The mental health of expatriate and Kosovar Albanian humanitarian aid workers

The mental health consequences of exposure to traumatic events and the risk factors for psychological morbidity among expatriate and Kosovar Albanian humanitarian aid workers have not been well studied. In June 2000, we used standardised screening tools to survey 285 (69.5%) of 410 expatriate aid workers and 325 (75.8%) of 429 Kosovar Albanian aid workers from 22 humanitarian organizations that were implementing health programmes in Kosovo. The mean number of trauma events experienced by expatriates was 2.8 (standard deviation: 2.7) and by Kosovar staff 3.2 (standard deviation: 2.8). Although only 1.1% of expatriate and 6.2% of Kosovar aid workers reported symptoms consistent with the diagnosis for post-traumatic stress disorder, 17.2% and 16.9%, respectively, reported symptoms satisfying the definition of depression. Regression analysis demonstrated that the number of trauma events experienced was significantly associated with depression for the two sets of workers. Organisational support services may be an important mediating factor and should be targeted at both groups.     

The impact of humanitarian context conditions and individual characteristics on aid worker retention

High employee turnover rates constitute a major challenge to effective aid provision. This study examines how features of humanitarian work and aid workers’ individual characteristics affect retention within one humanitarian organisation, Médecins Sans Frontières (MSF) Holland. The study extends existing research by providing new theoretical explanations of employment opportunities and constraints and by engaging in the first large‐scale quantitative analysis of aid worker retention. Using a database of field staff (N=1,955), a logistic regression is performed of the likelihood of reenlistment after a first mission. The findings demonstrate that only 40 per cent of employees reenlist for a second mission with MSF Holland, and that workplace location and security situation, age, and gender have no significant effect. Individuals are less likely to reenlist if they returned early from the first mission for a personal reason, are in a relationship, are medical doctors, or if they come from highly developed countries. The paper reflects on the findings in the light of policy.     

Kinship,nomadism, and humanitarian aid among Somalis in Ethiopia

This paper draws on extended ethnographic and health policy research in eastern Ethiopia to reconsider kinship and nomadism among Somalis, as both of these cultural features transform in the contexts of recurrent humanitarian crises and episodic relief operations. The emergence and importance of new patterns of travel and migration among Somalis in Ethiopia reveal significant changes in the configurations and enactments of Somali kinship, on which many Somalis' mobility depends. Conversely, an analysis of Somalis' dynamic sub‐clan groupings and geographically dispersed kinship networks also highlights emergent patterns of mobility and migration that enable access to training opportunities and employment with relief organisations, as well as to distributions of humanitarian aid. Based on these findings, this paper argues that kinship and nomadism—both long central to Somalis' identities in Ethiopia—remain interdependent, coevolved, and key to their resilience and livelihoods in the face of recurrent crises and intermittent humanitarian responses.     

Work‐related stress in a humanitarian context: a qualitative investigation

There is a paucity of research on the subjective stress‐related experiences of humanitarian aid workers. Most evaluations of stress among these individuals focus on trauma and related conditions or adopt a quantitative approach. This interview‐based study explored how 58 humanitarian aid workers employed by a United Nations‐aligned organisation perceived the transactional stress process. The thematic analysis revealed eight main topics of interest: an emergency culture was found where most employees felt compelled to offer an immediate response to humanitarian needs; employees identified strongly with humanitarian goals and reported a high level of engagement; the rewards of humanitarian work were perceived as motivating and meaningful; constant change and urgent demands resulted in work overload; and managing work–life boundaries and receiving positive support from colleagues and managers helped to buffer perceived stress, work overload, and negative health outcomes. The practical implications of the results are discussed and suggestions made in the light of current research and stress theory.     

Ethnicity, politics and inequality: post-tsunami humanitarian aid delivery in Ampara District, Sri Lanka

The provision of humanitarian aid at times of disaster in multi-ethnic community settings may lead to conflict, tension and even the widening of the distance between various ethnic groups. That aid agencies distribute humanitarian aid directly to affected communities, to speed up recovery, may often lead to chaos and the intensification of ethnic sentiments. The new distribution mechanisms introduced for the delivery of tsunami aid in Ampara District, Sri Lanka, did not recognise local networks and the culture of the ethnically mixed community setting. This paper analyses post-tsunami aid distribution in Ampara and shows how such an extemporised effort in an ethnically cognisant context increased ethnic division, inequality and disorder, while marginalising the poor segments of the affected population. It recommends the inclusion of local networks in aid dissemination as a measure for improving ethnic neutrality and social harmony in disaster-hit multi-ethnic communities.     

The futility of rights‐based humanitarian aid to the Occupied Palestinian Territories

A rights‐based approach (RBA) to humanitarian aid is intrinsic to Norwegian policy and should inform Norwegian aid to the Occupied Palestinian Territories, one of the main receivers of Norwegian aid. However, this is the case only to a limited extent. While Norwegian humanitarian non‐governmental organisations (NGOs) take RBA seriously, and design their projects in accordance with its principles, they are unable to pursue a programme of long‐term structural change. This is because the main duty‐bearer, Israel, is indifferent or hostile to their work, while Norway's foreign policy is given higher priority than following through a rights‐based agenda. The result of this situation is a large, long‐standing aid effort that is unable to provide more than temporary relief in a steadily deteriorating situation. The Palestinian case suggests that RBA in humanitarianism may lead to frustration rather than human liberation when not backed up by political power.     

Changing tracks as situations change: humanitarian and health response along the Liberia–Côte d'Ivoire border

In recent years, protracted crises and fragile post‐conflict settings have challenged the co‐existence, and even the linear continuum, of relief and development aid. Forced migration has tested humanitarian and development paradigms where sudden‐onset emergencies, violence and displacement arise alongside ongoing development work. Drawing on Médecins Sans Frontières interventions in the region from December 2010 to May 2011, this paper examines aid and healthcare responses to displacement in Côte d'Ivoire and Liberia; it focuses on challenges to the maintenance of preparedness for such foreseeable emergencies and to adaptation in response to changing situations of displacement and insecurity. This ‘backsliding’ from development to emergency remains a substantial challenge to aid; yet, in exactly such cases, it also presents the opportunity to ensure access to medical care that is much more urgently needed in times of crisis, including the suspension of user fees for medical care.     

Culture,local capacity,and outside aid: a community perspective on disaster response after the 2009 tsunami in American Sāmoa

Research on diverse cultural contexts has indicated that aid organisations often fail to leverage local, culturally‐grounded resources and capacities in disaster‐affected communities. Case‐study methodology was employed to explore the relationship between local and external disaster response efforts in American Sāmoa following the earthquake and tsunami on 29 September 2009 in the southern Pacific Ocean, with a specific focus on the role of culture in defining that relationship. Interview and focus group data from 37 participants, along with observational data, suggested that the local response to the event was swift and grounded in Samoan cultural systems and norms. External aid was viewed as helpful in some respects, although, on the whole, it was seen as a disruption to village hierarchies, social networks, and local response efforts. The study discusses the implications for the role of outside aid in diverse cultural contexts, and makes suggestions for improving the ecological fit of post‐disaster interventions.     

Risk,vulnerability, and pragmatic inevitability: the conflict–disaster nexus and urban governance in Johannesburg,South Africa

This paper spotlights post-disaster relief provision in Johannesburg, South Africa, following the floods of 2016 in a bid to explore how local government and non-governmental actors in the country conceive of compounding vulnerability and conflict within urban disaster governance. It reveals the diverse strategies employed to navigate violent conflict during the cyclical occurrence of disaster and reconstruction that the predominantly migrant population experiences in the Setswetla informal settlement, adjacent to the Alexandra township in northern Johannesburg. Rendered visible in moments of disaster and recovery are the spatial politics and multidimensional nature of conflict. These phenomena unfold across various levels of urban governance and in the affected community and effectively construct a disaster citizenship that makes risk reduction and community cohesion impossible in the eyes of disaster managers. This research, based on a set of expert interviews, integrates conflict and disaster studies to shed light on how the conflict–disaster interface materialises, and is operationalised, in an urban setting.