Disasters such as the December 26th, 2004 tsunami provide a good illustration of the complex response environment that disasters can create for the humanitarian aid agencies deployed to meet the needs of survivors. Two aspects of this complexity are explored in this edition of the Australasian Journal of Disaster and Trauma Studies. One relates to the delivery of mental health services to populations characterized by considerable ethnic, religious, cultural and social diversity. The other concerns the need for Aid agencies to operate in environments in which there may be an uneasy relationship between organizational priorities, established at some distance (physically and politically) from the disaster, and the capability of field staff to deliver resources and services that map directly onto the needs of local survivors.
Although dealing with quite different topics, the issues addressed by these two papers illustrate why more innovative ways of working with indigenous populations are required and the authors discuss how this might be accomplished. In both cases the solutions are derived from challenging the assumptions that normally direct the provision of humanitarian aid services. This theme of challenging assumptions is carried through to the final article in this edition, which explores the need to expand the conceptualization of critical incident and stress management intervention with high risk professions in ways that give the organization itself a more prominent role than has hitherto been the norm.
In the context of growing evidence of dissatisfaction amongst indigenous people with the mental health services received, Shah draws attention to the fact that, irrespective of its altruistic foundations, the provision of mental health services to indigenous populations following disasters tends to emphasise western conceptualizations of intervention at the expense of more culturally-embedded approaches. While recognition of the importance of cultural diversity has been growing, Shah argues that the dominant approach to doing so, based on the concept of Cultural Competence (which acknowledge indigenous beliefs, attitudes and structures, but still employ western treatment modalities), is inadequate. He advocates adopting Ethnomedical Competence principles that can lead to the development of strategies built on preserving and using culturally-embedded self-concepts and healing practices.
Shahs paper demonstrates the value of utilising existing social resources to facilitate recovery in ways that sustain the adaptive capacities of affected populations and that may even contribute to the development of their intrinsic capability to cope with future adversity more effectively. While Shahs work relates to identifying and mobilizing pre-existing resources within members of a community, the representatives of humanitarian aid organisations that make mental health and other skills and resources available to the relief, recovery and rebuilding efforts face other challenges if they are to ensure that they have the resources available to meet the actual needs presented by survivors.
Dekker and Suparamaniam discuss how a facet of the management of humanitarian aid missions, the gap between administrative and field operations, that is typically seen as a problem can represent an adaptive resource for those working in the field. They discuss how this gap can constitute an adaptive resource by providing a context in which knowledge and authority, which are normally separated by bureaucratic imperative, can be brought together in an actor capable of acting in ways that facilitate their mapping resources onto local needs.
Although not specifically discussed by Dekker and Suparamaniam, the decoupling of organizational systems and action can contribute not only to the effectiveness of the humanitarian aid mission, but also to the satisfaction of aid workers. Or, to put it another way, Dekker and Suparamaniam provide an illustration of how organizational imperative can have a detrimental impact on the well-being of those responsible for achieving organizational goals. This issue is explored in more detail in the final article in this edition.
Burke and Paton discuss how organizational culture and procedures can interact in ways that make a substantive contribution to levels of job satisfaction in professions characterised by their high risk of exposure to critical incidents. This work contributes to a growing literature that points to the need for organizational factors to be given a more prominent position in critical incident stress management programs and for such intervention to be delivered within a primary prevention framework. Only by including the culture, procedures and structures of the organization into the intervention matrix can emergency and protective services organizations effectively fulfil their duty of care to their employees.
Massey University, New Zealand
September 29, 2006