Managing dedication, risk and emotions: the experiences of French Red Cross volunteers during the Covid-19 emergency

O. Névissas

Olivia Névissas • Anthropologue

In direct contact with beneficiaries, the volunteers of the French Red Cross provide aid despite the risk to their physical and mental health. How did they cope during this unprecedented situation that affected both their capacity to commit and their usual management practices? Based on a study funded by the French Red Cross Foundation, the author attempts to provide answers to this important question. 

In the aftermath of the first wave of the epidemic of March 2020, the volunteer teams of the French Red Cross (FRC) responsible for modelling and implementing emergency activities saw their remit expanded. They quickly had to deal with a series of highly disparate institutional, organisational and health-related realities and challenges, particularly in Marseille and French Guiana, the fields selected for our study(1)« Les déterminants du bien-être psychosocial des bénévoles Croix-Rouge en contexte épidémique : perceptions des facteurs de stress, du risque et stratégies de coping mobilisées dans le cadre de la riposte au Covid-19 à Marseille et en Guyane ». The main aim was to record the experiences of the French Red Cross volunteers working in two territorial delegations, Provence-Alpes-Côte d’Azur (PACA) and French Guiana, by examining their perceptions of the individual, social, organisational and environmental determinants (risk and protection factors) affecting psychosocial well-being.. Behind these “response” activities are volunteer men and women mobilised on an emergency footing with three fundamental imperatives: to take care of themselves, of each other and of the wider community. How did these caregivers help each other when emotional fatigue took hold of a peer/colleague or an entire team? How did they manage to (re)build a community of caregivers in distressing circumstances?

Drawing on excerpts from interviews with twenty-one volunteers who took part in this socio-anthropological study(2) This research was carried out within the framework of postdoctoral fellowships awarded by the French Red Cross Foundation and with the support of its partners, SESSTIM (Economic and Social Sciences of Health and Medical Information Processing) and Prospective and Cooperation. This article reflects the views and opinions of the author only and not necessarily those of the French Red Cross Foundation., this article will first address the spontaneous behaviours of sociability(3)We are referring here to an “integrating organisational sociability” as analised by Guillaume Coton in his article « La sociabilité comme moyen de l’action collective, l’exemple des Verts », Presses Universitaires de Rennes, 2007, p. 87-102., mutualism and mutual assistance, behaviours that form the basis of the collective experience of a “close-knit” humanitarian community. Secondly, we will link the analysis of this search for social support within a “symbolic humanist community” in an unprecedented context in which it was important to recreate a sense of the ordinary, of normal life to avoid surrendering to fear, a loss of meaning and division within the teams. Volunteers faced personal, interpersonal, organisational and family risk factors that could rapidly affect their health (especially mental health) and the group dynamics. In conclusion, we will see that the management practices applied in a pandemic emergency had to strike a balance between, on the one hand, introducing measures to manage health risks and, on the other hand, introducing measures to manage emotions. Providing psychosocial support to volunteer caregivers and strengthening the bonds between caregivers remain major challenges for humanitarian response managers in charge of volunteer groups during this pandemic.

Methodology

This article is based on twenty-one individual interviews conducted with eleven people from the Provence-Alpes-Côte d’Azur (PACA) region and ten based in French Guiana. Participants in the study were selected using the “snowball” sampling method with the assistance of the heads of the operational and technical units of the PACA and French Guiana territorial delegations. Due to lockdowns and restrictions on travel outside mainland France, it was not possible for us to immersed in the respondents’ social and humanitarian space, i.e. their institutional, social, cultural, political and private sphere. This represented a major constraint in terms of building a relationship of trust with the respondents and understanding the sources of stress and socio-affective aspects described during the interviews “on the inside”. Yet the participants – often overwhelmed with work and exhausted – spoke with incredible passion and sincerity.

Given these sources of stress, volunteers used – consciously or not – coping strategies

Concern for the Other: sociability, mutualism and mutual assistance

The Covid-19 pandemic has increased the social, health, economic and psychological vulnerability of groups of people in precarious situations who are the beneficiaries of projects run by aid and development associations(4)See Abbé Pierre Foundation’s Annual Report no.26 on the state of bad housing in France 2021, in particular part I, Double peine et bombe à retardement: les mal-logés face au choc du Covid, https://www.fondation-abbe-pierre.fr/documents/pdf/partie_1_-_double_peine_et_bombe_a_retardement_-_les_mal-loges_face_au_choc_du_covid_.pdf See also OXFAM, The Inequality Virus, 2021, https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621149/bp-the-inequality-virus-250121-en.pdf. In this context, humanitarian aid and development operators had to cope with major challenges such as an increase and shift in social and healthcare needs, famine, the introduction of new operational practices and the adoption of new care practices (sometimes passed on remotely). Given these sources of stress, volunteers used – consciously or not – coping strategies(5)Also known as stress management strategies, coping mechanisms are the behavioural, emotional and cognitive responses of individuals in stressful and threatening negative situations according to Lazarus and Folkman’s model. The coping strategies referred to by the participants were classified into three broad categories: problem-focused, emotion-focused and social-support seeking. Richard S. Lazarus, Susan Folkman, Stress, Appraisal, and Coping, Springer Publishing Company, 1984., either to solve problems (individual or collective) or to control their emotions.

The mechanisms the volunteers used to protect the well-being of their peers and the group when doubts and exhaustion surfaced in the first weeks of April 2020 included seeking out one’s peers when one felt alone or exhausted or accepting advice and/or emotional support from one’s peers, sometimes without even having asked for it.

“We ring each other if we feel that someone is not doing so well… We are a great team; we can count on one another. We have very strong personal bonds.” (a volunteer from the La Croix-Rouge chez vous [Get support at home] initiative, Marseille)

Close links with individuals identified as “caregivers” often already existed thanks to a mentor or friend relationship between volunteers seeking help and a sympathetic ear and “caregiver figures”. The latter have all the characteristics of “a good listener”: they are present (remotely or physically), are valued for their emotional availability (good listeners) and have recognised social status within the delegation. This partly explains why the volunteers interviewed did not consult psychologists at the CRF’s operations centre (helpline, videoconference discussion groups). These listeners include doctors, nurses and “old timers” (experienced people who have worked for the CRF for many years).

“We don’t have a psychologist but a contact doctor for the volunteer firefighters and naval firefighters. I’ve known him since I was a kid and if I need to, I’ll go straight to him! Or a nurse if I have a mental health issue. There’s also the Director of Operations, who’s an old hand, a doctor. He’s not a psychologist, but I trust him. There’s a lot of experienced people and there’s no need for a psychologist. Volunteers provide their own psychological support without realising it.” (female volunteer, 22 years old, Marseille)

Remote self-support dynamics emerged when the de-construction and re-construction of activities unsettled the group dynamics and required a significant contribution from volunteers.

“With Zoom meetings, you get to see the faces and expressions of colleagues and guess what mood they’re in from their voices and what they say. We still look out for one another through our screens.” (male volunteer, 70 years old, Marseille)

“We each ensure that the others are not overwhelmed. Several times the team has said to me: ‘Come on, take a break!’” (female volunteer, 48 years old, Marseille)

These new forms of sociability have been central to the relationship dynamics within the volunteer “communities”, notably those in Marseille, which spontaneously formed between late March and April 2020. In the very particular context of emergency intervention, this meant that opportunities to come together could be organised and social bonds reinforced at key moments, so that the individuals who make up these new communities could feel comfortable.

“We support one another in Zoom meetings. It is not just a strategy [laughter]: we like to have a drink together at the end of the Zoom meeting – we are human after all. Connections, strong connections, have become forged, even remotely. We really look out for one another. But this way of working couldn’t be any more unstable or uncertain.” (female volunteer, 55 years old, Marseille)

The “emotional community” is characterised by “an ephemeral aspect, a ‘changeable composition’, local flavour, lack of organisation and routinisation”(6)Michel Maffesoli, Le temps des tribus, 2020, p. 123.. Unstable self-support dynamics emerged when organisational factors (working methods, health measures, etc.) and environmental factors (social precariousness, stigma from loved ones, etc.) weakened ties. The “assembly” that constitutes a collective is in fact a delicate, volatile balance of a “framework” that is necessary but also flexible enough to allow movement within the collective(7)David Vercauteren, Micropolitiques des groupes. Pour une écologie des pratiques collectives, Les Prairies ordinaires, 2011.. This instability was keenly felt in French Guiana following the implementation of certain health measures and later when the situation suddenly became precarious for some volunteers (especially those living in exile). A 26-year-old volunteer team leader in French Guiana said:

“Some volunteers clearly stepped back from the group when the question of masks arose. We had to teach them a lot, explain things.”

“They are all highly resilient, in different ways, even the most precarious. They don’t eat every day, they’re illegal, etc., and sometimes don’t come back from one day to the next. We had to support them, even more so than the other [volunteers].”

“People need one another to satisfy their emotional aspirations”, wrote sociologist Serge Paugam(8)Serge Paugam, Le lien social, PUF, coll. « Que sais-je? », 2008, p. 28-29 [Editor’s translation]., a specialist in contemporary forms of aid and development, when describing the interdependence between individuals where “elective participation bonds” (affinity between friends, peers, within associations and communities) and “organic participation bonds” (relationships at work) provide recognition and protection (close or contractual)(9)Idem..

The sense of belonging to a symbolic humanist community

According to sociologist David Vercauteren “we are not born a group, we become one”(10)David Vercauteren, Micropolitiques des groupes…, op. cit., p. 3.. Using this statement as our basis, we examined “multi-party action” from the point of view of dynamic internal processes in which power, the desire for change and individual and collective needs flow and create a singular experience where the people involved work together, form a “community”. Voluntary commitment throughout the crisis was motivated by a form of primary socialisation (becoming “aware of others” and therefore open to the world) and a return to the sense of belonging that volunteering brings. All the more so in a context of lockdown and isolation.

“We don’t come to the FRC for nothing. The Haitian and Brazilian populations think that being part of the FRC can help them with the administrative process. But it’s mainly to meet up with other volunteers, create social bonds. This enables them to feel more fulfilled and acquire knowledge and skills as well as find their place in a group, be recognised.” (male volunteer, 41 years old, French Guiana)

From what the volunteers said we noted that engaging in social networks and actions consistent with a system of humanist values also fulfilled a moral and altruistic purpose for some of them. It provided meaning(11)Bénédicte Havard-Duclos et Sandrine Nicourd, Pourquoi s’engager ? Bénévoles et militants dans les associations de solidarité, Payot, 2005, p. 113. whilst raising their awareness of the ability to act together on the world at a local level. “A society [or community]… above all is the idea which it forms of itself,” said Durkheim. Collective consciousness, adherence to social norms, symbols, moral values (the humanist universe of the Red Cross movement) supported a sense of belonging. Some volunteers admitted that they no longer found this symbolic aspect of social life(12)Émile Durkheim, The Elementary Forms of the Religious Life, George Allen & Unwin Ltd., 1915, https://www.gutenberg.org/files/41360/41360-h/41360-h.htm at work, either before or during the first lockdown(13)See Évelyne Josse, « Le brown-out, un syndrome professionnel de perte de sens révélé par la crise du COVID-19 », Résilience Psy, 2020, www.resilience-psy.com/IMG/pdf/brown_out_ej.pdf.

“It made me feel 150% great to be a volunteer because I was unemployed before lockdown and could not find any meaning in my daily life or… any sense of humanity at work!” (female volunteer, 55 years old, Marseille)

“After 45 years as a volunteer at the FRC, I can assure you that many people like to help, promote values, the principles of solidarity, humanity, etc.; it has a huge effect on the resilience of the FRC community as a whole, and even more so in this pandemic!” (male volunteer, 63 years old)

In a “process of humanitarian socialisation”(14)Isabelle Parizot, « La prise en charge des malades démunis : entre univers médical et univers humaniste », in Serge Paugam, Repenser la solidarité, 2011, p. 747-763., the actors bond around a certain “humanitarian ethos”(15)With reference to values such as charity, compassion, mercy, respect for human life and dignity and fundamental principles that also include the principles of unity, universality and voluntary service, see The Fundamental Principles of the Red Cross: Commentary, available at: https://www.icrc.org/en/doc/resources/documents/misc/fundamental-principles-commentary-010179.htm which has come to strengthen or create a sense of belonging to an FRC community that existed before the actions prompted by the Covid-19 emergency.

“There were a few interpersonal conflicts, due to different views that I have seen over the past twenty-one years volunteering at the FRC [laughter]. But the synergy and symbiosis have been stronger. Any conflicts have been resolved because we have focused on common goals and shared humanitarian principles! We created a real community, within the local units, within the department and through daily meetings, and there was no tension.” (male volunteer, 38 years old, Marseille)

“It’s very frustrating to see these problems, we feel helpless… you have nothing, but you have to fight, and the love [for the Other], the passion to help, we shared this value, the volunteers.” (male volunteer, 34 years old, French Guiana)

This process also generates a perception of nascent complicity and reciprocity within a “family”:

“A life has been born that didn’t exist before. We are a family.” (female volunteer, 55 years old, Marseille)

“The people at the FRC are amazing – I feel valued, useful and supported. I’m part of a family. To be part of the FRC and Doctors of the World motivates me.” (male volunteer, 34 years old, French Guiana)

Managing the risk of volunteer burnout and demobilisation

In what we might call “the joy of dedication”, observed among volunteer teams at the start of the crisis response period, assessing socio-affective risks – and health risks – became a must for managers of volunteer teams. For example, the measure of keeping senior citizens (volunteers over 65 years of age) away prevented them from “tasting” the collective effervescence, which immediately generated “reactionary” behaviour and emotions (opposition, shunning, anger caused by a sense of rejection, incomprehension).

“We [senior citizens] were sidelined. This caused an acute feeling of rejection and social isolation along the lines of ‘we are over 65 and the FRC thinks we are useless, too old!’” (female volunteer, 73 years old, Marseille)

Since participation in emergency activities had thus far contributed to the social and emotional well-being of some senior citizen volunteers, the management’s decision to use the age criterion as the primary risk factor was seen as “a way of being excluded from the Red Cross community”.

“They were willing to take risks for themselves, not to mention saying nothing about being worried about infecting a loved one! You see, the FRC is their life! They put their commitment above their physical health. It brings them more than you can imagine. […] Some of them, very upset, decided to leave the CRF for good” (female volunteer, 64 years old, Marseille)

Fatigue affected all the volunteers interviewed, not just the older ones. Managers did not always join the dots between a deterioration in the psychosocial well-being of their teams and a combination of several perceived stressors (at the individual, interpersonal, organisational, community and broader national public health level). At the organisational level, the workload, the level of responsibility, restrictive protective measures, the organisation of health and social work based on unprecedented operational intervention methods and a top-down management style have left the volunteers feeling unsettled. Orders given using emergency rhetoric may have caused some ethical distortions. For example, for volunteers involved in social outreach (solidarity groceries, outreach teams on patrol, etc.), the pandemic seems to have accelerated the “technicalisation of care” (for example, the Croix Rouge chez vous scheme(16)« Covid-19 : Croix-Rouge chez vous – Maintenir le lien social des personnes vulnérables isolées », https://www.croix-rouge.fr/Actualite/Coronavirus-COVID-19/COVID-19-Croix-Rouge-chez-vous-maintenir-le-lien-social-des-personnes-isolees-2356). Indeed, the response to Covid-19 has revealed different “organisational cultures” (managerial style, technical skills) and a certain tension between two intervention strategies: that of expertise (managerial or entrepreneurial rationality) in an emergency situation and that of community-based social action (a form of survival of the old methods of collective action) – that bastion of a “Red Cross identity niche”.

“Because we had to optimise, make it more profitable, we therefore had to cut the human ties… In that sense I think the aid was dehumanised.” (female volunteer, 73 years old, Marseille)

Our study has shown that local delegations and their units constitute a dynamic body that is adapting to the profound transformations brought about by the measures introduced to counter the Covid-19 pandemic. In teams whose members had bonds that were less close, harmonious and intangible than in other teams, managing emotions consisted of taking care of these peer-to-peer relations to overcome certain divisions (generational, socio-cultural, etc.). The purpose of all this was to rebuild the “community”, as this young volunteer from French Guiana puts it:

“We need to rebuild [a] collective. We didn’t realise before, but we are all mates here. Fortunately, some new blood [new volunteers] is arriving…. We are trying to think of the ‘after’, the end of Covid, so that we can bring the old and the new together.”

Local delegations and their units constitute a dynamic body that is adapting to the profound transformations

This “bottom-up” approach sought to add a socio-affective dimension to a category of actors who are often invisible and to highlight their “tricks of the trade” when it came to protecting a state of physical, mental and social well-being for oneself, for the peers, and, more broadly, for the “FRC community”. This study has also highlighted how the way in which volunteers managed vulnerability may itself have become a debilitating experience from a psycho-social point of view. When faced with the distress of other people and imperfect front-line emergency interventions, group supervision could help to support coping strategies(17)See the tools of the Reference Centre for Psychosocial Support (PS Centre) of the International Federation of the Red Cross and Red Crescent (IFRC): Supportive Supervision During Covid-19, May 2020, https://pscentre.org/wp-content/uploads/2020/05/Supportive-supervision-during-COVID-19.pdf; Mental Health and Psychosocial Support for Staff, Volunteers and Communities in an Outbreak of Novel Coronavirus, 2020, https://pscentre.org/wp-content/uploads/2020/02/MHPSS-in-nCoV-2020_ENG-1.pdf; Leslie Snider, Caring for Volunteers. A Psychosocial Support Toolkit, https://pscentre.org/wp-content/uploads/2018/02/volunteers_EN.pdf in specific situations as well as help with the ethical difficulties of caring for the public in a structured manner while also being attentive to the links of mutual aid between volunteer helpers.

This article reflects the views and opinions of the author only and not necessarily those of the French Red Cross Foundation.

Translated from the French by Derek Scoins

Biography • Olivia Névissas

Olivia Névissas is an anthropologist. She has been working on the emergency and post-emergency programmes of Doctors of the World – France and Humanity & Inclusion since 2008 (Haiti, Iraq, Lebanon, Jordan, Somalia, Rwanda, Democratic Republic of Congo, South Sudan, Bangladesh, Madagascar, France), carrying out anthropological studies or working as a technician in mental health and psychosocial support.

To read the article in PDF, click here.

ISBN of the article (HTML): 978-2-37704-861-8 

References
1 « Les déterminants du bien-être psychosocial des bénévoles Croix-Rouge en contexte épidémique : perceptions des facteurs de stress, du risque et stratégies de coping mobilisées dans le cadre de la riposte au Covid-19 à Marseille et en Guyane ». The main aim was to record the experiences of the French Red Cross volunteers working in two territorial delegations, Provence-Alpes-Côte d’Azur (PACA) and French Guiana, by examining their perceptions of the individual, social, organisational and environmental determinants (risk and protection factors) affecting psychosocial well-being.
2 This research was carried out within the framework of postdoctoral fellowships awarded by the French Red Cross Foundation and with the support of its partners, SESSTIM (Economic and Social Sciences of Health and Medical Information Processing) and Prospective and Cooperation. This article reflects the views and opinions of the author only and not necessarily those of the French Red Cross Foundation.
3 We are referring here to an “integrating organisational sociability” as analised by Guillaume Coton in his article « La sociabilité comme moyen de l’action collective, l’exemple des Verts », Presses Universitaires de Rennes, 2007, p. 87-102.
4 See Abbé Pierre Foundation’s Annual Report no.26 on the state of bad housing in France 2021, in particular part I, Double peine et bombe à retardement: les mal-logés face au choc du Covid, https://www.fondation-abbe-pierre.fr/documents/pdf/partie_1_-_double_peine_et_bombe_a_retardement_-_les_mal-loges_face_au_choc_du_covid_.pdf See also OXFAM, The Inequality Virus, 2021, https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621149/bp-the-inequality-virus-250121-en.pdf
5 Also known as stress management strategies, coping mechanisms are the behavioural, emotional and cognitive responses of individuals in stressful and threatening negative situations according to Lazarus and Folkman’s model. The coping strategies referred to by the participants were classified into three broad categories: problem-focused, emotion-focused and social-support seeking. Richard S. Lazarus, Susan Folkman, Stress, Appraisal, and Coping, Springer Publishing Company, 1984.
6 Michel Maffesoli, Le temps des tribus, 2020, p. 123.
7 David Vercauteren, Micropolitiques des groupes. Pour une écologie des pratiques collectives, Les Prairies ordinaires, 2011.
8 Serge Paugam, Le lien social, PUF, coll. « Que sais-je? », 2008, p. 28-29 [Editor’s translation].
9 Idem.
10 David Vercauteren, Micropolitiques des groupes…, op. cit., p. 3.
11 Bénédicte Havard-Duclos et Sandrine Nicourd, Pourquoi s’engager ? Bénévoles et militants dans les associations de solidarité, Payot, 2005, p. 113.
12 Émile Durkheim, The Elementary Forms of the Religious Life, George Allen & Unwin Ltd., 1915, https://www.gutenberg.org/files/41360/41360-h/41360-h.htm
13 See Évelyne Josse, « Le brown-out, un syndrome professionnel de perte de sens révélé par la crise du COVID-19 », Résilience Psy, 2020, www.resilience-psy.com/IMG/pdf/brown_out_ej.pdf
14 Isabelle Parizot, « La prise en charge des malades démunis : entre univers médical et univers humaniste », in Serge Paugam, Repenser la solidarité, 2011, p. 747-763.
15 With reference to values such as charity, compassion, mercy, respect for human life and dignity and fundamental principles that also include the principles of unity, universality and voluntary service, see The Fundamental Principles of the Red Cross: Commentary, available at: https://www.icrc.org/en/doc/resources/documents/misc/fundamental-principles-commentary-010179.htm
16 « Covid-19 : Croix-Rouge chez vous – Maintenir le lien social des personnes vulnérables isolées », https://www.croix-rouge.fr/Actualite/Coronavirus-COVID-19/COVID-19-Croix-Rouge-chez-vous-maintenir-le-lien-social-des-personnes-isolees-2356
17 See the tools of the Reference Centre for Psychosocial Support (PS Centre) of the International Federation of the Red Cross and Red Crescent (IFRC): Supportive Supervision During Covid-19, May 2020, https://pscentre.org/wp-content/uploads/2020/05/Supportive-supervision-during-COVID-19.pdf; Mental Health and Psychosocial Support for Staff, Volunteers and Communities in an Outbreak of Novel Coronavirus, 2020, https://pscentre.org/wp-content/uploads/2020/02/MHPSS-in-nCoV-2020_ENG-1.pdf; Leslie Snider, Caring for Volunteers. A Psychosocial Support Toolkit, https://pscentre.org/wp-content/uploads/2018/02/volunteers_EN.pdf