Interview with Dr Ted Lankester - Ensuring the Health, Safety and Security of Aid Workers

Dr Ted Lankester is the co-founder and Director of Health Services at InterHealth a London-based international health centre that helps prepare aid workers for overseas assignments, and provides medical and psychosocial services on their return. He recently spoke at the People In Aid HHR Conference on the trials, tribulations and trepidations of being a health professional committed to improving ongoing wellbeing for his clients.

Mike Johnson (MJ): In your presentation at People In Aid’s 2012 HHR Conference in Amsterdam, you pointed out some rather scary statistics – especially about how little all those inoculations and pills we are given pre-assignment really help. Would you care to repeat what you said, so we can grab some other people’s attention?

Ted Lankester (TL): Most aid workers and travellers in general don’t realiSe that less than one in ten episodes of illness abroad are prevented by having the right vaccines (we still need those). The rest can usually be prevented by simple measures we can all follow. We simply need the knowledge and motivation to realise that by doing a few simple things reliably, we can have less illness, more fun, and be more useful in our jobs.

 

MJ: So, do you think that we, as individuals, need to better educate ourselves on both the physical and mental health risks that we face, when we are working in the field? 

TL: Yes, we need to take responsibility ourselves rather than assuming other people will do it for us via injections, pills or even advice. If we can run projects, save other peoples’ lives and work in hostile environments surely we can understand our own body and learn to look after it!

 

MJ: And does the same thing apply to the organisations we work for? Do they have a “duty of care” to make sure staff are as well prepared as possible before they go on assignments?

TL: They do indeed and every aid worker needs to be screened medically- to be advised by a nurse or other practitioner on how to avoid illness and have a psychological/resilience review especially if going to an insecure environment or a demanding assignment. Agencies also need to make sure they are not making unreasonable demands on their staff especially in non-emergency situations. And they need to ensure their managers are well-trained, fair and approachable.

 

MJ: What would be your top five need-to-do things that everyone should be aware of pre-assignment?

TL:

• How to intentionally prevent diarrhoea because it’s the commonest cause of ill health and wasted time and resources and how to treat diarrhoea if the prevention fails. 
• Keeping life in balance- that may be regular time off, or it may be work hard and then taking adequate R and R. Ignore this and sooner or later you will burn out
• This includes regular exercise, and sticking to a sensible weight- or losing a few kilos.
• Not going crazy on inappropriate relaxation- any drugs, too much alcohol, unprotected sex, risky adventures.
• Learning to get on with our team mates- that probably means a bit more apology and a bit more forgiveness than we may be used to - that can work wonders.

 

MJ: What about post-assignment? Do you think that debriefings and learning from others is a useful part of the overall process of caring for staff?

TL: The “debriefing” or some semi-structured discussion with a trained counsellor or listener (we call it a Confidential Review) is appreciated by many even if they are not feeling obviously stressed. But the medical screening is also important. Not only for those who have symptoms, but also for those who may have been exposed to nasty bugs which can show up later such as giardia, bilharzia and an assortment of interesting parasites.  But checking for non-travel related problems such as high blood pressure, diabetes and raised cholesterol may be even more important.

 

MJ: You have been in the international healthcare sector for many years. What for you has been the most rewarding aspect of all the work you have done?

TL: Being inspired by people I see. Hearing of the tasks they have done and being encouraged by their faith or humanity. Best of all tramping remote Himalayan paths for many years to pilot ways of providing community based health-care to distant communities.

 

For more on Ted Lankester's presentation at HHR Europe 2012, as well as videos, blogs, audio clips and photos from the event, please visit www.peopleinaid.org/hhr2012

 

 

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