Conversations About Aid Worker Wellness with Aid Workers
Over the course of the World Humanitarian Summit, Emergency AIDio released two shows focusing on aid worker wellness. In the first show host Nuran Higgins discusses the critical challenges surrounding mental health, sexual violence and wellbeing of aid workers with four unique guests: Amy Brathwaite, Director of the documentary "Kick at the Darkness;â Megan Nobert, founder of Report the Abuse campaign; Amandine Roche, peacemaker and founder of Amanuddin in Afghanistan; and Samara Andrade, humanitarian and yoga teacher supporting aid workers in the field.
The following is a transcript of the audio show, which is posted here with the kind permission of The Healthy Nomad Emergency AIDio; âthe first independent international broadcasting community for aid workers. Emergency AIDio is focused on connecting aid workers around the globe to discuss the issues that shape our lives; and enjoy music with a purpose to strengthen the human dimension back into life. â Â
Nuran: Hi everyone. It's Nuran Higgins, and you're listening to Emergency AIDio. The community space that's all about connecting aid workers to discuss real issues that shape our lives. The World Humanitarian Summit kicks off today with the first day of the two-day summit in Istanbul, Turkey. And  as quoted by the Secretary General, "The core aim of the summit is to  propose solutions to our most pressing challenges, and to set an agenda to  keep humanitarian action fit for the future."
Now over the next two days of the summit we're going to be looking at some of the most significant issues effecting aid workers and  the humanitarian center, which have lacked the attention needed on the summit's agenda. Over the course of the extensive three-year consultative  process, more than 23,000 people in 153 countries were engaged in dialogue  opening up the opportunity to better understand the major challenges facing the world, which should be commended as moving these issues forward which  hold deep meaning to us all is no easy feat in the best of times.
Now it's important for us to not get caught up, I believe, in the circle of criticism, of what hasn't been achieved from our expectations, but instead to focus on keeping it real, what has been achieved to date, and continuing to hold those to account by asking those hard  questions of them moving the issues forward. Because the reality we all know too well is that these complex issues will take time. But, if we remember  that from small steps comes change, then the journey is worth it in the end.
So, what has been the result of the consultative process in shaping the current focus and direction of the summit's agenda? And, in  particular health and well-being of aid workers. And how have these critical issues been translated into essential commitments required in bringing about  real action to deal with the complexities of the changing humanitarian landscape? And, what major concerns remain for humanitarian organizations and  aid workers taking into account the summit's agenda and direction? And  lastly, why have certain issues been prioritized while others silenced?
Now in opening up the first day of the World Humanitarian Summit special, which will be focused on health and well-being  of aid workers we have with us a great lineup of guests, which include Amy Brathwaite, Megan Nobert, Amandine Roche, and Samara Andrade. Â
I wanted to send a huge thanks to all the guests for contributing to the two-day World Humanitarian Summit special. And, standing  together in solidarity to talk about these critical issues that effect all of us as aid workers around the world. But most importantly, I'm extremely  grateful for all the love and support provided to me during this time. Now over the last week and a half, I must say it hasn't been easy in trying to  balance my work and pulling the show together in such a short period of time while in the field.
But interestingly at the same time I've felt a sense of  coming full circle while being back here in Afghanistan. As, it's here, years  ago, my initial dream of creating Emergency AIDio, a space that as aid  workers we could be connected while in the field to discuss real issues that  effect our lives came from. Now, over the course of pulling this show  together I've felt moments of frustration, anger, disappointment, and  sadness, reflecting on how the human side of aids workers has been ignored across  the summit's agenda, which has been a complete contrast against the engaging and open process led during the global consultations. But at the same time  I've also felt moments of hope, determination, and a sense of gratitude from the solidarity and positive mindset offered by like-minded aid workers and  committed humanitarian organizations.
As aid workers, this really is a significant moment in time for us. We have two choices that future generations will look back and  question us, what did we do? We can either choose to continue to exist as complicit actors of inaction, knowing very well it contravenes against the very principals and values we hold true to our core. Or instead, we can choose to not be silent, be brave, and ask from those in power the difficult questions, and hold them to account.
The summit has been seen as a pivotal moment in humanitarian history to have the most pressing issues effecting aid workers raised, and brought to the table for high level decision makers to address tangible commitments for action. And looking back I believe this vision has been easier said than done, and to open this up for discussion I'd like to welcome our first guess on today's show, Amy Brathwaite. Thanks so much for joining us here on Emergency AIDio to talk about this vital topic today.
Amy Brathwaite: Thanks very much for having me.
Nuran:  Over the 3 year period considerable efforts were made to  draw attention to the issues surrounding health, safety, security, and  protection of aid workers from a very strong contingent of global advocates  of aid workers, organizations, and media. Now the greatest demonstration of this commitment was definitely seen in the coming together of a global  coalition under the Be Well, Serve Well campaign, with a number of  submissions to participate in the summit through a side event, however all  were rejected.
Now, out of 112 side events available to raise attention to key humanitarian issues, only one spot was allocated focusing on the protection of healthcare workers, facilities, and patients. However in contrast, the very absence of a side event on the health and well-being of aid workers, in spite of the submissions presented, speaks volumes for how we in the sector value all aid workers in the big picture of humanitarianism. Â Which is disappointing and alarming at the same time.
With this being the result, has most certainly raised some critical questions as aid workers that we need to inquire further and request answers from those at the highest level in order to ensure that this is not swept under the rug. So bearing this in mind, what does such absence of this topic mean for national and international aid workers? What are the potential risks for the sector if we continue to ignore the voices of those on the frontline of humanitarian crises?
Amy Brathwaite: Â This is a discouraging thought I think for those international, and particularly national staff, whose very engagement with the work that helps serves the most vulnerable in their communities. They themselves can be at risk for attack, or for death, or for injury. The shift in the landscape of the humanitarian sector over the past 15 years, has seen an increase in the volatility of missions, the mingling of humanitarian military, and development agendas, which can blur the lines.
And a shift from the neutrality that the banner of the UN flag, or an INGO flag might offer as some sort of solace or protection to those, particularly national staff, there's an increased vulnerability, and  an even uh, risk of, of violence, that has shifted. So with the knowledge of these statistics, with the bombings that we're seeing happening of hospitals,  of the most vulnerable populations ... This absence really leaves quite a  painful void to the, to the families of those who, who have, who have lost  their lives in service.
To those who have lost colleagues, or, who have been  injured. It just leaves questions about, I suppose, the value of these people  themselves in delivering aid.  Humanitarian programming is enabled by the very staff who carry out and implement  projects. And without speaking to their value, how do we, how do we leave these staff feeling supported and, and with the knowledge that what they do  matters and that their lives matter in service.
Nuran: As, as part of that global coalition that put forward submission for a side even to highlight the attention of aid worker health  and well-being at the World Humanitarian Summit, having gone through that process from the beginning of the engaging global consultation to then see  the end result, given the fact that there was so much recognition across the media over the last three years. There have been a number of events which  have solidified the importance of this issue. How did you feel coming out of that process with the efforts that had been put through by everyone, knowing  the importance of this issue?
Amy Brathwaite: Truthfully, I felt, I felt quite discouraged when we  were initially informed that we were not going to be participating. However, where I've taken my solace and my hope has been from the very process of  engaging, and the development of this global coalition of aid workers. You know, over a series of weeks, we coordinated global, global calls with people in  Bangkok, and London, and, and Canada, and Australia. We engaged people, many of whom had never met each other.  This dedication, this drive, and this advocacy, either  having been active in workers or connected in some way to the sector, there  was this drive in dedication to recognize, acknowledge, and communicate some  of the challenges and risks faced by all aid workers. So, that is where I  drew a huge amount of optimism from. And, even the process of trying to  participate in the summit, that there was a sort of a sense of exclusion,  maybe from more of my personal experience, as I'm not currently in the  sector.
But we haven't been successful in the sense of presenting at the summit itself, but the connections, the global advocacy,  the output of tangible support mechanisms that can help and serve those currently on the frontlines, the network that will continue outside and  beyond this summit. That's, there's a lot of encouragement. I guess it's a reminder of what people can achieve with a bit of dedication and a few  resources.
 It reminds me of this quote by Margaret Mead, she's a famous Canadian, and she says that:
"Never doubt that a small group of  thoughtful, committed citizens can change the world." "Indeed, it's the only thing that ever has."Â
 So, while there's a level of disappointment, that we're not participating,  that's where I take, take encouragement from. Is what I have seen, from the inception of my documentary, "Kick at the Darkness," which tried to penetrate the  silence around this issue of, of mental health and well-being, and to see that conversation go from one of shattering silence to now this global level  of engagement with stakeholders who are actively developing tools and resources for those in the field to specifically support the mental health  and well-being, I think is extraordinary.
I think that while this too is a reminder that while we may not be visible and present at a very important and unprecedented summit that doesn't stop the engagement with ourselves, with the community and network of aid workers, and it doesn't stop the advocacy moving forward. And we are in connection with all of- with our colleagues, and there's that real opportunity to, to have this message transcend regardless of whether or not there's high level engagement.
Nuran:  You know, given the fact that we have not been able to  participate at the summit through a side event, what concrete actions would  you like to see established at the summit by the humanitarian sector as a  declaration of its commitment towards the duty of care and protection of its  most valuable asset, it's people?
Amy Brathwaite: I think that's where a bit of the discouragement comes in again.  Because I think it should be there! It should be acknowledged. Our staff are our most vital asset! There's a complexity and multitude of issues facing the humanitarian development sector that is  undeniable. There are complexities in the world that are challenging us in  ways that we are still navigating; but I do feel it's a tremendously missed  opportunity to not have a sliver of time at the agenda to say the people that  implement the program, that save the lives, that intervene with, with  shelter, with water, with access, with, with search and rescue, with gender  advocacy, with all of the important, every single facet of humanitarian work  is, is woven together by the very people from the nation's in which we serve.
We, I feel it is a missed opportunity not to have a moment to acknowledge and highlight the importance of, of their lives in this work. We're all impacted. We all have a friend. We all have a colleague. We all know somebody that's been either killed, or injured, or traumatized, or faced tremendous strain in their work. And we need to know that those who make the decisions that impact our lives feel that our lives matter in our duty of service.
Nuran: Very much agree with that wholeheartedly. I guess looking ahead post the World Humanitarian Summit, what do you think is the most single important thing that we could do to improve the sector's overall  commitment towards valuing aid workers when looking from a more holistic approach that sees security, health, and well-being much more aligned?
Amy Brathwaite: I think you know that there is a level of dedication among the coalition that's going to continue to push this issue forward. And within this coalition there are a number of stakeholders who examine this issue holistically. What this coalition represents is a multidimensional, and multifaceted, and holistic approach to the protection, the well-being, and  the mental health of aid workers. We have a diverse, uh, and engaged group of stakeholders that are dedicated and driven to continue to push this agenda.
And the fact that you are in Afghanistan, and taking the  time in addition to your, to your work, to put together a podcast that will  be broadcast as the the summit is unfolding, I think that's our way of being  sort of the, the rogue advocates of saying, you know, we weren't, we weren't  able to participate, but we want our voices to be heard, and we're doing it  with diplomacy, and we're doing it with hard driving questions, because we  believe in the work, and we believe in serving the most vulnerable. We believe in the morals and the principals that guide us, and we just want to  feel that we're supported in that. So while we may not be at the table. I think again it goes back to what is possible when a few committed people come together.
 We can, we can ride alongside, you know, what is a two-day summit, and we can carry the momentum from that rejection almost to say you  know, we weren't part of this two-day summit, but moving much beyond into the future, for our generation of aid workers, and for those that follow us, what  are the legacies that we can leave?
Amy Brathwaite: In our wake. And that is what has come as a result of this group; this coalition coming together. There's a drive. There's an engagement. And, and, and, we're  driving by the exclusion to say okay we're not at this table, but you're going to hear us bang our, bang our drum.
Nuran: Amy. Thanks so much for taking the time to join us here on Emergency AIDio, and share your thoughts with the listeners on the  important issues surrounding aid worker health and well-being. It's been inspiring just listening. Now, if you want to check out Amy's documentary, "Kick at the Darkness," and I would suggest if you haven't, then  you need to get over to the website. You can find out more about the documentary at amybrathwaite.com, but also she has amazing photography there as well, which just shows the diversity of how we can explore the issue of  aid worker health and well-being in so many different ways, which is really exciting.
Amy Brathwaite: Thank you. Thank you for having me.
Nuran: Over the past 15 years more than 3,000 humanitarian aid workers have been killed, kidnapped, or wounded as a result of doing their job. A recent survey conducted by the Global Development Professional Network on mental health and well-being of aid workers revealed that 79% of aid workers had experienced mental health issues, and with 93% affirming that such experiences were as a result of their work in the aid sector. I'd like to welcome our next guests on the show, Amandine and Samara. Thanks so much for joining us here on Emergency AIDio today.
Samara Andrade: Thanks for having me.
Amandine Roche: Thank you for inviting us.
Nuran: Now there's no secret that as aid workers we find ourselves subjected to high levels of stress working in complex and insecure environments. However, that being said, it should in no way release humanitarian organizations of their responsibility to provide a healthy, safe, and secure environment for their staff. But generally the provision of psychological support for aid workers is still quite sporadic, with some organizations offering support, and when considering the quality, it also tends to vary between organizations.
 But for the majority of organizations, a lack of resources has long been the argument behind preventing the implementation of specific health and well-being practices and measures for aid workers. However, this could be strongly disputed today when taking into account the growing contingent of advocates around the globe working in parallel to organizations that are proving otherwise by pushing the boundaries of the way  we look at aid worker health and well-being through the development of  simple, innovative solutions.
So this begs the question, why does it matter? And, why is there so much resistant at the highest level to act on the mental health, well-being, and protection of aid workers? Because failing to do so is negligent, and essentially contravenes the very notion of humanitarianism.
Samara Andrade: I think that there's a couple things. The first is that, yes there are lots of innovations in the field of working around psycho-social support to staff, and as you mentioned, a lot of innovative  work in the area. I think on one hand it can be not necessarily a resistance,  but it can be a lack of um, funding, that's dedicated to this topic. Whether that is the funding sources that come in for programming externally from  donors, or within the organizations.
I also would say that I think that in places I've personally worked, that there has been really an attention to look at how to  best support staff. I will say, in the high threat context where I've worked, I've been extremely impressed with country directors responding, and not only  after critical incidents, but also in regular time, just recognizing the amount of staff stress and burnout. Um, and the need to access resources.
I do think that often programs like peer to peer support counseling are often under utilized, and I think there's mainly, what I've seen in the field, a lack of sufficient resources dedicated to the area who  can both provide the service, but also coordinate and run it. And I think that normalization of the topic is really important in our staffing.
And I do think that that's one contributing area, is that there is this stigma about discussing those issues, in general. I would say say in the general public, let alone in our sector, more specifically. And I think that that stigma is not only something that comes from higher levels, because I actually do believe that higher levels are more aware of this issue, and how it effects staff, even if it's from an area staff  performance, but it's also very much from staff on the ground.
And, I think there's a general culture of, well you chose this field, or you chose this work, or you accepted this posting in this high threat context. You knew what you were getting into. Or, just the  kind of down playing of what the effects actually are. There's often this kind of out rigging of different postings. Oh, well that's not so bad as this  posting, et cetera, and I think that's really a disservice to us together collectively. Because then we downplay what the effects of psycho-social care, mental health, well-being are.
I would also say that on the well-being side, personally having taught yoga and meditation in a number of postings, I have not faced resistance to offering those classes. What I've seen is that the community really comes together. There's often not classes that are paid for or organized by organizations themselves, but quite frequently they're more  aid workers themselves who are actually taking the initiative, recognizing  the importance of these, of these services as positive ways to deal with  stress, as ways to form another community, um, that's beyond your social  circle, or beyond your work circle. And I will say that the value from that really I've seen be quite profound. And, it speaks to me that I'll still get emails from students from different places that I've taught who speak to that.
And that's really prompted, I think, my interest in looking at how do we map these classes globally? Both that aid workers themselves are teaching, but also that are just available, because then it  can be something that's a resource, where people can really be able to look  up and say, I'm working in this location, what are the different types of  wellness activities available to me? Whether it's fitness, whether it's more mindfulness practices, or other forms of work.
And similarly I think it would be much more helpful that workers know when they come to a duty station where they can access counseling and psycho-social support services, whether it's only in-country, where that compound is, is it somewhere that they can easily access? Does it have to only be accessed during work hours? Can it be after work hours? Is there remote support? Et cetera ...
And then I think on the more protection side, you know, the, the issue and the idea of strengthening risk assessments, and risk management, and looking at that while still recognizing the importance of  reaching beneficiaries. So not wanting to go totally into things like remote  managements, and pull back from communities, but really weighing those with  improving how we look at security and management of risks.
Amandine Roche:  Well I do believe that valuing the human side of  humanitarian really matters, and it's even a question of integrity, because who are you to serving the world, if you are not at peace with yourself  first, and if you are completely broken, burnout, depressed, anxious, it's  better you stay at home, otherwise you will harm more the community you came  to serve. It's true in the word humanitarian there is the word human, and what does it mean to be human?
And it means to be connected with your mind, with your body, your spirit. To be in harmony. It's true that in the field I didn't  face any resistance to implement some uh, yoga meditations teachings to my peers, colleague, but I did face a lot of resistance at the highest level to  act on the mental health and well-being, and protection of aid workers, because for what I observe so far, they have their own agenda, their own  strategy, and, which the organization doesn't have enough staff in the field,  enough counselors to deal with this type of trauma, and so, which is  occurring to me a real lack of responsibility and conscious leadership.
Because we are on the 21st century, and I feel like so far the organization I have been working with are doing the politic of an  ostrich, and they do not want to see what's happening, but unfortunately letting the staff be under post-traumatic stress disorder, and keeping their  trauma for themselves really jeopardize any organization, and jeopardize also  the mission in the field.
 We can already observe so far the boomerang effect of that; of the fact that there is no common policy to move forward with a vision, and so what I observe is that yeah, the system is broken, and we need to change it. And, now because the policy so far us when you are broken, organizations prefer to change the aid worker, instead of trying to repair them. And why?  Because they say that it's, for instance in my case with United Nations, they say that it's so many people who want to work for, to join United Nation, and the waiting list is so long. So, if you are not efficient any more, somebody can replace you, but we are lacking the emotional intentions, and we are  lacking the human part in this type of policy.
Definitely something needs to be done, especially at the highest level. One recommendation is to design a strategy on a new policy of how to deal with mental health when, before, during, and after the missions.
Nuran:  I think what's interesting you know, listening to, to the points, and particularly coming back to the fact that if we look at the field level there is an acceptance or an interest to engage in wellness activities to support some of the challenges in which national and  international aid workers find themselves exposed to. Once we start to move from that, I guess grassroots space, to more where it involves decision makers, and budget line allocation, that is where we will start to see the first bottleneck, which was touched on briefly.
So, again, I guess coming to the next question of what are the most pressing concerns or barriers right now for humanitarians looking to seek access to mental health services, and other support to keep themselves healthy. We can't deny that the budget allocation has an implication for that. So, who makes those decisions comes up to that next level of how do you prioritize implementation of humanitarian activities over the very humanitarians that are actually responsible for delivering it? What, what have you seen, I guess looking at that sort of space? Are there barriers perhaps to accessibility or availability that we need to be considering in  the midst of all of these points that were raised?
Amandine Roche:  Well, so far what I have observed, working for 15 years with the United Nations and other international organization, there is definitely a lack of resources,  definitely. I have to admit that. There is not enough staff counselor at the headquarter and in the field. So there is a lack of budget also, and as they explained to me that, I think it was in 2009 at the general assembly, they reduced their budget. Unfortunately, there is a lack of policy. There is a lack of common vision. There's a lack of competency. And I'm sorry to say that, but  from what I've observed so far it's very, very poor staff counseling.
Like I've been working for 15 years with United Nation, and I've never ever received a training, for instance on what is mental  health, what is living under stressful environment, and what is, uh, how to keep you're well-being. And I would have loved to receive that before being sent  on a mission, or during the mission, or at least to have a follow up afterward. And I remember after the assassination of my colleague, two staff counselors came, came and and said, âwell you are lucky, because you survive  from the assassinations, so the best way now is to try and forget it. I'm very sorry to say it, but this, we are in the 21st century, and I do believe that's not the best way to counsel, and in to advise people when you face a trauma.
So, I do believe that what is the main barrier is, unlike the U.S. Army, there is not a Department of Veteran Affairs, maybe we need a Department of Wellness Affairs, for instance. And I believe this type of department should exist within any organization to really care from th beginning till the end of each staff member. So, I do believe that it's time now that any organization working in the humanitarian field must becomes aware that there are serious mental health issues among their staff, especially the staff that are on the frontline.
Amandine Roche: And it's time now that they become aware that their staff has suffered for too long, and they create this type of department, and  they develop a budget for that, and of course it'll require an agreement from  all the members there, so it will take times.
Samara Andrade: My perspectives are really on how does this system collectively look at pre-deployment, really preparing stuff in a different way.
I've worked in many emergencies. Â I don't think I've ever had a briefing or preparation where it comes to the types of stuff I'm going to be facing, the violence that may be around me. You know, the potential for being in attacks. Â How you cope with these things. I think all of these things, you know, what is the preparation. So that you go into it with better ideas and understanding, as well as better, better thinking about what coping mechanisms are.
And then I think of course it's during the mission what's accessible. And I would say that that can take many forms. You know, there are having counselors on site. And not just counselor on site for, for stress, critical stress andâŚ.but for, available for everyday. There are also, if that's something that is either the, the cost, the value of getting enough counselors, qualified people to work in these contexts perhaps, then it's  also having access to counselors by a phone call, being able to have Skype appointments, those types of services would be extremely helpful.
And I think something I touched on earlier. It's really the location of those services that they're, they're offered in-country. I know, for example, where counselors were about 45 minutes from where I actually worked, and only available during the daytime hours.
So to access the counselors you would need to obviously arrange transport, and a vehicle, and all these things. So, it was not as helpful. Now I have had myself helpful experiences with counselors. I do very much appreciate the access where I had access to it, particularly in dealing with a post-critical incident. I also think the issue of post-deployment is huge.
It's something that I after working in Afghanistan, and getting to know a number of different military colleagues, I must say I, as an American, I wish we had things like the Veteran Affairs system. Not that the VA system is functioning in the best way possible.
And I know there are many people, military and families who are unhappy with it. But when I look at what's available for the aid industry, once you leave the field, or you leave the job, which could even be because you're burnt out, it doesnât exist. I also think that this is tied to another issue, which is how do we look at staff who has worked in high threat level context for a while, how do we make sure that they rotate in and out sufficiently and have breaks. But, if you are choosing to leave the field location (i.e. end your contract) what access you have to those services. For most people once you end your contract you don't have insurance with that organization anymore.
So I think that's really a disservice, because as we know with issues with post-traumatic stress, those symptoms can arise far later than the immediate. Um, and I think when I, when I also look at what is the way in which you kind of debrief with people, um, when they are leaving a job, or leaving a mission. And I've never had like a post check in about mental health and well-being either. And so I think that there's really something fundamentally kind of missing, um, in how we look at those 3 areas. And I would say also that for a national staff this equally important.
Samara: For national staff it's very important that we look at what is the effect (of aid work) has on them, who often are put in more critical incident areas than even international workers.
Nuran:  Looking ahead, post World Humanitarian Summit, what do you think is the single most important thing that we could do to improve the  sectors overall commitment towards valuing aid workers when looking from a more holistic approach that sees security, health, and well-being much more  aligned?
Amandine Roche: The best thing to do is to improve the sectors overall is to develop this type of training, and by doing that, uh, maybe at the beginning, we could maybe um, collect different testimony showing that all  people, all humanitarian work, being on the frontline and filed for so many  years do require uh, this type of training, because they are being sent to  war zone, and conflict country, which are among the most challenging work environment. And the studies prove, the recent survey from UNHCR proves that more than half of the staff that come back from these type of missions suffer from post-traumatic stress disorder, anxiety, depression, and burnout, which can lead to alcoholism or life long dependency on antidepressants. And again, PTSD is not a sign of weakness, but at least you know.
You need to know how to recognize the symptom of that. And, it's true, if UN, other organization staff try to numb themselves and push their memory away, the post-traumatic stress disorder will only intensify. So, I feel like the fact that so far we avoid facing the reality, which will ultimately harm the staff relationship, and their ability to work, and the quality of their life, and so there will be unhealthy, unhappy, and completely unable to fulfill their mission in their  field.
So, I believe, as I mentioned before, and Samara mentioned it as well, that in order to prevent, and to help any humanitarian to deal with that, um, it's really crucial now that they receive a tool to cultivate their type of mind. Really, I do believe we need to focus on these type of missions- I mean of training, before being sent on mission, during the mission, and follow-up afterward. And, and, and, and, and, I do believe in this case what is the most important that all humanitarians, and that the organization agree on that, and uh, put a budget on that, and focus on their well-being.
And, and, so, and inside you, you learn more on resilience, on empathy, on, on um, and also on stress⌠So it's more so a type of stress management and mental health training where you understand the stress rate, the response, what is the amygdala hijack, for instance, and it's role as fight and flight. Our understanding the holistic approach of the different stress factor, or what, how does stress express itself through the body and the mind, and what are the different pathological expression of stress, or how to prevent stress, how stress effects our environment. Definitely (this sort of training) will help a lot the humanitarian serving in the frontline.
Samara: What Amandine says is very important. And I think that one thing she said, hit me on the head, this idea of knowledge is power, I think is huge. If you understand as a staff member, in any organization, what is the science and the brain implication, the body implication of being in a high stress environment. This idea of having the sympathetic nervous system activated consistently. Then I think with that knowledge, then you have choices to make. It's always going to be everyone's choice what, what you do in that situation, but having that knowledge is key, and having access to, to different ways to deal with that stress I think is key.
When you asked, though, about kind of 1 thing, the single most important thing we can do at this time to look at this, you know, it's sort of difficult, because there's so many things. I think that what I would say is I would really like to see that where we have in donor contributions, and where we have in project design, that there is actually a line item. So this is built into what's given.
Samara: It's a certain percentage that goes towards this work, and I think that with that, that allows this space for organizations to properly begin to staff, and bring in the right resources on this, and look  at how do they really build a program that can best meet the needs of a staff before, during, and after. I do think with some of the issues where you're talking about insurance and duty of care after. I think that really requires collective work, together. So whether that looks at a kind of global fund that's put together. You know, I think there are different models that  have been discussed about, and so I think that's really something that's a collective solution. I don't think it's a problem one organization, or two organizations can solve individually. I think it requires a collective look at this, but I think a good first step would be that donor contributions and projects have a percentage built in to address these issues. And then the rest is, is really bringing in the appropriate resources to, to design fully what this looks like in terms of support before, during, and after.
And of course I think that the CHS, you know the Core Humanitarian Standards on this, this topic, would be a, a wonderful way to look at a positive collectivization system for organizations. Or sort of like who has the seal of really implementing this? What's the criteria of really complying with that core commitment. And that could even be done by say an external auditing firm looking at if there's an agreed, I would say status, across the sector. What are the things that are the components of this?
Then you can have an external- al- um, looking at each organization, and giving a sort of seal, let's say. Like yes, this organization is meeting these standards. An I think that's and indication for humanitarian aid workers more probably just to know which organizations are really implementing this commitment, and what they're doing. So, positively incentivize organizations to really demonstrate their, their action on this area.
And I also think you could even explore things like having an index of which organizations are doing the best in this field. And that could be something that's published, you know, on a regular basis, an annual basis. Just as we have indexes for all kinds of things. And I really think looking at positive collectivization structures for the sector, and mechanisms to come together collectively for, for a change on this topic, is really where I'd like to see things move in the future.
Nuran: Amandine and Samara, thanks so much for taking time to join us here on Emergency AIDio, and to share your thoughts surrounding aid worker health and well-being. Now, to find out more about Amandine's work as a peace maker in this sector, and her foundation in Afghanistan, head over to  www.amandineroche.com to learn more. And to find out about the work that Samara is doing with aid workers around yoga, head over to yogamara.org to find out more.
Samara: Pleasure to be here today, and um, and support this topic.
Amandine Roche: Thank you very much, Nuran, for inviting us.
Nuran: Up next we'll be hearing from our last guest on today's show. Megan, thanks so much for joining us here on Emergency AIDio today.
Megan Nobert: Thank you very much for having me on.
Nuran: In order for us as aid workers to deliver effective principled humanitarian action, it's fundamental that we take care of ourselves, but also that our organization care for us too by providing a safe  and protected environment, and ensuring we're not exposed to unnecessary risks. There has been increasing media attention of the issue surrounding sexual violence across the humanitarian sector. And according to the aid worker security database, just 15 cases of incidents of sexual violence against aid workers have been reported since 2005. And of these cases, the majority were against international aid workers.
Now, the Headington Institute believe that sexual violence is widely under reported due to personal, cultural, and organizational complexities. In taking such factors into account they estimate that at least 2% or more of humanitarian aid workers have experienced sexual violence. Now with approximately 400,000 aid workers worldwide, this would suggest that sexual violence has directly effected between 4,000 to 8,000 aid workers, which is a frightening concern. Now taking this into account, what do you see are the main barriers limiting support provided to aid workers that have experienced sexual violence?
Megan Nobert: So, there are a couple of different big barriers. I think the biggest problem is that we don't acknowledge that this is a problem, and part of that is because we don't know how big the problem is. Â You know the Headington Institute is suggesting that it's between say 4,000 to 8,000 uh aid workers. Well part of the problem with that number is that- I mean, it's, it's a large number. It's a scary number, but actually I think it's probably, realistically a lot higher. Because you have to look at what is defined as sexual violence. I think that's actually the first problem, is how are people defining sexual violence?
When I consider sexual violence I look at it, the whole spectrum. You know, you're going from sexual harassment in the office, you know, the, the cat calls, the little comments that make you uncomfortable, to you know, the touching, the back rubs, you know, the arm rubs that you know, Â make you go a little squirrelly inside. All the way up to, you know, attempted sexual assaults, to actual sexual assaults, and rape. If you're looking at the huge spectrum of sexual assault incidents, I think that numbers are considerably higher. Um, so there's that problem. We don't know what is the, you know, what is the landscape of sexual violence in the humanitarian industry. And without knowing that it is difficult to say a), that it's a problem, and b), Â how big of a problem it is.
So we can begin to start addressing it. I think the other problem is that, so we're not, obviously ... acknowledging that it is a problem. That's obviously a big barrier, because it, when we say that it isn't a problem, it makes people who have experienced sexual violence feel that what has happened to them is either a one-off thing, therefore something not to be complained about. But it makes them feel isolated.
Nuran: And so why do you think there is such a barrier within this, the sector to acknowledge that there is a problem with sexual violence?
Megan Nobert: I think part of the issue is that we're scared to admit that it could be a problem. It's one of those things where, when you acknowledge it, that means that you could be at risk, and I think that there's a real sort of mental barrier for a lot of humanitarian aid workers.
Because you don't want to think of yourself as being at danger for that. We're at danger for so many things within this sector. And I mean you've talked to folks about this before, and you're talking about this with other individuals in the podcast. We're at risk for so many things, then sexual violence is just another thing to add onto the list. Um, and it's scary, you know. It's, and it's also part of the issue is that, I mean, for example we know that date rape drugs are happening in the humanitarian aid industry. Not in all countries, but South Sudan, for example, has been identified as a bit of a hot spot for drug rings.
And that's something that you wouldn't expect when you're working as a humanitarian aid workers. You know, it's something you'd expect at a bar back home, you know, you'd never leave your drink unattended kind of a thing. But it's not necessarily something that you would expect when you're in the field. It's an unanticipated risk.
Nuran: And so thinking about that, and the, the implications that that has on an aid worker that is exposed, what do you see being the overlapping areas between mental health and sexual violence? Is there any, in fact? Because, eh, I think, you know, part of the, the big problem is that we can often have a tendency to look at singling these issues into a box, but in  actual fact there are so many elements of where they're interwoven. The issue of mental health in itself is one that is isolated, and as you said there are  so many issues. You know, are there areas of overlap between mental health and sexual violence that we can draw on in understanding how to deal with  the, you know, potential solutions moving forward?
Megan Nobert: Absolutely. I think it's you know, sexual violence and mental health are both issues which, we have to look at them in isolation. There are so many factors which are allowing both of these things to become problems. Take, for example, sexual violence. We know that there's an aid worker mental health crisis going on right now; burnout, and PTSD, eh, either we're talking about it more, or they appear to actually be increasing. It's hard to say. From my perspective I do think that we're actually increasing in terms of burnout and PTSD, and I've seen a number of cases coming out of the field.
And, when you have an atmosphere which allows something like burnout and PTSD to occur, another thing that's going to occur is things like sexual violence. All part and parcel of one big package in which our working culture is that you give, and give, and give, and give, and give, and you never take care of yourself.
So, when you feel that you're getting burned out, you don't get the mental health support that you need. You don't seek it. You don't talk about it. And when you have an experience with sexual violence, similarly you don't talk about it. You don't seek- well, hopefully you'll seek at the very least uh, medical help, but often people aren't seeking psychological help until quite a time after the incident, when they're addressing, you know, the myriad of traumas that they've experienced while working in the field.
Nuran: I guess one of the other things for me that is an interesting space surrounding the, the complexity of mental health, sexual violence, and well-being is the linkages between security management. And, over the last 3 years of the consultative process, and more specifically in the last months leading up to the summit, we've seen much more prominence  given across the World Humanitarian Summit agenda to safety, security, and protection of healthcare workers, rather than taking into account instead a  more holistic approach to address the complexity of issues effecting all workers.
There is no denying that safety, security, and protection of healthcare workers is a critical issue that needs to be  addressed urgently. However, given the fact that there had been no inclusion to address the issues surrounding health and well-being of all aid workers,  it's important to ask the question that by having singled out a segment of  humanitarian aid workers over other, that are also exposed essentially to  security risks, have we actually done a disservice to the greater cause  surrounding aid workers on the frontline, and particularly being able to look  at the importance of linking security management systems and health and  well-being, and the protection of aid workers, um, that humanitarian  organizations need to consider when looking at the duty of care.
Megan Nobert: Absolutely. I think there's always a danger in looking at any of these issues in isolation, because they do all connect to one another. I mean you could talk about things, like duty of care extends from safety and security to security management systems. It extends to mental health and the provision of mental health assistance, um, creating atmosphere in which you know, it's reporting about mental health issues, and it's not stigmatized, but is, you know, encouraged. Where the work environment has is a semblance of work-life balance.
A work environment where you can have conversations about things like sexual violence, and what is appropriate, and what is not appropriate in the office. Â And you have work environments where individuals are not retaliated against for whistleblowing on the myriad of issues that we're hiding from. Â You know, things like embezzlement, sexual exploitation and abuse, to sexual exploitation and abuse of the population, and so on.
Nuran: You have launched a really important campaign, Report the Abuse, which I think is becoming much more widely known across the humanitarian sector, which is fantastic. Taking the opportunity to have you on the show right now, and hopefully we can get you back later in the year. Â Can you share with listeners why establishing the campaign is so important, and what the primary focus of the campaign is all about?
Megan Nobert: So, uh, thank you for asking about the Report the Abuse campaign. I'm always happy to talk about it. It's, um, it is becoming more widely known. And the motivation behind starting the Report the Abuse campaign was to start breaking down these barriers. To start these conversations about sexual violence within and against the humanitarian aid  community. That's something that everybody knows happens. I know, I don't know a single woman who's worked in the field that doesn't have a story about something from, you know, sexual harassment up through sexual abuse. And that struck me, it struck me as just being so disconcerting and disconnected.
We know this is happening. Why are we not talking about it? Because by not talking about these issues, we allow them to percolate, and we allow them to continue, and we allow them to escalate. Um, it's, you  know, similarly, we don't talk about mental health issues, we allow them to  get worse. PTSD and burnout are getting more severe. People are dropping in and out of the humanitarian world. We're not talking about funding issues. Those are increasing concerns.
If we don't talk about sexual violence, it just gets worse. So, there was, you know, that was kind of the big motivation was to have these conversations. Um, but the other big piece of it was to let survivors know that they're not alone, um.
Nuran: That's so important.
Megan Nobert: Yes. Absolutely. It's to have these conversations. It's  o empower other survivors to ha- you know, to find their voice, to tell  their story in their own way, whatever it is, if they're ready. If that's anonymously. Um, there's been many reports in The Guardian where we've had  anonymous testimonies, and that's been amazing.
And shortly after Report the Abuse started had a 50 days, 50 testimonies campaign, where every day we published a new snippet of a story of someone's experience with sexual violence across the range.  They were all primarily women, but we've had men report, um. Unfortunately we know men that havenât felt comfortable yet to talk about their own experience in sexual violence. But slowly and surely we are breaking down those barriers. And hopefully in the next 6 months we'll be including national staff within those voices. And we're looking at ways to include national staff voices, and encourage them to  report and um get through, you know, the stigmas, and uh, technical barriers,  and language barriers that they um, they face.
Nuran: That's fantastic. I guess looking ahead, post World Humanitarian Summit , and given the fact that the opportunity to have a side  event, unfortunately hasn't occurred for many of us, what do you think is the  single most important thing that we could do to improve the sector's overall commitment towards valuing aid workers when looking from a more holistic  approach that sees security, health, and well-being much more aligned?
Megan Nobert: I think the biggest thing that we can do in moving forward is to not work in a bubble. And I mean that in terms of like, you know, campaign versus campaign, individual versus individual organization, versus organization, issue versus issue. When we work in bubbles we become isolated. We lose that opportunity for innovation, and voice, and connectivity. So think about stopping to work in these bubbles by talking freely and widely, and having these conversations about such important issues. We can take what didn't unfortunately, you know, did unfortunately not get on the World Humanitarian Summit Summit's side event list, but we can take it far beyond. It's, the summit is two-days, and humanitarian aid work is going to extend far beyond those two-days. We're going to be looking at decades, and decades, and decades of issues that will not be fixed for years to come; but we can start that important work, you know ... The summit ends on Tuesday, and Wednesday we start that work.
Nuran: Megan, thanks so much for taking the time to join us here on Emergency AIDio, and share your thoughts surrounding such an  important issue effecting aid workers and the sectors with listeners.
Megan Nobert: Thank you very much for having me on.
 Nuran: Now, if you want to learn more about the work Megan is doing through Report the Abuse campaign, then head over to reporttheabuse.org  to find out more.
So we've come to the end of today's show. Thanks to our guests Amy, Megan, Amandine, and Samara, for joining us on today's show, and sharing their personal perspectives on the challenges facing the sector, and the importance of keeping aid worker health and well-being present in  people's minds.
If you enjoyed this conversation I would encourage you to visit Nuran Higginsâ website www.thehealthynomad.org and subscribe to EmergencyAIDio. You can also connect to The Healthy Nomad on Facebook,  Instagram and Twitter.
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