In 30 years of practice, Dr. Zerihun Tadesse has touched nearly every part of the Ethiopian health system. He worked as a general practitioner in a rural area for seven years, then as a psychiatrist, and served in the Ministry of Health as director of disease prevention and control before joining The Carter Center in 2009. As the organization’s country representative, he oversees 460 employees, a $19 million budget, and many programs on neglected tropical diseases, including trachoma, river blindness, lymphatic filariasis and guinea worm.

In recent years, Zerihun has developed a new appreciation for something he learned, not through his medical training, but as a boy from his mother: compassion.

“I found compassionate leadership as a gateway to working smarter, to excel, and to maintain my interest,” said Zerihun, 54. “If I work harder and harder, the risk of burnout would be very high, and there is no way for me to give compassion to others when I’m not taking care of myself. I really want to belong to the modern leaders and the best way is to be a compassionate leader.”

In the last quarter of 2020, Zerihun joined an eight-week program on “Compassionate Leadership and Resilience Training for Global Health Leaders” led by the Center for Compassionate Leadership and The Task Force’s Focus Area for Compassion and Ethics (FACE), with 22 participants from 11 countries. 

“He took the teachings and lessons seriously and applied them while working under very stressful conditions,” said Dr. David Addiss, FACE Director. “In addition to COVID, there’s a humanitarian tragedy unfolding in Ethiopia, and he’s in the middle of that. But after spending time with him, even on Zoom, you feel good. You mention Zerihun to people and people smile.”

Zerihun applies a disciplined physician’s approach to management. A self-described “morning bird,” he gets to work three hours early to prepare for the day. He’s mapped out a schedule that prioritizes quality time with his colleagues and with the communities they serve.

“I love monitoring meetings to see what the progress looks like,” said Zerihun. “I never miss them because these are opportunities to take the vital signs of my colleagues as well as the vital signs of my organization. With organizations, if we don’t take care of them they also get sick like people do.”

Likewise, he schedules community visits every other month, “spending hours working in the village searching for anyone suspected of having guinea worm,” a disease so painful and debilitating, he says, that the consequences to families can be beyond words.

“I go out to see how the program is run and that is the best opportunity for me to talk to women, children, the elderly, the chief and so on and make sure they are getting the best service we can provide,” he said. 

He describes these visits like a physician analyzing a drop of blood for type, number of red cells, and number of white cells. “To get a sense of where the program stands, the partnership with the community, and what the partnership with the government looks like. It gives me limited information in a number of areas,” he said. “And then I bring the people with expertise into a room to help me triangulate the information I got.”

Zerihun’s active, engaged listening and forums for heart-to-heart conversations are key to the approach the FACE team is promoting with health workers.

“It brings to mind all the people we are trying to support to maintain stamina and morale amid COVID-19,” said Ashley Graham, Director of Research and Operations at FACE. “Compassion is one of the many ways that we can support our workforce; those that demonstrate compassionate leadership really contribute to a stronger workforce.”

The FACE team notes that there is a shadow side to labeling health workers as heroes. 

“That’s part of the burnout, the heroic narrative that we’re always coming in to fix things,” said Addiss. “We in public health nurture and depend on idealism. Over-identifying with heroism might be helpful for a sprint but it’s not good for a lifetime career.”

Even during normal times, Zerihun’s work is challenging. The past two years have been anything but normal. Not only has Ethiopia suffered the impact of COVID, but it has also seen civil conflict since November 2020, which has killed thousands of people and displaced more than a million.

Zerihun spoke frankly about the repercussions.

“First and foremost the fact that we have very little if any control about what is going to happen puts everyone in a dark situation, that really makes most of us feel sad, that drains energy for a multitude of reasons,” he said, noting the loss of many beloved and influential people, including close friends and one he describes as his hero and mentor. “This communicates that anything could happen to anyone at any time. That very thought demotivates, and puts so many things at stake, so this feeling is really troubling.”

Zerihun himself had COVID in March 2021, which he describes simply as “a very tough time.” 

It’s not just the physical effects of the disease that take a toll, he said, but the way the pandemic affects interactions, forcing questions and decisions about participating in routine activities like weddings, graduations, and birthday parties. 

“If you say no then people will be disappointed and it makes it difficult for us to prioritize what is the right thing to do,” he said, putting words to an experience felt worldwide and adding that to live this way for so long is draining.

Speaking during a “Global Health Compassion Rounds” webinar, co-hosted by FACE and the WHO’s Global Learning Laboratory for Quality UHC, in March 2021, Zerihun discussed his motivation for incorporating compassion into his work. He recalled a one-on-one meeting with a coworker, who told him that the thing he appreciated most is that when a colleague lost a loved one, Zerihun always attended the funeral. 

“You see, little things make a lot of difference. It works very well if you first connect as human beings before you connect as coworkers,” he said.

Since December 2019, the FACE team has offered seven quarterly “Compassion Rounds” webinars, reaching more than 1,000 people in 60 countries, and three compassionate leadership trainings like the one Zerihun attended in late 2020. 

FACE Director Addiss emphasized the significance and impact of being intentional about compassion as Zerihun is trying to do.

“Without the Zerihuns our systems would be even less compassionate, and we would be bleeding public health workers even more than we are,” said Addiss. “Why Zerihuns are important is because, in their positions, they are able to affect systems change that we really need if we are going to rebuild our public health infrastructure and systems.”