Psychological and Readjustment Problems Associated with Emergency Evacuation of Peace Corps Volunteers



Psychological and Readjustment Problems Associated with Emergency Evacuation of Peace Corps Volunteers

Psychological and Readjustment Problems Associated with Emergency Evacuation of Peace Corps Volunteers

Jon Mark Hirshon, MD, MPH: Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland; Thomas R. Eng, VMD, MPH: Office of Medical Services, Peace Corps, Washington, D.C., also International Health Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Katherine A. Brunkow, MSW: Private Practice and Washington Psychoanalytic Institute, Washington, D.C.; Nedra Hartzell, PhD.: Office of Return Volunteer Services, Peace Corps, Washington, D.C.

Background: To assess the psychological impact of emergency evacuation on individuals temporarily residing in foreign countries, we surveyed two groups of recently returned Peace Corps Volunteers.

Methods: Cases were individuals (n = 265) who had been evacuated under emergency circumstances from their countries of service: Liberia, the Philippines, and Yemen. The control group (n = 90) consisted of the immediate predecessors of cases from the same countries who had completed their service under regular circumstances.

Results: There were no significant age or gender differences between cases and controls. The median length of service in the foreign country was 14 months for evacuees and 24 months for regular returnees. Feelings of depression were self-reported by 60% of evacuees while 29% of controls reported this. For feelings of disorientation, 55% of cases versus 33% of regular returnees reported such symptoms. Other symptoms identified by more than 40% of evacuees included: difficulty making decisions (49% versus 26% of controls); anxiety (46% versus 27% of controls); numbness of feelings (43% versus 14% of controls); and periods of crying (43% versus 12% of controls).

Conclusion: Temporary residence in a foreign culture may be associated with significant psychological symptoms upon return to one's home country. When forced to depart from one's host country under emergency conditions, the likelihood of individuals reporting these symptoms markedly increases.

Reprint requests: Jon Mark Hirshon, MD, MPH, Department of Emergency Medicine, The Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224.

J Travel Med 1997;4:128–131.