Care and Cohesion, Amsterdam May 19, 2006
Organized by the Antares Foundation in conjunction with CDC www.cdc.gov and with the assistance of Cordaid www.cordaid.nl
Summary of Presentations
Note: The summaries below are based on notes taken during the presentations and review of the speakers’ PowerPoint presentations. We apologize if our summaries inadvertently misrepresent the speakers’ positions.
I
Alastair Ager, Professor of Clinical Population and Family Health in the Mailman School of Public Health, Columbia University, New York, chaired and provided a broad introduction to the day’s presentations.
Introductory Comments: The Case for Building Social Capital in and Through Humanitarian Organisations
Abstract: Humanitarian agencies frequently emphasise resources associated with the human capacity of their staff, and also the benefits of a strong organizational culture and shared values. A third 'domain' of resource, the social capital associated with connections and personal networks within and outside the organisation, is seldom recognised, and even less frequently actively cultivated. Drawing from presentations earlier in the day, the potential benefits of building social capital within organizations, within teams and with beneficiary groups are illustrated.
II.
Pim Scholte is a psychiatrist who teaches at the University of Amsterdam and works as a clinician and researcher within the Psychological Trauma Center, Amsterdam. He is currently chairman of the Antares Foundation. He presented a survey of the concept of social capital and of its implications for populations and aid organizations.
Social capital in populations, parallel process in organizations
Abstract: The concept of social capital is used to describe active connections that bind the members of human networks and communities. It consists of trust, mutual understanding, shared knowledge, values and behaviours that make cooperative action possible. The loss of social capital is a great impact of war and displacement on communities and individuals, and its restoration may be considered a priority in humanitarian support provision. Aid organizations, however, may themselves suffer from a shortage of social capital, which impedes optimal functioning. In such cases there is a lack of measures promoting team cohesion, mutual trust, safety and support. This may result from parallel processes, that is: parallel to the disruptive processes put upon the population the agencies are supposed to help.
This presentation will address the notion of social capital and its different types (structural/cognitive, bonds/bridges/links, horizontal/vertical), and its role in the functioning of various sorts of cummunities: populations, organizations, teams. The talk will draw upon field work and research in Rwanda as well as work with refugees in Amsterdam and cooperation with various NGOs.
III
Leslie Snider is a psychiatrist. Former director of Mental Health and Medical Anthropology Studies at Tulane School of Public Health, International Health Department, and lives in New Orleans. She most recently served as psychosocial advisor to a major NGO’s Katrina emergency response in the southern US Gulf Coast. Her presentation examined the experience of being simultaneously a survivor of the disaster and a staff member of an aid organization – an experience much like that of “national staff”
Do You Know What It means, To Miss New Orleans? When Disaster Strikes Home
Abstract: The worst natural disaster ever seen in the US was caused by Hurricanes Katrina and Rita last year.The hurricanes left hundreds of miles of devastation, over 1300 dead and more than one million families displaced. Eighty percent of the city of New Orleans flooded, and insecurity from violence and looting added to the tragedy.Local mental health professionals responding to psychosocial recovery efforts faced numerous personal and professional challenges. Similar to “national staff” in overseas emergencies, these professionals found themselves coping with their own losses, damage to homes, displacement and uncertainty while working in a chaotic environment to provide psychosocial support to the affected population. These professionals also brought a unique understanding of the socio-cultural context, personal experience of the disaster and mental health system gaps and resources.This presentation explores lessons learned from working the disaster in “one’s own backyard,” including personal and agency factors contributing to staff stress and implications for psychosocial program delivery.Recommendations are given to local and international agencies for improving staff well-being, stress management and service delivery in future emergencies, drawing upon the Antares guidelines.
IV
Mark van Ommeren has degrees in statistics, intercultural counselling psychology and a doctorate involving culture-informed psychiatric epidemiology among Bhutanese refugees in Nepal. He is currently with the World Health Organization Department of Mental Health and Substance Abuse, where he is WHO's global focal point for mental health during and after emergencies. He is initiator and co-chair of the Inter-Agency Standing Committee (IASC) Task Force for Mental Health and Psychosocial Support in Emergency Settings. His presentation linked discussions of social capital with current efforts to develop guidelines for responses to humanitarian emergencies.
Social Capital: Food for Social Science Researchers of Inspiration for Better Aid and Staff Well-Being
Abstract: The speaker will draw on his experiences related to the Sphere Standard on Mental and Social Aspects of Health and the Inter-Agency Standing Committee (IASC) Task Force for Mental Health and Psychosocial Support in Emergency Setting to discuss the role of social capital in humanitarian aid, with a focus on (a) inter-agency staff relations, (b) aid workers relations with affected-populations, and (c) intra-agency staff relations.
Michiel Hofman is Operational Director of Médecins Sans Frontières – Holland. He was unable to present his paper in person, due to a personal emergency. His abstract was read to the audience. The audience was asked to discuss their reactions to his paper with those seated nearby, and then the paper was discussed in the full group.
Social capital – or the absence of it – and its role in ongoing traumatic events;
Containment rather than recovery.
Abstract: From a purely operational point of view of an organisation like MSF often criticised of humanitarian fundamentalism – as in running in-and-out with our interventions like a bull in a china-shop having no understanding the local culture, communities, setting and sensitivities – the concept of social capital would seem lost with such an interpretation of emergency assistance.
It is however, and has been, in different wording, also for MSF a valid consideration in our intervention logic.
Not, as is the main focus of this conference in the light of recovery, but containment. As the majority of our interventions are with populations trapped in ongoing traumatic events in the middle of ongoing conflicts. In these contexts there is a clear recognition it’s not just the physical breakdown of structures of state, destruction of habitat and – more specifically for us – health structures which constitutes the reason for our intervention, but also the destruction of the whole fabric of society which has sometimes been described searching for a broad definition simply as ‘absence of normality’
This concept has far-reaching consequences for both our intervention logic in which mental health for our beneficiaries is shifting more and more to the core rather than the fringe of our programmes, as well as our thinking around staff health and inclusion of psycho-social care as a structural rather than incidental component of our responsibility.
This realisation translates into a staff management practice, which is rather distinct between expatriate and national staff.
For national staff this ‘social capital’ is not just a key-resource to build on, but for our beneficiaries – and therefore for staff recruited from these populations – more often than not also the only resource left to them in these environments of ongoing destruction. As our national staff not only represents the back-bone of our interventions, but also guarantee some continuity in our programmes, MSF has come to realise it needs to invest and capitalize on this key-resource, and actually built on coherence and stability within our national staff teams, and building on the social capital will be an important resource to apply. Application of this investment is still in its infancy and far from perfect, but a clear choice for investment for the next coming years nevertheless.
Our expatriate staff teams however are by the very nature of our organisation short term and trans-national – recruited from across the globe for short-term missions, with a conscious choice to aim for a high turnover of staff. These teams are therefore neither a community, nor a long-term asset as a unit. In a sense the expatriate teams are exploited to its maximum – strategies for mental health aimed at prevention of breakdown of the teams during the mission, and ‘repair’ of the worst damage after the mission.
This is of course an extreme representation of the actual practice; where in reality national and expatriate staff care is a mixture of both depending on context and circumstances – but conceptually true which I hope to illustrate with some practical examples.
VI
Theo Wijngaard is a lawyer, who worked for seven years as a refugee lawyer with the Dutch Foundation for Legal Aid. He currently works as Refugee Coordinator with the Dutch section of Amnesty International. His presentation focused on the experience of lawyers who work with refugees in host (asylum) countries, a situation in some respects paralleling that of those who work with refugees in refugee camps and IDP camps.
Believing in Rights and Wrongs
Abstract: ‘Believing in Rights and Wrongs’ will discuss the potential negative impact of stressful situations and dilemma’s for human rights activists and lawyers working with refugees in asylum countries. Practical examples from refugee lawyers practices and the refugee department of Amnesty International, illustrate the impact on individual professionals and their behaviour in relation to their individual colleagues, their team and eventually also the beneficiaries of their work. The discussion is set against the background of increasing external demands for transparency and accountability provoking discussions on culture change in non-governmental organizations.
VII
Ros Thomas is Head of the Psychology, Sociology and Counselling Programs at Webster University, Geneva.Ros described and reflected on a study of aid worker stress focusing on what makes the workers “well” rather than what makes them “ill.”
Sense of Coherence and Social Support as Social Capital in the Livelihoods of Aid Workers in Complex Humanitarian Emergencies
Abstract: The broad objective of this paper is to review how Sense of Coherence and social support offer an alternative philosophical assertion to understanding aid worker experience. Dominant discourses on stress and trauma emphasize individualized medical notions of the patient, clinical illness and pathology that require a clinical response.I argue that although a great many studies have concentrated on what makes people ill in dealing with stress and trauma, at an individual level, dispositional attributes, and particularly Antonovsky’s Sense of Coherence (SOC) model, is a starting point for a fundamentally different approach to the entrenched, negative view of the human experience of stress management.At an interpersonal level, the key reciprocal relationships of social support facilitate cooperative action and bind the group together.This form of social capital has relevance for aid workers whose livelihood strategy is to operate in complex humanitarian emergencies.Complex humanitarian emergencies are the broader political, historical and social context that frames the effects of aid worker experience.Negotiating access to people means that aid workers are often placed close to the context of the violence of wars while historically most worked externally to war.They are positioned as vulnerable, weak, ill-suited and even mentally ill when troubled, distressed and angry. The underlying assumption is that while aid workers witness the results of torture, famine, disease and war, face emotional challenges and enter situations of personal danger they are also psychologically healthy individuals capable of agency, resilience and resourcefulness. Categorizing or labelling aid workers as ill obscures much of the reality of their experience. Sense of Coherence and social support as social capital are central pillars that prop up aid workers in times of stress.They may also become institutional mechanisms supporting occupational efficacy.
VIII
Thea Hilhorst is Professor of Humanitarian Aid and Reconstruction in the Department of Social Sciences, Disaster Studies Program, at Wageningen University in The Netherlands.
Everyday Practices of Humanitarian Aid
(No abstract available)
IX
Alastair Ager summed up and concluded the day’s events.
Concluding Comments: The Case for Building Social Capital in and Through Humanitarian Organisations
The issue raised by the day’s presentations is, do the concepts of “social capital” and “social support” add something to our discourse? Summing up the discussions:
We have neglected issues of social capital in humanitarian organizations. These issues are infrequently a focus of discussion in NGOs compared with human capital (e.g. training) and cultural capital (e.g. organizational values and mandate). Guidelines (e.g. Antares’ Guidelines for Good Practice) emphasize organizational, team, and individual responsibilities rather than connections and relationships enabling them to be fulfilled. We focus on “what should be put in place,” not “what would be necessary to put it in place.”
Why the neglect? Reasons may include the fact that the informality of networks discourages formal consideration; the impermanence of deployment and employment constrains understanding; and the concepts are either ‘obvious’ (e.g. friendship, trust) or overly technical (e.g. ‘social capital’).
The concept of social capital is, however, relevant for humanitarian organizations. Social capital is a key resource for maintaining presence in demanding situations. It is a key element of effective teamwork. It is a key bridge for securing engagement with local communities; and it is a key pathway for knowledge/skills and cultural awareness to be accessed.
Building social capital is also of considerable utility for humanitarian organizations. Increased social capital leads to more effective management and exploitation of global connection between humanitarian workers (e.g. recruitment, mentoring, communities of practice) and greater awareness of the value of differing forms of social capital to humanitarianism. A focus on the concept of social capital leads to prompting organizational strategies for the more effective (‘mindful’) training and deployment of staff; providing ideas for more effective engagement with issues around national staff; and connecting with agendas and strategies for the social reconstruction of post-conflict societies.
The Conference Group
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