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No rest for the caring

Published: Monday, July 1 2013 8:25 p.m. MDT

Marianne Elliot in Ghor, Afghanistan.

Vincent Jalabert

When Marianne Elliott took a job in Herat, Afghanistan, she expected difficulty.

The human rights lawyer from New Zealand had worked in the Gaza Strip, Timor-Leste and Kabul. She had come to do good, and to do it in a war zone.

But while she was still adjusting to her new job with the U.N. and its duties, senior officers took leave and left her in charge of the U.N. peacekeeping mission office. On her very first day in charge, a local tribal elder was killed, and the area escalated quickly into a violent tribal conflict.

"It was just the worst possible scenario," Elliot said.

Elliot handled her responsibilities fine, but the inherited trauma from those who lost loved ones was intense — 140 people were killed.

"Something in me was so deeply touched by the suffering, grief and loss," she said. "I went to a very dark place and stayed there for a long time, a mixture of depression and burnout. I say 'burnout' because I lost hope in the work I had come to do."

Elliot is the author of a new book, "Zen Under Fire: How I Found Peace in the Midst of War," and while her experience in Herat took place under extraordinary circumstances, burnout is a common problem among volunteers and those who deal with those affected by trauma. The experiences of Elliot and others like her raise questions about how organizations, nonprofit groups and relief workers can take better care of humanitarians.

The importance of self-care

Burnout is common in situations like Elliot's. A 2012 CDC study found that among international humanitarian workers around the world, rates of depression doubled after deployment — and rates of anxiety quadrupled. The rates can rise even higher in high-risk areas: a Columbia study of a humanitarian organization in northern Uganda found that 68 percent of workers experienced depression and more than half had anxiety.

Kimberly Williams is an associate director with Lasallian Volunteers, where she works with recent college graduates who spend a year serving the poor in schools and agencies of the De La Salle Christian Brothers. She said burnout is a problem among many people who work with trauma victims or in other stressful relief situations.

"A lot of people come in with really great intentions to give sacrificially and care for other people, and then they get to the point where they say, 'I need to leave,’ ” Williams said. "In order to stay involved for the long haul, as a leader you need to care for yourself."

Williams compiled and created materials for a self-care toolkit for urban workers in coordination with the Fuller Youth Institute. The toolkit contains articles, podcasts and recommendations on regular practices to facilitate resting and processing experiences.

Such self-care can look like different things for different people. For Elliot, a solution came in a previously ignored yoga CD her friend had given her to take to Afghanistan.

"(I learned you need to) allow yourself to feel what you're feeling," said Elliot. "One of the things I did for a long time … I would say to myself, you don't have the right that you're struggling with because you're so much better off than the people you're here to serve. As long as I denied it, it was unresolved and took its toll on me. If you're having emotional responses to what you're seeing, hearing, your first instinct might be to deny your own rights to have an emotional or physical reaction — because you think, 'Who am I to be having a breakdown?’ ”

That reaction is harmful, Elliot said. "Trauma does have an effect on you. If you can allow yourself to have the reaction that you do that's going to be a really helpful start."

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