Monday Developments - Greenleaf Integrative Strategies

Monday Developments - Greenleaf Integrative Strategies

MONDAYDEVELOPMENTSThe Latest Issues and Trends in International Development and Humanitarian AssistanceCheckOut OurJobsSection!Page 37My BossDoesn’t Get It!Why Good Management andStaff Well-being MattersPeer Support InHumanitarianOrganizationsTheImportanceStaffofCareInsights Froma NoviceGardenerStaffCounsellingIn theUN SystemPsychosocialIntervention WithNational StaffWorking InHIV/AIDS ProjectsSeptember2008Vol. 26, No. 9InterAction

MONDAYDEVELOPMENTSManaging Editor/Art DirectorChad BrobstCopy EditorKathy WardAdvertising & SalesMichael HaslettCommunications DepartmentNasserie Carew, Public RelationsTawana Jacobs, Public RelationsTony Fleming, New MediaChad Brobst, PublicationsMichael Haslett, PublicationsMargaret Christoph, Admin AssociateEditorial CommitteeInterAction Communications TeamInterAction1400 16th Street, NWSuite 210Washington, DC 20036Tel: 202.667.8227publications@interaction.orgISSN 1043-8157Monday Developments is published 12times a year by InterAction, the largestalliance of U.S.-based internationaldevelopment and humanitarian nongovernmentalorganizations. With morethan 160 members operating in everydeveloping country, InterAction works toovercome poverty, exclusion and sufferingby advancing social justice and basicdignity for all.InterAction welcomes submissions ofnews articles, opinions and announcements.Article submission does not guaranteeinclusion in Monday Developments.We reserve the right to reject submissionsfor any reason. It is at the discretionof our editorial team as to which articlesare published in individual issues.All statements in articles are the soleopinion and responsibility of the authors.Articles may be reprinted with prior permissionand attribution. Letters to theeditor are encouraged.A limited number of subscriptions aremade available to InterAction memberagencies as part of their dues. Individualsubscriptions cost $80 a year (add $15for airmail delivery outside the U.S.)Samples are $5, including postage.Additional discounts are available forbulk orders. Please allow 4-6 weeks fordelivery. Advertising rates are availableon request.FeaturesWhy Bother With StressManagement? | 10Ignoring stress in theworkplace leads to inefficiency,ineffectiveness and turnover.Staff Counselling Withinthe UN System | 13United Nations staff andfamilies benefit from awell organized system ofpsychosocial support.Social Support | 14Is staff care an individual or anagency responsibility?Insights From a NoviceGardener | 17When it comes to nurturingstaff, consider growing awellness garden.My Boss Doesn’t Get It! | 19Why good management andstaff well-being matters.10ContentsAddressing Stess InNational Staff | 21Secondary traumatic stressand burnout can affect nationalstaff too.USAID and Staff Care | 23Task force establishes agencywideprocedures.If You’re Not Infected,You’re Affected | 24Psychosocial interventionbenefits national staff workingin HIV/AIDS projects.Lest We Reinvent theWheel | 27Guidelines do exist for goodpractice in managing stress inhumanitarian workers.1719September 2008 • Vol. 26 • No. 9Walking the Walk | 28World Concern introduces “KnowYour HIV Status Day” for staff.Helper’s Fire II | 29Conference works to buildresilient communities forhumanitarian and developmentassistance field staff.Taking Care of EachOther | 31Peer Support inHumanitarian Organizations• Peer Support Network• “I No Longer Feel Alone”• Staff Care in CARE Lesotho-South AfricaThe Power of Presence | 34Sometimes just “being there”makes all the difference.DepartmentsInside This Issue | 3Letters | 4Washington Update | 4Inside Our Community | 6Southern Voices | 8Career Developments | 36EmploymentOpportunities | 3721

INSIDE This IssueUnderstandingStaff CarePhoto: Christina MooreAfter three days in El Fasher, Darfur, I realized thatthe coordination and stability of the NGO humanitarianeffort in this insecure environment depended onthe well being of a small group of NGO professionals.Everyone had a story to tell. Staff in all twelve organizationsI visited mentioned attacks, fear, frustrations, burn out, andconcerns for the safety of colleagues. In Darfur, I saw firsthand the staff care needs of people working in that difficultenvironment. This is an extreme humanitarian context whereNGO staff are under ongoing and severe amounts of stress,and our community needs to find ways to intervene. Theproblem is not just in Darfur; staff care is essential for nationaland expat staff throughout the world, as humanitarianwork has become ever more challenging.The leadership of major NGOs understands that employeesare their most valuable asset. Investing in staff, and inparticular staff care, is not only the right thing to do, it isalso the cost-effective thing to do. It improves staff retentionrates and the completion of assignments, and it decreasesthe costs associated with frequent staff turnover.Government donors and the United Nations have staff deployedto many of the most difficult humanitarian environmentsthroughout the world. Donors recognize the risks associatedwith working in these environments, and they areworking to improve their staff care procedures in the field. KyLuu, the Director for USAID’s Office of Foreign Disaster Assistance(OFDA), has repeatedly stressed the need to find betterways to care for staff in the field. In this issue of MondayDevelopments, he has included a call for NGOs to do more, totake on the care and well being of their own staff in the field.Ky has offered OFDA’s support for these interventions.Investing in staff care is not a big-ticket item. There arelow-cost and high-impact interventions that NGOs are easilyincorporating into their day-to-day programming. Examplesof these interventions appear throughout this issue, whetherit is taking a group of staff members to be tested for HIV/AIDS, setting up peer support networks, or even somethingas simple as ensuring staff posted in the field have access totelevision and DVD players to watch movies and relax. Mentalhealth care is often covered under an organization’s preexistinginsurance policy, both for staff at HQ and overseas,so it is worthwhile to review these policies to see what kind ofinterventions might already be covered.Often, when discussing staff care issues, individual staffare able to come up with creative solutions to relieve stressspecific to their context. With the majority of staff in the fieldbeing national, special consideration should be given to theirneeds when designing staff care programs. The stressors onlocal staff may be different from expats and there may be differentcultural approaches to stress reduction.Poor or unresponsive management in field offices or atheadquarters has been identified as one of the largest factorscontributing to the stress experienced by staff working in crisissituations. Better management is often synonymous withbetter staff care, and simple actions such as including staffcare in job descriptions and performance evaluations of fieldand HQ managers, can help us reach this goal.There is an existing community of professionals that areavailable to support NGOs as they attempt to incorporatestaff care into the work that they do. Some members of InterActionhave institutionalized their commitment to staffcare, some hiring full-time professionals, and finding moredemand for these services than they ever imagined.InterAction is committed to promoting staff care among itsmembers, and has applied for funding to address the immediateconcerns in Darfur and eastern Chad through a seriesof “stress reduction and self-care” (SSC) trainings; to developa training module on “Management in High-Stress Environments”;and to facilitate an interagency process among InterActionmember NGOs to improve staff care provision, withthe aim of developing a set of staff care guidelines.At InterAction’s annual CEO retreat in December I willraise the profile of staff care with the leadership of our members,and I hope to impress upon my colleagues the importanceof incorporating staff care into their programmingthroughout the world. MDSam WorthingtonPresident and CEOInterActionMONDAY DEVELOPMENTS September 2008 3

LettersSend your letters to:Chad Brobst at cbrobst@interaction.orgSecurity and Partisan Goals RequirePartnerships for Effective Aid DeliveryJim Bishop’s presentation on the “Militarization ofForeign Aid” [July 2008] follows on the heels of a concern overthe militarization of foreign policy. Such fears arise when a behemothenters one’s own area of expertise. I would recommendanother look at his observations and perceptions. He notesthat in November 2005, the Defense Department raised theprofile of stability operations, but he calls the tasks “spanning… peace to combat … a radical departure for the armed forces.”Not so. Despite a history of preferring to address combat operationsas if they were isolated from transition-to-peace, occupation,counterinsurgency, advisory, and constabulary duties,the military’s current emphasis on counterinsurgency representsa pendulum swing welcomed by observers who see policyengagement in many more shades of gray than those who perceiveblack-and-white distinctions between war and peace.Bishop attributes to the relief and development activities ofthe commands focused on Africa and Latin America a need tojustify staff and budget. Is it not equally likely that an analysisof the challenges in these regions led national-security plannersto conclude that our country’s interests there require theexpertise of multiple sectors? If food insecurity could lead tomass migration of Africans to Europe, isn’t agricultural developmentan appropriate response? If narco-trafficking is amajor challenge in Latin America (and Afghanistan), wouldn’tour government be most effective if we foster multilateral cooperationamong law-enforcement authorities combined withagricultural advisors who can provide attractive crop alternatives?Someone outside these domains is often the best advocatefor such activity.At a November 2007 speech at Kansas State University, Secretaryof Defense Gates articulated a conviction that economicdevelopment, rule of law, provision of government services, andthe like are necessary to meet our goals in Afghanistan andIraq. More recently, USAID Administrator Henrietta HolsmanFore has pointed to an emerging realization of how fundamentalsecurity is to her agency’s mission in fragile and failed states.Bishop faults the Bush Administration for providing insufficientadvocacy to Congress to fund greater capacity in the Departmentof State. But Congress has both a preference for fundingthe military and an aversion to funding foreign aid. In her recentarticle in the military journal Parameters (38.2 [2008]), the AIDAdministrator writes, “While relations between the military andUSAID have evolved, stereotypical views outside the Agency’swalls, including in Congress, have not. This may prove to be oneof the chief impediments to the Agency’s future effectiveness.”Belligerents often do not see humanitarian activities as impartial;they frequently divert aid only to their partisans andaway from those who may support others. As a donor to aidagencies, I resent a charity paying a “tax” to local warlords orcorrupt authorities. Aid workers are not necessarily more familiarwith the local environment than are the troops deployedto a trouble spot. Thus, every agency must become familiarwith local conditions. We hope that aid reaches those who needit, but commodities in tight supply require security to ensureequitable distribution. Humanitarian relief is not a question ofeither troops or aid workers; it requires all appropriate means.Kurt E. Müller, Ph.D.WASHINGTON UpdateBudget and AppropriationsCongress left for the August recess with mostappropriations bills still unpassed. Thanks to disagreementsover off-shore drilling, committee considerationof appropriations bills was called to a halt.At this point, the House has moved five bills through committee,and passed one of those on the floor – Military Construction/VeteransAffairs. The State/Foreign Operations billwas passed out of the House subcommittee but awaits fullcommittee consideration, and the subcommittee has releasedneither the text of their bill nor the text of their report.In the Senate, nine bills were passed out of committee,including State/Foreign Operations, but none made it to theSenate floor. Unlike the House, the Senate did release theState/Foreign Operations bill text and report.Democrats reportedly plan to pass and send two bills tothe President – Military Construction/Veterans Affairs andDefense – and will fund everything else with a ContinuingResolution (CR) that extends into early next year. ACR is a joint resolution enacted at the end of a fiscalyear if the regular appropriations bills for the nextfiscal year have not been enacted. It provides budgetauthority for federal government agencies and programsto continue in operation at current funding levels until theregular appropriations bills are enacted. At that point theyhope to be dealing with a new and more flexible administration,with which they can negotiate spending levels and passbills (probably glommed together in an omnibus) to fund therest of the fiscal year.RecessCongress began its summer recess on August 1, and willbe in session for three more weeks starting September 8. MDIf you have any questions, or would like to be added to theemail list for the weekly public policy update, please contactMargaret Christoph at MONDAY DEVELOPMENTS September 2008

INSIDE Our Community10th Anniversary of Women Thrive WorldwideOn September 10, 2008, Women Thrive Worldwide(formerly the Women’s Edge Coalition), the leading nonprofitorganization shaping U.S. policy to help women indeveloping countrieslift themselves out ofpoverty, celebratedits ten year anniversaryin Washington,DC. The event, whichwas hosted by CNN Anchor and Reporter Carol Costello,honored four individuals who have made extraordinarycontributions to women’s global empowerment.Congresswoman Nita Lowey (18th-NY) received theLeadership for Women to Thrive Award for her leadershipin Congress to ensure the U.S. government’s supportfor women’s economic opportunity, education andhealthcare. Ambassador John J. Danilovich, CEO ofthe Millennium Challenge Corporation (MCC), Juan SebastiánChamorro, Director General of Cuento Reto delMilenio (MCA Nicaragua), and Imara Martínez of Consejode Mujeres de Occidente, a local women’s organizationin Nicaragua, were jointly awarded the Partnershipfor Women to Thrive Award for their successful partnershipwhich has resulted in model programs that havehad a powerful initial impact on the ground.New Data Show 1.4 Billion Live On Less Than $1.25A Day, But Progress Against Poverty StrongThe World Bank said improved economic estimates showedthere were more poor people around the world than previouslythought while also revealing big successes in the fightto overcome extreme poverty.The new estimates, which reflect improvements in internationallycomparable price data, offer a much more accuratepicture of the cost of living in developing countries and seta new poverty line of US$1.25 a day. They are based on theresults of the 2005 International Comparison Program (ICP),released earlier this year.In a new paper, “The developing world is poorer than wethought but no less successful in the fight against poverty,”Martin Ravallion and Shaohua Chen revise estimates of povertysince 1981, finding that 1.4 billion people (one in four)in the developing world were living below US$1.25 a day in2005, down from 1.9 billion (one in two) in 1981.An earlier estimate—of 985 million people living below theformer international US$1 a day poverty line in 2004—wasbased on the (then) best available cost of living data from1993. The old data also indicated about 1.5 billion in povertyin 1981. However, the new and far better ICP data on prices indeveloping countries reveal that these estimates were too low.The new estimates continue to assess world poverty by thestandards of the poorest countries. The new line of US$1.25for 2005 is the average national poverty line for the poorest10-20 countries.“The new estimates are a major advance in poverty measurementbecause they are based on far better price data forassuring that the poverty lines are comparable across countries,”said Martin Ravallion, Director of the Development ResearchGroup at the World Bank, “Data from household surveyshave also improved in terms of country coverage, dataaccess, and timeliness.”“The new data confirm that the world will likely reach thefirst Millennium Development Goal of halving the 1990 levelof poverty by 2015 and that poverty has fallen by about onepercentage point a year since 1981,” said Justin Lin, ChiefEconomist and Senior Vice President, Development Economicsat the World Bank. “However, the sobering news thatpoverty is more pervasive than we thought means we mustredouble our efforts, especially in Sub-Saharan Africa.”The new data show that marked regional differences inprogress against poverty persist. Poverty in East Asia hasfallen from nearly 80 percent of the population living belowUS$1.25 a day in 1981 to 18 percent in 2005. However, thepoverty rate in Sub-Saharan Africa remains at 50 percent in2005—no lower than in 1981, although with more encouragingrecent signs of progress.InterAction Members Respond to Georgia CrisisInternational aid organizations are mobilizing a response tothe humanitarian crisis following the recent outbreak of fightingbetween Georgian and Russian forces. The United Nationsnow estimates that up to 100,000 people have been displaced,adding to a previous caseload of over 220,000 internally displacedfrom hostilities in the early 1990s. According to Russianand Georgian officials, up to 30,000 refugees have flednorthward into Russia since the Georgian offensive to retakecontrol of the autonomousterritory of South Ossetiabegan on August 8th. It isestimated that 56,000 peoplehave fled from the Goriregion in Georgia towardthe capital Tbilisi, approximately80% of the populationof the town.Twenty-four InterActionmember organizations areresponding to the humanitarianneeds with emergencymedical, food, shelter,water and hygiene supplies.Many organizationshave offices in the regionWhile on a two-day trip to accessthe U.S. humanitarian responseto the situation in Georgia, USAIDAdministrator Henrietta Fore met withPresident Mikheil Saakashvili in Tbilisi.implementing health, educationand conflict resolutionprograms, which havebeen mobilized to respondto the emergency needs. Itis hoped the recent cessa-Photo: USAID6 MONDAY DEVELOPMENTS September 2008

tion of hostilities following the Russian government’s decisionto halt its offensive will allow humanitarian organizations toaccess the affected populations to deliver much needed aid.The U.S. Embassy in Georgia issued a Disaster Declarationon Sunday, August 10, and the U.S. Agency for InternationalDevelopment (USAID) has announced an initial $250,000in emergency assistance for the people of Georgia. Countriesthroughout the world have pledged their assistance, and arecalling for protection of civilians and respect for internationalhumanitarian and human rights law. The Government of Georgiahas requested humanitarian assistance, specifically medicines,medical supplies, emergency shelter items and food.Sam Worthington Testifies Before SenateInterAction President & CEO Sam Worthington testifiedon July 31, 2008 at a hearing on Capitol Hill—“A Relianceon Smart Power: Reforming the Foreign Assistance”—beforethe U.S. Senate Subcommittee on Oversight of GovernmentManagement (part of the larger Committee on Homeland Security).His testimony focused on:• The mission of U.S. foreign assistance.• The U.S. Government’s capacity to be an effective partnerin development.• Protecting the “humanitarian and development space,”within which InterAction’s member organizations work.Brandeis UniversityThe Heller School of Social Policy and Management• The need to elevate international development as a componentof U.S. foreign policy—namely by creating a CabinetlevelDepartment for Global and Human Development.Free Web Portal for AfricanCivil Society OrganizationsGuideStar International (GSI) and the United NationsEconomic Commission for Africa (UNECA) announcedin August a joint venture to develop a free web portal forAfrican civil society organisations, which will showcasethe work of all NGOs, charities, nonprofit organisationsand community based organisations from the smallest tothe largest. Utilising a shared internet platform, organisationswill, for the first time, be able to display their visionand mission, objectives, activities, needs and finances todonors, researchers, policy makers and the general public.The service, known as GuideStar, is already fully operationalin the US and the UK where these websites contain detailedinformation on hundreds of thousands of registered charitiesand non-profit institutions. GuideStar Internationalis also working to develop similar systems in Europe,Canada, India, South Korea and South Africa. MDKnowledge Advancing Social JusticeThe End of Poverty ...One Degree at a TimeOver 150 students in residence from 65 countries forming one ofthe largest programs of its kind in the world.Alumni are employed by U.N. agencies, bilateral and multilateralaid organizations, and NGOs throughout the world.Generous financial assistance for Peace Corps and other serviceorganization volunteers.M.A. in Sustainable International DevelopmentM.S. in International Health Policy and ManagementM.B.A. concentration in Sustainable DevelopmentM.P.P. concentration in PovertyDual M.A. programs in Sustainable Development withCoexistence & Conflict and with Women & Gender StudiesA community of activists and scholars on the front lines of social policy.heller.brandeis.edu781-736-3820HellerAdmissions@Brandeis.eduMONDAY DEVELOPMENTS September 2008 7

SOUTHERN VoicesNow What? HowProject TerminationAffects National StaffBy Ana Uriarte, Advisor, InterActionAstark contrast exists in NGO policies whenit comes to the treatment of staff at the completion ofin-country projects. Suddenly unemployed and withoutincome, national staff are often left in similar conditions tothe populations they had previously been supporting. This ismuch different to international staff,who are free to apply for other positionswithin the same organizationand have many other opportunitiesthroughout the world. National staffhowever, must remain behind, oftenwithout the funds or the freedom topursue work in other locations. Forthem, there is little organizationalsupport – they are left only with theskills they’ve learned and a sense ofa job well done. Neither of these feedstheir family.To better illustrate this situation Iinterviewed several staff in one LatinAmerican country, who until recently,worked for a large U.S.-based NGO.After restructuring its program, theNGO let dozens of national staff go.Many had worked on the project foryears and now found themselvesfaced with the prospect of being unemployedin a poor job market that did not value their NGOskills. I asked how they felt when their employer terminatedtheir contract and what their expectations were.One staff member named Miguel stated: “As a nationalstaff member, I expected project termination would be a morehumane process, less shocking or traumatic considering thetype of organization we were working for. As a non-profitNGO, we assumed it would be different from private enterprisesthat are focused on productivity levels of manufacturedor consumable goods. We understood our existence was notbased on local or international market prices, because whatwe produced were improved lives. And here is where I askmyself why national staff are not part of the benefit that developmentprojects bring? I truly believed the organizationwould provide us some positive alternatives for our future.Soon I realized there was nothing reliable for us.”Humanitarian agencies should understand that the overwhelmingpositive impact they achieve worldwide would notbe possible without the extraordinary technical capacity ofnational staff – people with their own needs, aspirations, expectations,and responsibilities.Yolanda, a gender specialist, explained: “My perception isthat NGOs are not sending a coherent message based on theprinciples of solidarity and altruism they advocate. I especiallyfelt this when I discovered the absence of internal nationalstaff care policies once projects finish, and when I rememberhow our supervisors constantly reminded us of the importantrole we played as valuable individuals with technicalskills that helped achieve the agency’s goals. We were toldthat we contributed to maintaining the high prestige that theorganization enjoys worldwide. This process has been verytough and frustrating.”In general, there was disappointment and sadness amongstaff as the program started its termination phase. Many feltbetrayed and used. Feelings of frustration and impotencewere widespread and the feeling was that the agency caredonly about the budgets, auditing, and closure dates thatcomplete a successful project.Jimena, a technical coordinator, writes:“My initial feelings when I started working for this NGOwere very positive. I felt honored given the great prestige theagency represents. But when the project ended and many ofus did not even receive a simple paper acknowledgement ofour contributions, and knowing all the dedication and commitmentwe had given to our work, my feelings suffered adrastic change. Now I strongly believe there is a level of hypocrisyin some NGOs and I don’t regret voicing my profoundbitterness after all I have been through.”“My personal suggestion to other agencies from my positionas a national staff member is that they should help us lookfor opportunities in future expansions of the projects. We feltthe organization was not interested in investing time in ourprogram staff because our future with them was already de-Photo: Sara Sywulka8 MONDAY DEVELOPMENTS September 2008

“I strongly believe there is a level ofhypocrisy in some NGOs and I don’tregret voicing my profound bitternessafter all I have been through.”termined to end. I insist that it would have been a good policyto listen to us, or at least let us present our proposals for theformation of new enterprises by taking advantage of the experiencewe had acquired while working with the program.”Many feel the treatment of national staff is ironic and inconsistent.NGOs understand the essential roles these staff membersplay in developing countries, and their invaluable contributionto maintaining relationships with the community leaders thatensure humanitarian assistance reaches targeted populations.Yet most agencies do not have a project completion plan thataddresses national staff’s needs – they simply terminate staffcontracts and focus on new projects based on new trends.On the other hand, international staff members have amuch different experience when projects end. In most instances,the organization facilitates their transition to a newdestination in another part of the developing world. They aregiven the opportunity to continue the use and developmentof their skills. Their perspective and feelings are the oppositeof national staff because they do not face abrupt unemploymentand a dearth of assistance in job placement.Often international staff are already thinking about theirnext assignment before the current one is even finished. Infact, when told local staff (past and present) would be interviewedfor this article, the Country Director of the NGO inquestion reacted with deep concern. He instructed them tocontact headquarters before making any statement. Nationalstaff assumed that he did not want an expression of their dissatisfactionto jeopardize his new position within the organization.Of course several of the people that were interviewedhad already been terminated and certainly didn’t have to getpermission from headquarters to give their opinion.The expressions and feelings captured from those interviewedare testimonies in their own words. Hopefully, theircomments will spur NGOs to begin a dialogue with staff toaddress their concerns. A positive step would be to make nationalstaff an integral part of the overall organization, startingwith their inclusion in developing policies and proceduresat the country level. In addition, work needs to be done toreduce the existing gap between the treatment of local andexpat employees. MD*staff names have been changedMONDAY DEVELOPMENTS September 2008 9

StressWhy BotherStresswithBy Joshua LevinSpecial Assistant to the Executive CounselorMercy Corps?Ignoring stress in theworkplace leads to inefficiency,ineffectiveness and turnover.ManagementFor me, stress is the long hours,the loneliness and the attachment to work.I wonder how many IDPs [internally displacedpeople] we will reach today, and Iforget about my own needs. Meanwhile,the government is breathing down my neckand insecurity keeps me from leaving our compound.So much for privacy and relaxation. Individual personalitiesreally come out when you share the same livingquarters. The environmental conditions aren’t greateither: dust, sun, heat. Oh, and kidnapping is now anissue; we are a soft target, you see. So what are my majorcoping mechanisms? Well, the gym we were going towas attacked, so I guess I’d say gin and chardonnay.”– Comments of an aid workerin AfghanistanSuch sentiments are not unique to any particular organizationor region. Humanitarian relief and developmentorganizations place inordinate mental and emotionaldemands on their practitioners. Aid workers frequentlysuffer psychological strain as a result of isolation, difficultworking conditions, demanding programming obligations,and physical danger. In a study published by the Journalof Traumatic Stress in 2001, as many as half of all returnednongovernmental organization (NGO) expatriates exhibitedsymptoms of burnout, depression, or PTSD. These findingshighlight the importance of psychosocial support for fieldbasedstaff.So why, given its pervasiveness, have aid agencies beenso slow to respond to stress in their employees? Simply put,many organizations have not made employee wellness apriority. Under their funding constraints, they doubt theirability to implement high-impact solutions without a highimpactbudget. Furthermore, many aid workers havegrown to expect deprivation and self-sacrifice as inevitable.In other words, there is not enough complaining. Fatalisticattitudes about on-the-job stress, however, havedone little to inspire progress, and there are a number ofpractical reasons NGOs should pursue comprehensivestress management systems for their employees.First, stress affects judgment. Whether manifestedas indecisiveness, fatigue, distraction or carelessness,stress results in impaired decision-making. Foraid workers this can mean poor strategic choices,strained interpersonal relationships and diminishedjob satisfaction. For the international nonprofitsthey work for, it translates into lost funding opportunities,inefficiency and poor team dynamics. Ofperhaps greater consequence, though, unsounddecisions may impact the efficacy of programs andthe safety of teams in the field. After all, severelyPhoto: Anantha Vardhan - Istockphoto.com10 MONDAY DEVELOPMENTS September 2008

Stressstressed employees working in high-security environmentsnot only expose themselves, but also their colleagues andbeneficiaries to unnecessary risk.Second, overwhelming stress decreases productivity. Bettermental performance results in better efficiency and morale.And although nonprofits may have priorities that are less connectedto the bottom line than their counterparts in the forprofitsector, the success of their missions is just as tied to theeffectiveness of their employees. According to the September4, 2004 issue of The New York Times, “Workplace stress coststhe nation more than $300 billion each year in health care,missed work and the stress-reduction industry that has grownup to soothe workers and keep production high.” Investing inpsychosocial resources for NGO staff may, in the long run,make international nonprofits more cost-effective, not less.Finally, unrelenting stress leads to “burnout” which hurtsemployee retention. Aside from the obvious loss of organizationalmemory and the opportunity costs related to trainingand orienting new employees, turnover takes a significant financialtoll. In 2005 Financial Literacy Partners estimated thatthe average cost of replacing a staff member is between $3,000and $13,000. These expenses are especially striking whenconsidered in conjunction with the approximately 40 percentof job turnover that is directly attributable to stress. Given theskyrocketing costs of recruitment, aid agencies stand to benefita great deal from well-managed staff support systems.Beyond the practicalities of strategy, efficiency and staff retention,humanitarian relief and development organizationshave a moral imperative to look after the health and wellbeingof their team members. Staff deployed to the field face avariety of situational stressors. They must cope with the frequentlyconflicting interests of their organizations, beneficiaries,and host governments. They endure perennial resourcelimitations and the challenges of a restricted personal life.They brave dangerous operating environments and uncertainfutures. International NGOs demand a great deal of their staffand owe them a supportive working environment.Employee stress is not restricted to humanitarian relief anddevelopment organizations. In fact, the American Institute ofStress estimates that job stress costs the U.S. economy over$300 billion annually. In contrast to most NGOs, however,some private-sector companies have taken major steps to redresstheir staff support gaps. If the nonprofit sector wishesto continue to grow and develop, it must do the same. Developmentand relief organizations must pursue innovative,cost-effective employee wellness solutions. In the long term,a robust support platform may improve their programming,reduce their health care costs, and enhance the safety andsecurity of their field teams.Ultimately, the calculus is simple: Any money saved by ignoringstress in the workplace is lost tenfold in employee inefficiency,ineffectiveness and turnover. MD12 MONDAY DEVELOPMENTS September 2008

UN systemStaff Counselling Withinthe UN SystemUnited Nations staff and families benefit from a wellorganized system of psychosocial support.By Penelope Curling, Staff Counsellor, UNICEFThere are more than 80 UNCounsellors based in headquartersand field locations. Some ofthe Counsellors are internationalstaff and some are nationals of the countryin which they serve. Broadly, theCounsellors are responsible for the psychosocialwelfare of UN staff, and offerinterventions, consultations and trainingto individual staff and to managerson work-related stress and psychosocialhealth issues, including burnout,depression, anxiety, traumatic stress,family and marital problems (includingdomestic violence), bereavement, workplaceharassment and substance abuse.Counselling is offered on a face-to-facebasis, or referrals are made to localmental health professionals.If a UN staff member or one of hisor her direct dependants is affected bya traumatic event, the UN Counsellorwould usually make direct contact withhim or her, providing some informationabout common traumatic stressreactions and offer support either directlyor through a referral. For manyUN staff in the field, this contact witha supportive colleague, and the knowledgethat the Counsellor is available ifneeded, is all that is needed to boosttheir natural coping mechanisms andprevent the development of a stressdisorder. Similarly, for staff membersstruggling with burnout, substanceabuse or other mental health issues,being able to quickly and easily accessconfidential, in-house support and advice,which is often not available locally,can be the key factor that enablesthem to keep functioning, saving theorganization untold costs in sick leave,medical evacuations and resignations.Some staff members prefer to consulta local mental health professional,who is familiar with the local cultureand removed from the workplace, toguarantee anonymity. For others, becausethe Counsellor is a colleague,the stigma they may associate withmental health professionals is absentwhen they contact a Counsellor. For astaff member in the field, consulting aCounsellor based in headquarters offersadditional distance and “safety.”When a headquarters UN Counsellorgoes on mission to a field location, colleaguessometimes share intimate detailsof their lives, only to close with: “Ican tell you all of this because I knowyou are going away again.”Some of the UN Counsellors haveimplemented Peer Support or PeerHelper systems in their organisations,and are responsible for the training,supervision and support to these PeerHelpers. These trainings include a firstlevel and an advanced level training,teaching active listening and communicationskills, general stress managementand the role of the Peer Helper/Peer Support Volunteer, as wellas an introduction to the impactof trauma, bereavement, workplaceharassment, HIV in theworkplace and other work-relatedstress issues.The UN Counsellors meet annuallyat a forum for furtherlearning and to share experiences,tools and much neededmutual support. Close networkingamong the Counsellors facilitatesinter-agency referrals, back-up supportand the organization of inter-agencytrainings and workshops, all of whichserve to improve access to UN Counsellingservices. The Counsellors have awebsite where announcements can beposted, locations tracked, and tools andresources can be shared.A number of Counsellors have producedpublications for advice to UNstaff on managing stress and trauma,building resiliency, domestic violenceas an issue impacting on individualstaff or colleagues, substance abuseand other issues. Many also manageintranet websites for their colleaguesto access information about workshopsand other staff support activities, aswell as to download publications andother staff well-being information.During critical incidents affecting alarge number of UN staff, the UN Departmentof Safety and Security’s Critical IncidentStress Management Unit coordinatesthe UN Counselling response,ensuring that staff of all UN agencieshave access to Counselling resourcesand avoiding a duplication of services. AUN Counsellor on-site in an emergencyor following a critical incident offersmuch more than the availability of counselling:the Counsellor also advises andguides managers on creating a supportiveworking environment, and boosts themorale of staff, who see the presence ofthe Counsellor as a sign that the organisationcares about their well-being. MDMONDAY DEVELOPMENTS September 2008 13

SupportSocial SupportIs staff care an individual or an agency responsibility?By John H. Ehrenreich, International Associate, Antares Foundationand Professor of Psychology, State University of New York –College at Old WestburyAbad boss is more stressfulthan war, aid workers say. “Iwas expecting the conflict and thestress, but what really broughtme down was how mean my managerwas to me,” one aid worker travelling toSri Lanka told researcher Barb Wigley.Aid workers told Wigley they were constantlyfrustrated by the dynamics ofthe large organization they work for. “Itstarts to feel like no one cares.” (Reportedin AlertNet, January 26, 2006.)As aid agencies have become moreaware of the emotional cost of aid workto their staff, a simple understandingof the problem has developed. Aid workis inherently stressful, runs the logic.Difficult living and working conditions,separation from loved ones, chronicdanger, exposure to gruesome sights,and exposure to survivors’ terrible talestake their toll. To survive emotionally,aid workers need interventions to increasetheir resilience: training andsupport in carrying out stress reductiontechniques, before they are deployed,when they are in the field andafter they return. (This model may needspecific modifications for national staff,but the same general principles apply.)There are two problems with this understanding.First, in addition to the“inherent” stresses of aid work, staffcomplain of other, “non-inherent” stressors.These may include lack of the suppliesand equipment needed to do thejob expected of them, unclear expectationsand ambiguous job descriptions,poor organization and scheduling of thework process, overly bureaucratic agencypolicies and practices, unnecessarybarriers to communication with family,and, especially, arbitrary or unfairor unsupportive management practicesand conflict and mistrust within theteam. For example, in the HeadingtonInstitute study of aid workers in Darfurand eastern Chad, survey respondentswere asked about the most significantsources of stress. Fourteen percent citedinadequate management or supervision,18 percent communication difficultieswith colleagues or with headquarters,and seven percent lack of clarity as tojob responsibilities. These are clearlymanagerial and agency issues, not simplymatters to be dealt with by individualstress management practices.Second, as is well known, not allworkers show adverse effects from thestress they experience. For example,in the Headington Institute study, 46percent of the workers intervieweddescribed themselves as “emotionallystressed.” On the other hand, 19 percentreported that they were “not at allPhoto: iofoto - Fotolia.com14 MONDAY DEVELOPMENTS September 2008

Supportstressed.” To some degree the variabilityin the impact of aid work may reflectdifferences in the particular field experiencesof individual staff members. Tosome degree it may represent individualdifferences in vulnerability, due tofactors such as personality, prior experiences,training and use of individualstress management practices.But a growing body of research suggeststhat it is social support, not individualdifferences, that are the keydeterminant of the impact of stress onindividuals. Even under the extremestress of war, studies of war veteranshave found that social support (e.g., platooncohesion, post-war support) playsthe largest single role as a protectivefactor against the development of PTSDand other combat stress reactions.For aid workers, the key social supportsare their team and, for those withfamily nearby, their family. If there iscohesion, good communication anda sense of trust within the team, it isfar easier to withstand the rigors of thework. Conversely, dissension within theFor aid workers, the keysocial supports are theirteam and their, team dynamics making decisionmakingdifficult, clique formation, orharassment and bullying both interferewith the ability to staff to withstand the“inherent” stresses of the job and arethemselves potent sources of stress.The team leader plays a critical rolein establishing and maintaining positiveteam functioning. In addition, ateam leader who is considered competent,fair and able to make decisionsbut open to information and feedbackfrom the team, and who can lead byexample increases team resilience andreduces individual vulnerability.Leadership and management behaviorsat higher levels, and agencywidepolicies and practices also play acentral role. Critical supports for staffemotional well-being include clear jobdescriptions, a clear chain of command,efficient logistical support, clear andwell-implemented safety and securityprocedures, good communications, appropriateworkload expectations, appropriatepolices with respect to days off,work schedules and vacation time, fairand appropriate human resources policies(e.g., benefits, career paths), andeffective planning with respect to issuessuch as any needed evacuations.The implications of these observationsare clear: Maintaining staff capacitydoes not result from interventionssolely targeting individual staff members.Effective stress management andrisk reduction is a systematic policy,carried out by the team and the agencyas well as the individual worker. It includes:systematic, self-conscious effortsby team leaders and by the agencyas a whole to promote team cohesion;selection and training of managers atall levels with respect to skills and behaviorsthat reduce staff stress among;and systematic scrutiny of both existingand proposed agency policies andpractices for their impact on staff. MDIn MemoriamOn August 13, 2008, International RescueCommittee staff members Shirley Case, NicoleDial, Jackie Kirk, and Mohammad Aimal died inthe line of duty in Logar Province, Afghanistan,as their clearly-marked IRC vehicle came underheavy gunfire."These extraordinary individuals were deeplycommitted to aiding the people of Afghanistan,especially the children who have seen so muchstrife. Words are inadequate to express oursympathy for the families and loved ones of thevictims and our devoted team of humanitarianaid workers in Afghanistan."— George Rupp, President, IRCThe InterAction community expresses itssincere condolences to IRC and the staffmembers’ families.16 MONDAY DEVELOPMENTS September 2008

Human ResourcesInsights From aNovice GardenerWhen it comes to nurturing staff,consider growing a wellness garden.By Bing Castro, Human Resources Manager, Save theChildren USA, Philippine Country OfficeIgot introduced to gardening of a different kindabout ten months ago. The idea of planting a seed andnurturing it patiently quietly came in November 2007 afterthree days training for Human Resources Managersduring which I gained some insights andpicked up some skills. It was all about havinga sharper psychosocial lens dimensionin the HR work that protects staffand builds resilience. It gave me a mentalmodel of what was until then perhapsjust intuitive.The gardener must pay attentionto the plant to give it enough of what itneeds to survive and thrive. Each plantneeds different kinds of care.This training was about paying attention to the person insidethe person in various HR interactions such as screening,recruitment and selection, briefing, deployment, de-briefing,and end of employment. It’s calledtaking care of staff wellness.simply hearing out staff in one-on-one encounters.Four months later, a group of Save the Children staff wentfor wellness workshop trainer certification in Melbourne,Australia. Our trainers were careful to make us understandthe sensitivities of a wellness and stress mitigation programwith a psychosocial foundation for development workers.Our staff have not only different perspectives and capacities,but also different potentials for wellness.A gardener will always have theneed to garden.Two months later, for my fellowtrainer Ariel Balofinos and me, our confidenceand competence grew enough todeliver the one-day wellness workshop programwith integrity. This was initially to 25 staffmembers in the Philippines, and has now grownto reach 60 staff members after four sessions. Thisone-day wellness workshop conducted for 25 membersof the Expanded Senior Management Team ofthe Save the Children Philippine Country Officeand other staff in mid-May was a global premier!And Ariel and I were happy to deliver it.The subsequent sessions were held for staff groupsacross the country – our South Central Mindanao ProgramOffice, our Metro Manila Program Office, andour projects in Mindanao. We were surely helped bythe build-up on wellness support throughout SaveBut the gardener hasto come out in thegarden everyday.Photo: Serj Siz`kov - Fotolia.comBack at work after thattraining, there followed aseries of daily attempts,applications and experimentsin everyday settings. Some weresuccessful; others became “lessonslearned.” No fanfare, just quiet wellnessinitiatives. Among these are the “Fridayhabit” of aerobics at the office, celebratingmonthly birthdays with a little more flair throughthe initiative and creativity of staff, braving some tough talkbetween staff to help smooth interpersonal differences, andMONDAY DEVELOPMENTS September 2008 17

Human Resourcesthe Children, our robust certification training, and our ownin-country campaign – all of which gave us the platform todo our job (but also some jitters knowing the importance ofwhat we are doing).The wellness workshop participants now have a commonappreciation of their individual responsibility for theirwellness, confidence in their potential to achieve their ownwellness, and comfort in knowing that they have given themselvespermission to recognize, manage and reduce stressand act on it: the best lesson of all!Participants are now more sensitive about recognizingtheir workplace stressors, their signs of stress (as well asthose of their colleagues) and most importantly, their multidimensionaltools for managing stress at the physical, mental,emotional, spiritual and behavioural levels.After planting a seed, often the best thing agardener can do is patiently wait. And on thesurface, we may feel that we may not haveaffected anyone with what we have tried todo. But indeed, somehow we have plantedthat seed. And when that person is ready – inhis or her quiet time – coming back to thatmoment, the bloom appears.It has been a quiet journey but along the way a garden hasbeen growing...... in me as a person and as a Human Resources Managerand a certified trainer.... in my fellow community of trainers and fellow gardenerswho you can count on to help nurture this wellness culture.... in those who have gone through the wellness workshop.The garden needs daily attention. It is a joyfor a gardener to have a happy helper.Some three weeks after the first wellness workshop in ourCountry Office, a new friend “Louellawella” with a Save theChildren email address, surprised participants with an email.She began this way:Hi! You have a new friend - Louellawella – your wellnessfriend! It is 25 days you since our wellness workshop. Haveyou given yourself permission to recognize, manage and reducestress? Hmmm. Perhaps you have not been paying attentiontoo much. But that’s okay. We can revive that. Rememberyour Self Care Plan? Why not check on it again and see whereyou are. Let’s do a quick check shall we? Stay with me just awhile…And from there she reminded participants of practical learningpoints for wellness: identifying stressors, being aware ofsigns of stress and developing strategies to manage these.Louellawella visited with us as our wellness friend and advocate,as a constant reminder, and therefore our “constantgardener.” Let us welcome her if she comes to your garden.Why not have or be your own “constant gardener?” MDThis program is part of the Global Employee Wellness pilotproject. Initially designed for the Indonesia Country Office incollaboration with Save the Children and Antares Foundation,the project aims to improve the overall wellness of Save theChildren’s employees, thereby increasing employee satisfactionand retention. It consists of three major components: (1)HR managers training; (2) employee wellness certificationtraining of trainers; and (3) program manager training to addressemployee wellness issues in the four major domains ofpersonal, environmental, organizationaland home life wellness. If youhave questions or comments,please contact, John Fawcett,Deputy Director StaffWellness, at jofawcett@savechildren.org18 MONDAY DEVELOPMENTS September 2008

ManagementMy BossDoesn’t Get It!Why good management and staffwell-being matters.By Rick Augsburger, Managing Director, The KonTerraGroup, and Lynne Gilliland, Partner, Gilliland & JudPhoto: Bela Tibor KozmaMy boss doesn’t get it!”– a common comment fromfield staff working in crisissituations. One of the greateststressors that field staff endure isnot the lack of security, poor living circumstancesor overwhelming workload.It is the absence of healthy managementsystems and skilled managers. Andthey are talking about their managersin the field and their managers based inheadquarters or in third countries.Humanitarian personnel often workin situations of chronic stress andcrisis, characterized by chaos,upheaval, and ongoing threatsto safety. This reality makesgood management and solidmanagement systems criticallyimportant.Leadership and managementchoices made in thiscontext can be helpful or hurtful:to the organization, to beneficiariesand to employees.A supervisor’s management strengthsand weaknesses influence staff’s abilityto perform well and can greatly impactstress levels. Effective managers helpus be at our very best so we can bounceback from stressful situations and bringcreativity and resilience to the work athand. An attentive, effective boss canhelp a divided team become high performinginstead. For NGOs, investing indeveloping good management and leadershipskills can reward the agency onethousand fold through increased staffwellness, output and staying power.A Headington Institute study onNGO staff well-being in Darfur, (NGOStaff Well-Being in the Darfur RegionSupervisorsthat “get it” haveworked at developingand honing some or all ofthese skills.of Sudan and Eastern Chad, December2007) found that:“It was evident that the strengths andweaknesses of organizational managementsystems and/or individual man-MONDAY DEVELOPMENTS September 2008 19

ManagementEffective managershelp us be at our verybest so we can bounceback from stressfulsituations and bringcreativity andresilience to the workat hand.agers were, in part, responsible for significantlymagnifying or mitigating thelevel of stress experienced by staff andtheir functional ability.”The study went on to say:“A focus on strengthening the selfcareand stress-management skills ofindividual staff deployed to complexemergencies without a concomitantfocus on strengthening organizationalmanagement skills, systems andstructures seems unlikely to result inenduring improvements in staff wellbeing.Any systemic strategy aiming toenhance staff well-being should prioritizestrengthening individual managementskills and organizational managementsystems.”Think of a time when you were ina highly stressful professional situationand your supervisor helped youachieve or maintain high performance,mitigating the unnecessary stressorsso that you could really focus on thetask at hand. What did he or she dothat made that possible?Chances are you listed such traitsas good communication skills, goodmanagement of conflict and a strongability to create teams that worked welltogether. She probably had a sharp eyefor knowing signs of stress in staff andhad the skills to address them. Maybeyour supervisor kept the drama toa minimum and was good at managinghis own emotional state and wellbeing,modeling consistency and calm.You probably would say there was trustand open and clear communicationwith your supervisor. You might alsosay that that person was a competentand effective leader.Supervisors that “get it” have workedat developing and honing some or all ofthese skills, and they have the ability toconsistently apply these skills in extremelystressful working environments.MDFour Critical Skill Areas:Communication SkillsListening, asking open endedand curious questions, refrainingfrom micromanaging by givingunwanted advice. Facilitatinguninterrupted conversations.Acknowledging the work orbehavior of the staff person.Sharing information freely andtransparently. Consistency.Team Development SkillsShared work and responsibility.Team decisions. Team purposeand rewards. Ability to handletension so that all viewpoints areheard. Fun. Acknowledgement.Clarifying goals. Establishing aclear decision-making process.Modeling accountability as a team.Facilitating productive conflict.Leadership SkillsSetting the vision. Staffdevelopment. Delegating.Handling problem staff withrespect and decisiveness.Managing multiple demands andstakeholders. Troubleshootingorganizational barriers. Clarifyingroles and responsibilities.Maintaining good relations withall staff. Setting and enforcingbehavioral standards. Taking creditfor nothing and responsibilityfor everything. Holding staffaccountable.Self-Management SkillsServing as a model of expectedbehaviors. Self-care that maintainsmental and emotional well-being.Heightened self-awareness.Adequate self-confidence. Holdingoneself accountable. A goodmeasure of humility. An ability tolearn and to handle change.20 MONDAY DEVELOPMENTS September 2008

National StaffLaughter yoga therapy with Indian NGO.Photo: Siddharth ShahAddressing Stressin National StaffSecondary traumaticstress and burnout canaffect national staff too.By Siddharth Ashvin Shah, MD,MPH, Medical Director, GreenleafIntegrative StrategiesThe geographic cure. R&R.Regular alcohol use with compatriotsin an end-of-day catharticritual. Phone calls to family.Many readers will recognize these NGOworker attempts to deal with humanitarianaid stress. Although these interventionsmight mitigate the stress andworkplace difficulties that accumulateinto burnout, they leave untouchedan important category of occupationalstress: secondary traumatic stress(STS) – the neurobiology that humanitarianworkers develop in the processof working with other people’s trauma.Given that STS is such a massive topicand that it has been dealt with in thehumanitarian literature in a generalsense, I want to focus on the untoldopportunities for humanitarian effortswhen we engage with the stress vulnerabilityand resiliency of national staff.In 2002, I began providing trainingson identifying, mitigating and preventingsecondary trauma stress to humanitarianorganizations headquarteredin India, Pakistan and Sri Lanka.Translating a validated instrument fromthe scientific literature into Gujarati, Idesigned a quantitative public healthstudy for four organizations workingwith victims of violence. Out of the nearly100 workers studied, every single personidentified a negative, vicarious traumaticconsequence of their work.That means that every national stafferacknowledged that their work hurtstheir mind. The staffers responded tothe simple 17-item instrument withSTS symptoms such as, “Due to thetrauma content of my work, in the lastweek I have found myself:• Re-living the trauma experienced bymy client.• Having trouble sleeping.• Being easily annoyed.• Having trouble concentrating.STS makes its imprint on buried regionsof the brain and there is no oneclassic form of STS. It could be chronicinsomnia as a result of working withrefugee populations; or it could take theform of memory gaps in an otherwisefresh, new worker who starts listeningto the testimonies of rape survivors.STS often means an affected personfeels stuck or frozen in seemingly irrationalfeelings and behaviors.STS also occurs in headquarters staffor back office staff who may never go tothe field. When an organization workswith what have been called “traumascapes,”the whole organizational chartbegins to vibrate with trauma. People donot have to work in the field to absorbenough crisis, grief, anxiety and pain tobe impacted by STS. After all, regions ofour brain with their specialized neuronsare built to suffer vicariously.I was warned that humanitarian organizationswould be reluctant to delveinto STS. However, in my experience,South Asian NGO leadership is nothindered by a cowboy machismo denialmindset or a slowness to acknowledgethat their work has mental healthcosts. South Asian groups ask me forcheap, low-tech, adaptable and porta-People do not haveto work in the field toabsorb enough crisis,grief, anxiety and painto be impacted by STS.ble interventions to mitigate traumaticstress. I give them a menu of 20 to 30options from which they can pick andchoose including:• Intra-agency, horizontal (peer-topeer)and vertical (throughout thehierarchy) “neuropsychoeducational”exchanges. Learning together howthe brain is wired for vicarious trauma,their occupation’s sector-widevulnerability and signs of difficultyreduces stigma for everyone in anagency.• Inter-agency meetings in which staffersshare mental notes and crosspollinateconcerning stress mitigationtechniques. This method reduces theneed to adapt techniques foreign toMONDAY DEVELOPMENTS September 2008 21

National StaffGuided meditation with Indian aid workers.the culture (e.g. psychodynamic orcognitive-behavioral therapy or exposuretherapy – all powerful evidencebasedtherapies, but which requirepainstaking adaptation).• Mind-body therapies such as breathmodulation (pranayama, breathwork)and meditation have been popular.• With the proper framing, systematicshaking, trauma-sensitive yoga,dance and other movement therapycan be powerful given the trauma literature’srecognition of how animalsbounce back from horrifying eventsthrough shaking and engaging thebody purposefully.• Laughter yoga, a sequence of activitiessystematized by an Indian physician,although not appropriate for theacute or subacute phase of recovery,can be used to build group resiliency,to engage the body, and frankly, tohave fun while promoting wellness.What doesn’t work? One-size-fits-allprotocols. People do not have identicalcognitive styles. So while yoga andmeditation may work for some workers,journaling and poetry will work forothers. Referring a worker to a mentalhealth professional, while it may seemlike the diligent and scientific thing todo, is useless if the worker does not acceptthe basis of psychotherapy. Prayerworks great in organizations, but itmust be done in a way that ensuresthat those who do not believe in prayerwill not feel ostracized.While the geographic cure (a trip awayfrom fieldwork to somewhere nice orhome) can help with the stress leadingto burnout, it does nothing to reach theneurobiological changes that occur intraumatic stress. In fact, the geographiccure can actually do more harm thangood by allowing the trauma to simmerin someone’s brain. As the psychiatristNational staff can beespecially open tocreating interventionsthat are essentially are-tooling of familiarcultural or spiritualpractices.who helped develop trauma-sensitiveyoga explains, “Trauma is not like finewine. It does not get better with age.”National staff can be especially opento creating interventions that are essentiallya re-tooling of familiar culturalor spiritual practices. For example,in Pakistan, I took a generally acceptedreverence of Noor (“Divine Light”) anddeveloped a guided meditation thatwe packaged in mp3 files thatcould be easily emailed frompeer to peer. When acceptedpractices are re-tooled, workerswill more easily buy into amenu of interventions for destressingthemselves daily (i.e.,while the work is in progress)and not only at workshops ortrainings. In fact, as a form ofSouth to North learning, we inNorthern nations have an importantopportunity to learnspecific resiliency factors fromabroad and adapt them to oursettings and mindsets.As a physician who seesmultiple opportunities for prevention,I take a hard-nosedview of what we are dealingwith here. Burnout and secondarytraumatic stress areboth bona fide occupationalhazards in this industry. Thereis an ethical responsibility to mitigatethese hazards, just as we have a responsibilityto safeguard people whowork near asbestos or tuberculosis because,otherwise we are putting themin harm’s way without providing themeans to avert the harm. We knowthere is harm in working near trauma.The medical and humanitarian literatureis rife with the evidence. Is thereany doubt that there are costs to suchwork? No doubt at all.As mentioned, reluctance from SouthAsian NGO leaders in acknowledging“our work has its costs” has not been abarrier. There are opportunities in bothdirections: provide training to nationalstaff in a way that meets them halfway,and reduce current barriers to adequatelytraining headquarters and expatriatestaff. Is it possible that in theWest we are more nervous about addressingthis subject because if STSwere discussed regularly as an occupationalhazard a lot more due diligencefrom legal departments would be necessary?Do managers fear that workerswould ask for more psychotherapybenefits? Would donors have to comeface-to-face with the reality that in theprocess of doing good in the world weput humanitarian workers in harm’sway? When it comes to STS, it will takestrong leadership to capitalize on ouropportunities. MDPhoto: Siddharth Shah22 MONDAY DEVELOPMENTS September 2008

USAIDUSAID and Staff CareTask force establishes agency-wide procedures.By Alonzo Fulgham, Chief Operating Officer,U.S. Agency for International DevelopmentAs the principal U.S. governmentagency extending assistanceto countries recoveringfrom disaster, trying to escapepoverty, and engaging in democraticreforms, the U.S. Agency for InternationalDevelopment (USAID) employsthousands of staff in the United Statesand around the world under a varietyof hiring mechanisms. USAID recognizesthat its primary resource for ensuringthe successful delivery of fundsfrom the American people to supportoverseas causes is its staff; and thesurest way to maximize assistance tothose in need overseas is to ensurethe well-being of its personnel. Manynon-governmental and private sectorpartners are already leading the way ininnovative staff care concepts designedto improve morale, productivity andretention. USAID is reviewing many ofits best practices as it looks to draft itsown staff care policy that would applyto all hiring mechanisms.Humanitarian and development stafffrequently work in high-risk, unstablefield environments that are often characterizedby unpredictability, rapidchange, and pressure in both the fieldand from Washington, DC. While thisenvironment encourages personal andprofessional growth, these factors cancause serious stress in staff and, ultimately,adversely impact the delivery ofaid and assistance to beneficiaries.USAID encourages implementingpartners to begin or continue to developstandard staff care policies andpractices, and it looks forward to continuingcollaboration with partners ondeveloping baselines for staff care in allenvironments.USAID began its own Staff Care TaskForce through the Democracy, Conflictand Humanitarian Assistance (DCHA)Bureau in February 2008, followingstaff deaths in Khartoum, Sudan andfollowing recommendations from anumber of earlier reports, such as lessonslearned from the U.S. Embassybombing in Kenya in 1998. The TaskForce was formed to pioneer implementationof cutting-edge ideas and previouslessons learned, with the goal ofadopting agency-wide operations andprocedures in support of staff care. Forthe purposes of the Task Force, “staffcare” includes broad issues rangingfrom personal emergency preparednessand response to staff wellness ona day-to-day basis, including physicalsafety and psychological well-being inthe workplace.Initial Task Force efforts include: (1)surveying DCHA staff to gauge theirmorale, understanding and opinionsOFDA and Staff Careon staff care issues; (2) creating an internalwebsite that will eventually serveas the primary point of information forstaff care resources for all USAID hiringmechanisms (there are currently23 hiring types in the Agency); (3) creatinga common emergency databasefor all staff hiring types in the bureau,as well as a database that providesuseful staffing reports for offices in thebureau; (4) developing more detailedpre-departure checklists for both temporaryand permanent staff of all hiringtypes; and (5) researching all availableagency mental well-being services todetermine which services are availablefor which hiring types, and providingthis information to all agency staff, aswell as holding pilot “road shows” withservice providers and DCHA.The Task Force has recently begunexpanding and institutionalizinga number of its pilot efforts agencywide.An expanded USAID Staff CareWorking Group will continue to: raisecontinued on page 30Excerpts from an address by USAID Office of U.S. Foreign Disaster Assistance (OFDA) DirectorKy Luu to a staff wellness conference in Denver on May 18, 2008:“The field of humanitarian assistance has evolved and professionalized over theyears, and continues to do so. The next challenge in the evolution of our field shouldbe to better incorporate concerns about the psychological and emotional well-beingof our humanitarian workers into our standard way of doing business.“The work we do and the difficult places we work take a toll on our staff. Are welosing experienced, highly qualified staff members prematurely because we donot help them care for themselves properly in stressful assignments? Effective staffcare can boost staff retention, which is a highly desirable goal from a managerialperspective.“OFDA is willing to help fund initiatives that facilitate progress on staff wellnessstandards for the humanitarian community. In the same manner that NGOs, over theyears, have collectively identified and agreed to performance standards on a rangeof humanitarian issues, we believe that NGOs working together should developminimum standards and guidance for staff care within our profession.“NGO personnel policies should include staff care procedures. NGOs should ensurethat managers at all levels are trained on staff care issues. Let it be clearly understoodthat OFDA considers staff care by our partner agencies to be a legitimate andimportant component of indirect operational costs.”MONDAY DEVELOPMENTS September 2008 23

HIV/AIDSIf You’re Not Infected,You’re AffectedPsychosocial intervention benefits national staffworking in HIV/AIDS projects.By Carla Uriarte, Coordinator Mental Health Support to Field Teams,Doctors Without Borders - Spain (Médecins Sans Frontiers -MSF OCBA)Humanitarian help is intrinsicallystressful. In orderto respond to this reality, MSFSpain consolidated psychosocialsupport for its field teams in 2005.One of the areas the organizationaddressed was the impact of workingon HIV/AIDS projects – a reality solidlydocumented in the relevant literature.To assess the situation we conductedin-depth interviews with coordinators,supervisors and key personnel,individual debriefings with counselors,focus groups organized by work functions(such as laboratory workers,medical assistants, and home healthnurses), activities such as clinic visits,accompanying home-based care teams,and sensitizing activities, and meetingswith advisors of local services that providetraining and support.In total, around 300 local professionalsparticipated in these activitiesconducted in and through the MSF-Spain missions in Kenya, Malawi, Tanzaniaand Zimbabwe, with particularhelp from Carmelo Vázquez in Kenya,Beatriz Rodíguez Vega in Tanzaniaand Cristina Vivares in Zimbabwe. Thefindings presented here are drawn fromthese visits.Results: Stresses and Strengths“If you are not infected, you are affected.”This sentence powerfully sumsup the reality of working on and livingwith HIV/AIDS. With high levels of infectionin the general population, mostof the local MSF personnel in thesecountries are directly affected by theepidemic. Even if they are not infectedpersonally, one or more of their familymembers, friends and neighborsare infected.In most of the places wheremedical support projects havedeveloped there is also a strong stigmaassociated with HIV/AIDS, in spiteof the efforts of many organizations toeliminate this stigma. Before MSF cameto Busia in Kenya, the room whereterminal HIV/AIDS patients were lefthad the popular name of “the Bosniaroom” because whoever entered therewas destined to die. The fear and lackof means to deal with these deaths ledlocal health professionals to refuse tohelp the sick people. More recently, theintroduction of antiretroviral medicineshas given hope to many communities,although the stigma continues.StressesThe local teams working in this environmentshare a number of challenges.Secondary stigma is a common problem.In many places there is the beliefthat if you work in an HIV/AIDS project(as a doctor or driver, for example)it is because you are infected.Exposure to people in life-threateningcrises drains staff emotionally andsometimes physically as well. The professionalsworking on these projects aredaily witnesses to the social and emotionalimpact that HIV/AIDS has ontheir patients such as orphans unableto go to school, and the harrowing prospectsfor widows with infected children.Dealing daily with patients who alsohave other opportunistic, infectious diseasessuch as tuberculosis, and the riskof contracting those diseases, creates additionalstress for many team members.In most of theplaces wheremedical supportprojects have developedthere is also a strongstigma associated withHIV/AIDS.Another factor is the limits of theability of the organization and the localhealth system to respond to the overwhelmingneeds. Workers frequentlymust operate in a reality in which theyknow they cannot satisfy the treatmentneeds of all those in need and thatthey, the workers, will have to choosewho will receive treatment.Powerlessness to address social andeconomic needs (such as food, schoolingand livelihood support) of the patientsthat lie beyond the scope and resourcesof the program and for whichthere are no local support systems, canalso take a toll on team members. Ascan the emotionally draining reality ofidentifying with their patients.Working in international organizationsalso creates challenges due tofactors such as frequent turnover ofcoordinators, operating in a multiculturalenvironment, and the existenceof very limited opportunities for promotionto the top leadership ranks.Photo: Ricardo Verde Costa - Fotolia.com24 MONDAY DEVELOPMENTS September 2008

HIV/AIDSThe investigations identified a numberof risks and challenges particularto different types of work related toHIV/AIDS programming:• Laboratory Personnel. In some projects,the laboratory is perceived asan infected place that other healthworkers consider dangerous and donot want enter unless it is absolutelynecessary. In this context, some peoplemay have irrational fears aboutbeing infected by tuberculosis andother opportunistic diseases. Laboratoryprofessionals also maintain directcontact with the patients, who oftenshare with the workers their storiesand difficulties and engage in strongemotional expressions for which theworkers have not been prepared.• Counselors. Some counselors dailyconfront people dealing with issuesof death, infidelity, misery and otherlife crises. Although most counselorshave received specific trainingon how to manage HIV/AIDS counseling,sometimes that training hasfailed to include basic psychologicalcoping strategies for the counsellors.• Home-Based Health Care Teams.Workers in this field witness the difficultconditions, misery and the lackof general resources with which manypatients live. The house visits can beemotionally demanding, putting workersin the midst of the realities theirpatients and their support networks,including children caring for the terminallyill, patients so sick they cannotgo to the hospital, and orphans.This, in turn, increases the likelihoodthat the workers will identify with theirpatients at emotionally draining levelsthat can be greater than those experiencedby workers at health centers.StrengthsThe study also revealed a number ofstrengths that allow the professionalsto continue day after day in the face ofso many difficulties.For the majority of those workingwith MSF, the understanding that “Ifyou are not infected, you are affected”makes them proud to be part of themiracle of introducing the antiretroviralmedicines (ARVs). In working in theseprojects they are saving thousands oflives and even though there are stillnot enough ARVs available to provideStaff Care on a Shoestring:Comments From NGO Staff Around the WorldWhile some aspects of staff care may require additional resources, there are manythings you can do with little or no budget to start building a culture of staff-care in yourorganization. Here are a few examples offered by field staff in various organizations:• Recognize and appreciate colleague’s good work and/or extra effort.• Have managers serve as role models of good self-care and a healthy work-life balance.• Celebrate special occasions and holidays; acknowledge transitions in people’slives (e.g., births, deaths, birthdays, promotions, new jobs). This doesn’t have tobe elaborate or expensive.• During times of high stress, be mindful of each other’s well-being. Spend timechecking in with each other and actively listen to responses. Protect your sleep!• Use newsletters, emails and meetings to provide information about stress andresilience. This helps normalize people’s experiences and may expand their repertoireof coping strategies.• Host a party or social event that includes family members.• Encourage staff to take mini-breaks during the day. Managers: set a good exampleand take them yourself.• Have a pot-luck lunch• After work-related travel (especially lengthy and intense travel) encourage staffto take some down-time....What else would you add?treatment to all those in need, the mostvulnerable groups (children, pregnantwomen) are being saved. While themanifestation varies from team to team,in the majority of cases team membersalso share a sense of pride in being partof MSF – a sense that translates intodynamic, protective teams.Team members also draw on respectand support they receive from familyand communities because of their worksaving lives and the status of belongingto an international organization. Benefitsinclude stable employment, personaleconomic stability in the midstof shattered economies, social status,and access to influential people. Othersources of support include personaland social resources such as supportfrom co-workers and family, and naturalsupport networks, including religiouscommunities.Intervention:Strengthening Existing StrengthsThe assessment also led us to identifya number of steps in the areas ofadvance preparation and on-goingmeasures that would help create a betternetwork of support for our teamsworking on HIV/AIDS programs.Preparation• Improve the basic psychological andsocial skills training for the frontlinepersonnel working with patients.This training would cover issuessuch as how to manage the anger,pain and anxiety of patients, and basicpsychological support. We recommendthat this training be providednot only to counselors, but also to allother personnel with direct contactwith the patients in any way, such aslaboratory technicians and drivers.• Strengthen team members’ understandingof humanitarian principlesand the organization’s strategy.This can help the teams better understandthe limits of a particularproject, the decision-making processand the global strategy to fight HIV/AIDS into which the project fits.• Continue technical training, with aspecial focus on protection measuresto be used when working in environmentswith infectious diseases.On-Going SupportThe sessions that formed the heartMONDAY DEVELOPMENTS September 2008 25

HIV/AIDSHumanitarianorganizations nowdisplay a regularand ever increasinginterest in providingpsychosocial support.of the assessment highlighted the importanceof social support as a primaryresource for confronting these challenges.The following steps can helpteams strengthen this social support:• Create and maintain an organizationalculture that recognizes andfosters the sharing of difficulties,challenges of daily work.• Technical supervision of cases, withspecial attention to managing psychosocialproblems that arise.• Create formal spaces for mutualsupport among professionals, and,where local external resources exist,work with an outside facilitator. Proposedsessions include group debriefingsand/or psychosocial workshopson topics such as how to manage thefear of infection, stress managementand conflict resolution.• Include key national staff in decision-makingand positions of responsibility.• Facilitate access to outside psychologicalsupport for individuals whoneed it.• Be flexible with the working rules togive space to local cultural copingstrategies (e.g., provide time to prayduring a medical workshop for Muslims).• Sensitize international personnel,who usually hold coordination positions,on: the need to minimize theimpact of turnover of staff in coordinationpositions; cultural differences;the psychosocial impact ofworking in HIV/AIDS projects; andorganizational factors that causestress and how to prevent and minimizethem.• Incorporate team dynamics andteam-building activities into the workagenda.Humanitarian organizations now displaya regular and ever increasing interestin providing psychosocial supportfor their teams. This is good news forstaff welfare, and its impact is reflectedin the mental health and quality of serviceof the NGO staff and project beneficiariesbeing helped and supported.Until recently this interest was largelylimited to providing support for internationalstaff. Yet the majority of thoseworking in humanitarian aid are nationalstaff, and it is therefore importantthat organizations implement supportstrategies that take into account thespecific psychosocial risks and strengthsfaced by these local workers, and developways to invest in their well-being. MD26 MONDAY DEVELOPMENTS September 2008

GuidelinesLest WeReinventthe WheelGuidelines do existfor good practice inmanaging stress inhumanitarian workers.By John H. Ehrenreich,International Associate, AntaresFoundation and Professor ofPsychology, State University of NewYork – College at Old WestburyThe Antares Foundation’sManaging Stress in HumanitarianWorkers: Guidelines for GoodPractice ( to help aid agencies definetheir own needs in relation to stressmanagement in their organization. TheGuidelines were developed over the lastfew years by an international workinggroup, made up of NGO staff (humanresources, national and field managers,safety and security officers), people withextensive experience consulting withNGOs and NGO staff on staff stress, andacademic experts on stress and stressmanagement. Feedback responding toseveral earlier drafts was obtained frommeetings of national and internationalfield managers in Jerusalem, Melbourneand Canberra (Australia), NewYork, Amsterdam, Tbilisi (Georgia) andTuzla (Bosnia).The starting point of the Guidelines isthat managing stress in staff of humanitarianaid organizations is an integralmanagement priority in enabling theorganization to fulfill its field objectives,as well as being necessary to protect thewell-being of the individual staff members,their teams and the communitiesthey work with. The Guidelines emphasizethe actions that agency, managersand the team must undertake to mitigatestaff stress, as well as actions thatindividual staff members can take. TheGuidelines are organized around eightkey principles, reflecting the phases of astaff member’s deployment. Thus, thereare principles on overall agency policy,screening and assessing staff, preparationand training of staff, monitoringstaff in the field, ongoing support in thefield, crisis support, end of assignmentsupport, and post-assignment support.Each principle has supporting indicatorsand comments designed to helpagencies more fully understand the conceptsunderpinning the principles andhow they translate into managementpractice. The principles and indicatorsare intended to apply to both internationaland national staff and to bothheadquarters and field staff, recognizingthat adjustments may be necessary totake into account the unique needs andcharacteristics of each group. They are atool for learning, reflection and planningrather than a set of rigid rules or solutionsapplicable under all conditions.The Antares Foundation is currentlydeveloping a variety of ancillary materialsin support of the Guidelines. Theseinclude: an interactive web-based versionof the Guidelines; training workshopsfor individual staff members,team leaders and agency managers;written materials developing some ofthe principles further, and managerialtools for analyzing agency behaviorwith respect to the Guidelines’ principles;case studies on using the Guidelines;and sample policies.In addition, the Inter-Agency StandingCommittee (IASC) Guidelines on MentalHealth and Psychosocial Support inEmergency Settings ( developedby the IASC Task Force on MentalHealth and Psychosocial Support inEmergency Settings, co-chaired by theWorld Health Organization and Inter-Action. The overall thrust of the Guidelinesis “to enable humanitarian actorsto plan, establish and coordinate a setof minimum multi-sectoral responsesto protect and improve people’s mentalhealth and psychosocial well-being inthe midst of an emergency.” One section,Action Sheet 4.4 (and, to a lesserextent, several other sections, especiallyAction Sheets 4.1-4.3), addresses staffsupport issues. Early drafts were circulatedin the humanitarian communityand the feedback was incorporated.Action Sheet 4.4 notes that, “The provisionof support to mitigate the possiblepsychosocial consequences of work incrisis situations is a moral obligationand a responsibility of organizations exposingstaff to extremes. For organizationsto be effective, managers need tokeep their staff healthy. A systemic andintegrated approach to staff care is requiredat all phases of employment – includingin emergencies – and at all levelsof the organization to maintain staffwell-being and organizational efficiency.The word ‘staff’ in this action sheet refersto paid and volunteer, national andinternational workers, including driversand translators, affiliated with an aid organization.”Like the Antares Guidelines,although the Action Sheet notes that“support measures should in principlebe equal for national and internationalstaff,” it points out that “some structuraldifferences exist between the two.”In virtually all respects, the sectionsof the IASC Guidelines dealing with staffsupport issues closely parallel the AntaresGuidelines. Like the latter, theIASC Action Sheets specify roles for theagency, managers and the team. Specific“key actions” include: actions toensure the availability of a concrete planto protect and promote staff well-beingfor the specific emergency; prepare stafffor their jobs and for the emergencycontext; facilitate a healthy working environment;address potential work-relatedstressors; ensure access to healthcare and psychosocial support for staff;provide support to staff who have experiencedor witnessed extreme events(critical incidents, potentially traumaticevents); and make support available afterthe mission/employment. MDMONDAY DEVELOPMENTS September 2008 27

HIV Status DaySome [staff] saidthat knowing theirstatus made themfeel empowered toencourage others toget tested.WalkingWorld Concernintroduces “Know YourHIV Status Day” for staff.By Bethany Baxter,HIV/AIDS Program Coordinator,World ConcernAt a meeting of WorldConcern HIV/AIDS field staff,the question came up of howmany of us knew our HIV status.A few hands went up, but not everyhand. Which led to the next question,“How can we refer people to voluntarycounseling and testing (VCT) centers ifwe haven’t gone ourselves?” As is beinghighlighted throughout 2008, moreleadership is required if the world is goingto tackle the AIDS pandemic. Andat this meeting, World Concern wasthe Walkconvinced to start leading by example.The HIV/AIDS team agreed on a datethat we would all go get tested – thefirst World Concern Know Your StatusDay. The invitation was extended to therest of the World Concern Kenya staffwho were informed that: (1) attendancewas not required; (2) they would not beasked to disclose to their status; (3) thecurrent staff health plan covered treatment;and (4) they could not be firedfor testing positive. In an effort to makegetting tested as easy as possible, eachHIV/AIDS district team was responsiblefor making arrangements (e.g. transportand appointments) for those interestedin their office interested in participating.The results of the day were amazing.In the Nairobi office, 80 percent of thoseavailable (i.e., not on leave, traveling orthe like) chose to be tested. One staffmember said that he had wanted to goa number of times, but had been tooscared. He said he was happy to have theopportunity to be tested through work,because going in a group helped himface his fears. In Narok, only the HIV/AIDS team wanted to participate, whichgive them the opportunity to show leadershipwithin their own office. The Narokstaff reported the experience as tough,but also encouraging. And in Embu, thewhole staff chose to be tested.Staff who felt comfortable talkingabout their VCT experiences were encouragedto share their thoughts andfeelings, and were informed that theirviews might be shared with others ifthey agreed. Many were willing, andsome even asked to have their picturetaken while they were being tested.Some said that knowing their statusmade them feel empowered to encourageothers to get tested including family,church and other community members.One male staff member (age 33),said that he wanted to be an example tothe youth in his church. Another commentedthat going in a group had madethe waiting time less stressful. Onewoman admitted that she did worry abit about going in a group, because shewasn’t sure if she would be able to hidethe emotions of testing positive. Recognizingthat results were inevitable, shedecided to get tested and found it comfortingto be amongst friends.Since Know Your Status Day, therehas been a heightened interest in HIV/AIDS facts and a more open environmentfor discussion and informationdissemination. In response, an “HIV/AIDS fact” is posted weekly: the first beingon the reliability of HIV tests. In addition,the day helped World ConcernHIV/AIDS staff gain a better understandingof some of the challenges andconstraints to being tested, includingconcerns about being tested by somebodyyou know. World Concern plansto make this an annual event. MDPhoto: Bethany Baxter, World Concern28 MONDAY DEVELOPMENTS September 2008

Helper’s FireHelper’s Fire IIConference works to buildresilient communitiesfor humanitarian anddevelopment assistancefield staff.By Sharon Forrence, MSW, Trainingand Staff Care ConsultantIn March 2004, humanitarianand international development professionalsfrom more than 60 organizationsgathered at the University ofNotre Dame for a groundbreaking conferenceentitled “Tending the Helper’s Fire:Mitigating Stress and Trauma in InternationalStaff and Volunteers” organizedby Without Borders.The conference reflected an increasedunderstanding that humanitarian aid ishighly rewarding but demanding work,and that aid workers and volunteersface a variety of threats to their physicalhealth and mental health and emotionalstability. However, attention to staff careand support before, during and aftertheir time in the field, and the study ofhow to improve outcomes in this arenawas still relatively new in 2004.Since that time, recognition that effectiveself-care and management ultimatelycontributes to the ability of allhumanitarian workers to work moreeffectively, more safely, and ultimatelyfurther the mission of the organizationhas gained considerable traction.In line with these advances, in May2008 the University of Denver’s GraduateSchool of Professional Psychology’sInternational Disaster Psychology Programhosted Helper’s Fire II: BuildingResilient Communities for Humanitarianand Development Assistance Field Staff.The conference brought together participantsfrom the non-governmental sector,donors, government organizations, consultants,researchers, graduate studentsand other expert practitioners to focuson key staff care issues for humanitarianand development workers and theorganizations for which they work.Stressors in the field of humanitarianaid, from those indigenous toemergency situations to demandingand stressful management practices,adversely affect the capacities of humanitarianworkers to deliver services.The Helper’s Fire II conference was designedto provide information on newstaff care initiatives and organizationalefforts to institutionalize support to aidworkers. It also served to identify thedifficulties with implementation and topropose strategies and actions that willcontribute to the forward movementof this developing field. Key issues in-How Secure Is Your Organization?InterAction Minimum Operating Security Standards WorkshopOctober 30th—Washington, DCThe working environment for international humanitarians and development professionals has become increasinglyvolatile in recent years. Because of this, many NGOs are seeking a way to incorporate more robust security measuresinto their programming. However, few NGOs know how best to do it.InterAction has been tasked by USAID to create a set of Minimum Operating Security Standards (MOSS) for itsmembers. Under the MOSS, InterAction members are required to create organizational policies and plans; makeappropriate resources available to comply with the standards; implement appropriate human resources policies;incorporate accountability for security at the management level; and work together as a community in order toadvance their common security interests.This workshop seeks to assist InterAction members and other interested organizations in the incorporation ofInterAction’s Minimum Operating Security Standards (MOSS). Recognizing that every organization will have differingneeds, the “Suggested Guidance” section for each standard will be presented by members of the Security AdvisoryGroup. A brief review will be followed by an open forum that will enable attendees the opportunity to discussmethods, policies and practices of other members in order to aid all in compliance.This workshop is open to InterAction member organizations only.Please RSVP by email to line: “MOSS RSVP.”MONDAY DEVELOPMENTS September 2008 29

Helper’s Firecluded: management and leadershipin stress reduction; staff assessment,selection and retention; training andworking with national staff; respondingto critical events, including familysupport; building external and internalsupport for staff care initiatives; buildingin evaluation of staff care policiesand programs; and field staff exit interviews,debriefing and re-entry.Ky Luu, Director of USAID’s Officeof Foreign Disaster Assistance (OFDA),provided the keynote address. Staff careissues have become one of OFDA’s prioritiesgiven how they affect OFDA staffas well as the staff of partner organizationsworking in complex emergency situations.He described the challenge ofencouraging the humanitarian communityto incorporate staff care/staff wellnessas a routine operating standard.Panel presentations provided anupdate on recent developments in thefield including guidelines from the AntaresFoundation and the Inter-AgencyStanding Committee (IASC) Guidelineson Mental Health and PsychosocialSupport in Emergency Settings, aswell as new initiatives undertaken bythe Headington Institute, InterAction,People In Aid and USAID. Break-outgroups discussed the key questionsoutlined during the plenary presentationsin order to identify concrete stepsthat could move the field forward in thegiven area.The field of staff care for humanitarianand development workers and organizationshas made considerable progresssince the first Helper’s Fire conference.Several key themes emerged. First, staffcare is everyone’s business and needsto be integrated throughout the lifecycleof an employee or volunteer. As an organizationalpriority, staff care needs tobe incorporated in management practicesfrom headquarters down to thefield office. Second, national staff mayHelper’s Fire: What does that mean?In March of 2004, Action Without Borders and The Joan B. Kroc Institute forInternational Peace Studies at Notre Dame University organized the conference“Tending the Helper’s Fire: Mitigating Trauma and Stress in International Staff andVolunteers.” The name of the conference - “Tending the Helper’s Fire” - comes from theMaster’s thesis title of Karen Brown.After the Notre Dame conference, groups formed in Washington, DC and New Yorkunder the name “Helper’s Fire” to hold continuing presentations and discussions onstaff care issues.What is the mission of Helper’s Fire?To promote wellness of staff working in chronic and acute stress environments bysharing resources, best practices and training materials.What are some current activities?Representing government agencies, non-government organizations andindependent consultants, the Helper’s Fire group is well-placed to serve as anadvocate for staff wellness, as an advisory group, and as an information resource fororganizations, agencies and groups engaged in development and relief efforts. Theoutcome of our efforts will serve expatriate, third-country, and host country staff.How can I get involved?Since September of 2004, the DC Helper’s Fire group has been meeting on the firstWednesday of the month from 10:30 am to 12:00 pm. Since January 2008, the DCHelper’s Fire group has been meeting in conjunction with the InterAction Staff CareWorking Group at the InterAction office (1400 16 th Street NW, Suite 210). You canjoin the DC Helper’s Fire yahoo group at: very different needs for staff care.The best way to identify appropriatesupport for national staff is to consultwith them. Third, it is important for organizationsto develop critical incidentprotocols and include plans for workingwith staff members’ families. This isan important component when dealingwith critical incident stress.Another key theme is senior managementbuy-in for staff care. Whilethe need seems obvious to those whohave worked under difficult conditionsand for those who provide services toaid workers, convincing senior managementthat investing in staff careinitiatives is a cost-effective businesspractice continues to be a challenge formost organizations. Assessing staff careinitiatives that are currently being undertakenby various organizations canhelp to further support efforts to pushthis issue with senior management.The final Helper’s Fire II conferencereport will be published on the Universityof Denver’s website, on the Psychosocial.orgweb site ( on the InterAction staff care website ( Helper’s Fire III conference will beheld in 2010, with details to be announced.In the near future, a Helper’sFire II.5 meeting will be held in earlyNovember either before or after thePIA/Headington Symposium. For furtherinformation, or if you have questionsor comments, please contact theauthor at MDUSAIDcontinued from page 23awareness of staff care issues at all levels;review office, bureau, and missionpractices in staff care; make appropriaterecommendations to the agency;and provide appropriate, relevant resourcesto assist all staff in better mitigatingor coping with the stressors ofUSAID work.The Agency working group will be anavenue for USAID offices and bureausto share and learn from each other’s experiences,seeking to create a standardbaseline of services and support thatenable the agency to not only fulfill itsmandate, but also its desire to protectthe well-being of its staff members. MD30 MONDAY DEVELOPMENTS September 2008

Peer SupportTaking Care of Each OtherPeer Support in Humanitarian OrganizationsPeer support describes a variety of ways that people with similarexperiences can assist each other with difficult situations. Workplace peersupport programs have grown in popularity over the past two decades,especially in professions characterized by service to others and high threat ordanger. When implemented effectively, peer support programs can contributeto increased social support in the workplace, improved organizational climate,and greater numbers of people with problems or in distress seeking assistance.A number of humanitarian organizations have developed peer supportprograms to address the challenges facing aid workers around the world.The following articles provide three perspectives on peer support program.Two psychologists describe peer support programs launched by their NGOs,and in the third piece, staff in the field discuss how they have made peersupport practical and concrete in a context of HIV/AIDS.Collected by Sharon Forrence, MSW, Training and Staff Care ConsultantPhoto: Sandy KrawitzPeer Support NetworkBY Christina Moore, PsyD, Doctors Without Borders/Médecins Sans Frontières (MSF) USAThe MSF USA Peer Support Network (PSN), begunin 1999, is the non-professional, peer-operated, informationsharing system provided by a group of MSF-USA volunteerreturned field staff (RFS). PSN volunteers offer listeningsupport and information for other RFS within one month ofreturning from assignment. Typically, this is done throughemail and telephone contacts, and often with face-to-facemeetings. The content of the peer-to-peer conversations remainsconfidential.PSN Volunteers are distributed across the U.S. They determinewho will contact returning field staff based on similarityof professional background, familiarity with field assignments,ease of shared time zones or by date of return.The returned field staff list is managed by PSN coordinatorsthrough a web-based contact management system. Introducedearly in 2007, the system tracks contacts from the time of theRFS return from assignment to the end of the PSN volunteer’scontacts with that individual. PSN Volunteers enter details regardingcontact dates. The PSN Web-tool provides substantialinformation to the PSN coordinators about quality and efficiencyof PSN services, and statistical data on operational effectiveness.Early training of PSN volunteers was done with assistancefrom professional consultants and included significant inputfrom the MSF human resources department and other MSFNew York office resources. Gradually, the PSN has assumedresponsibility for its own training, with logistical support fromthe MSF USA Association Coordinator’s office. A long-term consultantattends trainings and provides welcome training andpractice in stress reduction techniques. The PSN guidelineshave evolved over time, in parallel with the maturing networkand increased technical support.The PSN participates in national and international conferenceson staff support and security, regularly updates trainingsbased on current research and developing best practices.In April, 2007, the PSN met at Peaceful Valley Ranch, nearLyons, Colorado, for a formal training and welcome for newmembers; continuing members attended for the required updateto their training. Training included formal discussionsand practice sessions for making peer-to-peer contacts. Thegroup learned to use GPS tools while hiking in the mountainsand exchanging experiences from assignments and from PSNcontacts over the years.The training provides direction and formal guidelines, aswell as a perspective on how MSF returned field staff findand redefine life and work on assignment and on return. Thetraining emphasis is on listening, and providing information(or reminders) about additional support systems, such as theEmployee Assistance Program, that are available to assist thereturned field staff with reintegration after an assignment. Newmembers bring vitality and a wealth of experience to the PSN.Please send questions and comments to the author at DEVELOPMENTS September 2008 31

Peer SupportSIT Graduate InstituteInternational DevelopmentPrograms including Sustainable Development,Conflict Transformation,Management of Mission-Driven Organizations focus in Middle Eastern Studies,International Organizational Development,Social Entrepreneurship and Innovation,Intensive Arabic Language StudiesInterAction’sNew OnlineJob Board!Visit: careers.interaction.orgTalk about interacting!To compliment MondayDevelopments’ popular monthlyjob section, InterAction’s newonline job board instantlyconnects you to the latestinternational developmentjobs as they become available.Search by job sector, level,region and country—or postyour resume and let the hiringmanagers come to you!“I No LongerFeel Alone”By Lynne Cripe, PhD, CARE USAInvoluntary conscription in Sri Lanka. Carjackingsin Darfur. HIV-related loss and orphaning in Malawi.These are just a few of the serious stressors facing CAREstaff around the world. CARE staff have reported five primarycategories of stress: (1) lack of job security; (2) concernsabout security and safety; (3) overwork and difficulty withwork-life balance; (4) internal staff conflict, e.g. competition,issues with trust; and (5) personal issues, e.g. stresses fromfinancial pressure, family demands and health problems.To increase social support to help staff cope with thestresses of life, CARE launched a Peer Social Support Team(PSST) in 2007 in ten of its Country Offices (COs) in Africa. Inmid-2008, the PSST expanded to six COs in Asia.After six months, the program in Africa reported the followingsuccesses:• Improved morale and communication in the CO;• Conflict resolution among team members;• Improved relationships with supervisors;• Improved response to critical incidents;• Improvement in human resources programs devoted tostaff care and staff wellness;• Better coordination and synergy between programs devotedto staff care; and• Improved contribution to Country Office strategic planningthrough coordination with the senior management teamand other CO staff.To get started, Country Offices selected two Social SupportAdvisors (SSAs), typically one male and one female, througha variety of ways. Some were selected by their senior managementteam; others were elected by the entire staff. Currently,all SSAs are national staff, drawn from the entire range ofpositions within CARE COs: administrative, drivers, humanresources, program managers, technical advisors. SSAs devote,on average, three hours per week to their PSST activities,although in some COs more time has been allocated.The regional Peer Social Support Teams were launched ina week-long training and planning workshop that focusedon knowledge- and skill-building, and action planning. Topicsincluded empathic listening, stress management, communicatingself-care information to colleagues and buildingtrust. Working in their country teams, SSAs developed termsof reference and action plans based on the unique needs andexisting initiatives and programs within their Country Office.This is a critical element of the PSST because staff needs andoperating environments vary greatly across CARE COs. Forexample, the objectives of the Sudan PSST focus on improvingsupport for staff affected by critical incidents. In contrast,a key objective of the India PSST is to help the CO “downsizewell” by attending to the social and emotional needs of staffaffected by job losses. Although the PSST operates within32 MONDAY DEVELOPMENTS September 2008

Peer Supportshared basic parameters there is the need for considerablecustomization and flexibility across COs; this customizationis crucial for ownership and sustainability of the PSST.As CARE looks to the future of the PSST we see a numberof challenges ahead:• Securing the financial resources needed to expand thePSST into other regions;• Developing models of support, supervision and follow-upthat can withstand geographic dispersion, time differencesand imperfect phone/internet connections;• Cultivating sustained engagement by CO leadership in thePSST activities;• Training new team members when inevitable attrition occurs;and• Developing a meaningful monitoring and evaluation approachthat allows us to effectively tell the story of thePSST without unduly burdening our volunteer SSAs.Although we are still grappling with how best to evaluatethe work of the PSST, I will close with a small anecdote thatdemonstrates that the PSST is making an impact. At theconclusion of a workshop co-facilitated with Social SupportAdvisors, a colleague stated, “I thought I was the only onethat felt this way. But now I know that I am no longer alone.”That’s a result worth replicating.Please send questions and comments to the author or to Kathleen Gaines at Care in CARELesotho–South AfricaVoluntary Savings and LoansLearning from our work in the community, we adopted theVoluntary Savings and Loan (VS&L) program to encouragestaff to save money. Groups of five or six staff members contributean agreed upon amount and borrow amongst eachother with an agreed amount of interest. This initiative helpsmembers because it helps them achieve their personal goalssuch as buying furniture, and paying for school fees (manystaff are taking care of orphans and vulnerable children), andbuying medicine. We are also looking at longer investmentopportunities for staff that will give them piece of mind toknow that their families will be taken care of if needed.Workplace NutritionThe organization is also contributing to staff wellness byproviding nutritional support in the workplace. Staff do nothave a lot of time to take care of themselves while at workbecause their concentration is focused on meeting the needsof the communities. To improve their health and help keepthem fit so that they can perform well, we are providing eachstaff member with two fruits per day; as they say, “an applea day keeps the doctor away.” CARE views this as a smallamount to pay compared to the price of unmotivated, unhealthystaff. This initiative has helped reduce the number ofsick days staff have taken.Please send questions and comments to the authors and MDMoleboheng Patose, Wellness Coordinator, and HofnieLebone, Human Resources ManagerCARE Lesotho-South AfricaStress (whether work-related or personal) inthe workplace is a common feature of life today. It can damagethe health and well-being of employees. From CARE’s perspective,employees who feel valued have lower levels of stress andabsenteeism and higher levels of motivation and loyalty to theorganization’s core business. HIV and AIDS are serious issuesfor staff in CARE Lesotho-South Africa. We seek to address theneeds of an employees at all stages of the HIV/AIDS timeline:from prevention for HIV-negative staff to impact mitigation afterdeath. Several initiatives are helping us to improve staff care.Consultations for choosing the Peer Social Support TeamThrough intense consultations with staff, a group of employeeswere chosen to be Social Support Advisors (SSAs). TheSSAs were chosen for a variety of skills, including good listeningskills, empathy, calmness, popularity within the workplaceand friendliness. The SSAs offer confidential one-on-one supportto staff on various issues: domestic violence, HIV management,workplace stress and employee relations. Staff nowknow people are there to offer support.MONDAY DEVELOPMENTS September 2008 33

PresenceThe Power ofPresenceSometimes just “being there” makes all the difference.By Lisa McKay, Director of Training and Education Services,Headington InstituteOn Monday I was up at5am. This was partly becausemy body was convinced itwas still in Michigan where ithad woken up on Sunday, instead of inCalifornia. And partly because I neededto be at work at 6am.In my opinion, 6am is practically anobscene hour of the morning, an hourwhen no one should have to be at workunless it’s for an exceptionally goodcause. But although I grumbled a bitto myself as I left the house in the dark,I did have to admit it was for an exceptionallygood cause.How it all came about is a long storythat starts in January as I was planningfor workshops in Kenya. We’retrying something new this year at theHeadington Institute called regionaltraining – running free workshops onunderstanding and coping with stressand trauma for humanitarian workersin different cities around the world. ByJanuary we were well into organizingour first regional training for humanitarianworkers in Kenya.Regional training is simple, really. Youchoose a city. You estimate how manypeople you think might show up to thesefree workshops. You book a venue, organizecatering, and review your budget.You pull together a team of experiencedtrainers and counselors. You co-ordinateeveryone’s dates, book air tickets,get visas, review the security situationin the destination city, remember to pickup malaria medication, plan the workshops,backup presentation materials,and organize handouts. Oh, and checkand double check which day your flightleaves because, believe it or not, thatone has almost derailed me more thanonce during the last five years.Okay, when I look at all of that maybeit’s not quite so simple. Maybe it’smore like organizing a wedding. In aforeign country. When you don’t knowhow many people will be attending thereception. And everyone who does showup is bound to be way more stressedout than your average bride.So back to Kenya, where I was supposedto be heading in March. It wasall planned. We’d made all the hotelbookings. I’d even organized to takea couple of days after the workshopsand travel down to Tanzania to spenda couple of days with friends. Thingswere on track.I was going to Australia in Januaryfor almost a month, but my amazingproject manager, Bree, was going tosend out the fliers and organize theworkshop registrations in my absence.In the flier we asked people who wereinterested in attending to send us a200-word statement of interest. Why,we asked, did they feel they’d benefitfrom these workshops? I hoped thesestatements would help me make surethe training I planned would meet asmany of the needs as possible of theapproximately 30 people we estimatedwould turn up.So I went on a much-needed holiday.Bree sent out the fliers. And insteadof 30 registrations, within thefirst forty-eight hours after we sent theannouncement we were flooded withemails from well over one hundred humanitarianworkers and mental healthprofessionals who wanted to attend theworkshops. And their statements of interest…theywere heart-breaking.At the same time, things were goingfrom bad to worse in Kenya. I knewwhen I left for Australia that things inNairobi were unstable. I’d moved forwardanyway, reasoning that the violencewould probably have simmereddown by March. But by the time I returnedto the office in February it wasclear that the prudent course of actionwould be to postpone the workshops.When there would be one hundred peopletraveling around Nairobi to reachthe training the risk was too high thatsomeone would get seriously hurt, orworse. Given that we could still go laterin the year when things would hopefullyhave calmed down, it didn’t seemworth chancing.So we postponed, which we hated tohave to do when the need there was soPhoto: Darren Baker - Fotolia.com34 MONDAY DEVELOPMENTS September 2008

Presenceclearly acute. And we started thinkingabout what we could do in the meantimeto help support the hundred peoplewho had wanted so much to attendthe workshops. One thing we decided todo was offer some free phone consultationsto anyone who had registered. Anotherwas to organize several hour-longwebinars (virtual online trainings) onthe topic of resilience in the face of trauma.It was one of these webinars I wastrundling off to co-facilitate on Mondaymorning at 6am, 5pm Nairobi-time.The session was designed for othermental health professionals, and wehad several counselors working withkids living in slums in Nairobi – kids“Your mere presenceis hope. The fact thatyou are alive, andwalking, and talking,and present – thatsends the message thatthere is life and hopesomewhere, that adifferent kind of futureis possible.”who have seen and heard awful, awfulthings in the last four months. “It’soverwhelming to know what violenceand poverty can do to children’s lives,”one counselor said. “My passion isabout helping advocate for children sothey are better served and more protected.So when the political situationmeans that stray bullets from the policehave killed two of our students, Ifeel powerless.”We ended up talking a lot on Mondayabout this issue of feeling overwhelmedand powerless, and what can anchorus in the midst of situations that provokethose feelings. In the face of violence,and injustice, and the fragility oflife that is so evident when people areregularly being killed on your neighborhoodstreets, what do we have tooffer as helpers? What weapons do wereally have to fight against this feelingof powerlessness? These are crucialquestions to find some personalanswers for, as research on “learnedhelplessness” suggests that when webecome mute or frozen for too long inthe face of powerlessness, we tend toend up rather hopelessly traumatized.One person talked of the key role herfaith has played in helping anchor her.“I have found that because I can releasemy powerlessness to God there isa sense of relief. I feel so for friends whodo not have faith and can only releasethe powerlessness into anger.”“Being there is so critical, even if youdon’t know what to say,” someone elsesaid. “Your mere presence is hope. Thefact that you are alive, and walking,and talking, and present – that sendsthe message that there is life and hopesomewhere, that a different kind of futureis possible. Jesus walked amongthe people. We tend to focus only onthe miracles that were performed, buthe must have spent most of his timesimply walking among the people, andI think that, in itself, brought hope.”This theme of the power of presenceis what stuck with me long after we’dwrapped up our discussion. Presencecan seem like such a small offering.More than once I’ve sat on a plane myselfwondering what I can possibly sayin the workshops I am going to givethat will make it worth the time, themoney, the energy and the risk to getthere. But I was reminded again onMonday of times when the presenceof other people in my life has been ananchor for me. I might not now be ableto recall even what they said, but I doremember their presence – their loving,caring, understanding presence,and the message that sent that I wasnot alone.This is what the counselors we havethe privilege of talking to in Kenya aretrying to do for children in the slumsright now. And what we at the HeadingtonInstitute – imperfectly and acrossmany miles and time zones – are tryingto do for them.This is what makes a 6am startworth it: the chance that you might, byshowing up and, through the power ofpresence if nothing else, sow someseeds of hope in fields of violence anddespair. MDPlease send questions and commentsto the author at DEVELOPMENTS September 2008 35

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40 MONDAY DEVELOPMENTS September 2008 To advertise, call 202-667-8227 ext 548 or email

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“Any intelligent fool can make things bigger, more complex,and more violent. It takes a touch of genius— and a lot ofcourage—to move in the opposite direction.”—Albert Einstein, at whose suggestion the IRC was foundedPETER RUOT | EducationSouth SudanIt takes the best to prevail againstthe worst of crises.To join us, please visit: MONDAY DEVELOPMENTS September 2008 To advertise, call 202-667-8227 ext 548 or email

SKILLANDPASSIONAT WORKCurrentOpeningsReproductive Health ManagerChadHealth CoordinatorChadSenior Gender Based ViolenceProgram CoordinatorKinshasa, DR CongoGrants CoordinatorSudanChief of PartySouth SudanDeputy Director of OperationsSouth SudanTo learn more about workingwith us, please advertise, call 202-667-8227 ext 548 or email MONDAY DEVELOPMENTS September 2008 43

1400 16th Street, NW, Suite 210Washington, DC 20036Phone: (202) 667-8227Fax: (202) 667-8236publications@interaction.orgwww.interaction.orgInterAction is the largest alliance of U.S.-based internationaldevelopment and humanitarian nongovernmentalorganizations. With more than 160 members operating in everydeveloping country, we work to overcome poverty, exclusionand suffering by advancing social justice and basic dignity for all.

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