Fieldset
Mental Health in MSF: The Ultimate Improvisation

"In my previous life, my favorite pastime was performing improvisational comedy."

The improv team

In my previous life, my favorite pastime was performing improvisational comedy (improv). Improv is a type of theater where the entire show is created on the spot, based on a random word or idea solicited from the audience. It’s acting on stage, usually in front of an audience, but without a script, props, or virtually any rules or structure of any kind.

Every practice, every performance, is totally unique and never repeated in exactly the same way. It’s unpredictable and at times extremely anxiety-inducing and/or embarrassing, but almost always super, super fun.

I’ve learned a lot from my years of classes and performances, including: flexibility and going with the flow, better teamwork and listening skills, comfort in public speaking, and, well, how to improvise. That is, to produce something from whatever is available. Thinking and acting on the fly. 

Christine Rufener  The "improv" team.

You can probably see where this is going. That MSF life is basically one giant improv. Particularly, I suspect, on one’s first mission, though time will tell on that one. Not only have I had to learn the basic ropes of a new job (the rules and regulations, human resources structures, a new acronym-heavy vocabulary), but I’ve also had to adjust to living in a new, developing culture, and on top of that, learn how to cohabitate with my coworkers, who bring with them their own unique cultures, languages, and personalities. 

Then there’s the work itself, where even the most basic communications are complicated by language and translation barriers. Where I work without the basic comforts that I’m used to—reliable internet; copy machines and fully stocked office supply cabinets; a temperature controlled, insect-less office; or even coworkers with similar backgrounds. I previously worked in a large hospital with 30+ other psychologists. Here, since March, I’ve been the only Mental Health Officer (MHO) in MSF Myanmar, so I can’t exactly easily phone-a-friend, much less walk to the office next door, for consultation or advice. It’s been a steep learning curve, with more than its fair share of frustrating and wearisome moments. Repeatedly, however, those improv skills of flexibility and going with the flow have proven to be invaluable. 

Clinic staff have mentioned that they have gotten to know each other better, feel more comfortable approaching team members with problems or questions, and are more aware of how their verbal and nonverbal communication impacts clients. The awesome power of improv!

Altogether, improv has affected my successful and enjoyable times just as much, if not more, than it’s helped me in my challenges. Here are just a few memorable experiences where it came in handy:

  • When, days after first arriving, I was handed a microphone at our clinic Christmas party and directed to sing “Feliz Navidad,”
  • When teaching a seminar of 30 national staff about self-care and a male participant yelled out "what about sexual practice?"  And then a female participant yelled "That doesn’t count because only married people practice sex!" And 30 heads spun towards me for my reaction.
  • When I had no idea I was expected to talk about MSF and mental health to a group of 15 IDPs (internally displaced people) camp leaders…but I was. (This has actually happened so many times that I quickly learned to expect it.) 
  • When I have reserved two hours for a training, and finish the material in 45 minutes...   
  • When a very young and sweet national staff coworker very innocently asked me, "Christine, is it OK to call my girlfriend a (vulgar word found in many rap songs)?"
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Upon reflecting on how much improv skills have helped me in my work, I wanted to try teaching some of the games to our clinic staff. For the last couple of months, we have turned Friday mornings into Improv Fridays, where available clinic staff gather for an hour of team-building activities that teach and reinforce a variety of communication skills: reading body language, monitoring one’s own body language and facial expressions, supporting coworkers, and working as a team to accomplish a goal. We also have a blast, and it’s quickly become one of my favorite times of the week. Clinic staff have mentioned that they have gotten to know each other better, feel more comfortable approaching team members with problems or questions, and are more aware of how their verbal and nonverbal communication impacts clients. The awesome power of improv!

I haven’t yet actually tested their improv prowess, but they have caught onto the games quickly and improve week by week in terms of being flexible and thinking on their feet. It may be time to shove a microphone in front of them and request Feliz Navidad. After all, Christmas is right around the corner…