This thesis presents how humanitarian aid workers were attracted, motivated, recruited, and prepared for fieldwork, and how they reported their work experience directly from the field and when they returned home. Data were derived from interviews with experienced aid workers, focus group discussions with presumptive aid workers, analysis of letters from aid workers in the field on MSFs homepages in Europe, and from interviews with recruitment officers at some of the main humanitarian organisations. Health professionals were attracted by the positive images of humanitarian action. They wished to work in teams with like-minded people, and to make a difference in the world. However, this image was not supported by the recruitment officers, or experienced aid workers, who described a complex reality in humanitarian action. The experienced aid workers instead had realised they learned more than they contributed. The recruitment system for relief workers would benefit from a more holistic approach, where personalities of the aid workers are more in focus. More time must be spent with the applicants, both recruited and returning aid workers, in order to improve the system. A socialisation approach could help identify the right personnel and to motivate current personnel to continue.

The significant rise of both chronic diseases and disasters in the last 20 years and the healthcare outcomes of individuals with chronic diseases during and in the aftermath of disasters have raised concerns among public health practitioners, healthcare providers, the U.S government, and the general public. Researchers have indicated that during disasters, the health outcomes of individuals with chronic diseases are significantly unfavorable compared to the general public. However, there is inadequate information on the management of chronic diseases, quality of care, and resource identification and allocation by disaster responders. This qualitative, grounded theory study, explored how the study participants addressed chronic disease needs during and after disasters. A total of 15 adult disaster relief responders who had been involved in disaster planning, response, or care management of individuals with chronic diseases, were recruited through snowballing, public/bulleting postings, and social media. Using the ecological model of disaster management allowed the identification of individual and societal influences that hinder disaster preparedness and chronic disease management. Data collection consisted of semistructured in-depth open-ended interview questions, allowing participants to share their lived experiences. Data were analyzed through open, axial, and selective coding and managed using the Atlas ti8 software. The findings supported the ecological model of disaster management and strategies such as the use of special needs shelters during impending disasters. Such strategies could enhance disaster preparedness and planning efforts and potentially improve health outcomes during and after disasters.

Aid relief workers active in complex humanitarian emergencies often develop mental health issues, due to the complex context of these settings and several workplace stressors. In order to cope with these problems, aid relief workers rely on organizational preparation and support, and social support. However, there is a gap between the needs for and availability of preparation and support, which has negative effects on their mental health. This qualitative study provides a phenomenological review of the experiences of aid relief workers active in these complex humanitarian emergencies, with regard to mental health issues, levels of preparation, organizational support and social support. For this study, interviews with five aid relief workers in different fields were conducted to research the effects of working in complex humanitarian emergencies on their mental health, and how preparation and support, or the lack thereof, influences their psychological resilience. The results show that organizational preparation and support, and social support have a positive impact on the psychological resilience of aid relief workers. However, the availability of and access to adequate preparation and support often lacks, which has negative consequences for their mental health. Therefore, this study provides recommendations to humanitarian NGO’s to improve their mental health support, and explores how the psychological resilience of aid relief workers in complex humanitarian emergencies can be improved.