The things that get to you are not necessarily the ones you expect. Most of us who worked in Somalia found that the really frustrating part was not the death and dying, but not being able to do the job properly, when aircraft could not get in with supplies, or when trucks broke down.
Working in Somalia was stressful, because you could not get away from the conflict. As soon as you walked out the door, you had to have your wits about you.
During the early part of my stay in Mogadishu, two factions were fighting each other and we were helping to run the hospital. There were 120 casualties a day - the size of a major train crash - and often you could not see the floor because of the blood. Seventy-five per cent of those hit were civilians, so there were women and children brought in who had nothing to do with the fighting.
Then there was the famine period. We had 2,000 children in the feeding centre. I liken it to working in a hospital. You either get on and treat it as a professional job, or you take it personally and have to leave.
To counter the stress, we (the senior managers) had a policy of making staff take a week off, every six weeks. People were often gripped by the job and would protest that they did not need the time off. But we made it mandatory. They would go to Kenya and drink a few beers and unwind. They came back new people.
We tried to make the working environment as good as possible. We tried to allow people to have separate rooms and ensured that people ate well. It is a misconception about famines that there is no food at all. There is food available, but it is very expensive.
Before anyone left, we also tried to make them feel positive about what they had done. Often you feel that, although you have worked long hours, you have not achieved anything because so many thousands have died. It is important for people to realise that they have saved lives and trained local staff and left a useful legacy.
Although the media focus on aid agency workers as if they are 20th-century nuns, you do not see angels out there. It is just a job.
Sometimes things do get to you. Something will happen to your local staff, whom you are close to. We had a couple of people shot and killed, and staff who lost members of their family. Then the professionalism wears a bit thin.
I had my wife with me in Somalia, which helped. I have not found counselling useful, because I find it hard talking to someone who has not been in these situations. They can nod their heads, but I don't think they can understand.
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