Moral Distress in Humanitarian Aid Workers: How Decolonising Aid Benefits Us All

Abstract

Power inequalities and structural racism are long-standing problems within the humanitarian aid sector. Staff from high income countries typically work as “international staff,” receiving better treatment than “national staff” from low- and middle-income countries. This can result in harm not only to those disadvantaged by the system but also to those who appear to be benefiting from but are morally conflicted by systemic disparities. Ten current and former international humanitarians, with careers spanning from 3 to 15 years, were interviewed for this qualitative exploratory research. Participants were asked to share occupational experiences that they perceived to be morally troubling and to describe any mental health or other implications. Using Thematic Analysis, responses were coded and grouped into key themes highlighting inequities between international and national staff in − (1) decision-making authority and roles, (2) salary, contract status, leave and access to medical services, (3) access to equipment and other resources and (4) security risks. Participants described morally conflicting events vis-à-vis structural inequities and corresponding psychological, social, and behavioural outcomes that suggest the presence of moral distress in international aid workers. Reform of the humanitarian system is necessary for both individuals and operations to thrive, as we work collectively to decolonise aid.

Keywords

• moral distress
• structural racism
• decolonise aid
• thematic analysis