Burnout is hitting humanitarians — but not for the reasons you'd think
From oppressive workloads to toxic cultures, humanitarian organizations are unintentionally burning out their own staff.
By Elissa Miolene // 04 September 2024The second time it happened, Kate Roberts made a decision. The aid worker — who was then focused on helping children affected by Syria’s civil war — swore she would never work at a humanitarian organization again. “I felt like I had experienced too many similar situations with too many different organizations, and I thought, you know what? This is the way it is, and it's not going to change,” said Roberts, speaking to Devex five years later. “So I left.” At the time, Roberts was traveling across Lebanon, Jordan, Turkey, and Egypt, providing psychosocial support to those facing unimaginable circumstances. But even so, Roberts felt like she wasn’t being heard — and as a result, she felt like she wasn’t making an impact. Roberts was experiencing burnout, a state of emotional, mental, and physical exhaustion brought on by stress. “It’s a pattern, and it’s very well known,” said Roberts, who now runs her own consulting company focused on aid worker well-being. “I didn't feel like it was okay for me to raise questions, or to push back, or to share my opinion if it was different.” Roberts is far from alone. Though the true rate of burnout among humanitarian workers is hard to determine, many studies report up to one-third of humanitarian staff experience psychological distress. In part, that’s because humanitarian workers are often bearing witness to conflicts, crises, and disasters that can leave lasting psychological scars. But more than that, experts say burnout comes from organizational culture itself, and the result of aid workers failing to feel supported, equipped, and valued while they’re on the job. “You can be in, for instance, South Sudan, and see that you’re doing good work,” said Kaz de Jong, a mental health adviser at Médecins Sans Frontières Amsterdam. “But if you have a lousy organization around you that doesn’t give you the resources, or a project coordinator who is bullying you, there comes a moment when you’re going to say: ‘Hm. This is not meaningful for me anymore. What am I doing here?’ That meaningfulness is really important, and as an organization, you have tremendous influence over that.” Why burnout happens Across the world, more than 360 million people are in need of humanitarian assistance. Famine has spread across the Gaza Strip. Millions have been displaced in Sudan. And gang violence has made life in Haiti unbearable. In each of those hotspots, humanitarian aid workers are doing their best to respond — and often, they’re forced to take pieces of the crises with them. In a recent study led by de Jong, three-quarters of the 600 aid workers surveyed reported facing “potentially traumatic events” on the job, such as experiencing physical or sexual assault, being exposed to a warzone, or witnessing extreme human suffering. “The goal of an aid worker is to save lives. When that doesn’t happen, or when they can’t do it, or when they’re not supported, it breaks them down,” said Diana Calthorpe Rose, who leads the Garrison Institute, a nonprofit that hosts retreats for organizations to think through the world’s problems. “There’s an emotional load that a good humanitarian aid worker carries with them when they go in to save a life.” Aid workers have also increasingly become a target themselves. The number of humanitarian staff killed more than doubled from 2022 to 2023, with 261 lives lost last year alone, according to the aid worker security database. This year’s death toll has moved at a similar pace, with 187 deaths registered by August 30. Nearly 65% of those deaths have occurred in the Gaza Strip alone. “The statistics are undeniable — it’s a high-risk occupation,” said Cheryl Yunn Shee Foo, a psychologist at Massachusetts General Hospital and instructor at Harvard Medical School. “But it’s not just about the adversities inherent in the work, or the individual coping abilities, skills, or resilience that an aid worker can build or learn. It’s really more of these chronic workplace stressors that are contributing to burnout way more than what is inherent to aid work.” Last year, Foo published a study focused on aid workers in Bangladesh, which has been home to one of the world’s largest refugee crises for years. Since 2017, 1 million Rohingya refugees have settled in the already-crowded nation, fleeing violence and persecution in neighboring Myanmar. Many have tried to resettle in refugee camps within Bangladesh’s Cox’s Bazar district, where services are stretched beyond capacity — and from 2020 to 2021, Foo and her colleagues spoke with local and international aid workers working there. Foo’s questions attempted to better understand how humanitarians were coping with what they were experiencing, assessing everything from poor living conditions to threats of violent attack. But Foo also asked about stressors in the workplace, and whether respondents found their work meaningful, felt a sense of job security, or had difficulty keeping up. Such stressors included sexual harassment, violence and bullying at work, discrimination, workload and pace, organizational culture, job security, and other factors. Overall, more than one-third of respondents screened positive for “moderate psychological distress,” and just over 8% were found to be experiencing burnout. Though both types of stressors impacted the aid workers, Foo found that those in the workplace were associated with higher levels of burnout and psychological distress, despite the overwhelming conditions in Cox’s Bazar. “One possible explanation is that work organization and communication stressors such as lack of role clarity and lack of recognition at work can contribute to low job control, which in turn strongly predicts mental health outcomes and burnout among humanitarian staff,” the study stated. In the same breath, it highlighted another study that found the number of past traumas was not associated with negative mental health outcomes, while other factors — such as higher income, long-term contracts, and previous psychosocial support — could actually protect aid workers from burnout. There’s also the meaningfulness factor. If aid workers were able to derive purpose from their work, that sense of meaning could serve a “buffering protective role” against burnout. That was something also noted by Alice Schruba, a psychologist and the director of training and education services at the Headington Institute, a nonprofit focused on the well-being and resilience of humanitarian workers. “Given the nature of aid work, our clients are always going to have some expectation of the heartache affected populations will be experiencing,” Schruba told Devex. “But what I’m seeing again and again is that stressors in the workplace override that.” Research by the Headington Institute underlines Foo’s. In 2021, the organization undertook a multiyear project with a large nonprofit organization in Lebanon, which hoped to assess how staff members were coping one year after a port explosion in Beirut left much of the city in rubble. While many of the staff members spoke about that crisis — along with the political and financial instability that came as a result of it — more than half of the 70 surveyed highlighted job insecurity, short-term contracts, and workload stressors as “highly stressful,” along with a culture of overwork and burnout. As a result of those factors, 45% of the organization’s staff members met the criteria for moderate to severe depression, Schruba said, and nearly 48% met the criteria for a provisional diagnosis of post-traumatic stress disorder. “A lot of organizations have really wonderful missions and really important values. But those values can run up against budgets and deadlines and goals that the organization has set,” said Scruba. “That has this cascading effect that really lands on the people on the ground, and forces them to make more with less while still having a high level of impact.” Why it matters Anthony Neal, the former coordinator of Sudan’s INGO Forum, has witnessed the ripple effects of burnout firsthand. After fighting erupted in Sudan’s capital, Neal and hundreds of other aid workers were forced to leave everything behind, first evacuating to Port Sudan and then leaving the country entirely. Though Neal eventually made his way back to Sudan, many others — especially those in the highest ranks of international organizations — did not. Especially in the early days of the conflict, less-experienced, mostly national staff members were left to fill their shoes, and required to push through their own trauma, devastation, and fear to take on elevated levels of responsibility. These staff members were being asked to deliver at an unprecedented scale, and month after month, those expectations took a toll. “Your ability to really add value deteriorates over a long time,” Neal told Devex. “As you get more and more burnt out and the trauma has more and more of an impact, you start to be less productive.” When it comes to burnout, there are some differences between national and international aid workers, Foo explained. National staff members report feeling underpaid and undervalued compared to their international counterparts; they also spoke about the struggle to balance the needs of their families and the needs of their jobs. International staff members report feelings of isolation, and difficulties of adapting to living in a different culture in a difficult country. Left unaddressed, psychological distress among both types of aid workers can lead to higher rates of accidents, illness, and absenteeism, along with lower productivity, performance, and commitment to their work. Burnout can also lead humanitarians to leave the field entirely — despite the fact that today, conflict, climate change, and economic drivers are throwing millions into crisis. “Organizations are very concerned with attrition,” said Foo. “But almost unequivocally, self-care or mental health for employees is probably the lowest priority budget line.” What can be done For MSF’s de Jong, it’s much more interesting to focus not on whether aid workers are burning out, but how they are staying healthy. In his 2021 study, de Jong and his colleagues found that international humanitarian aid workers on short-term emergency assignments experience a range of stressors that are, at least in part, preventable — that is, if such stressors are taken into account by the workers’ employers. De Jong’s study suggested managing staff members’ workload, implementing policies to curb sexual assault and harassment, and creating a culture of mutual support for coping with traumatic events, loneliness, and moral distress. In a conversation with Devex, he also highlighted creating a culture of communication, transparency, and feedback, and ensuring organizations have a comprehensive health support system that allows for follow-up before, during, and after an aid worker is deployed. Foo’s study had similar implications, while also advocating for increased benefits — such as time off and accessible health care — stress management training and team-building exercises to ensure staff members feel valued. And Headington’s Schruba spoke about more systemic solutions, such as ensuring programs have the resources they need to actually be successful. “These are very simple things, not rocket technology,” de Jong told Devex. “If you send people to these places on Earth where it’s difficult, then you have a duty to care for them.” But for Kate Roberts — who went from experiencing burnout herself to supporting others to combat the feeling — there’s one other essential ingredient for curbing psychological distress among humanitarians: starting from the top. “My clients want a job that is fulfilling, and where they feel they’re contributing to something meaningful and are valued by their team,” said Roberts. “That really starts with leadership, and it has to be modeled by top leadership, otherwise it won’t stick.”
The second time it happened, Kate Roberts made a decision. The aid worker — who was then focused on helping children affected by Syria’s civil war — swore she would never work at a humanitarian organization again.
“I felt like I had experienced too many similar situations with too many different organizations, and I thought, you know what? This is the way it is, and it's not going to change,” said Roberts, speaking to Devex five years later. “So I left.”
At the time, Roberts was traveling across Lebanon, Jordan, Turkey, and Egypt, providing psychosocial support to those facing unimaginable circumstances. But even so, Roberts felt like she wasn’t being heard — and as a result, she felt like she wasn’t making an impact. Roberts was experiencing burnout, a state of emotional, mental, and physical exhaustion brought on by stress.
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Elissa Miolene reports on USAID and the U.S. government at Devex. She previously covered education at The San Jose Mercury News, and has written for outlets like The Wall Street Journal, San Francisco Chronicle, Washingtonian magazine, among others. Before shifting to journalism, Elissa led communications for humanitarian agencies in the United States, East Africa, and South Asia.