FACE Director discusses compassion of the Twenty-Fifth Annual Trachoma Program Review

Recently our founder and director, Dr. David Addiss, spoke at the Twenty-Fifth Annual Trachoma Program Review meeting held at The Carter Center. In his role as chair of the Trachoma Expert Committee (TEC), Dr. Addiss took the opportunity to speak on the overlooked yet vital nature of compassion within global health. Take this chance to read his words for yourself below!

Photo credit: The Carter Center (original post)

As we come to the close of the Twenty-Fifth Annual Trachoma Program Review, it’s fitting that we spend a few moments reflecting on the importance of compassion. Indeed, this Trachoma Program Review is itself a powerful manifestation of the compassion that each of you bring to your work.

Psychologist Paul Gilbert’s definition of compassion is a good one for us in global health: “sensitivity to suffering in self and others with a commitment to try to alleviate and prevent it.”1 Another useful framing, favored by Dr. Shams Syed and his colleagues at the World Health Organization, is that compassion is composed of three key elements: awareness of suffering, empathy, and action to alleviate or prevent that suffering. 

I’d like to suggest four reasons why compassion is important for our work to eliminate blinding trachoma. First, compassion is essential to who we are as humans. After studying the world’s major religions, scholar Karen Armstrong concluded that, “The principle of compassion lies at the heart of all religious, ethical, and spiritual traditions.”2  Even Charles Darwin recognized the importance of compassion for human survival and flourishing. In The Descent of Man, he wrote, “Communities with the greatest number of the most sympathetic members would flourish best…We are impelled to relieve the sufferings of another in order that our painful feelings may be at the same time relieved.”3

A second reason for the importance of compassion is that it motivates our work. As noted by a gathering of eminent global health leaders at The Carter Center 14 years ago, “Global health is rooted in the value of compassion and grounded in an awareness of our interconnectedness.”4 Compassion has been a strong and explicit motivation in the NTD community, in particular.5 And, compassion motivates us individually. Many of us entered the field of global health after a powerful personal experience of compassion – often an encounter with a particular individual, perhaps a patient – that shifted the trajectory of our lives.  

This leads us to a compassion paradox. It is often these individual personal encounters that shape and motivate us. But in global health, we operate through complex systems and bureaucracies – which are sometimes impersonal. In his autobiography, Larry Brilliant recounts how, as young clinician in India, distraught by his inability to save the lives of individuals who were dying of smallpox, Bill Foege advised him, “As a public health doctor, your satisfaction comes quietly, alone, late at night when you are analyzing numbers. You won’t be able to watch the curve of a child’s fever on a hospital chart go down and feel good about yourself. You have to look at charts and graphs of hundreds of anonymous cases, watching the epidemic curve instead.”6

But the challenge is that, when we focus solely on the numbers, we lose connection with the motivating power of individual relationships, we risk losing our moral bearings, and our motivation dissipates. So, when speaking to a public health audience at CDC in 1984, Bill Foege famously said, “If we are to maintain the reputation this institution now enjoys, it will be because in everything we do, behind everything we say, as the basis for every program decision we make—we will be willing to see faces.”7 Not more modern laboratories or smarter epidemiologists, but the willingness to see the faces of suffering. In global health we need to see the faces to regain our perspective, restore our human connection, and reinforce our motivation – even while we attend to the numbers. To have compassion for populations – to have “compassion on the multitudes,” in the words of the New Testament – we need to see the faces and the numbers at the same time. Characteristically, Dr. Foege doesn’t tell us how to do this – he leaves it to us to figure out. The presentations and discussions during the past two days reveal that, many, if not all of you, already have this ability.   

Third, compassion leads to better health outcomes. In his recent book, Compassionomics, Steven Trzeciak has detailed the benefits of compassion in health care settings: for patients, providers, even health systems.8 Our experience tells us that this also applies to global health.

And finally, compassion sustains us. When the flame burns low – when we ourselves suffer – we rely on the compassion of our colleagues, families, friends. Theologian Paul Knitter was referring to this sustaining power of compassion when he wrote, “Unless the tree of justice grows in the soil of compassion, its roots will not go deep enough to bear lasting fruit.”9

President Carter noted that compassion is a choice. He and Mrs. Carter chose the way of compassion throughout their entire lives. In President Carter’s Nobel Prize speech, he said, “We can choose to alleviate suffering. We can choose to work together for peace. And we must.”10 Thank you all, for choosing compassion, and for your amazing, inspiring, consequential, compassionate work.

Photo credit: The Carter Center (original post)

References

  1. Gilbert P, Catarino F, Duarte C, Matos M, Kolts R, Stubbs J, et al. (2017). The development of compassionate engagement and action scales for self and others. J. Compassionate Health Care 4:4. doi: 10.1186/s40639-017-0033-3
  2. Armstrong K, 2024. Charter for Compassion.  http://charterforcompassion.org/
  3. Darwin C, 2004. The Descent of Man, and Selection in Relation to Sex. London, England: Penguin Books. (Original work published 1871).
  4. Task Force for Global Health. 2011. Compassion in Global Health. Richard Stanley Productions. http://www.taskforce.org/press-room/videos/compassion-global-health-video.
  5. Addiss DG. Global elimination of lymphatic filariasis:  A “mass uprising of compassion.”  PloS Negl Trop Dis 2013; 7(8): e2264. 
  6. Brilliant L, 2016.  Sometimes Brilliant: The Impossible adventure of a spiritual seeker and visionary physician who helped conquer the worst disease in history. New York: HarperCollins. 
  7. Foege, W, 1984. Smallpox, Gandhi and CDC.  Fifth Annual Joseph Mountin Lecture. Atlanta, GA: Centers for Disease Control, October 26.
  8. Trzeciak S, Mazzarelli A, 2019. Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference. Pensacola, FL: Studer Group.
  9. Knitter P, Haight R, 2016. Jesus and Buddha, Friends in Conversation. New York: Maryknoll.

Carter J, 2002.  Acceptance speech: Our nation’s past and future.  https://www.jimmycarterlibrary.gov/sites/default/files/pdf_documents/assets/documents/speeches/acceptance_speech.pdf

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