In Cebu, in the Philippines, on July 30th 2018, a significant milestone in the way NGOs prioritise and support the mental health and wellbeing of workers was marked. The launch of the first dedicated 'Wellbeing Cluster'. Here Hitendra Solanki, Action Against Hunger’s Project Lead for the Mindfulness & Wellbeing Project urges NGOs to act now to protect worker’s mental health and wellbeing.
Last to the party.....again?
It seems in recent years, that the humanitarian sector is often 'late for the party' when it comes to the important areas it needs to address.
Take, for example, the seemingly panicked and knee-jerked reactions on issues around duty of care, and more recently, safeguarding.
Respectfully, isn't it time we prepared for the party this time, rather than awaiting the next big thing, the next high-profile incident, to happen to us?
The mental health of aid workers does not need to be the 'next big thing' or have to be the next 'high-profile incident' to knee-jerk us into action. It's already here and has been a very well-known slow-onset crisis for years.
Calling it a major humanitarian crisis is not being dramatic, it's simply a fact.
For years it seems that the data and research urging us to address stress, anxiety and burnout, through an emphasis on preparedness and prevention, within the humanitarian sector has been compelling. But here are some recent statistics again.
The Guardian newspaper conducted a survey of humanitarian workers in 2015. The results revealed that an astonishing 79% of the 754 aid workers surveyed had experienced mental health issues, of which 93% indicated this was directly related to working within the humanitarian sector itself.
Other recent research into the wellbeing of humanitarian workers has also revealed similar shocking findings. Research conducted in 2011, compared the rates of Post-Traumatic Stress Disorder (PTSD) in the US and European general population, approximately 6.6%, and 1.9% respectively, to humanitarian workers. The researchers observed that aid workers had PTSD rates that ranged from 8% to a staggering 43%.
In addition to these disturbing statistics, a survey conducted by the Mindfulness & Wellbeing project component in late 2016 also revealed that 48% of deployed staff had indicated they had experienced ‘a threat to their life’.
These surveys illustrate the exposure to stressful and traumatic situations, and the chronic state of stress and mental illness experienced by aid workers in the humanitarian sector, and the need to prioritise mental health.
I wonder? Are we waiting for that high-profile incident to happen to us? Will we be late for the party again?
If we are not acting now, when 79% of staff have reported a 'mental health issue', at what actual percentage figure will we feel it appropriate to do so, and at the scale required, as a sector?
We cannot, and should not, wait for a major incident to knee-jerk us into a reaction. If an individual's performance is significantly affected by mental ill health, the implications for our organisational performance, and indeed our impact as a sector for our beneficiaries, will inevitably be affected.
Wellbeing Clusters – mainstreaming mental health
This is where the Wellbeing Cluster model has the potential to become an important component in the humanitarian architecture, and a way that can mainstream mental health and wellbeing, not only for ourselves, but also the communities we support.
The Wellbeing Cluster being piloted in Cebu, may potentially be the first of three major localized clusters across the Philippines, and perhaps, even, globally. Indeed, discussions are already underway, and look promising, in replicating the model in Luzon, in the northern part of the Philippines.
In its simplest form, ‘clusters’ will link local and national NGOs, with INGOs, governmental departments, academia, youth organisations, the private sector, CSOs, and other key stakeholders to work together in strategically building the capacity of both individuals and organisations in all aspects of wellbeing related to mental health.
Collaborative approach
The Cebu Cluster has already been recognised and integrated into the Department of Health, and initial resources have been allocated to further operationalise it. The University of San Carlos, Ateneo de Manila University, University of the Philippines, London South Bank University, and Oxford Brookes University have also linked with the Wellbeing Cluster.
Together they are working on various research to map out mental health needs and to pool knowledge, resources, and services around mental health and psychosocial support. In addition, supporting the endeavor are, the Humanitarian Leadership Academy, Plan International, Philippines Red Cross, a large number of local NGOs, and of course, Action Against Hunger UK and Philippines as the lead agency.
Chief amongst the local NGOs, and providing inspired local leadership, are the Central Visayas Network of NGOs (CENVISNET) and the Ramon Aboitiz Foundation Inc. (RAFI), both based in Cebu, who have been instrumental in taking the global vision and making it a reality on the ground. The strategy of using the 'hijacked' term Cluster worked, and in the early planning and design stages, UN OCHA attended and participated in the design and consultation meetings. Further liaison with the UN is envisaged, and will continue as the wellbeing cluster evolves. In the Cebu Wellbeing Cluster stakeholder agencies are now working together, and steadily operationalising and pooling their knowledge, expertise and resources.
The public launch of the cluster on July 30th and 31st was attended by nearly 200 people, and over the course of two days, the various stakeholders signed the 'Cebu Accord', agreeing to the key principles of the cluster model, and presenting and committing to the vision both locally and globally. These principles will form the backbone for future clusters nationally and globally.
The multi-agency approach means costs can potentially be reduced, training can be quality controlled and made more consistent, and the capacity of organisations can be increased. For instance, via, the promotion of wellbeing policies, training of trainers, monitoring and evaluation frameworks for wellbeing, and protocols around good practice. For small agencies, and CBOs, this means that high-quality training and services will be accessible, allowing for the elevation of practices and capacity on wellbeing for entire communities.
A local approach
The localized approach also means that the wellbeing needs can be contextualized where appropriate, and that cultural taboos and stigma around mental illness may also be challenged by differing perspectives from other approaches globally. Importantly, the localized ‘cluster’ approach means that individuals and organisations can connect and grow together in challenging and catalyzing mental health issues, and in building capacity together as a community, rather than in isolated pockets. This working together may allow for greater coordination before, during and after a crisis or disaster.
Prevention, preparedness and post-crisis support
Importantly, the focus on prevention and preparedness is a key emphasis for the wellbeing clusters, as it links directly to building capacity and resilience at both individual and organizational level, and to ensure that agreements and coordination mechanisms are agreed prior to a disaster or crisis occurring. This emphasis on preparedness may ensure that the wellbeing support is prioritized and made available to personnel at the grassroots level during emergencies, further supporting resilience and in mitigating stress and trauma where possible.
Additionally, post-crisis, the wellbeing cluster agencies will be better prepared to support personnel affected or requiring support following their interventions, via suitable services and training available at local level.
Global and Local Cluster - Next Steps
As the Cebu Wellbeing Cluster now begins to operationalise, several key working groups have now been organised to begin the important work of delivering services, designing training materials and resources, communicating and advocating on mental health, conducting academic research, mapping needs, and in developing strategies for both 'peacetime' and humanitarian phases of response.
It is paramount that the lessons learned thus far, and in the preceding months, are captured and documented. This learning process is also a key component of the ongoing work and will help to establish guidelines and templates, as well as support services and resources. These will be an important resource for supporting the replication of potential clusters regionally and globally.
A global approach
In parallel, Action Against Hunger UK have begun developing the UK Wellbeing Cluster. This will be based on the same principles but will form a global approach, with a focus on advocacy, training and resource development, research, and innovation. A group of core agencies, experts, and other professionals, that were involved in the Mindfulness & Wellbeing project component of the DEPP's Transforming Surge Capacity project are working together to establish the cluster in late August.
The UK and Cebu Wellbeing Cluster working groups will also be connected, so that the policies and protocols collaboratively developed and are relevant. The learning from these global-local working groups may also leverage greater awareness and resources to tackle mental health globally.
In addition, Action Against Hunger UK is also preparing to hold a major two-day Wellbeing Conference in the coming few months. These will be held both in London and in Manila, and as well as presenting and advocating for the Wellbeing Cluster model, as a necessary component of the humanitarian architecture, will present and showcase innovative ideas and practices on humanitarian wellbeing, as well as offer practical tools, resources and materials to help further disseminate good practice and advocate for mental health globally.
A Movement for Change
In the wise traditions of prevention, rather than cure, it seems wiser that we not only attend the party, but we make sure we organise it ourselves. We really should not be late for this party this time.
The creation and pilot of the first wellbeing cluster in Cebu offers a potentially practical and tangible opportunity for agencies to address, mainstream, collaborate, mitigate, and positively change the way in which mental health is managed in the humanitarian sector.
The approach may be new, but the need definitely is not. As such, the creation of the wellbeing cluster in Cebu is an important and significant first step towards a better way to support our workers, not only in the Philippines but perhaps globally also.
Hopefully, this milestone will bring us closer to journey's end. A place where mental health and wellbeing of our staff, indeed ourselves, and our beneficiaries, is genuinely prioritised, nurtured and celebrated.
Perhaps for next World Humanitarian Day?
For more information about the Wellbeing Cluster, and initiatives, please contact Hitendra Solanki, Mindfulness & Wellbeing Adviser, Action Against Hunger UK at h.solanki@actionagainsthunger.org.uk
Read more about the DEPP's Transforming Surge Capacity project.