Humanitarian aid settings are, first and foremost, emergency settings.
Experience in managing emergencies (including natural catastrophes and war) has led humanitarian aid organizations to develop specific expertise (including ready-to-use kits, protocols and organizational structures) and has put certain professionals, including logisticians, resuscitation specialists, surgeons and emergency care nurses, on the front lines. But this is the first time we have practiced real emergency psychiatry; that is, intervening in the midst of traumatic events.
Previously we intervened to ease events' after-effects. Now we are there with people as the trauma occurs and even growing in intensity. We provide psychological care to strengthen their defenses and allow them to hold on in spite of everything.
We address the effects of trauma on infants, children, adolescents and their families. Many fields recognize the significance of this concept, which now extends well beyond the medical setting. As reflected in the term PTSD (Post-Traumatic Stress Disorders), the broader concept has contributed to a recognition of suffering that is not limited to the spontaneous empathy expressed in cases of war, conflict, persecution or catastrophe.
Empathy, our capacity to put ourselves in another's place, is an instantaneous mental state. It is emotionally-based and situationally- dependent. Opinion is mobilized on the basis of empathy and of information presented visually or in writing. When attention wanes, that shift is not caused by moral weakness or laziness. Rather, empathy simply evaporates. Compassion is ephemeral.
Humanitarian workers in the field may themselves sense empathy wax and wane. They may also feel its effects, which can both energize and paralyse.
Naming and bearing witness is quite different. This process allows everyone - those who experience suffering and those who witness it - to identify and represent it in the psychological life of the individual and the group.
Rather than seeking factual, "objective" accounts, our approach allows us to see events through the eyes of those who experienced and suffered from them.