The temporary pause in the fighting, agreed upon between Hamas & Israel, is providing much-needed relief to Gaza’s civilians. Aid workers rush to deliver food and water as the future of Gaza is still uncertain. The resources available are not enough to meet the current needs of Palestinian civilians.
WorkersWorkers are forced to make difficult decisions, and they feel helpless when faced with overwhelming needs. Aid workers are exposed to a high risk of moral Injury because of the ethical challenges they face in Gaza and around the world.
A moral injury occurs when an event is so contrary to our moral values that it can cause us to question our deep-seated beliefs about justice, morality, and what is right or good.
Morally challenging situations weigh heavily on aid workers
Aid workers are constantly faced with a variety of moral challenges. Recently, my colleagues and I conducted a study about the psychological effects of moral challenges. We interviewed 243 workers in the aid sector about their work, any morally distressing experiences they had and their mental health. The majority of aid workers were based in Africa, Asia and the Middle East.
81% of aid workers reported having experienced traumatizing events because they were in violation of their core moral beliefs. Some of the events were caused by aid workers themselves. Aid workers, for example, struggled with how to allocate and utilize insufficient resources such as food, medicine.
On Oct. 23, 2023, UN workers and Red Crescent workers prepare supplies for distribution to Palestinians in UNRWA’s warehouse at Deir Al-Balah (Gaza Strip). (AP Photo/Hassan Eslaiah)
Another study revealed that medical personnel felt a great deal of anxiety when they had to decide which patients were seriously ill to treat and which to ignore due to limited resources. These are the kinds of decisions that aid workers face, and they have no way to win.
Sometimes, aid workers have made decisions they thought were right only to discover that the results were not what they had intended. For example, deciding to give food first to women and children, which led to a series assaults against them.
Our research shows that many aid workers are disturbed by the events they witness. Aid workers may find it difficult to understand others when they are in survival situations or see inhumane treatment towards other humans. It may be difficult for them to remain silent in the face of violence or injustice.
Aid workers may also feel betrayed in other morally challenging situations. Aid workers may feel betrayed if they believe that their organization, or even a leader, has failed to protect them. Around 27 percent of aid workers have reported at least one event that has left them feeling betrayed.
Traumatized aid workers
Moral Injury can manifest itself in many ways. Research on veterans has shown that the majority of them report feeling very strong emotions such as anger, disgust or shame.
Depression, anxiety and posttraumatic stress disorder (PTSD) are common symptoms. Self-sabotage or withdrawal from family members may be a symptom. Morally injured people often think negatively about themselves. They may, for example, feel weak or think about suicide. They may feel broken or like their life is meaningless.
Morally challenging situations appear to be a significant risk factor for aid workers. According to our research, many aid workers may be suffering from moral Injury. These events were associated with significantly more PTSD symptoms and depression. Morally challenging events were more likely to cause symptoms of PTSD or depression than situations where safety was compromised.
A woman follows a Red Cross volunteer carrying the food she has received on her head in Kibati in eastern Congo. (AP Photo/Karel Prinsloo)
Dealing with moral Injury
They work in chaotic and complex environments. They are extremely resilient, but their work is inevitably morally challenging and can lead to moral Injury. There are still steps individuals and organizations can do to reduce moral Injury.
To begin with, creating procedures that help aid workers to make difficult decisions can help them reduce their personal burden. Research on high-risk occupations shows that discussing moral issues and making decisions together as a group can help protect people against moral Injury.
To make the public aware of this risk, it is also important to discuss moral Injury in aid work as an occupational hazard. Aid organizations must recognize that workers may question the morality and understanding of certain events. They might also have difficulties in interpreting their own actions and the actions of other people. It is important to validate the experiences and reduce stigmatization of aid workers.
Third, shame and disgust are all signs of healthy moral functioning. They should not be interpreted as objective indicators of wrongdoing. To begin to understand these feelings, it can be helpful to reconnect with an individual’s core values and why they chose this career.
vulnerability and strength are often linked. There is evidence that morally challenging situations can result in psychological growth among aid workers.
The distressing events can lead aid workers to reconsider their goals, develop a better understanding of their own lives, develop a stronger personal sense of strength, feel their social relationships are more meaningful or intimate, and have a better appreciation of life.
Self-care is a great way to help aid workers deal with the moral dilemmas they face. Gaza’s current crisis shows how vital aid workers are for civilians. It is vital to conduct research on the mental health of aid workers in order to support them and their work.