Humanitarian aid workers experiencing moral dilemmas in the course of their work is not a new phenomenon, nor is it specific to COVID-19. But the pandemic has shed light on what it means for aid workers to deliver medical assistance in sub-optimal conditions and to be presented with only poor choices.
COVID-19’s rapid spread created an unprecedented amalgam of constraints—a global shortage of medical supplies, travel restrictions, and the sudden absence of staff who contracted the disease.
Doctors Without Borders/Médecins Sans Frontières (MSF) teams were concerned about their ability to respond to the pandemic—including in wealthier countries, many of which were new contexts for the organization—while fighting to maintain existing activities in more than 80 countries.
"Silent Wounds tries to put words and express the feelings, experiences, distress, and the suffering that the humanitarian workers face . . . when you do know what is the right choice when you do know what you need to be doing, but you can't because it's out of your own control."
Early on, scientific uncertainty around a disease we did not know how to prevent or treat limited the care we could provide. Shortages of medical oxygen made it impossible to treat severely ill people or provide appropriate end-of-life care so people could die with dignity.
Aid workers had to deal with the unknown at work and in their private lives. Their risk of contracting the disease was higher due to the lack of personal protective equipment. As borders started closing, some of them also wondered whether to stay with MSF or go home to support their national health systems and be with their loved ones.
"We had to adapt to this unknown. We had to adapt to the lack of control on our lives and on the choices that we were used to making."
Having to make imperfect decisions, even while knowing that those decisions lead to the least harmful outcome, can generate feelings of inadequacy, meaninglessness, and frustration. Such feelings are symptoms of moral distress.
To shine a light on the direct and indirect impacts of the pandemic on our staff, MSF offered them a space to share their stories.
MSF has undertaken the “Silent Wounds” video project, along with a research study of experiences that bring about moral distress, in order to understand the ethical challenges our staff face. Such understanding is essential to developing the resources we need to support them. From Eswatini to Ukraine, watch more videos of our aid workers sharing their pandemic experiences. This project is also viewable on ArcGIS.