December 1, 2002 - PCOL Exclusive: Improvements Needed in Peace Corps Volunteer Support Services

Peace Corps Online: Peace Corps News: Headlines: Peace Corps Headlines - 2002: 12 December 2002 Peace Corps Headlines: December 1, 2002 - PCOL Exclusive: Improvements Needed in Peace Corps Volunteer Support Services

By Admin1 (admin) on Sunday, December 01, 2002 - 2:11 pm: Edit Post

Improvements Needed in Peace Corps Volunteer Support Services





Read and comment on this report on Peace Corps Support and Security Services written by Dr. Joan P. Gerring, Associate Professor of Psychiatry and Pediatrics at Johns Hopkins University School of Medicine in Baltimore.

Dr. Gerring's involvement with the Peace Corps began in 1999, when her daughter began a two year tour of service in Kazakhstan and from acquaintance with other Peace Corps Volunteers (PCVs) and their parents. Concerns raised by the Kazakhstan Volunteers prompted a dialogue with Peace Corps Washington that began in November, 1999. During their meetings in Washington they focused on a few long-standing issues that have not been adequately addressed and that continue to impair the progress of the Peace Corps. Their extensive review of the Peace Corps and expatriate literature have led them to believe that these problems are widespread throughout the agency.

Read Dr. Gerring's report on how improvements could be made in Peace Corps Volunteer Support Services to provide better support for Volunteer Mental Health, improve Volunteer Security, and reduce Premature Volunteer Attrition. Leave your comments and own experiences on the subject at:


Improvements Needed in Peace Corps Volunteer Support Services*

* This link was active on the date it was posted. PCOL is not responsible for broken links which may have changed.



Improvements Needed in Peace Corps Volunteer Support Services

Introduction

Since its creation in 1961 the U.S. Peace Corps has attracted thousands of Americans to volunteer in countries around the world. Altruistic citizens respond to the Peace Corps mission to promote peace and friendship through assistance to others and through intercultural exchange. This year, as the Peace Corps celebrates its 40th anniversary, there exists a number of major problems which need to be addressed if the Peace Corps is to remain a safe and fulfilling vocational choice for American volunteers.

Background

My involvement with the Peace Corps began in 1999, when my daughter began a two year tour of service in Kazakhstan and also from acquaintance with other Peace Corps Volunteers (PCVs) and their parents. Prominent concerns raised by the Kazakhstan Volunteers prompted a dialogue with the Washington Peace Corps Administration that began in November, 1999. The observations we made have been fully corroborated by the scathing report of an audit of the Peace Corps/Kazakhstan July 3-28, 2000, by the Inspector General ("Volunteers expressed disappointment with what they characterized as the country director's disinterest in them and his lack of response to their concerns." No. IG 00-15, 2001).

Mrs. Kathleen Kennedy Townsend helped us to establish contact with Peace Corps senior management. This dialogue involved members from the Peace Corps Office of Special Services, Mrs. Maureen Chemsak, and myself. I am an Associate Professor of Psychiatry at The Johns Hopkins University School of Medicine and Medical Director of a child community psychiatry program in Baltimore. Mrs. Chemsak is a Returned Peace Corps Volunteer (Yap, Micronesia, 1969-71) and the mother of a Returned Peace Corps Volunteer (Kazakhstan, 1999-2001). During our meetings in Washington we focused on a few long-standing issues that have not been adequately addressed and that continue to impair the progress of the Peace Corps. Although we came to the discussions most familiar with Peace Corps problems in Kazakhstan, our extensive review of the Peace Corps and expatriate literature have led us to believe that these problems are widespread throughout the agency.

History

During our two years of interaction with the Peace Corps we formulated and extensively discussed our concerns and possible solutions with Peace Corps doctors, nurses, social workers, security experts, and administrators. Dr. Mary Gutmann, Director of the Office of Special Services, made available to us Peace Corps training manuals and policies having to do with mental health, physical health, and security. At our request the Peace Corps held a Review and Roundtable Discussion on Volunteer Adjustment and Mental Health on September 25, 2000. This panel was to have been a well-prepared discussion by national experts on mental health and security issues, with the focus on recommendations for improvement. Videotapes of the panel reveal instead more of a nostalgic trip down memory lane, in which most participants were important people from the past, extolling how well things worked years ago.

The offer of the Chairman of Psychiatry at Johns Hopkins, an acknowledged expert in principles of preventative psychiatry, to be a member of the panel was turned down with the statement that his presence would "overmedicalize" the panel. Finally, in February, 2001, with not the slightest progress or change resulting from our discussions, we were informed by the Director of Special Services, "I'm not sure that we have a system that is broken." We knew at this juncture that another forum would have to be chosen if any positive change were to be effected. We are buoyed in our efforts by our desire to prevent another tragedy such as the disappearance of a Peace Corps Volunteer in Bolivia this January, even as we work to obtain security improvements for the Volunteers.


Issues



We have confined our focus to volunteer mental health, volunteer security and premature volunteer attrition, three issues that are inextricably linked:

Issue 1. Volunteer Mental Health.

The incidence of Peace Corps authorized mental health evacuations (medevacs) from the country of service increased 78 % from 0.9 per 100 V/T Year in 1996 to 1.6 per V/T-Year in 1998 (Office of Medical Services-Authorized Mental Health Medical Evacuations, 1996-1998). Between 1996 and 1998, there were 240 Office of Medical Services (OMS)-authorized medevacs with a mental health primary final diagnosis. During this time period there were 307 medevacs with either a primary or secondary mental health diagnosis. Stress induced disorders accounted for 22.9% and 18.3% respectively of the medevacs with a mental health primary diagnosis (total equals 41.2%). Both stress induced disorders and adjustment disorders are in response to identifiable psychosocial stressors. Of those medevacs with a primary final diagnosis of stress induced disorder, 56.4 % had been assaulted prior to medevac.

On the other hand, depression disorders and anxiety disorders accounted for 16.3% and 13.3% respectively of the medevacs with a mental health primary diagnosis (total equals 29.6 %). Peace Corps Volunteers with these disorders were more likely to have family and personal psychiatric histories. However, psychosocial stresses may have increased the tendency for overt disorder to appear in these vulnerable individuals.

As these two types of disorders are different in their basic pathology (Foyle et al., 1998), so their treatments are also different. Medication is more often used in the initial management of the depression and anxiety disorders. Stress reduction procedures would not likely be used as initial treatments for these disorders, which are usually treated with combined psychiatric medication and some form of talking therapy.

Possible reasons for this increase in mental health evacuations include:

1). There is no psychiatric oversight currently for mental health problems of the Volunteer. The chief mental health officer of the Peace Corps is a half-time social worker in Washington, D.C. I was informed at a February 23rd meeting in Washington that the Peace Corps maintains 12-15 mental health consultants (psychiatrists, psychologists, social workers, psychotherapists, breakdown not known), who are periodically convened by a Field Support Manager who is a master's degree nurse.

2). The Peace Corps Medical Officer (PCMO) assesses mental health problems in Volunteers and provides supportive counseling. Peace Corps Technical Guideline 510, Mental Health Assessment and Support specifies that all counseling should be conducted in a private, confidential, face-to-face session. In reality, considerable counseling takes place by phone sessions, especially when the Volunteer resides at a distant site. Such reliance on phone interventions in many circumstances leads to misinterpretation of content or intensity of the presented problem. Unfortunately, listing of mental health problems in the Peace Corps document The 1999 Annual Report of Volunteer Health (Table 12) does not distinguish between face-to-face and telephone contact.

3) In a February 23rd meeting at Peace Corps headquarters, A. Russell Gerber, M.D., Chief, Surveillance and Epidemiology Unit, Office of Medical Services, proposed his hypotheses for the great increase in mental health evacuations:
Issue 2. Volunteer Security

Security is the primary issue for the well-being of the Peace Corps Volunteer and has major impact on all other issues that the Volunteer faces. If the Volunteer is not safe or does not feel safe in his country, he will not enjoy mental health and in some circumstances will leave the Peace Corps prematurely. Our initial involvement with the Peace Corps began with incidents in which our children in Ekibastuz, Kazakhstan, were taunted and stoned by groups of unsupervised boys. One Volunteer in this town was attacked by three local youth who demanded money. Another Volunteer suspected that his host family was engaged in illegal activities.

Factors that contributed to the insecurity of the Ekibastuz PCVs included insufficient development of the new site, followed by infrequent site visits from the central staff, despite requests from the Volunteers. Two of the three Volunteers felt insecure in their first apartment and had to move elsewhere.

The incidence of reported major physical assault events in the entire Peace Corps has been increasing steadily since 1995 (The 1999 Annual Report of Volunteer Safety). The incidence of reported aggravated assault events has been increasing since 1994, and reached a high in 1999 of 1.6 per 100 V/T-Year. The incidence of reported minor physical assault events has been increasing steadily since 1995, and reached a high in 1999 of 1.6 per 100 V/T-Year.

In the 1998 Survey of Peace Corps Volunteers: Final Report, 11.2% of the respondents answered that they were "not at all" or "not much" satisfied with the safety and security provided by Peace Corps staff in their host country.

Mr. Michael O'Neill, Coordinator for Volunteer Safety and Overseas Security, held a Safety and Security Workshop for the Central Asian Countries, Ukraine, and Russia in Spring, 2000. Provision of safe and secure housing for every Peace Corps, site development, and volunteer support were central topics of this conference. Were the outcome and recommendations from this meeting published and disseminated ? Have there been similar subsequent meetings in different regions?

Issue 3. Premature Volunteer Attrition

Fully 33 percent of Peace Corps Volunteers leave before the end of their 2-year assignment (Crisis Management: A Training Module for Overseas Staff, 1996). This figure has remained constant for years. Forty percent of responding Volunteers in the 1998 Survey of Peace Corps Volunteers: Final Report stated that they had seriously considered leaving Peace Corps service early.

The 1990 GAO Report Peace Corps: Meeting the Challenges of the 1990s addressed the issue of attrition, "It is generally agreed by the Peace Corps that the current rates of attrition-33 percent overall-are costly," and "Our interviews with numerous volunteers indicate that early returns not only hurt the volunteers, who may feel a sense of failure at not being able to complete their tours, but also the host government, which may have been counting on a volunteer to perform a specific task, and the Peace Corps, which is seen as unreliable (p.38-39)."

Many reasons contribute to attrition. A precise compilation of the major reasons needs to be performed. Two primary sources exist and the contained data need to be statistically analyzed (using multiple regressions) in order to identify the most important predictive factors contributing to attrition:
Solutions



We propose the following possible solutions to the described problems of mental health, security, and attrition:

Solutions to Issue 1. Volunteer Mental Health.

Psychiatric oversight is needed in areas of diagnosis and treatment decisions. Diagnostic precision and treatment have advanced greatly since the early days of the Peace Corps in the 1960s. A psychiatric crisis in a Peace Corps Volunteer constitutes a medical emergency. It is very important that Peace Corps Volunteers having mental health crises have rapid access to emergency psychiatric services so they can be diagnosed and treated as quickly as possible. It is unclear who is managing the mental health program of the Peace Corps. I was informed that a Field Support Manager who is a master's level nurse administers the 12-15 mental health consultants. I was unable to find out if she reported to the Office of Special Services or to Medical Services. Dr. Gutmann during our February 23rd meeting could not tell me the number of psychiatric consultants. There is also a mental health officer on call at all times for emergencies. It is important that this front-line person be knowledgeable about severe mental health disorders and their treatment in order to make informed decisions about ill Volunteers.

Mental health services for Volunteers need to be improved in many countries, both to prevent psychiatric emergencies and to lessen attrition. Peace Corps administration has rejected as too costly a proposal to hire psychiatric social workers in country to provide mental health and substance abuse counseling. One alternative to provide basic individual support to Volunteers is the use of Peer Counseling (Peer Helping: A Training Module for Overseas Staff, 1996). A Peer Counselor is a second year Volunteer who receives additional training in helping skills and who assists his fellow volunteers with work-related, cross-cultural, personal, and other problems that arise during service. A peer counseling program has enjoyed success in several Eastern European and Central American countries, but implementation of Peer Counseling occurs only by request of the individual Country Director. So, for example, Mrs. Chemsak and I requested implementation of Peer Counseling in Kazakhstan, citing reasons for the request. However, the Country Director did not feel that the program was necessary or useful, so he refused to implement this effective and low-cost service for the Kazakhstan Volunteers.

Solutions to Issue 2. Volunteer Security.

A safe and secure Volunteer communicates freely with central country staff, host country staff, and fellow Volunteers. Frequent site visits, around issues of living location, job, and social interactions, are important and promote adjustment. If dictated by personal emotional issues, face-to-face counseling issues need to take place so that the Volunteer is able to function well. If a particular country is very large and a Volunteer is assigned to a remote site, then regional offices need to be established so that central staff can reach the Volunteer in a reasonable amount of time if necessary. For example, in Kazakhstan, Volunteers live up to 77 hours by train (the standard means of conveyance) from the central city Almaty. This great distance is a stressor that contributes to a sense of isolation and insecurity in some of the Volunteers. Finally, risk factors need to be continually assessed with the Volunteers, in formal and informal situations, and strategies discussed. When risk becomes too high, as assessed by central country staff and the Volunteer, then the Volunteer needs to be removed from the dangerous situation.

Solutions to Issue 3. Reduction in Premature Volunteer Attrition.

Social scientists from the Office of Personnel Management (OPM) presented a plan to address the Peace Corps attrition problem when they addressed the September 25th Review and Roundtable Discussion on Volunteer Adjustment and Mental Health. OPM can design for the Peace Corps a customized weighted application blank, which is a biodata profile tailored to predict turnover in a government agency. The constructed questionnaire contains no questions about personal health, but covers a broad array of general experiences and achievements in order to capture the extent to which individuals have taken advantage of the various opportunities available to them (Gandy, Dye, & MacLane, 1994). This application blank constitutes an indirect measure of wellness. The initial cost to design a biodata weighted application blank for the Peace Corps would be fairly high, but the return on the investment would occur rapidly, as attrition figures quickly begin to decrease.

Obstacles to more effective Volunteer Support

A major obstacle to implementation of a strong, effective Volunteer support program remains the lack of accountability of the Country Directors. The Inspector General audit on Kazakhstan described how the Country Director has significantly impeded Volunteer morale and Peace Corps operations in the country (No. IG 00-15, 2001). The 1990 GAO report, Peace Corps: Meeting the Challenges of the 1990s, stated that no Peace Corps evaluation program required country management to take actions on the basis of the evaluation (p.31). The GAO recommended that procedures be put in place to ensure that each country post develop periodic, comprehensive program plans that provide for 1) clear, workable contributions to the countries' continuing development; 2) well-developed assignments for utilization of Volunteers upon their arrival in country; 3) adequate oversight of the Volunteers' projects; 4) host government commitment to support continuation of the work; and 5) data upon which to evaluate post and Volunteer contributions (p. 39).

The 1994 GAO Report, Peace Corps: New Programs in Former Eastern Bloc Countries Should Be Strengthened, again described minimal central management oversight of the country programs that were visited (p. 5). Little headway will be made until this lack of accountability is addressed in a reasonable manner.

We are turning to government leaders in the hope that they will listen, seek to corroborate this information for themselves, and then work for enlightened changes. The goal is not to increase the number of Peace Corps Volunteers during the next decade, but rather to strengthen and increase the effectiveness of this important American institution. Constructive attention to these three important issues, mental health, safety, and reduction in attrition, will make a big difference to the Volunteer and to the entire Peace Corps program.


Recommendations



With the increase in the annual Peace Corps budget to support improved volunteer infrastructure, our recommendations include:

1. To make Peer Counseling programs available in all Peace Corps countries to assist volunteers with work-related, cross-cultural, personal, and other problems that arise during service.

2. To hire a psychiatrist as the Peace Corps Chief Mental Health Officer to head the team of mental health consultants in Washington, D.C. and to communicate with mental health workers in the individual countries of service.

3. To hire psychiatric social workers for each country of service to assess mental health problems and to provide face-to-face counseling when appropriate, even in distant sites.

4. To minimize security risks through attention to choice of a safe living environment and through careful and frequent in-country security training.

5. To request that the Office of Personnel Management design a Peace Corps customized weighted application blank, which would be a biodata profile tailored to predict turnover. Such an application would quickly lead to a reduction in the long-standing 33% attrition figure.


Related Links



Read and comment on the following related links which have previously been reported on PCOL:

The GAO Report on Volunteer Safety and Security

Have Health Concerns about Lariam been overstated?


References



1. Crisis Management. A Training Module for Overseas Staff. Office of Special Services, January, 1996.

2. Final Report: Evaluation, Safety and Security Assessment and Administrative Review, Peace Corps Kazakhstan. Peace Corps Office of Inspector General. No. IG 00-15, September, 2001

3. Foyle MF, Beer MD, Watson JP. Expatriate mental health. Acta Psychiatr Scand 97: 278-283, 1998. (Although there is a large literature on expatriate mental health extending back to the 1800s and describing groups such as missionaries, military personnel, and overseas employees of large companies, this article adequately and concisely describes the different types of mental health problems experienced by today's Peace Corps Volunteers.)

4. Gandy JA, Dye DA, MacLane CN (1994). Federal Government Selection: The Individual Achievement Record. In GS Stokes, MD Mumford, and WA Owens (eds.)Biodata Handbook: Theory, Research, and Use of Biographical Information in Selection and Performance Prediction (pp. 275-310). Palo Alto, CA: CPP Books.

5. GAO: Report to the Chairman, Legislation and National Security Subcommittee on Government Operations, House of Representatives. Peace Corps: Meeting the Challenges of the 1990s, May, 1990.

6. GAO: Report to Congressional Requestors. Peace Corps: New Programs in Former Eastern Bloc Countries Should Be Strengthened, December, 1994.

7. 1998 Survey of Peace Corps Volunteers: Final Report. Office of Planning, Policy, and Analysis. August, 1999.

8. The 1999 Annual Report of Volunteer Health. The Health of the Volunteer. Volume 6, Spring 2000.

9. The 1999 Annual Report of Volunteer Safety. The Safety of the Volunteer. Volume 2, Spring 2000

10. Office of Medical Services-Authorized Mental Health Medical Evacuations, 1996-1998. August, 1999

11. Peace Corps Technical Guideline 510. Mental Health Assessment and Support. March, 1995.

12. Peer Helping: A Training Module for Overseas Staff. Office of Special Services, January, 96




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By bankass.com on Tuesday, December 03, 2002 - 5:44 am: Edit Post

Thank you for your interest in this subject and the positive impacts you are making at Peace Corps regarding attrition, security and mental health issues at Peace Corps.

Its now 2002, personally I believe in the program goals of the Agency, however I feel totally betrayed by Peace Corps. I will always have fond memories of my service and the experience I had with the Malian people. However, the staff at Peace Corps for me has been a "nightmare". Most often they know everything about "life". You personally have experienced the attitude. Paul Theroux, the famous writer who is a former volunteer experienced it too. The system is not "broken" was a senior Peace Corps staffers response. I have read your numbers in Statistics. You use the 1990's as an example. Super job by the way. Your Volunteer efforts should be paid for. Just think, you are doing what some bureaucrat at Peace Corps makes $60,000 plus a year is supposed to be doing.

In 1994, I brought legislation to the hill with a report written document stating that approximately 45% of volunteers leave service early. This includes trainees. I did a thirty plus year history on the Agency. I used that 33% percent figure, then proved there were more. Senator Leahy's office did inquire about my concerns. His staffer told Peace Corps, that we had a budget for 3 million dollars to start a Veterans type organization of Peace Corps Volunteers. They asked who introduced it, the next day I had three calls on my ansewering machine for job interviews within the Agency. That's when I knew, Peace Corps senior management Republican, Democrat, Independent is corrupt when it comes to attrition rates, security problems and mental health issues. I would be so bold as to say that most of the mental health issues stem from disagreements. Medical Services is still primitive in their services to volunteers but they are better. Years ago, I think they used Medical services to fire many good people who joined Peace Corps. They used untrained medical staff to do it too. I have a hard time calling them "medical" staff myself.

There are about 65,000 approximately who have left service early. Have these people ever been polled about their experiences? Are they getting services from Peace Corps? Do they feel that certain volunteers get upwardly mobile jobs, yet they were marginalized after service? Do they still have a problem with their record at Peace Corps? How do they feel about their colleagues attitude to each other after service, the implied question is do you think they help or hinder one another? Are they serving the third goal? If not, how does that hinder the program?

There is basically one GAO report that did a real comprehensive examination of attrition. It was John Conyers report in the 1970's. That is when the FECA program began being discussed. Now it is a normal program for the individuals who use it. By the way, have you ever asked the question? How many of the volunteers who receive the program get assistance and guidance? Its easy to get caught up in the bureaucracy of Peace Corps Volunteer Services. Just look at the "Republican hack" that runs Volunteer Services. He is a Doctor and a Lawyer. Why don't volunteers have a lawyer working for them? That is the only way the Peace Corps will change. If you get into their annual budget with Congress or have the law working for you. Peace Corps has a team of lawyers to gang up on former volunteers. Oh, they play fair. Just ask Congressman Marty Meehan when he tried to get information about Walter Poirier.

Here is is another way you can really change Peace Corps. Go on the TV and make an appeal to all the Veteran volunteers who served and didn't finish and set up a 1-800 line. Your phone will ring off the hook. You will be astonished. These folks care about Peace and most of them care about Peace Corps, but they have not been heard for twenty to thirty years now.

The NPCA is not interested in helping either. Their focus is primarily development efforts.

Keep up your good work. Keep asking the questions that need to be raised. Since 1998, 21 volunteers have been killed, have died in service or are considered missing. On top of that, check out Marty Meehan's GAO report on Walter Poirier and the other more recent report published in July about Security concerns. They are a powerful testament to your thoughts. If you get discouraged, because you will, think of those 21 volunteers who can't speak for themselves. Speak up for them and volunteers who you feel aren't being served correctly. Remember, Peace Corps blamed Walter for his unfortunate circumtances. Nobody is questioning his APCD who didn't visit his site once in his service. Talk about volunteer support.

Today, I work in the same job I had when I was sixteen. I have a Master's Degree and great experiences and I am using the other job as a positive to try and build my own business. It is true, if I had never had these negative experiences with Peace Corps I probably wouldn't have the courage or drive to better myself. However, I will never forget applying for at least 75 jobs with Peace Corps and about 2,000 jobs in development and really never got the opportunity to use my skills. That is up until this time. I am still hopeful.

Looking on the bright side. I just put my student loan in forebearance today $30,000 plus and I look at the $50,000 thousand my family and I have put in over the years trying to either defend my own Peace Corps case or helping other veterans by advocating. Additionally, I will be delivering fish tommorow. I will see a Cameroonian girl in one of the kitchens I deliver to and I will be able to speak french with her. I guess that will be serving the third goal.

Oh, I forgot to mention for all you cynical ex- Peace Corps folks. You will be happy to know. That my case against Peace Corps was turned down again in Federal Court in Boston. The judge wrote a six page letter back to me. I asked for a court an appointed lawyer. The judge said, I was not an "Indigent" so I will not be getting a lawyer. Fourteen years, one medical nurse writing rubbish in my file, that is gossip, untrue statements and innuendo and still Peace Corps remains stubborn. Peace is the word my friends, that always comes to my mind.

Thanks again, I thought I would add to your thoughts.

Daniel

By venayawa on Tuesday, December 03, 2002 - 9:32 am: Edit Post

Wow. Both of these writings are amazing. Daniel--you are a brave and determined person, two key qualities in any volunteer!!!

I think part of the problem with mental health is the stigma we still have in American society and the idea that Big Brother is watching. I was a volunteer from '94-'97 and I saw many PCVs struggle with mental health issues but NOT report it to the PCMO for fear of being kicked out or having damaging information put into their record.

Peace Corps *is* a government run agency, which is mean the Peter Principle applies--those with the least capability rise to the top. Peer couseling is definitely the way to go. Only a peer could comprehend and adequately advise a volunteer.

I think one additional area where Peace Corps is terribly remiss is Readjustment to America. There is no guidance whatsoever and this leads to serious mental health issues as well. Peace Corps spends at least two months orienting trainees to a new country, seems like they should spend at least a month or a few weeks orienting RPCVs to America. Family attitudes change, friendships change and many do not survive, volunteers need to be aware of how they have changed and how to adapt to no longer being the center of attention. RPCVs need to adapt to new rules, constantly making choices (I was wisely advised not to venture down the cereal aisle of the supermarket until I'd been home for 2 weeks). Most importantly, few jobs are as personally satisfying as Peace Corps. RPCVs need help to find a way to adapt to less satisfying work.

By Maggie McQuaid on Tuesday, December 03, 2002 - 10:46 pm: Edit Post

After reading this article and the reactions from other former volunteers, I find myself with a variety of feelings, some of them contradictory. I truly appreciate the efforts of the researchers who did the study and submitted this article. I am moved by the heartfelt responses already printed here. I realize that my own responses to this, as a volunteer who served some 26 years ago, make me sound like one of those old codgers who are always complaining about how much tougher they had things back in their day.

The overriding, long-lasting lessons I learned from the Peace Corps are: the world is not a safe place. The majority of people on this planet lead very tenuous lives, never certain if their lives won't be snuffed out tomorrow or next week. Depression, fear, uncertainty are all part of the human condition, and shrinks aren't easy to come by in most parts of the world. I would not have learned this if I had never been in the Corps, hadn't had to deal on my own with disease and bad water, hadn't faced that long night of the soul on my own and far from the people I wanted to be with.

I'm not sure that the Peace Corps experience SHOULD be made safe, dependable, and closely monitored. Of course, the obvious dangers and risks need to be dealt with, but I think volunteers and their families need to go in knowing that there are some conditions you just can't predict. You never know what you're going to have to deal with when you're out there on your own. but that's how we learn about ourselves and our world.

Yes, I lost a good friend down there, another volunteer, in a needless accident. I had dengue and malaria. I have a chronic intestinal problem that started when I was in-country and which I will have the rest of my life. But the experience was still the most meaningful thing I've ever done, and I wouldn't be the person I am today if I hadn't gone through those challenges and ordeals then.

Let's take some sensible steps, but please, don't try to sanitize the experience or make it fail-safe. If that's the experience we really want for our volunteers, why send them into the developing world in the first place?

Respectfully, Maggie McQuaid

By bankass.com on Wednesday, December 04, 2002 - 8:51 am: Edit Post

Maggie,

I agree with you about alot of what you say. It is part of the experience and I could get hit by a car today too. The world is not always safe, but there are precautions we all take here and should abroad, especially after 9/11 and the rise of problems with violence against volunteers.

I was threatened near the end of service to the point, I felt it was time, not to "volunteer" my life away to people who did not agree with our country's foreign policy. My response was to report the incident. I did. (This group was from a western country, there aims were similar to what our threatens us today, there was a man from Algeria, who had the weapon. I don't want to figure out just exactly who they were. I can't I don't have those kind of resources. Whatever the case, it was no joke.

The Peace Corps used ignorant nurses (lack of knowledge of what I had just been through)to respond to my request to take a medical break and have my site moved based on being threatened. I was lieing according to the "experts at Peace Corps in medical services". I too had a multitude of intestinal problems and lost fifty pounds in service. I was 15 hours away from them. Instead of providing care they tried to besmirch my character. The Medical nurse involved with my case got a raise and moved to headquarters, as if she had been rewarded after destructively getting me fired.

She was there for five years after that. Then came the fight about obtaining my file from medical services. If I had not been involved in politics in 1992 with our friend Mr. Tsongas, I would have never had gotten that file. During the transition to the Clinton administration, "one and only one member of the General Counsel was willing to try and get it. He filed the request and got it from National Archives. He told me, she, the "medical tyrant" would not give it up. He literally had to pull it from her hands. I finally was able to read it. The file was littered with character assasination. That is not the reason a person joins Peace Corps.

Every volunteer needs to be protected against their civil rights being violated and false light cast upon them. Secondly, after being in a situation we're I felt my public safety was compromise, I reacted. I was told by someone in the General Counsel's office and IG's office, that medical services stopped being the safety expert due to my case.

Today, the Peace Corps holds twelve pages with my name on it that they won't release under so called national security. The facts are that this medical tyrant got me fired because she didn't like me. Maggie, I ask you, if Peace Corps is so broad in their thinking of the world. How can an untrained medical get away with that?

There are thousands of us. If the Peace Corps continues to say there are risks and doesn't protect its own from safety breaches (precautionary measures),having the threat of being fired if you report something and our right to work in the public sector during our life then they will continue to hear from us. You know being a volunteer. There is room for flexibilty. In my lifetime there will be more major changes in the way these issues are handled.

You think about it differently, I understand, but please really think to yourself. For Example: Say, the Peace Corps diagnosed your intestinal disease as a form of AIDS and you did not have the financial resources to fight it or did not have an attorney. What would you do? In Wisher Vs Coverdell, Ms. Wisher did the right thing, but she had to get a high priced attorney to do it. We need the same. So the Medical Tyrant will think twice before besmerching character, covering up safety concerns or casting our service in false light.

Oh, recently here in Boston. I have run into former volunteers who are activists. Some disagreed with me at first, but the more they hear and are aware of the problem and its implications for the future, they too say Peace Corps needs to change. Many agree in the Agency.

What the Old school Peace Corps response is that "People die every day". They want to compare death rates living in a town in America and do the statistics. Over the forty years of Peace Corps, the numbers are off the chart in comparison. And like the new Safety report says, a much higher trend of violence toward volunteers occured during the 1990's. Now, because this is now proved. Will the volunteers who were victims or injured during that time be given a review? No, because Peace Corps could care less. They just want more people in their budgets to Congress.

That is my feeling now. Perhaps, I would feel better about Peace Corps if we had been treated better with reasonable care.

Thanks Maggie appreciate your input.

By Joanne Marie Roll (joey) on Wednesday, December 04, 2002 - 7:58 pm: Edit Post

I really appreciate the comprehensive nature of the report and recommendations on improving support services to serving Volunteers and am still reflecting on its contents. I also respect replies from RPCVs-I always read bankass's comments and marvel at their anguished honesty. So I will try to match that honesty.
I believe, finally, and always, that Peace Corps is a political tiger and Volunteers ride at their own risk and ultimately alone.

By bankass.com on Friday, December 06, 2002 - 2:48 am: Edit Post

Joanne,

Political Tiger was a good reflection. I say to Congressional members all the time, watch out now, they are some of the best politicians in the world.

By Barbara George on Tuesday, December 10, 2002 - 7:30 pm: Edit Post

I am a Honduras RPCV (98-01). I was a Psychologist for many years before joining PC. I was in Hillside Ag for the 2 years and then extended to open a Regional Volunteer Support Office. Throughout my 3 + years, I was involved with the Support Advocacy Group (SAG), what Dr. Gerring called "peer counseling", first as a presenter on PTSD and depression, then designing and leading trainings, finally by totally revamping the training curriculum and the resource Manual. During my year developing the regional office, we placed heavy emphasis on site development and increased accessibility for PCVs.

This piece prompts many comments, ideas, responses, some general and others specific. I have actually spent quite a lot of time thinking about these issues. I certainly agree that mental health, security, and premature attrition are intimately related. The first two are key to whether volunteers have safe and productive services.

It appears that the writer's daughter and colleagues had a particularly bad apple as a CD. My experience is that this is the exception. Based on my experience with CDs, Sub-Directors, and PCMOs in my own country and several other countries, I think they are overwhelming well-prepared, very responsive to PCV concerns, and very interested in the general PC mission as well as individual PCVs. Very aware of safety and security issues as well, since they are the ones who have to deal with all of the crises. Given the decentralized PC system however, each post will only be as good as the in-country staff. The 3 positions I mention above are most key.

There ARE things which interfere with the ability of the in-country staff to stay in touch with issues in the field. The amount of bureaucratic paperwork and political schmoozing required is extreme (it IS a U.S. govt. agency). I also think that being a RPCV makes a critical difference. It is not a guarantee, but 9 times out of 10, it means that they GET IT on the level that is important in understanding safety and security issues (the impact of deprivation, loneliness, physical discomfort).

Is it possible for PC to keep prepared, clued-in, dedicated, aware staff in these positions in every PC country in the world all the time? Is it possible for PC HQ to monitor each post as closely as needed? How quickly does HQ respond when they become aware of problems with in-country staff?

Dr. Gerring makes the statement that "there is no psychistric oversight currently for mental health problems of the volunteer". While I do not know the exact organizational structure, I take issue with that. If she means Psychiatrist by 'psychiatric', perhaps. However, I agree with whoever declined the Johns Hopkins Psychiatry Chair's offer to participate in the 9/25/00 meeting because it would "overmedicalize". Psychiatry by and large follows the medical model. What is needed for the PC experience is at least a biopsychosocial model. Well-trained Psychologists, Clinical Social Workers, and Psychiatric Nurses are all perfectly well qualified to address the mental health needs of the PC population. I am admittedly biased, but as I note above, I think they (we) do a better job than Psychiatrists as a group.

Specific to PC, I know that the Office of Special Services has a number of well-trained and qualified and skilled clinicians. I have observed them in action on a number of occasions and in a number of settings and have been consistently impressed. PCV comments about them have been overwhelmingly positive. As far as I know, they are the ones who respond to anything that could be considered a mental health crisis in-country (from a sexual assault to death to evacuation). I know that the OSS staff and the staff in the "safety and security" group worked hand in hand (offices on the same corridor). Here also, being a RPCV is that much better.

Regarding mental health services for med-evaded PCVs, I was able to talk to a PCV who had been med-evaced to DC after being sexually assaulted. From what she described, PC offered her excellent, state-of-the-art mental health care, including EMDR and expressive therapy. She was very pleased. I know of several cases where people felt they received excellent care, to the point where they were able to return and complete their service.

Regarding the issue of in-country counseling taking place over the phone, I never knew this to happen. EXCEPT when the PCV (or a SAG member) called in from the field and it was the first contact. Routinely (in Honduras anyway), crisis mgt. was done over the phone and the person was brought in to post for evaluation. Then, s/he stayed as long as needed for a decision to be made.

Could PC staff up the Office for Special Services? Could PC hire a dedicated American mental health expert in each country? Sure (It would be a fantastic job I have thought).

Regarding the oblique reference to the ADA and the need for PC to accept applicants with histories of mental health treatment, I saw the strain placed on posts who were sent people who needed mental health "accomodations". This is harsh, but after living it for 3+ years and knowing what an immense challenge it is on every possible level 24/7, it is not fair to PC staff to require PC to create a stable enough situation for someone who requires psychoactive medication to be stable here in the U.S.

This goes to the nature of what makes PC a unique experience still. As Joanne Marie Roll says, we take the ride ultimately at our own risk and alone. As Maggie McQuaid says, we see the truth about the reality of the world and what we committed to: risk and confrontation with self. [Thanks to these two for your wisdom and perspective]. At some point, modifying the PC experience to eliminate the risk will eliminate what is best about it.

Sure, more can be done to decrease unnecessary risk.

Dr. Gerring asks whether the spring 2000 Safety and Security workshop held by Michael O'Neill for the Asia region was replicated or followed-up on. I attended a country-specific workshop in October of 99 where we (SAG members, E-Zone coordinators, VAC members) identified safety and security issues and concerns and then developed an action plan, including the design of the next All Volunteer Conference. The findings from this conference were disseminated to staff and volunteers. I personally designed and led sessions during the AVC on "Living in an Atmosphere of Violence". Other sessions relevant to safety and security (e.g., alcohol) were led by other PCVs. Staff and Volunteers participated. The overall response by all was very positive. Several specific initiatives came out of those sessions.

This could not have happened without the support and participation of the CD and other in-country staff. I do think that PC HQ has a voluminous amount of resources and support available. One glitch in getting that to the PCV in the field may lie in the 5-year rule. I understand why it is in place. However, I think that there is a lot of reinventing the wheel that goes on, also a lot of solid info and lessons learned goes into a black hole or leaves with specific people.

Dr. Gerring mentions the 1990 GAO recommendations: well-developed assignments for PCVs, adequate oversight, host govt. commitment, data to evaluate a post and PCV contributions. Again, I saw all of this in operation in Honduras. Not that wasn't room for improvement . I am not claiming that the post ran perfectly smoothly without incident or complaint. My point is that I saw the infrastructure in place, either coming from DC or in-country to develop sound projects, support (oversee) PCVs in carrying out the projects, maintain contact with host country govt. and agencies, gather data on post, project, and individual PCV performance.

On to Dr. Gerring's recommendation that there should be a peer counseling program in all countries. Here here!! It is called SAG (Support Advocacy Group) and was started by a PCV in Honduras in the late 80's. Completely volunteer run. Amazingly has maintained itself continuously since then despite the regular turnover of members. It also is not perfect. However, highly effective and cost-effective. As I noted above, the curriculum recently was revamped and updated to reflect the current realities of PC experience. Sections on PTSD, depression, alcohol and illegal drugs, loneliness, risk behavior, harassment, culture shock, etc., etc. are included. The training is a 3-day affair and quite intensive. Trainee feedback is very positive. To make a little plug for myself: I have thought that it would be a fantastic job to go around helping countries start up SAG groups...

As to the issue of site development, also key. I am perplexed though, as this was understood in Honduras. In fact, one of the main points of opening the regional office was to enhance site development and increase site visits and accessibility for PCVs.

Dr. Gerring notes that some Kazakhstan volunteers felt "insecure in their first apartment". I think this may be the norm. Is it because it inevitably takes us several months to get a (more) true sense of our communities and our neighbors? Aside from being clear about what to look for and to avoid in housing (something also covered in a new SAG training and thus something that any SAG member can help new PCVs with; also something that is exhaustively reviewed in training and with project managers), I am not sure whether this risk can be eliminated.

About the 40% who "seriously consider leaving early", I would say: Is that all? The rest must have lied.

The 33% constant-for-years ET rate also seems low to me. I think that there is a good understanding within PC of the "major reasons". Some of it is unforseeable stuff, life. How to change that?

I do think that applicants could be assessed much more stringently. Particularly with regard to alcohol and drug-related behavior. I would put this as the single greatest risky (and stupid and dangerous and destructive) behavior engaged in by PCVs and trainees. I know of several instances where PCVs put themselves, the other volunteers in his/her area, and the reputation (read: ability of other volunteers to be taken seriously and be effective) of PC at risk. These can and do become serious safety/security risks.

However, will this happen when the typical recruiter is a fresh RPCV and young? When the offices compete amongst themselves for numbers? While there is pressure to up the numbers?

Maybe the biodata weighted app suggested by Dr. Gerring would help here. I am skeptical. Face to face, evaluative interviews are essential, maybe more than once if in doubt. Conversations with family, friends, colleagues.

Lastly, I cannot end without mentioning something that significantly puts PCVs at risk but over which we have no direct control: U.S. foreign policy. Certainly since 9/11. But, I sensed increased resentment, envy, and hostility over the 3-year period of my service toward the U.S. and Americans. When will this boil over? Or has it already?

The attempt to bring PC within the fold of intelligence-gathering organizations would be even more disastrous for the PCV in the field.

Ok, I have worn myself out.

By Joanne Marie Roll (joey) on Wednesday, December 11, 2002 - 9:05 am: Edit Post

I am really learning alot from this report and the RPCV discussions. It was good to read the analysis by Barbara George. I have two questions.
The first: Kazakhstan, the COS which prompted Dr. Gerring's study, was a new Peace Corps program in a country formerly hostile to the United States. Honduras is a COS which has had peace corps programs for decades. How do you think the difference impacted the volunteer support services? What lessons can be learned (if any) from this comparison?
The second question is technical. In Dr. Gerring's report, page 4 - 5, Issue 1. is the sentence "Of those medevacs with a primary final diagnosis of stress induced disorder, 56.4% had been assaulted prior to medevac." I would like some help in interperting that data. I read it to mean that between 1996 and 1998, almost forty volunteers were medevaced with stress disorders, AFTER being the victims of criminal assult. Is this correct?
Thanks to all of you for the work and the contributions.

By bankass.com on Saturday, December 14, 2002 - 6:16 pm: Edit Post

Ms. George,

Thanks for your insight and time.

Your comments are well taken. Though I personally disagree with a number of your underpinnings. For instance, you say in the third paragraph that it is "the exception" generally that the CD, sub director's and PCMO's are not bad apples. Sorry, I will have to say, "I don't agree with you".

In most cases these are the folks trying to fire people and put the blame on the volunteers. Walter Poirier's APCD, I think was at fault not Walter. In my case, the medical tryant had her own personal problems she dragged into Peace Corps and then reacted on me with her anger. That is my opinion. In my case, the PCMO in Washington, coerced me into her designed ability to get me fired. Thirdly, Country Director's are too political with providing resources for volunteers at their given sites. They may be qualified on paper, but are they qualified in being fair, just and empathetic? In my experience, no. And the experience above is just one of thousands. There are solutions to the problems you present. A lawyer working on behalf of volunteers, so that staff don't misbehave, take advantage of people, or try to screen to keep their friends in and "different volunteers" out.

Tolerance and empathy could help. How do you measure it?

I think you can measure it by the 33% of attrition rate that you agree may be low. I personally think its 40%-45%. Even if it 33% percent. It should be between 5%-7% of volunteers leave service. If you put more resources into the what you already have, the volunteers, and empower them, that's when the program will thrive and be a "biopsychsocial model". With support, every volunteer will feel better about their Peace Corps experience. I also think that Peace Corps from the Director down has to have a goal 5% attrition rate. Put the emphasis on retention. If a volunteer comes back to Washington with a medical issue, that they won't necessarily be fired. With an attorney on their side, none of the "monkey business" at Support Services will occur.

However, I do agree with you on issues related to in-service counseling and they are good points to raise. Peace Corps is an un-normal thing for many American's. We are in a foreign land, have a new job, diseases and a host of other things. I think it is essential that the staff have more counseling, but not so much documenting the sessions, but giving their advice openly without the threat of being fired.

I don't agree with you about, The Office of Special Support Services. They may be well trained, but their assumptions, opinions, judgemental attitudes becomes a culture at Peace Corps which hinders the volunteer support. The current Director told someone directly in the this office not to handle my case last year. He used his "political hack weight" to cover up even more. That isn't supporting anybody. If they treat me wrong and many others. How can you say they are qualified? Many people have been sending e-mails with their separation nightmare experiences with Peace Corps. It is also known now in the general population.

My negative comments on some of your discussion are not with mal-intent. You raised a number of good issues and I appreciate all your attention you have given to this issue personally. Perhaps, someday people like yourself and a group of us will have constructive discussions about changing the culture of firing people, fear of being fired, safety of volunteers through support and site selection, volunteer support at site with financial resources and volunteer "rights" support with an active attorney working for volunteers.

By Jamaican RPCV on Monday, December 16, 2002 - 9:47 am: Edit Post

FYI - should be noted that the statistics are under estimated. They do not take into consideration mental health (such as PTSD) treatment sought after service. Even though the trauma is PCorps related, often these cases are treated under a RPCV's personal health insurance, sometimes years after COS.

This is a serious issue and I applaud those who have worked so hard to make appropriate changes.

By bankass.com on Wednesday, December 18, 2002 - 10:08 am: Edit Post

To Jamaican RPCV,

I hear you, man! or woman! Just trying out my Jamaican. Kidding. You are right this is no joking matter. I probably have some forms of it myself, however, because Peace Corps separated me wrongfully on their bogus terms. I pay for my government service in terms of health care costs and other costs related to it. Because Peace Corps has only one method of dealing with this, through FECA, a bureaucratic nightmare. That is why we need advocates (a lawyer) working for us, so we can bring our experiences home properly (3rd goal), make sure Peace Corps looks out for us as well as the lickspittle group who get all the priviledges. You and I should not be paying for health care related to service. That is unjust and needs to be stopped.

Keep participating on this discussion board. I have been getting alot of e-mail about from RPCV's and Separated Veterans concerning their treatment. Thank God. You wrote in.

Another thing, until you and I and volunteers who have been injured and hurt by Peace Corps are involved in our own decision making about these issues, they won't change. When I saw my Congressman, I told him I did not vote for him because of this issue. Congressional Members are fully aware of the corruption at Medical services and after service services volunteers are not getting.

I have lost so much money fighting this. I will be trying to enter law school myself. There are too many people who have suffered, are suffering and been killed, that it is time to start speaking out and making Congressman Far, Chris Dodd, Chris Shays and other former RPCV's on the hill do the right thing by enabling us.

Another action you can take, Call John Kerry Presidential Campaign. Ask them what they have done on behalf of Walter Poierer and other Peace Corps Veterans. Ask him if he has helped me Daniel Pailes, a Massachusetts Constiuent. He has not. Make it part of the National Debate. He has been on the Foreign Relations Committee for alot of years now and done nothing for us legislatively or on a constituent level. He is a great guy on many issues, but not this one. He cow-tow's to Senator Dodd because he wants his support for the Presidency.

Howard Dean of Vermont is considering our concerns. Howard Dean was a Doctor and is more qualified on these matters than any other candidate.

When it becomes a national issue we will get services. That is when NPCA President, Dane Smith and the country club RPCV's will have to help us, Gaddi Vasquez will have to react and other bureaucrats will have to find excuses for their misdeeds. They will put up great arguements. But, just remember. They are being paid for their job, while you go to the Doctor and pay your medical bill.

Thanks for your service.

By kc76 on Tuesday, January 07, 2003 - 8:58 am: Edit Post

Hi to all,
This has been an interesting conversation of sorts. I agree that the issues definitely need some attention, but I do not agree with some of the generalizations.
I was also a PCV in Kazakhstan 1999-2001. It was a wonderful experience. Of course, every experience at every post will always be different, especially in a country as large and varied as Kazakhstan. I have heard some stories about PCVs with valid mental issues which required help from the PC staff, and I am not sure how helpful the staff was (although I thought our PCMO was excellent). However, I do know of several people who used 'mental crisis or stress' as a way to get off their post and possibly go home. In fact, one girl devised a plan to 'get medevaced.' While this is probably the exception to the rule, I think it can be said that there are people who should not have joined the Peace Corps if they did not expect some hardships. THese people complain about the lack of comforts, the distance, and lack of general services of the country- what did they expect? This same individual taught school in my town and had constant fights with officials, other teachers, and students because things were not going according to her plan. She became stressed and wanted a break. Clearly, much of the problem was with her, not the host country conditions. And yet, were PC to say it was her, people would blame PC.
I do believe that more sight visits by staff are required. For us, they came once a year for a half day- and there were 6 PCVs in and around our city to see. This was highly insufficient. I also believe, in the case of Kazakhstan, that there needs to be another PC office in the northern part of the country-which is 3 days by train from the current office. For a PCV to be in such a bad state to want to travel that far to see a doctor- it has to be really bad- and then it's too late. The country is just to vast to have one office in a non-central location.
As for security and safety, this is also an issue which needs attention. But I agree with Maggie in saying that people can't expect PC to be fail-safe. We are working in developing countries, often hostile environments and part of the job is to overcome that and form friendships.
In conclusion, I think these issues are realities that need to be dealt with. But I also hesitate to put the total blame on Peace Corps as an institution. Not ALL CDs are bad- how can anyone make that generalization- have they served in EVERY country? WHile PC could probably do a better job hiring more appropriate people for posts overseas, they could also do a better job screening volunteers, although it would be difficult. I do not believe everyone who goes into PC belongs there- some people create problems and blame the system when the system won't 'help.' It is easier to tell everyone back home that you left because PC didn't provide, rather than saying you couldn't hack it. THere are problems with the PC system. But volunteers need to also meet them halfway and know going into it that it will not be luxurious. That way, when there are REAL mental, physical issues they can be addressed quickly and without doubt.

By Don on Tuesday, January 07, 2003 - 12:06 pm: Edit Post

This discussion has intrigued me. Fortunately, Barbara George weighed in before I got around to it and presented a viewpoint with which I completely agree. I'd just like to underline a couple of things. Of Gerring's five recommendations, the first four are fine. One and four are, based on my extensive experience in Latin America, pretty much in place. Two and three are fine if, as George recommends, they are "de-shrinked." Which leaves number five. This one is out there--way out. Since my stint as a PCV in Bolivia 1962-64, the application, invitation, training and selection process has experienced virtually every iteration possible. Attrition was and is about 30-35%. Peace Corps remains a unique people-to-people, face-to-face kind of experience which will proudly fly in the face of any egregious attempt to "customize a biodata profile tailored to predict turnover." You take the human element out of application and selection--you take the human element out of Peace Corps. Finally, as Maggie McQuaid suggests, we probably can't and may not want to completely sanitize the experience and make it fail-safe.

By kaz7 RPCV on Tuesday, January 07, 2003 - 3:24 pm: Edit Post

I, too, was a PCV in Kazakhstan from '99-'01, and I, too, had a positive experience and fond memories. I am, however, curious if the posting by KC76 of the girl who devised a "plan" to be medevaced in based on fact or rumor because we all know how the Peace Corps rumor mill works, no matter what country you are in.

While it is true that in a country as vast as Kazakhstan, volunteers will have a variety of experiences, I do not think that KC76 could argue the fact that many volunteers were unsatisfied with the support that they received from staff. If KC76 would like to argue this, I refer him/her to the OIG report that was published based on interviews from volunteers from Kaz6 and Kaz7.

In response to the statement by Barbara George: "Regarding the issue of in-country counseling taking place over the phone, I never knew this to happen. EXCEPT when the PCV (or a SAG member) called in from the field and it was the first contact. Routinely (in Honduras anyway), crisis mgt. was done over the phone and the person was brought in to post for evaluation. Then, s/he stayed as long as needed for a decision to be made.", I have personally experienced the over-the-phone counselling and I know of other PCVs in Kazakhstan who experienced the same thing. I can remember the PCMO sending me a box of books to relieve my depression and anxiety and telling me that I should read more. I had plenty of books, it didn't help my problem. That's when I knew that I had two choices, to figure it out on my own or go home. Lucky for me, I didn't have a serious mental health problem, otherwise I may not have been able to figure it out on my own. I remember another PC Kazakhstan volunteer being upset becuase the same PCMO told him to "light a candle and take a bath". Neither one of us were even given the option of further counselling and/or assessment.

The fact remains that the PCMO in Kazakhstan did a good job with resources that they had, but if you refer to the OIG report that has been published on Kazakhstan, you will see that they did not fullfill their obligations as medical officers and it could be argued that they were not given adequate resources (staff and financial) to fullfill this obligations.

And so, while every volunteers knows and assumes some risk, the Peace Corps needs to stop hiding behind this and the flexibility issue. They need to take responsibility for their actions and change what needs to be change. And, even if our CD was one "bad apple" in the bunch, isn't one bad apple to hundreds of PCVs who served under him too many? Does that justify the frustrations that were felt in Kazakhstan? What is good to know for me, personally, is that other volunteers from around the world feel similar about their experiences.

By Tiffany K6 on Tuesday, January 07, 2003 - 4:37 pm: Edit Post

I would just like to add, on top of all this very constructive feedback from both sides, that the Peace Corps is an enormous organization. Each country is unique, each in-country staff is unique, and each CD and their interpretation of PC policy is unique. I was a PCV in Kyrgyzstan from 98-00, on the border with Kazhakstan, and had the opportunity to meet with other PCVs from Kazhakstan and Uzbekistan and compare notes on how our country offices were run. In the same area of the world, the differences in attitudes towards PCVs were drastic. You are dealing with different conditions, travel requirements and staff in each country. Even if changes were made in DC, would these policy changes necessarily "trickle down"? It does seem to me that peer counseling is the best place to start -- PVCs helping other PCVs -- but it needs to be instituted in every country, and that is an awesome task. Perhaps it would do more good for RPCVs to start with their country of service and instigate for changes there, providing ideas and support to local staff and PCVs, instead of asking DC to send out the psychiatric troops. As bumper stickers in my part of the US like to claim, "If the people lead, the leaders will follow."

By kaz7 RPCV on Wednesday, January 08, 2003 - 11:17 am: Edit Post

I agree with Tiffany K6 to an extent that Peace Corps is a huge organization. However, if you read the OIG report published on the Kazakhstan office, it is clear the PC Washington did literally nothing but slap the hand of the country director.

I think the point needs to be made that PC Washington has an obligation to step in when something in an individual country is not right. I am also learning through these comments and other research that the Peace Corps as a whole has a history of not accepting responsibility and covering up situations ... just an observation.

By McGarvey, Kimberly L. on Wednesday, January 08, 2003 - 11:43 am: Edit Post

I was in Fiji in the 1980's and it was clear at that time as well that PC-Washington takes little responsibility for supporting volunteers.

There were huge issues with medical problems that ended up damaging volunteer health for a lifetime that would not be addressed openly or with primary concern driven by health and welfare of the volunteer. There were problems with volunteer placement that had been on-going for years that never got resolved!

PC is huge and the differences from country to country are legitimate and profound but that does not in any way, in my view, relieve PC-Washington or the in-country PC staff from supporting volunteers...

Kimberly McGarvey
Fiji 58 (1985 - 87)

By mike osborn (majoroz) on Wednesday, January 08, 2003 - 3:32 pm: Edit Post

Interesting stuff. If PC would realize it means "Peace Corps" and not "Politically Correct", many of the problems would disappear.
My service (Micronesia and Palau, 1994-96) differed in that our CD was a hack and the PCMO was an outstanding person who simply ignored policy and did for the volunteers what was needed.
Perhaps the mort egregious treatment of volunteers is that, during training, we were instructed, in many active and passive modes, to be subservient. The women, in particular, were told, in no uncertain terms, never to offend, in any way, any male.
Example: when a male member of the family was in a room that the female PCV entered, she was prohibited from having her head higher than his. This resulted in a game for the HCN and a form of torture for the PCV, as the male lowered his head to the point that the PCV had to crawl across the floor.
When the complaint was raised to the CD, the response was: "that is their kulll-churr".
I am a volunteer. Abuse me and I un-volunteer. I came here out of a sense of help to do what I can to give WHAT YOU REQUESTED.
In my personal case, I did not have a problem. I arrived on site two weeks after my 55th birthday, having world travel experience (much of it backpack style) and having retired from the military thirteen years previous. I had seen hacks like our CD before and ignored him in order to do what needed to be done on site.
The other older volunteers (the oldest average age in the history of this post) acted as the advisors and "parent" figures to the young idealists. My shack served as a refuge to many of them to get away from abusive practices from their "families".
What happened was the PC office became a mail room and a place the see the doc. Other than that, nobody concerned themselves with it.
When the next hack CD came in, he wanted us all to turn in our passports to the office, "to keep them safely in the safe". We all ignored him. He threatened to send us all home. We all ignored him.
At COS, we partied and filled out paperwork, and partied some more.
We finished with the highest retention rate in the history of the post.
Our programs grew, both in kind and quality. Most of us remain in touch with the locals, but few of us remember staff names.
Peace Corps never had a clue.
WE are our only source of support.

cheers

oz

By bankass.com on Tuesday, January 14, 2003 - 10:08 pm: Edit Post

To all who try to say Peace Corps can't be fail safe. I agree, but it can be 95% fail safe with good programming and taking resposibility. I am concerned that volunteer's stating that one has to endure an unsafe environment to the point of death. As one woman has told me who lost someone in Peace Corps service. "If volunteers have this attitude even after service, perhaps they should join the Army."

I think to myself after what I went through perhaps the military would have been a better option. At least they back each other up.

P.S. I just turned forty. Still no justice in my Peace Corps case on a personal level. 14 years. There will come a day, my case will get resolved. Unfortunately, I will have to go to law school to do it. That is not why a person joins the Peace Corps.

By Joanne Marie Roll (joey) on Sunday, January 19, 2003 - 11:56 am: Edit Post

Mike Osborne’s recollection of life in Micronesia and Palau (PCOL 1/8/03) was right on target: Bond with your buddies - minimal cooperation with authority. That is how GIs were trained to survive as POWs. How ironic that Mike found another hostile environment in which those techniques also worked. These are my thoughts and suggestions after reading and pondering all the articles and posting on PCV Support Services.


I believe the institutional environment of the Peace Corps agency makes the delivery of Volunteer support services difficult and can, itself, contribute to stress. Every serving volunteer has two essential relationships; the most important is the relationship with the COS people with whom he/she works. Maggie McQuaid (PCOL 12/3/02) has most eloquently described the beautiful and existentialistic nature of this relationship. But, serving Peace Corps volunteers also have a relationship with the Peace Corps Agency. This is the one I want to talk about. It is not necessarily pretty.

The volunteer is literally a creature of the agency-a status unique in American public law. The work of the volunteer is not necessarily valued because Peace Corps staff do not to have served, first, as Volunteers. Nor has any persistant effort been made, through the decades, to document the actual Volunteer field experience. This means there is not a comprehensive record of reference to frame the agency envirnoment. If as a Volunteer, you are powerless and the work you are doing is not valued and the effort you are making is not validated; then any mental health problems you have will be aggravated.

If a volunteer is well trained, well placed and very lucky, the system works. But when any problem occurs, then these conflicts and incongruities in the system can create havoc for the serving Volunteer. Ironically, the Volunteer (in difficulty ) replicates the exact situation of the powerless poor with whom he/she was sent to help. The Volunteer may beg, pray, bribe or attempt to seek the intervention of powerful patrons; but is finally absolutely dependent on the what can be the arbitrary decisions of the agency. This dependency can be god awful-given the fact that the Volunteer is in a 24-7 cross cultural environment and ego committed in a unique psychological way. As a dear RPCV friend said to me “ Duh. We all have PTSD. Have a beer.” I did. PCV friends kept most of us sane and safe. That’s the lucky part.


But that is not enough. One way to improve the delivery of support services to volunteers is to improve the relationship between the volunteer and the agency. Three changes would help:


1) Give every Volunteer a Service Contract...spell out rights and obligations in individual contracts...gives the volunteer status and power, independent of the staff
2) Enhance so-called institutional memory by exit interviews with every volunteer...and make that information widely available.-providing privacy and security safequards for returning volunteers and COS nationals.
3) Make previous successful volunteer service a prerequisite for employment-reduces “disconnect” validates experience

A individual service contract could spell out medical services-defineinformed consent; confidentiality; independent second opinion; protocols when the volunteer is a crime victim and the responding staff is the medical officer and the issues surrounding all maleria medications.
Specific prohibition against intelligence gathering should be restated, in the contract, to protect the serving Volunteer.
Issues, such as, First Amendment rights; Draft eligibilities; In Country relationships with American military personnel (see Ready Reserve volunteers) should all be clarified. Service contract could also appeal procedures and specific reasons for early exit and at whose discretion.

Information from an data bank of exit interviews, could facilitate safe and healty COS placement. For example, through time and space, how has isolation impacted the mental health of the serving Volunteer? Do Volunteers do better assigned in pairs? Victims of criminal assult appear to be at higher risk of mental health problems. How is placement associated with these factors? What about “site partner” personality problems?
What happens to volunteers assigned to programs where they are overwhelmed with death and dying? ( ie the HIV/AIDs programs or materal infant health....in countries where the basic medical infrastructure is not there?) The mantra is: over 160,000 volunteers in 130 plus countries in more than forty one years. Where is the sum total of all those experiences recorded and archived? Nowhere. Why? Because a whole lot of people working for the peace corps agency didn’t think it was important. Which is why sucessful experience as a Peace Corps Volunteer should be an employment prerequistite. To staff an unique mission with people who are unfamiliar with the philosophy and work of that mission is in a word - “crazy-making.” and that is where I came in.

By bankass.com on Monday, January 27, 2003 - 9:16 pm: Edit Post

Joey Marie Roll,

I too read your comments regularly. You provide alot of great insight. Especially, your consistent advocacy for documenting the Peace Corps service. I think it is a good idea and is attainable to some degree. Perhaps, one day, a director will see the value in it.

I know decisions are arbitrary at Peace Corps. At times they can be capricious too. I think staff that work in volunteer support have to understand each volunteer's experience is important and should be valued. I have to say, after all the things I write and all the negativity that has come my way. I know I did a good job in my village and Peace Corps provided the venue and opportunity to do so.

The sucess of my experience was in the time I spent working in my village. For the last week of service, I think it was negative and I would not want to see others go through that. We are at the mercy of a system and staff of Peace Corps. However, we do live in a democracy, live within laws and if "you" as a volunteer are not treated right we should have recourse. If we are "at the hands" of bad personnel and our service and "volunteer time is not validated", we should be able to speak, seek our rights, and have a lawyer working for us and ultimately be able to define our own experiences. We are grown people. In a democracy, all people are heard, even the powerless if they seek it. When we serve in Peace Corps we are serving the America whether we like it or not. It is my belief that the decisions some of the staff members make "officially define" a sucessful experience. Therefore, at times staff members are making decisions on cirsumstances they are aren't qualified to make, authorized to make and at times make that negatively effect people. The Political Tiger's tail should be caught if these occurences happen, especially a person "volunteering their time" vs the person gettting paid.

Personally, I have never filled out my COS because my country director at that time would have to sign off on it and the medical separation I have continues to be bogus. So, how are we able to fill out the form?

As I have said in the past, the Peace Corps reform is coming. Too many people in the public know now, that the mistakes of the past need to be looked at, to make the program more of a sucess for all American citizens who want to volunteer for their country.


I am tired tonight. So that's all I have for this evening.

Thanks,

Daniel

By bankass.com on Monday, January 27, 2003 - 9:29 pm: Edit Post

Kimberly McCarvey,

Thank you for expressing your opinions on support. They are appreciated.

Daniel

By Joanne Marie Roll (joey) on Saturday, February 08, 2003 - 12:20 am: Edit Post

Daniel,
It is so powerfulto me that you still reaffirm your Peace Corps experience and committment. I don't know what happened to you during the last days of your tour but it must have been awful. I hope that you soon have a good resolution.
Joey

By Prospective PCV on Friday, September 05, 2003 - 9:24 pm: Edit Post

Thank you for your insights. I am a senior in college and considering becoming a PCV after I graduate. My father was a PCV in Western Samoa in '69-'70 (I think), and left after a year because of similar problems with bureaucracy at his site that so many of you have mentioned here. From what I have heard, it seems like the Peace Corps is a "mixed bag" -- I have heard so many complaints about problems within the system, yet its veterans (my father included) seem to be such amazing individuals, much of it due to the Peace Corps experience. Please continue making your comments, prospective PCVs much appreciate it!
Laurel

By bankass.com on Saturday, September 06, 2003 - 11:03 am: Edit Post

Laurel,

You are right. Peace Corps will be part of any of us who really serve a good amount of time. Its really too bad the rights aren't set up so that your dad's experience can be validated properly. We are strong willed folks. Most of the time, we have a political or social concern that motivates us to perform in the areas we are striving to endeavor in. I just met some volunteers from Namibia, Turkminstan SP?, South Africa, and Poland working with Howard Dean last week in New Hampshire. In the book trade I work in, I always come across RPCV's.

When I meet a former volunteer, whether i like them Personally or not, I have respect for their committment and third goal committment.

I really don't like to discourage people from joining Peace Corps. I sent some folks under Peace Corps nose who did just fine. I warned them about bureaucratic nightmare and told them to stay away.

Its culture will change. Our generation is recognizing the need for structural changes in discriminating against each other. Discriminate meaning a disconnect between two different experiences which occur in service.

Your father should be proud of his service.

Peace Corps is an adventure. It is an individual experience, so I say experience it. However, make your own rules with them (the Great Bureau in the Sky, the Peace Corps policy). Don't let them push you around. You are the program, not the administrators. Remind them of that.

Go in and have fun. If they start the monkey business tell them you know who we are and can contact us to help you. You will see them change their tune. Alot of people are becoming aware that you should have rights as a volunteer. We are not perfect, but we are better than the IG sometimes.


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