I worked in humanitarian disasters - AMA

[Moondust001]

Inspired by a thread about the current situation on St Vincent's Island. I spent 30 years travelling around the world as a "first / early responder" to natural and man-made "disasters" - from war zones to famines to earthquakes.

AMA.

[BlackCatShadow]

This may be a weird question, but I think people are often quick to exploit those who are vulnerable and that seems to be the case in Haiti. Is this a big problem do you think? I’m thinking of cases like aid workers exchanging sex for aid and governments stealing food meant for people. It’s such an awful thing to happen to people.

[YouAintKingDingALing]

Did you work for a charity or were you an independent consultant?

[Moondust001]

@YouAintKingDingALing
I worked mostly for NGO's (many of which are also charities or have charitable arms). Notably UNHCR and MSF, but also some others.

@BlackCatShadow
Not weird at all - it's actually one of the most commonly asked questions! Which is kind of sad. These are two different things so I am going to answer them separately if I may...

Governments or others in official positions can be corrupt, so yes, money and do "go missing". I won't pretend that everyone that people elect or appoint to look after their best interests actually does so. However, we need to be cautious about the assumptions that are often made. It's "them people over there" who are corrupt, "innit"? The West, collectively, are in no position to throw stones though - look at the recent stories about appointments to jobs that people aren't qualified to do (Track & Trace?) or contracts awarded for the supply of PPE (some of which appears not to work anyway) in the UK. So yes, corruption happens. It happens everywhere.

Exploitation is something different. Again, I am not going to say that it doesn't happen. It does. In my experience, it seems to happen less in my field than in some aid work. I suspect for three reasons. One, we are not on the ground long-term compared to many aid agencies who may work an area for decades. Two, we most often deal with the immediate aftermath of situations, it's long hours and intensive work and frankly, I can't recall actually being awake long enough at the end of the day to have time for sex. Or eating, at times. Third, at least where I was responsible, anyone I caught would have been on the first plane out - it wouldn't have been tolerated, and I don't know many who would tolerate it.

That said, yes, of course it happens. Wherever people have power over others, there is always a risk. But again, aid workers etc are not saints. They are ordinary people. And things that happen in ordinary lives happen in our lines of work too. Have you never heard of a workplace boss who sleeps around with juniors staff? Or harasses them? It shouldn't happen - no, but we also shouldn't be held to a higher standard and everyone blamed for the poor actions of a small minority.

I'd add one further comment on that - and it will be controversial, but I am trying to be honest about real life here, and not life as we might want it to be. There is never any excuse for anyone to exploit the vulnerable in these circumstances, but the vulnerable aren't angels either. Sometimes they are complicit in this because they know it is a way to get better treatment. I am not in any way saying that they are to blame, but it is complicated when people are also away from home, exhausted, perhaps struggling with what they deal with on a day to day basis, to then turn away offered "comfort". I'm probably going to get crucified for saying that, but it's a real issue, so I won't duck saying it.

That is why I always operated an absolute on this - no concessions, no reasons, no excuses; you will be on the first flight home. It's always tough, because people can and do form real and honest relationships, and I know people who have - but how do you judge? My method was, if you want to come back on your own dollar and without the job, that's the measure. It probably wasn't perfect, but it was the best I could do.

[BlackCatShadow]

Thank you for taking the time to answer my question. I really appreciate it.

I think it must be very rewarding work but emotionally very hard too.

Are you still doing this kind of work? If so, where are you working now?

[Moondust001]

No I am not longer doing this. Unfortunately, I developed rather bad arthritis about 5 years ago - my mobility is now extremely poor. I was old enough to retire (early) - but I got bored! So I now manage a programme that works in deprived UK communities.

Yes, it is rewarding; and yes, also very hard. It's only for the resilient - you have to care enough to want to do it, but you also have to be able to detach from what you see and hear as well. It's a balancing act. I don't know if anyone has ever done a study on it, but from personal experience, I'd say that probably 60 - 70% do a few years and no more, and a big part of that is burning out.

[Bzzzzzbumblebee]

My daughter is interested in this. How did you get into this and how safe were you?

[Moondust001]

I trained as a doctor, qualified, and then took a short contract in a medical aid NGO. Kind of never left. Just moved! To do this sort of work you must have relevant qualifications. That's also mostly true of aid work, but you can volunteer or get low paid work experience in longer term work.

Is it safe? Not remotely. It's safer than what the people you work with gave most of the time. But no, not safe. You can, however, get run over by a bus in the UK. I'm a believer that whatever your allotted time is is the time you have, and so what matters is what you do with it. You never really think about safety.

[Mumoftwoinprimary]

Thank you so much for setting this up. I have loads of questions as it fascinates me:-

What is it about you that meant that you could do it for 30 years and not burn out?
In an average year how many disasters did you go to and how long were you at each one for?
Do you have a “preferred” type of disaster? (I always think war would be harder to deal with than an earthquake for example.)
Did you ever refuse to go to any disasters?
Were you able to have a private life? (Spouse? Kids?) If not - was that a sacrifice you made or something that you didn’t want anyway?
How do you avoid the whole “I feel useless” feeling?
Would it be something that someone who worked in logistics could have got involved with? (I was once a mathematician and when I graduated I looked at jobs in actuarial and also logistics. I went for actuarial in the end and have been an actuary for many years. But I do wonder occasionally about working in logistics and what “might have been”.)
Were there a lot of relationships between the aid workers and was that discouraged, accepted or encouraged?

[Moondust001]

Wow!
What is it about you that meant that you could do it for 30 years and not burn out?
Hard to say - the right personality type? - being able to see the bigger picture? This isn't work for people who care too much, like I said - sympathy, empathy or whatever you want to call it, too much of that and it'll kill you. You need to be able to use it, but also to be able to turn it off. It isn't a unique quality. Why be a doctor and specialise in oncology? Often times that won't work out well either. You just have to believe that what you are doing will make a difference, even when it doesn't. Small pictures are the losses, big pictures are the wins. Does that make sense?

In an average year how many disasters did you go to and how long were you at each one for?
It depends on where you are needed and for how long. Bear in mind we generally get long "holidays" after a work detail! But seldom more than one a year, unless exceptional circumstances, although that might involve moving around or different field sites. Haiti, for example, was about nine months for me, in two "shifts", but all on one site. Bosnia was nearly two years, but again broken up into "shifts", and this time in different field locations as needed. The shortest were probably the 2004 tsunami, because that was very much about stabilisation and then handing off to longer term solutions; and my last field setting in Nepal's earthquake.

Do you have a “preferred” type of disaster? (I always think war would be harder to deal with than an earthquake for example.)
No. I have never really thought about it like that. But I guess that it's easier to come to terms with what nature does than what people do. Nature acts without malice.

Did you ever refuse to go to any disasters?
No, not as such. Once I was asked "if" I could go into the field, but there were reasons why I needed to be at home for that time. You don't refuse, although I guess it never crossed my mind to. But you aren't forced to go anywhere either. It's more a discussion, and sometimes the outcome of that discussion might be that you aren't the best person to be there.

Were you able to have a private life? (Spouse? Kids?) If not - was that a sacrifice you made or something that you didn’t want anyway?
Whew, that's a hard one. I wasn't particularly keen on having children - it was never in the plan, I'm not maternal as such, and I can't abide babies. But yes, I married someone in the same field of work, and ended up as step-mom! But it was perhaps not the most conventional of lives for any of us. My husband died a decade ago, perversely in a car crash in the UK. The kids - one is a doctor and the other a university academic. So I guess you could say yes to the private life, albeit rather unconventional.

How do you avoid the whole “I feel useless” feeling?
I think you mean getting overwhelmed by it? You don't have it in the first place. You count what you've achieved, not what you haven't. You can't control everything. And being kind of blunt, many of the professions and character types involved - well, we know we're good! You know how, no matter how good your doctor may be, the best of them are also a little arrogant? I guess that's one of the qualities that many of us have, whatever the profession. A bit of arrogance.

Would it be something that someone who worked in logistics could have got involved with? (I was once a mathematician and when I graduated I looked at jobs in actuarial and also logistics. I went for actuarial in the end and have been an actuary for many years. But I do wonder occasionally about working in logistics and what “might have been”.)
Yes. Absolutely. I was lucky and was good at medicine and logistics (although the latter was a talent I didn't know I had). We get quite a few ex-military in the logistics area too. Moving quickly, efficiently and without forgetting anything, plus being able to think on your feet if anything goes wrong - every site needs several of those.

Were there a lot of relationships between the aid workers and was that discouraged, accepted or encouraged?
I wasn't joking when I said that we were often too tired to think at the end of a day, or night. Aid work is different, longer term, but I think probably the answer is yes there would be relationships. For us, yes some. Some marriages / partnerships like mine. I'd have to opt for the middle choice - accepted. Consenting adults, not the people we work with, well it was no big deal. One of my closest friends was a translator in Bosnia, and married a UN peacekeeping officer. I'd have to say that few people managed to stay in the life and also have a family life - but it wasn't at all unheard of.

Does that answer all your questions?

[Mumoftwoinprimary]

It does. Thank you. It sounds like you have had a fascinating life. I am sorry to hear about your husband.

[Phrenologist]

What exactly were you primarily doing,OP — presumably not ‘pure’ emergency medicine? Setting up field hospitals? Do you have excellent language skills?

[Haydaywithbellson]

I know you have not posted for praise but you have achieved something really worthwhile with your life (so far! It's not over ) which many of us cannot say.

[tedx]

I have loads of questions!

How much did you earn?
You said you need the right qualifications, you are a doctor but what other qualifications did you mean?
What was one thing that you've seen / experienced that has stayed with you?
What did it teach you about people, the human race?

[blueshoes]

OP, what is the personality or traits of a person who would do this. Why do you choose the hard and high road when you could a comfortable more stable and conventional life.

I am full of admiration for people like you. I would get secondary PTSD in a moment and question God immediately if I even saw a fraction of what you do on the field. Just reading about it makes me so sad and, where it is cruelty that humans inflict on each other, angry. How do you deal with these emotions.

[Enrosadira]

Have no questions at the moment OP but thank you for this thread, it is so interesting.

[Maskedrevenger]

How do you cope mentally with “repeat events” such as repeated famines in certain parts of the world. For us watching news bulletins at home, we can donate, raise awareness, do what little we can then in a few years it’s happening again on a bigger scale it’s heartbreaking.
What is the most effective way that we can help?
Now you are back home do you take normal things for granted again like plentiful food, reliable electricity, sanitation and running water?

[Enrosadira]

Have a question: what’s the shortest and longest time a stint has lasted?

[Nevth]

Thanks for this thread OP, incredibly interesting! Will return with some more questions this evening...

[Steph64]

Are some NGOs and charities more efficient than others?

What can I do to ensure my charitable donations are most wisely spent?

[jay55]

Did it put you off normal travel/holidays?
Were you able to switch off properly when home or were you always waiting for the next disaster?

[Moondust001]

@Phrenologist

What exactly were you primarily doing,OP — presumably not ‘pure’ emergency medicine? Setting up field hospitals? Do you have excellent language skills?

Not A&E no. Field hospitals and/ or emergency camps - think about a village thrown together that provides everything you need for basic life - food and water, shelter, medical services (not just emergency ones either), power or other fuels.... More often than not it is about organising a village for people.

[Moondust001]

@Mumoftwoinprimary

It does. Thank you. It sounds like you have had a fascinating life. I am sorry to hear about your husband.

Thank you. And yes fascinating...

[Moondust001]

@Phrenologist

What exactly were you primarily doing,OP — presumably not ‘pure’ emergency medicine? Setting up field hospitals? Do you have excellent language skills?

Oops sorry - missed th language skills. Not bad, and I pick up smatterings quickly. But no, not entirely necessary as we have translators. Nobody could possibly be proficient in the number of languages required.

[Moondust001]

@Haydaywithbellson

I know you have not posted for praise but you have achieved something really worthwhile with your life (so far! It's not over ) which many of us cannot say.

I don't agree. I think everyone can and does do worthwhile things, whether that be raising children, teaching, making sure the supermarket shelves are stocked....Sometimes we don't value that which is seen as ordinary. For you, perhaps, it seems to be more valuable than whatever you do - but to me it's quite ordinary. Like I said before - do not put me in a room with babies because I'd rather have two armies bearing down on me...

[Moondust001]

@tedx

I have loads of questions!

How much did you earn?
You said you need the right qualifications, you are a doctor but what other qualifications did you mean?
What was one thing that you've seen / experienced that has stayed with you?
What did it teach you about people, the human race?

Okaayy...

How much did I earn... not as much as I might have done in a more conventional job, but more than enough to keep me happy.

In this line of work it isn't just medical staff we need (and a full range of them) but also engineers, specialists in water /sanitation.... I go back to that previous answer - we were often building villages. It takes all sorts of skills. Sometimes that would be available locally, but not always. Unskilled labour is easy, but much is skilled labour.

One thing? I honestly don't think I can think of one thing, and the answer probably overlaps with the next question. The human race can be incredibly cruel, selfish and insular, and anything else terrible you can think of. We say "never again" and then do it again. Repeatedly. But they can also be selfless, self-sacrificing, and bloody brilliant! I kind of hope that the latter always outweighs the former and that eventually we get to a point where it doesn't need to.

That has made me think of the one thing! It's actually a photo I took - I'll try to track down the original and scan it. It was in India. I was working in an "untouchables" community. As I was working I looked up and following us along the rooftops was a girl - a child, probably 10 or 11. She was following us and watching what we were doing. She didn't know I was watching her, and I took a photo of her against the skyline. She looked confident, curious, intelligent, powerful - all the things that the women of her village no longer looked. She looked as if she could do and be anything she wanted to be. It was the raw power of what could be, and probably wouldn't be. I have often wondered what happened to her. I never met her. I'll never know. But I hope it was something glorious.