I lay in a hospital bed, just months after I started my first international job. I had swollen joints, blurred eyes, high fevers and no diagnosis. Doctors didn’t know what was wrong. Four weeks later I was better – and by then knew what had happened. The lesson was one of the biggest gifts of my life.
I had agreed to teach in an isolated town. I was young, alone, the only person who spoke English, out of my depth in the work – and too proud to ask for help.
And so I got sick; sick from stress I didn’t know how to handle. To paraphrase a stress expert, it wasn’t my being there that made me sick – it was my reaction to being there.
Stress is nature’s way of calling attention to the fact that we feel threatened and may need to fight or take flight. I was too proud to flee from the challenges I faced, so my body went into fight mode instead. That was helpful for a few weeks, but ultimately it exhausted me. Not equipped to manage sustained stress, my body and spirit got tired. I literally fell over.
In the hospital I realized I needed a different way to deal with my situation. I developed new behaviours and attitudes and worked in that country, happily, for several more years.
Just as we learn to wear seat belts in cars and to sleep under nets in malaria country, all of us need to develop practices to manage the stress that is part and parcel of our international careers, whether we work in Lahore or London.
Stress and Humanitarian work
People who work in refugee, disaster and post-conflict situations are uniquely exposed. Stress feeds a silent epidemic among humanitarian workers, with symptoms ranging from fatigue and cynicism through burnout. None of us is immune. Good intentions and past experience may not adequately prepare us for our next time out. We need to practice “safe stress.”
It is an epidemic. According to the Headington Institute, at any moment:
25% of humanitarian workers may be experiencing significant anxiety or depression.
10% of humanitarian workers carry psychiatric issues such as depression, anxiety or PTSD from one assignment to the next.
At least 15% of humanitarian workers appear to increase alcohol or other substance use to hazardous levels while on mission, in response to stress.
And stress affects us even when we aren’t in a disaster or war zone.
Stress in "peaceful" assignments
According to studies on international business travel and work:
Personnel taking more than three short missions a year file health claims for anxiety and stress three times more than stay-at-homes.
40% of workers in most postings reported being unprepared for the stresses encountered.
Burnout –in short or long term assignments – is one of the top five challenges for international staff.
Not dealing with stress is costly
Those of us struggling with stress are anxious, worry about damage to our reputations, and may lose confidence in our own abilities.
Unmanaged stress is expensive for employers. Dun and Bradstreet estimate that between 5% and 20% of people posted abroad come home early because they can’t cope. Each of these early returns means:
– a loss of productivity while recruiting and fielding a replacement;
– significant additional time and financial costs;
– the loss of established relationships with local partners.
The risks can be managed
All of us go abroad with knowledge and skills to use in dealing with stress. At home, we know to eat well and get adequate sleep and exercise during an intense period of work. Those strategies will serve us well when we are abroad – and they can be complemented with others that veterans recommend.
The best companies and agencies acknowledge and create strategies for stress management. They educate both headquarters and field staff. They support families. They promote self-care measures. They provide support and care before, during and after assignments. They recognize that risk management reduces liability and increases productivity or profit.
What can you do?
Draw up a “balance sheet” of imagined rewards and risks in your assignment. It is in your power to change the balance. We can act to increase our levels of satisfaction and pleasure, and we can lessen the impact of each discomfort and risk.
Step one: Get two pieces of paper. Label one “Rewarding” and the other “Worrying.” Divide each page into two columns. In the first column of the Rewarding page make a list of the good things you hope(d) for or are experiencing from the assignment. In the first column of the second page make a list of the real or feared discomforts and fears.
Step two: Work through each item on each of the lists and consider strategies to change it in the second columns. You hoped to make new international and local friends. What can you do – this week – tomorrow evening – that will lead to meeting more people with whom you might have a positive connection? You have trouble sleeping because of noise through the night. What can you do? [Tip: one colleague who lived next to a building hosting a loud night club learned to sleep with one ear buried in a pillow and an index finger tucked in the exposed ear.]