What About Our Mental Health?

April 14, 2014January 2, 2015 / aidleap / 2 Comments

For a long time I thought that post traumatic stress disorder (PTSD) was something that only Vietnam veterans got. Or perhaps I would have also stretched it to include those who are kidnapped for months and then released. Now I know differently. I’ve seen enough cases – mild and severe – amongst friends and colleagues to better appreciate the prevalence of it amongst the aid community.

PTSD is ‘an anxiety disorder caused by very stressful, frightening or distressing events’. This disorder doesn’t always emerge immediately after a traumatic experience: it can build quietly before exploding into someone’s life without warning. The most common symptom is the reliving of the trauma, but equally prominent are irritability, insomnia, anxiety and guilt. All of which can create severe problems with continuing day to day life – even more so if we are once again in a foreign land or in the midst of an emergency response.

The good news is that it can be treated through a variety of methods, allowing the affected individual to find one that suits them and their lifestyle. PTSD is just one of numerous mental health illnesses that aid workers are vulnerable to. There are also cumulative stress, depression, guilt, burnout and so on. Aid workers are prone to suffering one or several of these during their careers.

Many organisations now include a debriefing session upon return from deployment and sometimes with a psychologist. Take it! Even if you’ve been on a short deployment. It’s free and the likelihood of developing PTSD and other problems can be reduced by talking early on about your experiences. If you worry it’s a cliché, unnecessary or a luxury, see it as part of your professional duty.

Aid workers are often celebrated for their stamina or resilience. The reality is that these attributes require strong mental wellbeing as well as physical strength. This is an often overlooked fact right from the recruitment of aidworkers to their living conditions in the field. Once I commented on how little sleep a colleague was taking in a first phase emergency and was told ‘It’s fine, he does that every deployment: he burns himself out and then gets sent home’. What shocked me was that this was considered acceptable: there was no consideration of how they might work to change his behaviour. Another colleague had to be fed plumpy nut to stop him from collapsing from exhaustion each day, but no action was taken when I suggested that maybe they should be sent home or even for a couple of weeks holiday.

As highlighted by How Matters, we have to look after ourselves. Aid organisations and senior managers are dealing with lots of complex issues. A member of staff who is unable to look after themselves – physically and mentally – is an added burden. To get them back to health requires time and money. This applies both during and after deployment. If you really want to help then you need to properly rest and get yourself back to 100% health before starting a deployment. A member of staff suffering from undealt with mental health issues can endanger colleagues and even the whole operation. How can you be competent and professional in your job if you have negative thoughts memories storming around your head like a herd of elephants?

Interestingly, the need for psychologists and psychiatrists in emergencies is finally beginning to be recognisedIt is important that we recognise the impact of the horrors experienced by refugees, internally displaced persons and others affected by crises or natural disasters. But it is also important that we appreciate the impact that working with affected communities can have on us. It shouldn’t be seen as selfish or weak, but rather as a normal part of our jobs. Professionl psychologists themselves have to spend an hour a fortnight with another psychologist as part of their professional training. We should recognise this in our sector, . . . . and not just by getting blind drunk in the nearest establishment, even if that can help in the short term!

Rakhine Crisis, Burma (Myanmar) – Sitrep

April 10, 2014August 3, 2014 / aidleap / 3 Comments

(Photo Source: UN News Centre)

Who, what, where?

Violence in Burma’s western Rakhine State has left hundreds dead, thousands of homes razed to the ground and over 140,000 displaced – dependent on international aid for food, water and basic health facilities. And since mob attacks against INGO compounds prompted the mass evacuation of all humanitarian organisations from the area, the situation has deteriorated severely, with the UN warning that the situation could reach critical levels within a week.

So what exactly is going on?

The Rohingya are a persecuted minority Muslim group, hailing from Rakhine State where many have lived for centuries. They are denied citizenship and subject to endemic and state-sponsored discrimination and abuse so severe that rights groups have identified actions as crimes against humanity. The Rakhine people, government and many Burmese reject the ethnicity and name Rohingya, favouring ‘Bengali’ and consider the Rohingya illegal immigrants from Bangladesh. Bangladesh refuses to recognise the Rohingya.

In a broad sweep, the violence in Rakhine can be characterised as ethno-religious and symptomatic of a much wider anti-Muslim sentiment that is on the rise across the country. As reforms have allowed greater space for public dissent, so too has nationalist Buddhist fervour and hate speech against Muslim minorities – exemplified by the anti-Muslim ‘969’ campaign and virulently anti-Muslim monk Wirathu.

Targeted attacks have been perpetrated against Muslim communities in Yangon and elsewhere – such as the killings in the central town of Meikthila in 2013, when houses and shops were burned, and over 40 murdered, including a group of students and their teachers massacred at a school.

Sectarian tensions are not new to Burma, and conflict not isolated to religious divides – Burma is home to some of the world’s longest running civil wars (e.g. Kachin conflict) where appalling human right abuses have been committed against minority groups. However, the waves of anti-Muslim violence starting in 2012 is the most severe seen in decades – and the Rohingya have to date suffered the brunt of this violence.

Rakhine State suffers extreme levels of poverty, and the dominant population, the Rakhine people- echo grievances of longstanding neglect from the central state. Some have suggested a political root for recent events, with reports of groups of extremist youths turning up to carry out the worst of the violence – seeking, ostensibly, to destabilise the local area and garner support for the leading USDP party.

Certainly much of the violence is fed by fear: rumours abound that if officially recognised, the Rohingya would demand a separate state within Rakhine – or even attempt to establish Muslim rule and ‘wipe out’ Buddhists – fears that are happily fanned by extremist monks such as Wirathu, and not helped by violence against Burmese migrants in Malaysia.

So what is happening now? I hear that all the INGOs have been kicked out?

After several months of relative calm, the situation has deteriorated rapidly since Christmas when reports began filtering out of a massacre of 48 in the northern village of Du Char Yar Tan. The government has repeatedly denied these reports.

MSF stated that it had treated 22 people for injuries in the area, adding fire to a simmering hatred of INGOs in Rakhine State – most of whom are seen as partisan for their needs-based approach to aid delivery (which ultimately ends up skewed towards Rohingya, who constitute the vast majority of victims). Protests against INGOs in general and MSF in particular escalated until in March all MSF operations were suspended nationwide (later resumed, except in Rakhine). Further protests degenerated into mob violence, systematically targeted at INGO compounds and forcing agencies to evacuate. Negotiations are now ongoing for UN and INGO return.

These attacks appears to have been exacerbated in part by Wirathu’s visit to the region in recent weeks, to conduct a series of anti-Muslim rallies, and the UN-backed national census –which until recently would have allowed Rohingya to register. Under pressure, this has now been rescinded and Rohingyas forced to register as Bengali or not at all.

Rakhine Crisis, Burma (Myanmar) – Resources

April 10, 2014August 3, 2014 / aidleap / Leave a comment

What are the papers saying?

Coverage tends to be patchy. The national papers cover the crisis pretty comprehensively, though with some considerable divergence in quality depending on their editorial line. Some reliable sources:

The Irrawaddy report on Sittwe attacks on INGOs

The Myanmar Times on the impact of INGO pullouts

DVB ask whether authorities are actively undermining efforts to resume aid

Spikes of violence have captured international attention – but interest has waned just as rapidly, as the humanitarian crisis rumbles on with no immediate solution. The international press only picked up the story of NGO expulsion a number of days after it occurred.

Reuters have had consistent coverage of the situation as a whole, and the recent evacuations covered here, and here.

Reuters have also been conducting some excellent research into the trafficking of Rohingya refugees.

CNN ran a story on protests against aid workers and have covered a handful of stories on violence in Rakhine, including this one.

This BBC magazine piece gives a good insight into the harsh realities of everyday life for those Rohingya living in Sittwe town.

Radio Free Asia have had some coverage of recent events.

Time covered the census, and got their magazine banned in October for running this frontpage article on extremist monk Wirathu.

The Guardian covered the census, but not the evacuation of aid agencies.

The Washington Post published a short opinion piece.

Recent Al Jazeera reports have focussed on the Muslim/Buddhist divide and the Du Char Yar Tan massacre. They ruffled feathers some time ago with this documentary suggesting that the crisis is a ‘hidden genocide’- with material later called into question.

What are others saying?

Human rights organisation Fortify Rights have been outspoken in their criticism of discriminatory state policies, and published a comprehensive report documenting state support for abuses committed against the Rohingya population.

Human Rights Watch have published a number of reports, including this statement on the consequences of intercommunal violence, and this report, ‘All you can do is pray’.

Physicians for Human Rights produced a meticulous narrative investigation into the massacre of a group of students and teachers in Meiktila, which gives insight into the systematised levels of brutality being perpetrated against Muslim communities.

Campaigning organisations such as Burma Campaign and End Genocide have also produced various reports and labelled the situation a forgotten genocide and calling for international intervention.

What about some basic background info?

This ICG report is a good overview.

The BBC have a basic Q&A that is useful for getting a few key facts but not much else.

The UN Myanmar Information Unit is a good place to go for humanitarian data – maps, 3W, UN sitreps and other info.

Here is the latest UNOCHA Humanitarian Bulletin 1-28 February 2014.

More broadly, The Global Post recently did a very interesting joint venture between Burmese and American journalists, exploring various aspects of the reforms.

Some Twitter handles…

@Reaproy – Phil Robertson, Human Rights Watch Asia Director

@AungMoeWin – prolific Burma-related tweets

@FortifyRights – Human rights organisation with a strong Burma focus (also @MatthewFSmith)

@DemocVoiceBurma – Democratic Voice of Burma

@david_m_stout – Journalist covering Burma

@IrrawaddyNews – The Irrawaddy

@TheMyanmarTimes – The Myanmar Times

@Atomicalandy – Tweets on Burma and SE Asia

@AmyAlexSmith – Human rights researcher with focus on Burma and SE Asia

@MatEick – ECHO SE Asia regional information officer

@burmapartners – Human rights, democracy and peace network

@Journotopia – Reuters journalist covering Burma

@htwenge – Burmese journalist for Myanmar Times

@JessicaMudditt – Freelance journalist based in Yangon

@JonahFisher – BBC Burma correspondent

@tayzar44 – Freelance photojournalist

@Hanna_Hindstrom – Freelance journalist and researcher on Burma

Missed anything? Send us additions, comments or corrections to share with our readers!

The Boy Who Cried Wolf*

April 7, 2014January 2, 2015 / aidleap / 1 Comment

In August 2007 an earthquake measuring 7.9 Mw hit the central coast of Peru resulting in the deaths of over 500 people and the destruction of more than 60,500 homes. Further up the coast, towns and cities were told to prepare to evacuate as they suspected that the earthquake would create a deadly tsunami. There were even warnings as far off as Hawaii. Many in northern Peru rushed back to Lima and beyond to check on family members, many of whom could no longer be contacted by phone. The one highway was packed both ways with those rushing home and others rushing out of the capital to escape what they feared would be equally strong aftershocks. Though many in the north started to pack and the wealthy readied their vehicles, there was little to no movement. Those with international news channels sat watching CNN for reliable information.

On April 1st an earthquake of 8.1 Mw hit the north coast of Chile resulting in the deaths of 6 people and damage to over 9,500 homes. Along the western coast of South America, towns and cities were told to prepare to evacuate as it was suspected that the earthquake would create a deadly tsunami. There were even warnings as far off as Mexico. In Peru’s coastal towns most people carried on as normal. This earthquake had taken place in a different country and after all, they had been told to evacuate before. Some laughed as the ‘tsunami’ constituted a wave 2 inches larger than normal. But in northern Japan waves of 40 cms higher than normal were recorded.

Fortunately the earthquake this week had a much smaller impact on the lives of Chileans than the 2007 quake had on Peruvians, partically in Ica and Pisco.

However, there is one potentially deadly consequence of the events of this past week. Following two false warnings and the tiring energy that it takes to prepare your family for evacuation, the worry of where you will go, how you will get there and for how long you will have to stay, will Peruvians and Chileans take future warnings seriously?

Information is power. Few have access to the scientific knowledge and technology to predict natural disasters and it is recognised that the information we do have is not always perfect. It is the role of those who have the information and the knowledge to interpret it to share that with affected populations, but how can we avoid ‘the boy who cried wolf’ dilemma endangering people in the long run?

*This title refers to Aesop’s fable but does not mean to infer that those with the information are intentionally crying wolf, but rather that we need to be aware of the end of this fable.

AID LEAP

A motley group of international aid bloggers, practitioners, and critics. Interested in impact, poverty, evidence, and throwing things off planes.

Month: April 2014

What About Our Mental Health?

Rakhine Crisis, Burma (Myanmar) – Sitrep

Rakhine Crisis, Burma (Myanmar) – Resources

The Boy Who Cried Wolf*

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