Most of the people who start to work for relief agencies in Africa have not bad previous experience of knowingly contributing to the suffering and death of a large number of people. Relief agencies do not tend to attract people who have this sort of experience, and they do not include it in their job descriptions when recruiting. Yet the disturbing activity of voluntarily being unpleasant to strangers is one of the most frequent activities that working in a relief programme involves. This is a striking claim, but in this paper Alex de Waal argues that it has a significant element of truth, and that it results in important psychological damage to relief workers and impairment of relief programmes.