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Brief agenda
• People In Aid Code – Principle 7
• A model of health care for international staff
• Our experience with regional and national staff care
• Group discussions – key questions
Principle 7 – Health, safety and security“We recognise that the work of relief and development
agencies often places great demands on staff in conditions of complexity and risk. We have a duty of care to ensure the physical and emotional well-being of our staff before, during and on completion of their period of work with us.”
Health, safety & security policies
published
Region specific health, travel & security risk assessment
Pre-departurebriefing
Health clearance
Full medical Travel clinic& supplies
PsychologicalScreening
Travel clinic& supplies
Regular medical Work-life balancesupport
Training – stressHealth support
Before
Clear plans for security incidents
& evacuation
Record keepingand work plans
In-country support
Identify local reputable
practitioners
ISOS clinics etc.
Remote supportPsychological
Support
THAC EAP/ buddy/line managerdebriefings
Email/phone advice
Trauma management
During
In-field responsePsychological
first aid
After
Relief/development worker
Frequent traveller
International staff model of care
Post assignment health clearance
Debriefing/ personal review
Full medical + tropical screening
Ongoing trauma management
support
Before - indicators of good practice
Health, safety & security policies
published
Region specific health, travel & security risk assessment
Health clearance& pre-departure
briefing
Medicines & supplies
Before - Risk assessment – psychologicalRisks to your agency:
• Strategic – Organisational reputation
• Compliance - Health and safety legislation
• Operational – Disruption in functioning
• Human Resources – Motivation
• Financial – Prevention vs remedial costs
Before - indicators of good practice
Health, safety & security policies
published
Region specific health, travel & security risk assessment
Health clearance& pre-departure
briefing
Medicines & supplies
Before - Health clearance
Face to face medical
(Pre-assignment medical or Adult Health Screening)
For development & humanitarian workers
Travel clinic
(advice, vaccinations, supplies & briefing)
Psychological Clearance
(focus on resilience)
Before - Health clearance
Face to face medical
•Medical history •Physical examination and blood tests – FBC, Blood group, liver & kidney function tests•Managing pre-existing health conditions- asthma, epilepsy, diabetes, depression/anxiety, obesity, low immunity, high blood pressure…•Access to medications and local health facilities
Before - Health clearance
Psychological clearance
•Preventative better than curative •Selecting individuals who are psychologically robust for role•Assessing individuals resilience•Stress factors, coping mechanisms, past experiences, self-awareness•Suitability for specific role/environment
Before - Health clearance
Annual/biennial face to face medical
For frequent travellers
Travel clinic
(advice, vaccinations, supplies & briefing)
Annual/biennial work-life balance
/stress management review
Before - pre-departure briefing
•Operational briefing
•Security briefing
•Medical health briefing – risks, awareness, know what to do if….
•Psychological health briefing – stress awareness and emotional self-care
Before - indicators of good practice
Health, safety & security policies
published
Region specific health, travel & security risk assessment
Health clearance& pre-departure
briefing
Medicines & supplies
During - indicators of good practice
Security plans/ evacuation
Record keeping & work plans
In-country health support
During - Security plans
Critical incident & trauma management
• Clear guidelines • Front line responses• Psychological first aid available• Standing arrangements with international specialists
During - In-country health support
Medical
•InterHealth – THAC, remote email support, emergency phone•Access to local services – recommended providers, guarantee quality of care?
Psychological
•Buddy support, EAP, Centre for Humanitarian Psychology etc.•Trauma / critical incident support
After - health checks
End of Assignment medical
•45-70% cumulative stress/aggravated prior health condition, new health issue – tropical disease related
•High levels of stress manifested in weight loss, sleep deprivation, loss of appetite, relational breakdowns etc.
After - psychological health
De-briefing
•Operational vs. emotional/personal• Mandatory vs. optional•In-house vs. out of house
What about regional and national staff?•Staff in developing countries play down health issues as problems are normalised (anaemia, diabetes etc.)•Many have bilharzia, malaria which have not been addressed•Malarial strains differ between regions•Outside of region for 6 months or more then lowered immunity•Less easy access to reliable health care•More at risk from fake or substandard drugs or unaccredited health providers
Health, safety & security policies
published
Region specific health, travel & security risk assessment
Pre-departurebriefing
Health clearance
Full medical Travel clinic& supplies
PsychologicalScreening
Travel clinic& supplies
Regular medical Work-life balancesupport
Training – stressHealth support
Before
Clear plans for security incidents
& evacuation
Record keepingand work plans
In-country support
Identify local reputable
practitioners
ISOS clinics etc.
Remote supportPsychological
Support
THAC EAP/ buddy/line managerdebriefings
Email/phone advice
Trauma management
During
In-field responsePsychological
first aid
After
Relief/development worker
Frequent traveller
International staff model of care
Post assignment health clearance
Debriefing/ personal review
Full medical + tropical screening
Ongoing trauma management
support
Group 1 discussion
•What staff care provisions do your agencies have for international and frequent travelling staff? •Are these models of care working? •How are you measuring the impact/effectiveness of your practices?•What are the issues?•Where can they be improved?
Group 2 discussion
•What ‘model’ of care do your agencies apply for national and regional staff?•Is the international staff model presented an appropriate model of care for these staff? •Where are the current gaps?•How can agencies ensure support accessed is culturally appropriate?•What are the issues do you face with national and regional staff and how to these differ to the UK? E.g. resources, insurance, legislation