Dr. Donald S. Bosch
Clinical Psychologist, Headington Institute
The coronavirus (which causes the disease officially named COVID-19) has been declared a public health emergency by the World Health Organization (WHO), which often brings feelings of uncertainty, fear, anxiety and worry to many of us and to our families. It can also lead to changes in mood and behavior. Some may experience a need to “do something” but you don’t know what to do. Others may feel a low mood and feel sad or hopeless.
The call to practice social distancing is now worldwide. Restrictive country closings and lockdown measures are increasing. A quick glance at the internet will find a plethora of advice on how to manage working at home and being more isolated. Keeping up contact with others remotely, exercising, maintaining a regular routine including your sleep schedule, setting aside days off or holy days with different routines, journaling, and simply getting up and dressing as normal are all important and helpful tips.
However, there are some unique challenges we face as humanitarians during this pandemic. As a whole, humanitarians approach communities and individuals in distress by stepping forward and reaching out to them. Distancing and isolating are foreign to our helping desire. You see the faces and names of families and children in IDP and refugee camps around the world. Their stories and living conditions are personally known by you. You have interacted with them and have often provided life sustaining assistance to them. Under the current circumstance, both expat and national staff are now facing increasing restrictions on your ability to respond for an indefinite future. This can result in a variety of personal challenges. I’ll touch on a few of them below.
Moral Injury
As it is becoming increasingly clear that everyone is vulnerable to Covid-19, you have to seriously think of yourself and your health. This results in a moral dilemma that is akin to operating in high risk security areas. How long do you stay in the danger zone? During some HEAT trainings ‘high threat casualty care’ is taught. The principle is that you save more lives by saving yourself first. It’s like putting on your own oxygen mask first before helping others on the plane. In HEAT simulations participants are forced to decide whether to go back into the attack area to help victims or to save themselves and not return. This engenders a visible emotional struggle as there is no clear moral solution. ‘Moral Injury’ results where our values and self identity clash with our actions and we can be left feeling guilt and shame.
Feeling Trapped
For those of you who have chosen to remain in the field or have been unable to get home due to restrictions, other psychological issues may arise. You may struggle with not being able to be more present with vulnerable loved one’s who wish you were with them. In the worst case scenario you may need to endure the death of a friend or relative from afar. Depending on how long the Coronavirus restrictions remain in place, you may begin to feel trapped or more isolated as the freedom to get home is not possible.
Loneliness At Home
For those who have been able to return home, other challenges can arise. For many of you your aid work community has become your family and primary friend group. Your ‘home’ friends and family have become more distant as their lives are so different from yours and you often feel like a fish out of water when you are with them. Being forced into close proximity for an indeterminate time can increase your loneliness and exacerbate underlying family conflicts that may have become dormant during your geographic absence.
There are no easy solutions to any of the issues I’ve highlighted here. I hope by ‘naming’ them you will realize you are not alone in your experience. Humans are attachment animals. Whether we lean more toward being introverted or extroverted, we all benefit by sharing our experiences. Sharing our anxieties and struggles make them more bearable. For this reason, virtual tools like open chat rooms where aid workers can share their experiences with fellow humanitarians is more valuable than ever. If you find yourself feeling like your emotions are becoming unmanageable consider reaching out for help. Don’t suffer this isolation alone. Someday, hopefully soon, we will all be back on planes or in the field doing the work we love.
For more information or counseling support please email: support@headington-institute.org.