Health before a mission

Many of the Swedish Civil Defence and Resilience Agency missions are undertaken in countries with a poorly developed infrastructure, where both basic as well as advanced medical services are either inadequate or non-existent. On certain missions, there can also be limited possibilities for rapid medical evacuation. For this reason, the Swedish Civil Defence and Resilience Agency as an employer stipulates medical standards for its field staff. The purpose of these health requirements is to reduce the greater risks to health that international missions involve.

At our mandatory induction course, our field staff receives an increased understanding for the health risks that missions can entail.

In connection to the preparation for a mission, a pre-deployment briefing is normally booked. On this meeting you will receive specific health aspects from our medical coordinators that are relevant for the specific mission. You will also have the opportunity to ask questions.

Before participating in an international mission, you must have an approved health examination. If this does not already exist prior to the mission, a health examination must be carried out at a medical clinic before the intended departure. All field staff are being assessed from the same guidelines. The characteristics and duty station of the mission can in some cases be weighed into the final assessment.

There are no age limits in the guidelines. However, increased age can result in an increased risk for medical issues and disability on for example vision, hearing and the musculoskeletal system.

The Swedish Civil Defence and Resilience Agency also finance vaccinations for the diseases that are most relevant based on the duty station and type of mission.

Health during a mission

In the event of disease or injury during a mission, all field staff are insured and can receive support and advice from our medical coordinators and/or current assistance company. The insurance also give access to the service of the assistance company that implies advice on medical care and in terms of needs, medical evacuation. Decision regarding medical evacuation is made between the assistance company, treating physician, the field staff in need and the Swedish Civil Defence and Resilience Agency.

Outside office hours, you can contact our Duty Officer (TIB).

Stress

The Swedish Civil Defence and Resilience Agency employs a staff counselor (licensed psychologist), who is a part of the back-office and provides field staff psychosocial assistance during a mission. Normally the staff counselor is part of the pre-deployment briefings and field staff have the opportunity to discuss all matters related to stress and mental health during the upcoming mission. During the mission, field staff have access to the staff counselor if needed and all conversations are confidential, unless otherwise agreed upon.

Field staff may encounter situations that cause stress. Stress reactions are our psychological strategy to prepare for a challenging performance. These psychological reactions stem from ancient survival instincts when facing a threat and we were required to fight or flee. Short term stress is usually harmless and managed without it impeding our daily performance. Long term stress, with little to no possibility for recuperation, can negatively affect both our body, sleep and mental health. During a mission stress can take many forms, for example:

• Factors related to the context – e.g. unsafe environments, demanding living conditions and/or extreme climate.
• Work related factors – e.g. little to no control over one’s tasks and duties, high workload and dysfunctional work environment.
• Organisational factors – e.g. long and bureaucratic decision-making processes, lacking and incompetent leadership and moral dilemmas.
• Personal reasons – e.g. limited contact with family, pressures from family-members and struggling with being away from the family.

Field staff are encouraged to take inventory of known stress factors in their life. It may also include assessing the possibility of decreasing the impact of known stress factors. It is wise to have a plan already thought through for personal recovery and relaxation and maybe scheduling small feasible activities to look forward to. Don’t hesitate to ask for support or delegate tasks, practice relaxation exercises, try to maintain a healthy lifestyle and create healthy, positive relationships with colleagues.

Returning home from a mission

When coming home from a mission, do remember that you return to a daily life where people have not experienced all that you have. Even if the mission itself was productive and uneventful, both the body and the brain need time to adjust back to and get accustomed to everyday life. With that in mind, it is valuable to consider both feelings and expectations together with your family members, before returning home. It may also be beneficial to make a preliminary plan regarding which activities that you will participate in during the first week back home.

During those first few days at home, it is recommended that you do not plan too many activities or time-consuming social events in larger groups, in order to enable the body to rest and recuperate. Be mindful of which expectations you encounter when you return, both from yourself and friends and family.

Even though you have a multitude of things to share and tell, family and friends may show a limited interest for your experiences, even less than you expected. In order to not get too isolated your first period back home, it is important to balance your own recovery process with social activities and re-connecting with family and friends. It may take some time to find your footing in the relationships you left, but it is recommended to try to get back in touch with some friends as soon as you have come home.

Your relationship with your partner can become altered when returning home and the expectations from both of you need to be addressed. Everyday life continues while you were apart and it may not be easy for you to just step back and continue where you left off. Try to set aside uninterrupted time for each other on a daily basis where you spend time with each other in an un-demanding manner. It may be necessary to put away your mobile devices and find other joint activities.

If you have young children, it is important to keep in mind that they may show hesitation or trepidation towards you, when you return home. The time that you have been away might be perceived as an eternity since children’s sense of time is different from that of adults. Depending on the age of the child/-ren it is recommended to plan some easy activities and time together. Children can react in different ways when you return home, and stay home. The behaviour can vary between testing limits and rules, to ignoring you and preferring the other parent. It is important that you as the adult continues to initiate and invite them to spend time together. At the same time keep in mind that the child/-ren keep their own pace in re-establishing your relationship.

If you are single, consider how you may react and feel when you come back home. It might feel empty and lonely being back from a mission, since you may have gotten used to having people around you and keeping busy.

Even if nothing traumatic occurred during the mission, you may experience some post-reactions. The most usual reaction that may develop is, among others; insomnia, feelings of emptiness and/ or irritation. A large part of managing your experiences after a completed mission, is to understand that these are normal physiological reactions. It may be helpful to discuss your experiences with your colleagues from the mission. If your symptoms have not subsided after circa a month, professional help might be required. Feel free to contact MCF’s staff counsellor for advice and help to seek appropriate care.

If you have been in a mission country where the physical health risks are assessed as increased, a health examination post-mission may be offered.

Security

During international missions, security is a core aspect. As part of the pre-deployment phase, the Swedish Civil Defence and Resilience Agency’s security advisors submit a risk assessment in order to establish information about various threats and vulnerabilities in relation to the planned mission.

Within the frames of the mandatory Induction course, a two-day security course is also included. On this course, field staff will for example learn more about:

• Personal security
• Living security
• Vehicle security
• Healthcare

When the field staff attend the pre-deployment security briefing, they are given specific security information. The field staff is briefed about the security situation in the mission country and what security measures the Swedish Civil Defence and Resilience Agency has taken in relation to this, what they ought to be prepared for and what to bear in mind throughout the deployment.

If the field staff participates in a mission for a partner organisation, it is the organisation who is responsible for your safety and security. This is regulated in accordance to an agreement between the Swedish Civil Defence and Resilience Agency and the partner organisation.