The Psychological Toll Taken On Refugees And The Volunteers Who Care For Them

Originally published on October 9, 2018 4:05 pm

Every day, more than 100 refugees and migrants arrive in rickety boats on the Greek island of Lesbos. The first faces they see are those of humanitarian aid workers. That means the workers witness trauma up close, nearly every day, for months, which can take a toll. The George Washington University Global Mental Health Program has drawn up a version of the Hippocratic Oath for aid workers to address the problem. Dr. Philip J. Candilis is one of the doctors behind the new version of the ancient mantra.

Here & Now‘s Lisa Mullins speaks with Candilis, interim director of medical affairs at the Department of Behavioral Health at Saint Elizabeth’s Hospital. He is also a professor of psychiatry and behavioral sciences at the George Washington University School of Medicine.

Interview Highlights

On the updated version of the Hippocratic Oath, and the importance of humanitarian aid workers taking care of themselves

“It’s still the general principles of caring for patients — first, not doing mischief, knowing one’s limits, keeping confidences — that continue to this day.

“The way we turned it to humanitarian ideals was by basing it on the resilience training that we were doing, so we were eager that people take care of their team, take care of themselves, recognizing that there’s a cascade of care that has to occur. If people are going to take care of refugees, they have to take care of themselves first, they have to take care of their teams, they have to make sure that they stay within their areas of expertise.

“One of our colleagues at George Washington tells a story of when she was working in Africa, and as a psychiatrist, she was asked to do cesarean section on a pregnant refugee. So, the temptation to go beyond one’s expertise is really difficult, and desperate … So defining the limits of one’s expertise, what one can do safely without the resources that one needs is one of the key principles of this work.”

On whether he thinks the new oath will serve as a guideline for aid workers in the future

“Our hope is that it can be kind of a unifying project for the folks that we work with. We’ve had it translated into Greek already. We’re making a gift of it to the groups that we’re going back to work with next month. So we’re hoping it’ll have some traction.”

On the cultural differences, as well as similarities, between the aid workers and the refugees they care for

“We’ve been impressed that the people who work with the refugees have their own immigrant stories. So there is a shared experience, a shared humanity, that even those who are more Western or European, generate, that they show when they’re working with folks from North Africa and the Middle East.

“We learned that many of them had grandparents, great grandparents who were part of the genocidal exchange of populations in the 1920s in the fall of Smyrna. They were refugees from Asia Minor. Everyone seemed to have an immigrant story.

“So there was a sense that we are all immigrants in one sense, and therefore, this kind of work takes on a shared humanitarian motivation.”

On what the oath means for him personally, and his background of immigrating to the U.S. after World War II

“Well, it’s an opportunity to take the expertise that I’ve learned here in the states and take it back to the origins of my family’s migration in the 1950s. So, my family left Greece after or during the civil unrest there after World War II, and to be able to go back and offer what I can…

“We were just there in September talking to folks in Salonica and Athens about the work that we do and recruiting help from the Greek psychiatric community. So being able to collaborate in this way has been both professionally and personally fulfilling.”

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