No easy answers.

I just got a call from the Director of one of our partner organizations. It is 11:30pm, but he was not surprised to find me awake, and I was only mildly surprised to hear from him. He told me he is having trouble sleeping, and didn't think he would be able to tonight unless he told me what was on his mind. One really never knows what to expect after a lead in like that, but the worry du jour was staffing.

Amongst all of the other challenges of implementing health programs here on the border, human resources remains one of the biggest. Local organizations routinely loose staff to third country resettlement (registered refugees can apply to be resettled; common destinations include Australia, US, Canada, Norway, and Sweden. This new country is hoped to be a final destination, and is referred to as 'third country' as it is third in line from their home county (home country, country where refugee camp is, resettlement country). Of course no one blames any individual for seeking a better future for themselves and their family, considering the slim to none chance or their returning home, and the drastic shortage of opportunities in the refugee camps. At the same time, those that leave are the 'best and brightest' the most educated and trained members of the refugee community, a continual 'brain drain' from the local organizations and community in general.

There are few enough opportunities here - most of the refugees cannot legally work, so unemployment is very high in the camps. Those that do work are often illegal, and so their movements are restricted (often living at the office, and seldom going out) and their protections can be few. They often cannot bring their family to live with them, and there are limited opportunities to go and visit.

Limited funds and security risks limit staffing for some organizations, so that those who do work there are often significantly overworked, leading to rapid burn out and high staff turnover, further challenges to an already difficult HR situation. And they come with limited training, to find themselved immediately thrown into the deep end, and asked to be responsible for activities that they have not been trained for.

Many organizations consider their employees to rather be public servants, who owe service to their people, and thus don't consider it out of place to ask everything from them, to ask them to dedicate their whole lives to the work during their years of service (with contracts as long as 5 years), and for minimal pay. And some try to keep pay for office staff commensurate with that of staff in the field, although cost of living in Mae Sot is substantially higher.

The Director was calling to tell me that yet another staff was just approved for resettlement, and in addition, another key staff member was quitting. The latter gave two months notice, which is very generous, and unusual, as people often just disappear in the night (creating gaps in capacity transfer), as there is significant stigma against resettling, as well as breaking contracts. Both cited over work and lack of support as major contributors to their decisions. Both are great losses - one is the coordinator for two programs, and the other is a key member of the data team (leaving only one remaining after other previous defections).

We are trying to work with our partners to address some of these staffing challenges. Helping to provide additional funds, so that staff can live separate from work, encouraging them to limit work hours (even if that means cutting programs in order to make the work load reasonable), facilitating more social activities for staff that cannot go out, etc. Although, we are fully aware that our organization is not exactly the best model of a balanced work life... Making work life more attractive will hopefully convince more people to stay, although resettlement will continue to be a challenge. Hopefully changing the stigma around leaving, though, will encourage people to give more notice so replacements can be hired in time, and be trained by their predecessor before their departures.

Considering all of the other challenges to implementing cross border programs, it seems there should be a way to prevent staffing from being one of them, and yet, its hard to see an easy answer, as some of these issues are built in to the cause of the need of the work to begin with. So we will be dealing with some of these issues as long as we are doing cross border work. Which given the recent degradation of the security conditions, may not be for much longer.