Humanitarian Aid Workers Are Not Unbreakable

On the second anniversary of the COVID-19 pandemic, Doctors Without Borders/Médecins Sans Frontières is releasing the “Silent Wounds” video series. We know that humanitarian aid workers experience moral dilemmas in their work; this is not new, nor is it specific to COVID-19. But the pandemic has brought to light what it means for aid workers to deliver medical assistance in sub-optimal conditions and to be presented with only poor choices.

Early on in the pandemic, our medical staff did not know how to prevent or treat this disease, which limited the care we could provide. Shortages of medical oxygen made it impossible to treat many severely ill people or provide appropriate end-of-life care so people could die with dignity. Staff had to deal with the unknown both at work and in their private lives. Their risk of contracting the disease was higher due to the lack of personal protective equipment.

Personally and professionally, having to make imperfect decisions, even knowing that those decisions led to the least harmful outcome, can generate feelings of inadequacy, meaninglessness, and frustration. Such feelings are symptoms of moral distress.
To shine a light on the direct and indirect impacts the pandemic has had on our staff and to offer a space for them to share their stories, MSF created “Silent Wounds,” a video project along with a research study of experiences that bring about moral distress. We did this to better understand the ethical challenges our staff face. Such understanding is essential to developing the resources we need to support them.
Read more here https://arcg.is/1GiaaX
See the full video series here: https://bit.ly/3sRG7je

Donatella Paioro is a psychologist with MSF, and Miriam Kasztura is a researcher.

Video transcript:
Donatella Pairo:
I think that we have a bit to demystify the fact that humanitarian workers are heroes and are untouchable or unbreakable. As an emergency medical organization, the humanitarian workers are exposed to the death of our patients, to the limitation of means and equipments that we can have, to the large scale of problems that we can face. This is part of our world. This is also part of what we choose to do. This doesn't mean that it is easy.

Miriam Kasztura:
When the first wave came, there was very little knowledge of the disease, of what COVID actually is, how it is transmitted. What kind of PPE do we need to protect ourselves and the healthcare workers? How can we treat it? There was a limited amount of knowledge. It was extremely difficult to move people across borders suddenly, or material. That confronted teams two situations where they've seen immense need to intervene because people had COVID-19 and were really sick and needed hospital care, sometimes intensive care, and we were not able to provide.

Donatella Pairo:
We had to adapt to this unknown. We had to adapt to the lack of control on our lives and on the choices that we were used to to make. We realized that it is not easy. There is still a lot of stigma, mental health. And I think that COVID helped to talk about the problems that people can face in their normal life.

Miriam Kasztura:
If these situations, these experiences of moral distress are accumulated, one after one after one, they can, in that sense, lead to very strong frustration and burnout, and that is then a condition that would need psychological support. The accumulation of model distress in individuals and in teams has an impact on the quality of care we are able to provide, and that is a very clear link. So, the more we work in supporting individuals and people to deal positively with model distress, the better our quality of care will be as well.

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Doctors Without Borders/Médecins Sans Frontières helps people worldwide where the need is greatest, delivering emergency medical aid to people affected by conflict, epidemics, disasters, or exclusion from health care. Learn more at https://www.doctorswithoutborders.org

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