forty percent of 177 aid workers said they would feel “reasonably comfortable” discussing their mental health concerns with their line managers, but the numbers are not as high when it comes to discussing with colleagues (36.72 percent of 177), human resources (30.34 percent of 178), staff welfare (29.76 percent of 168) and occupational health service (23.35 percent of 167).
Out of 172 aid workers, 44 percent also felt discussing their mental health needs would have a “somewhat” adverse impact on their promotions and deployment opportunities.
“There’s lack of foresight, understanding and consistency from one agency to another on well-being,” Solanki said. “Not only are there no policies realistically in place, we don’t even know who’s going to manage those policies, and there’s hardly any money or resourcing even if you’re able to put those things in place.”
The opportunities and limitations of mindfulness
Some aid workers are aware of the practice. Alessandra Pigni, a humanitarian psychologist and author of “The Idealist’s Survival Kit,” a book that tackles the reality of burnout in the humanitarian sector, is a mindfulness practitioner herself.
But while most of the literature on mindfulness leans on the positive, Pigni cautions it’s no panacea. While she herself does mindfulness meditation and has introduced the practice with aid workers from different backgrounds in the Palestinian territories, it is not and cannot be the only answer to assuring aid workers’ well-being — in the field or in the office.
“I remember a line manager took the time to write to me because she could see the benefits of [mindfulness meditation] in her staff … [and] meditation helped me and helps many others, but the real mindfulness here is to tune in with what works for you and do it regularly, almost as a ritual,” she told Devex.
In addition, addressing one’s own health and well-being is just one part of the equation, she said. Burnout, based on research, is born and breeds in “toxic workplaces” where staff are overworked and still have to deal with tons of paperwork, red-tape, micromanagers and few incentives, in an “environment that lacks care, respect, personal and professional growth,” she explained.
“Can you beat that on your own with mindfulness? Well, yes if you decide to challenge it and maybe walk away. No, if self-care becomes a crutch to make it to your next R&R,” she said. “We need a more systemic approach to deal with staff care; it cannot just be a training here and a counseling session there.”
Solanki agrees the practice is no “panacea for all ills,” but he is eager to get more aid organizations and their staff to at least try mindfulness meditation and see for themselves how it can be useful for them in managing stress.
“We’re doing our best here to really explore how this could help aid workers, to see how it could be utilized by aid workers to try and improve not only their well-being in the sector, but also ultimately, if they have a sense of well-being, then they convey that to the people they are helping as well to improve their well-being,” he said.
Solanki plans to conduct a larger survey later in the year to further explore the issue of well-being. Among the focus of that survey is understanding from human resources the barriers keeping organizations from having strong well-being policies and functions, and how open they are in talking about these issues outside the confines of their organizations.
While some are careful of airing their issues in public for fear of attracting negative attention, there are those who may just be looking for guidance and inspiration on how to put in place a proper well-being policy and support that fully meets and matches staff needs.
“I want to explore how we can have a safe space where everybody can just sit down and discuss openly of the problems they’re having and document them and address them as a sector,” Solanki said.
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