Mental health of emergency workers in humanitarian crises must be protected

Imagine a healthcare worker still tending to injuries at midnight as another battle for survival begins. Amid the sound of sirens, gunshots or bombing, the steady hands of the paramedic, doctor or nurse work tirelessly to save a life.

There are countless healthcare workers in our country and across the world serving in humanitarian emergencies. Whether caused by crime, war, pandemics, floods, droughts, earthquakes or displacement, it is the healthcare workers – the doctors, nurses, paramedics, aid workers and volunteers – who are the frontline responders.

They stand not only as healers but as fellow human beings who share the trauma, living the fear and uncertainty. Yet they press on because people depend on them for survival.

The collective mental health toll of humanitarian emergencies is as devastating as the physical. Severe injury, trauma, grief, loss, uncertainty and the breakdown of communities create invisible wounds that outlast the visible ones.

World Mental Health Day was commemorated on 10 October and the 2025 theme – “Mental health in humanitarian emergencies” – reminds us that mental health in emergencies can never be an afterthought. It must be central to how we respond, recover and rebuild.

It calls for essential psychosocial support, the protection of rights and dignity, and actionable steps that make mental healthcare accessible to all, because health is not whole without mental health. This also tells us that recovery is not complete without the recovery of mental wellbeing.

In South Africa and across the world when crises strike, resources for mental and psychosocial support are often the first to run dry. The trauma and psychological pain that linger – insomnia, fear, hopelessness and moral injury – are easily hidden beneath the rush for food, shelter and medicine. But unattended, they seep into our collective being, transferring across generations.

Mental health in all emergencies must include those who serve at the frontline. When others run away from danger to seek safety, healthcare workers are the first to run towards it. Their courage sustains communities, but it also costs them dearly. Occupational mental health in crisis zones is often overlooked.

Healthcare workers treat the injured while worrying about their own families. They console the dying while mourning their colleagues. They make impossible choices about who to treat first when supplies run out, and they carry the moral scars long after the world has moved on.

Many live with post-traumatic stress, depression, anxiety or burnout. The systems meant to protect them are often the weakest at the very times they are needed most.

It is not enough to celebrate frontline responders as heroes. Heroism cannot replace protection, safety or care. We owe them structured psychosocial support, adequate rest and legal protection across international borders.

In too many conflict and disaster settings, the right to mental health collapses alongside infrastructure. Access to health services, including mental healthcare, becomes a privilege instead of a right.

Access to safe medicines – including those controlled under international conventions such as essential psychotropic drugs, strong painkillers and palliative medication – may be obstructed by bureaucracy or conflict, while patients suffer untreated pain, trauma or seizures because vital medicines are withheld or convoys blocked.

The right to safe humanitarian aid and the right to mental health are two of the universal human rights. They do not expire in conflict and war. They do not pause for natural disasters. They are not defined by borders or politics. Every human being deserves the right to safety, to care and to the medicines and food that sustain both body and mind.

While the world’s attention often focuses on armed conflict, humanitarian emergencies also include community murders, floods, cyclones, earthquakes, droughts, epidemics and forced displacement due to climate change. These disasters unravel lives.

In such moments, the first responders are often local – the emergency medical responder, the nurse, the community volunteer, the teacher turned caregiver. They work in conditions of scarcity and exhaustion, yet their commitment holds the line between despair and recovery.

For them, mental health is not an abstract principle; it is a very real condition that suddenly falters, and yet they cannot stop serving. For as long as they are needed in the emergency, they breathe through the burden they carry. Every evacuation, every burial, every improvised clinic carries an invisible weight. We must ensure that psychosocial support, rest cycles and trauma-informed leadership become non-negotiable components of every humanitarian mission.

To truly honour the spirit of World Mental Health Day 2025, we must move from passive empathy to systems of intentional action. That means embedding mental health into all humanitarian response and disaster plans.

It means training first responders in psychological first aid, protecting health workers mentally and physically, ensuring safe supply chains for essential psychotropic and palliative medicines and building cross-sector coordination between mental health, protection and public health systems.

We must also support occupational wellbeing through peer support groups, rotational rest schedules and psychological support. Governments, donors and humanitarian agencies should commit resources not only to the survival of those affected but to the sustainability of those who serve.

In addition to professional therapists – psychologists, psychiatrists and social workers – local leaders of faith, educators, youth groups and traditional healers are important partners in mental health support. Their inclusion makes interventions accessible closer to home, and more holistic and sustainable.

When we speak of recovery, we often think of rebuilding homes, roads and hospitals. But the true measure of mental health recovery is whether people can hope again, smile again, sleep again, believe again and love again beyond the hate and despair.

Mental health is not a luxury for peaceful times, it is a foundation for survival. It allows people to care, connect, rebuild and dream again.

As we reflect on the countless crises unfolding across the globe, we must remember those who keep showing up, the quiet heroes who keep humanity’s flame alive. They deserve not only our gratitude, but our protection. Their safety and mental wellbeing are not optional, they are central to all humanitarian missions. DM

Professor Zukiswa Zingela is executive dean of the Faculty of Health Sciences at Nelson Mandela University.