But there is a shortage,’ Mr Thompson says.He has to advise his own workers in Goma on some of their difficult decisions. ‘They are organising the water supplies, but people are dropping dead from thirst all round them. They know that if they stopped and picked up some of these individuals and took them back to their headquarters they could revive them, but if they kept stopping to do that they would never get their job done. And their job is to deliver supplies to hundreds of thousands.’I say to them: ‘Don’t blame yourself for not doing what you can’t do.’ ‘Save the Children Fund has an elaborate system of preparation and debriefing for its staff. Helen Daly, the charity’s staff health officer, talks to staff both before and after their trips abroad.’Before they go, we address physical and psychological health issues. The psychological briefing includes the impact of their whole environment – the job, culture, isolation, stress, relationships and the appalling events that may be happening around them. Staff are encouraged to think about their motives for wanting to work overseas, and how this may affect their lives and the lives of the people in the country.’On their return, they have a technical debriefing about the programme, and a personal one, where they can unload any concerns that they may feel.

It is important for staff to air their feelings and concerns and for the organisation to support them in whatever way possible. For those who have suffered trauma, Save the Children Fund offers further support through counselling.’I feel we must reinforce the positive for them – if the agency had not got involved, how much worse it would have been.’She advises people going abroad to identify someone in the field whom they can trust to tell them when they are overworking; she emphasises the need to take annual and local leave; and she tells team members to meet and discuss traumatic events when they occur, so that staff have an opportunity to express their feelings and not suppress them.Ms Daly recognises the same difficulties of readjustment that Dr Thompson describes. ‘Field workers returning home feel that people here have so much more than those people in the countries where they work. They see life differently and feel isolated.’(Photograph omitted). MARCUS THOMPSON, 49, is emergencies director for Oxfam. Once, when I was on a relief project in Uganda, we picked up a family in our Land Rover, who were in extremis – extremely malnourished and in rags, because they had been hiding from the conflict in the bush.

I had to carry one of the boys on my knees for the two-hour journey to the hospital. He was about the same age as my son and when he did not make it, I wept.
I was involved in a relief operation in Cambodia in 1979-80 It was hard to relax. We were living in a community of aid workers and, of course, there were no children. But I love being with children, so I used to spend my Sundays at the local orphanage playing Chinese chequers or football with the children there. It would get me through a week of frustrations, when the plane would not arrive, or the drugs did not work, or the fax machine broke down. It kept me going, knowing that I would be able to play football on Sunday.One of the difficulties about getting back home is that my wife will say to me: ‘This bathroom is a tip. We really need to spend pounds 100 redecorating it.’ And I will say: ‘Come on, it’s perfectly adequate.

I have just been somewhere where people do not even have a shack to live in. If we have got pounds 100 to spare, you should give it to Oxfam, or to one of the local people I have been working with, who has now fled to a refugee camp.’The same thing happens when the children ask for a new bike, or for a colour television But it is unfair of me. There is no point in persecuting the families because we do live in this economy.When you go home, you step out of one economy into another. The two economies meet in me – the economy of a refugee camp and my normal middle-class life outside Oxford There are immediately tensions within the family..