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The Monitoring & Evaluation of Wellness Programs for Peacebuilders
Peacebuilders often work in some of the most challenging locations in the world. They can be profoundly affected not only by the stories they hear from communities they work with, but may also find themselves working in locations marked by insecurity, or volatility, such as South Sudan. Hence they have double exposure to trauma, both on a primary level, as well as potential to experience vicarious trauma. They also often work in highly stressful environments. Working long hours, with few positive or constructive outlets for self-care, and limited organizational support for job mobility or rotation to more stable postings, can lead to burnout as well as empathy fatigue, sometimes called compassion fatigue.
While some efforts have been made to bring more attention to staff welfare and duty of care under the broader term of “aid workers,” by and large it still comes down to each organization’s personal commitment to developing and implementing it’s own policies and programs to support staff. Such initiatives include the Core Humanitarian Standards (CHS) on Quality and Accountability number 8 referencing wellbeing and security, the aid worker security database, the aid worker security report, the World Humanitarian Summit Synthesis Report, section 7.4 and Box 6 and commitments made at the Summit by the European Interagency Security Forum (EISF), the Garrison Institute, who runs the Contemplative-Based Resilience program for aid workers, Action Against Hunger, International Location Safety and a number of other stakeholders, as well as resolutions by the United Nations General Assembly in 2015, A/RES/70/104 Safety and security of humanitarian personnel and protection of United Nations personnel, and the 2015 32nd Conference of the International Committee of the Red Cross/Red Crescent Society Resolution 5,
While many organizations have policies on staff wellbeing and duty of care, they are often not comprehensively implemented. There is already substantial good practice developed on the topic, including Antares Foundation and the Center for Disease Control (CDC) collaboration for the Guidelines on Good Practice for Managing Aid Worker Stress. Many international staff report having minimal pre-deployment training to prepare for the contexts they face, as well as limited access to services during deployment, and few, if any, resources to support in the transition back to life in a ‘normal’ context. National staff are also often exposed to a high level of stress and traumatic incidents, and they can have even less resources than international staff.
High levels of burnout and empathy fatigue create immense challenges for organizations, and often result in much higher costs to the organization than if they supported health and wellness programs for staff. Offering trauma informed yoga or movement programs, alongside access to psychosocial counseling and support for staff, can be an extremely important part of staff welfare, which in turn can help improve morale, productivity, and decrease turnover in an organization.
Trauma-informed movement, breath-work and gratitude programs can be an important cornerstone of staff welfare programing. They help support resilience by strengthening vagal tone; an important part of an individual’s ability to self-regulate, cultivate (or re-cultivate) empathy to build choice-making based on interoception, and by introducing practical breathing and meditation tools to staff.
Creating these programs can be easier than organizations may think. At Feet on the Ground, we believe supporting access to such self-care programs is a vital part of an organization’s success. Where an organization is committed to investing in such areas, monitoring and evaluation is pivotal to not only demonstrating the success of the program but also assessing what areas could be improved to best meet the needs of staff.
Depending on whether the program has trained staff, including those offering counseling services, a pre and post survey using the Clinically Administered PTSD Scale (CAPS) for DSM-5 or equivalent for the World Health Organization’s ICD-10 (ICD-11 due out soon) can be beneficial to demonstrate change. While actual diagnosis of PTS[D] is not static, and can change over time depending on life and current symptoms, the data can highlight the negative or positive impact of trauma informed movement programming on PTS[D] symptoms. A few challenges to note: both CAPS and the ICD require administration by clinicians and it is important to note that for some PTS[D] symptoms can appear after someone leaves a field environment and not necessarily when they are there.
Other trauma-informed yoga programs have been utilizing other types of pre-post self-tests such as mindfulness scales or interoception scales, such as the Multidimensional Assessment of Interoceptive Awareness (MAIA) which can provide good information as well. Other options could include self-check sheets by Headington Institute, compassion fatigue self-tests, disassociation and vicarious trauma tests by Sidran institute, etc. Feet on the Ground has often found the need to adapt such general questionnaires for each organizational context, and specific sub sector of aid workers or peacebuilding practitioners, hence it may be important to develop an M&E framework customized for your organization
These tests could be done at the start and end of a predefined pilot project, of 6-8 weeks to measure the outcomes. Such tests could be supplemented by short qualitative interviews to dig a bit deeper into the changes.
Providing staff with access to health and wellness programs, such as trauma-informed movement or yoga programs can be profoundly helpful. The benefits are not limited to individual staff members but also benefit an organization when staff are not burning out and quitting. It also benefits an organization to demonstrate that it is committed to genuinely fulfilling their obligations on duty of care for staff as it increases ability to attract, and retain, qualified and talented staff. Monitoring the effectiveness of such programs is often fairly straightforward in terms of being able to use traditional monitoring and evaluation tools.
Samara Andrade is a yoga teacher, movement educator and international aid worker based in New York City. She has worked in peace and security for over 10 years and holds a M.A. in International Policy Studies from Middlebury University at Monterey. Samara has taught yoga to aid workers, diplomats, police, veterans, and civil servants in Sudan, Nepal, and Afghanistan. She currently teaches yoga for female veterans with Connected Warriors, yoga for survivors of sexual and domestic violence with the NYC Mayor's Family Justice Center and Exhale to Inhale, and trauma-informed yoga for United Nations staff in New York, in addition to her regular studio classes. She has studied Mindful Yoga Therapy for Veterans with Suzanne Manafort and the Give Back Yoga Foundation, trained with David Emerson and Jenn Turner, creators of Trauma-Sensitive Yoga from the Trauma Center in Brookline, MA and studied trauma-informed yoga and self-regulation with Hala Khouri and Lisa Danylchuk. Samara is co-founder of Feet on the Ground and the Aid Worker Wellness Directory.