Stress, Mental Health, and Burnout in National Humanitarian Aid Workers in Gulu, Northern Uganda


  • The authors acknowledge the work and support given by Child Fund International, Uganda Office (Vincent Adude, James Pimundu); the local research team (Juma Jospeh Simon, Betty Lanyero, Jacob Obong, Charles Ocan, Ojom Stephen Baker, Lakot Monica Anywar, Akoli Stella, Amony Joyce); the Antares Research Group (including David Foy, Leslie Snider, Pim Scholte, Carol Crawford, Julia Zhu, Reinhard Kaiser, Miriam Sabin, Miranda Olff); and the Antares Foundation (Winnifred Simon, Tineke von Pietersom, Bas Rijnen). The work was made possible through the technical and funding support of the Program on Forced Migration & Health at the Mailman School of Public Health, the CDC and the Antares Foundation. Views expressed in the paper are those of the authors alone. The research described was conducted with respect to the IRB determination of Columbia University Medical Center IRB-AAAE0811.

Correspondence concerning this article should be addressed to Alastair Ager, Program on Forced Migration and Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, NY 10032. E-mail:


This study examined the mental health of national humanitarian aid workers in northern Uganda and contextual and organizational factors predicting well-being. A cross-sectional survey was conducted among 376 national staff working for 21 humanitarian aid agencies. Over 50% of workers experienced 5 or more categories of traumatic events. Although, in the absence of clinical interviews, no clinical diagnoses were able to be confirmed, 68%, 53%, and 26% of respondents reported symptom levels associated with high risk for depression, anxiety disorders, and posttraumatic stress disorder (PTSD), respectively. Between one quarter and one half of respondents reported symptom levels associated with high risk regarding measured dimensions of burnout. Female workers reported significantly more symptoms of anxiety, depression, PTSD, and emotional exhaustion than males. Workers with the United Nations and related agencies reported fewest symptoms. Higher levels of social support, stronger team cohesion, and reduced exposure to chronic stressors were associated with improved mental health. National humanitarian staff members in Gulu have high exposure to chronic and traumatic stress and high risk of a range of poor mental health outcomes. Given that work-related factors appear to influence the relationship between the two strategies are suggested to support the well-being of national staff working in such contexts.