Stress and Depression from working in the slums of Kenya (I'm Australian)

Hi,

Just wondering if anyone has any advice (especially if you have also been through a similar experience).

I head an NGO here in Kenya and have been here for 14 months.  We support and work with HIV+ men and youth (male and female) and sex workers and other vulnerable groups, with a particular focus on keeping a grass-root approach. This means I spend a lot of time in the slums (for those of you who know Kenya, I mean Korogocho, Kibera, Soweto and in Mlolongo) and meeting with the communities. I pay a particular focus on gathering first hand evidence from talking to individual community members (ordinary men, women, children, drunkards and those high from glue sniffing, as well as the [often corrupt] community leaders and local administrators).

This brings about many benefits, especially in terms of knowledge, understanding, trust and respect, as well as being personally rewarding. But the stresses of hearing these life and death / poverty line stories of heartache, pain, despair, frustration and anger and then added to that the "what can you do to help?" or "we need you to do ??? for me/us!" or worse the "you're not doing enough!" statements is very draining and depressing.

As much as I know I and my team and doing all we can, extra pressure is added in huge loads to constantly be raising (or begging) for funds/donations, raising awareness and trying to educate the public (both domestically and internationally) of the reality of the situation and what can be done (in a sustainable and accountable means), contrary to all the "aid is bad" publications that are all the rage at the moment (I urge all of these authors to spend months working in the slums so as to understand that foreign aid is only bad when given to the stakeholders that should ultimately be responsible for the problems, i.e. governments, when the poorest of the poor and vulnerable need the urgent and basic needs of health, food, safe water, shelter and education/training).

Anyway, I'll end that there as I could go on forever! What results from these stresses is a constant, nagging depression that can sometimes become overwhelming. In addition a feeling of hopelessness, awe and horror at the size of the problem and guilt that I can not be doing more to help.

Any advice on how to cope (that are cost effective) would be greatly appreciated!

Thanks and cheers!

Adam

[blunik]

you sound a lot like me in some ways. I'm australian and I was in India for a time and had a similar response to the awful poverty and social situations there. I can only suggest that you learn mental techniques to deal with the stress and depression - thoughts along the line of  
"Of course it's stressful and depressing but this would be happening whether you are there or not".
"This is not your fault this is happening -  The poor will always be with you".
"from little things big things grow" (very australian!!)

I'm not saying you stop empathising but you will need over time to learn to do it differently, feeling their pain without taking it upon and into yourself. You need to learn how you are not guilty and not to feel guilty for this situation or for how lucky you are.

It may take time to work through and develop ways to deal with and isolate your immediate emotional reaction - similar to an emergency doctor or paramedic. These are not light psychological issues, lots of people at the coal face - aid workers, doctors without frontiers, volunteers, paramedics - suffer these problems and they can cause a lot of mental problems especially when you come home - my god the culture shock! You end up hating everyone for wasting so much money and food and for caring about such stupid things as what colour their shoes are, you feel like screaming at them "people's babies are dying of diarrhea" - which is not helpful either!

If you can't speak to anyone through your organisation (they def. should have some resources for people feeling this way) maybe another NGO can help? Talking to someone who helped me change the "tapes" in my head as I said above is really important. at first you will say it but not believe it, but over time you do lose that awful, disabling softness and are able to live and do what you need to do, without necessarily being hard and cynical.  Notice I'm not there anymore (other reasons), but lots of people do stay - it is possible. Good luck, and thank god just for the fact that you care about people at all! ... and probably don't really care what colour your shoes are... :)

[clyons11]

Hi Adam,

I spent a summer as an intern in Mississippi. Definitely not Kenya or 14 months, but I might have some idea of what you're talking about. I was working with an organization that targets the poorest communities in MS and tries to put new, enthusiastic, well-trained teachers into those communities. In order for us to "understand" the situation, we were constantly hearing speakers testify to the horrifying conditions, taking trips through these neighborhoods, and working with kids who had failed in school (and been failed by the system) and were in summer school. We lost one student in a shoot out. People know that poverty and education reform are issues in America, but it is much easier to shut our eyes to rural poverty and discovering how insidious this problem is really depressed me. I felt aggravated that my organization wasn't doing more, yet how could we do more? It was simply never enough and it was very hard to see any real sense of change. I also had the task of reading teacher reflections, which were very depressing. Most of the teachers felt hopeless and ineffective (in the larger picture) within the first few months.

While I left MS after the summer, that doesn't seem to be an option (or something you want to do) in your case. I think more than anything talking to people about what you're experiencing (not "educating" them, but talking about your personal emotional responses) is a good start. I think it's also vital that you hold onto the small gems that you find along the way-- moments when you can see that you did make a difference. And you also need to know --and probably don't hear enough-- that while you might get complaints that you're not doing enough, it is extremely admirable that you're doing what you're doing. You're making more of a difference than the vast majority of people who are privileged enough to do so and choose not to. You are obviously making sacrifices for others and that is something you should try to feel good about.

I responded more because I felt some connection to your message than because I have answers for your problem. However, I would suggest that you keep a written record of those gems I mentioned or maybe some photographs. I would also, as much as possible, set aside a small amount of time when you try your best to not think about the situation at all. A little bit of escapism can be refreshing-- maybe read a novel or write about something completely unrelated.

Also make sure that you're taking good care of yourself, physically and emotionally. Check in with yourself and try to process your experiences so they don't build up (it sounds like you're pretty good at this), but also make sleep/nutrition/exercise a priority. It's really hard for your mind to feel good when your body doesn't.

I know a lot of that is obvious, but I'm hoping that even this simple message of support and also gratitude might make the smallest of differences. Please keep us updated.

[therese83]

NO 1 You are doing a lot to help.

Most people turn their back, you are there, helping in a big way !

You know people are cut out for different jobs, it is nothing to be ashamed of.

I couldn't ever do anything that involves touching peoples skin for example.  I have four kids and am a great Mom, very affectionate and caring, but i couldn't cut someoneother than my childrens toe nails.
Undertakers love their work because it reminds them of 'life', i couldn't do it.  I hate morgues.

Yet I work with teenagers, I have endless energy for that, I am very dedicated.  One kid said to me "you can turn anyone into an angel"  I love them.

Find a job that suits you.  This job is killing you, someone else who does not feel the same can do it.  You can do something you enjoy.

[blunik]

you sound a lot like me in some ways. I'm australian and I was in India for a time and had a similar response to the awful poverty and social situations there. I can only suggest that you learn mental techniques to deal with the stress and depression - thoughts along the line of  
"Of course it's stressful and depressing but this would be happening whether you are there or not".
"This is not your fault this is happening -  The poor will always be with you".
"from little things big things grow" (very australian!!)

I'm not saying you stop empathising but you will need over time to learn to do it differently, feeling their pain without taking it upon and into yourself. You need to learn how you are not guilty and not to feel guilty for this situation or for how lucky you are.

It may take time to work through and develop ways to deal with and isolate your immediate emotional reaction - similar to an emergency doctor or paramedic. These are not light psychological issues, lots of people at the coal face - aid workers, doctors without frontiers, volunteers, paramedics - suffer these problems and they can cause a lot of mental problems especially when you come home - my god the culture shock! You end up hating everyone for wasting so much money and food and for caring about such stupid things as what colour their shoes are, you feel like screaming at them "people's babies are dying of diarrhea" - which is not helpful either!

If you can't speak to anyone through your organisation (they def. should have some resources for people feeling this way) maybe another NGO can help? Talking to someone who helped me change the "tapes" in my head as I said above is really important. at first you will say it but not believe it, but over time you do lose that awful, disabling softness and are able to live and do what you need to do, without necessarily being hard and cynical.  Notice I'm not there anymore (other reasons), but lots of people do stay - it is possible. Good luck, and thank god just for the fact that you care about people at all! ... and probably don't really care what colour your shoes are... :)