- For me empathy fatigue sets in when I careen my attention from this crisis to that one to the next one to the one after that, always feeling overwhelmed by each emerging problem but never having the time or attention to devote myself to one problem or another.
I'll give you an example. In 2014, a horrific ebola epidemic swept through Guinea, Liberia, and Sierra Leone. The world paid attention to it. Everyone was talking about it. And then .... it ended. At least in the global imagination. Money dried up. The world moved on to the next crisis.
That's not to say the next crisis wasn't important. It was important. But in Sierra Leone, the ebola crisis wasn't really over even after people stopped contracting ebola. 15% of Sierra Leone's healthcare workers had been killed by ebola, and the already fragile healthcare system plummeted into what one Sierra Leonean physician described to me as "a state of collapse."
And so the crisis remained a crisis even after the world's attention shifted. 1 in 17 women in Sierra Leone were dying in childbirth. Over 10% of kids born died before the age of five. Tuberculosis killed thousands every year despite curative treatment being available.
And this is when Hank and I finally, belatedly realized that responding to crises in the news was not adequate. Instead, we would need to commit the kind of long-term attention and long-term support that long-term crises demand. This means making difficult choices--there is also high maternal and child mortality in countries other than Sierra Leone, but we choose to focus on Sierra Leone because we see an opportunity to make a difference, because the government is serious if limited in its commitment to improving healthcare and educational opportunities, and because we had to make a choice or else we would be overwhelmed by the many causes.
What about the other causes? Well, we trust people to work on those causes. We believe in their importance. And we support their work by doing ours as well as we can, and trusting they are doing theirs as well as they can. I still get overwhelmed. I still get depressed. But I find that the deeper I go into my particular areas of interest--global healthcare delivery, health care accessibility, ending TB, fighting maternal mortality--the better I feel personally, and the more good I feel like I'm able to do.
2. Johnson & Johnson has not abandoned their secondary patents on bedaquiline but they have committed to allow generics to be available in most countries, even those where the secondary patents apply. Unfortunately this deal leaves out many countries that need generic bedaquiline, including Ukraine, which is absolutely unacceptable. So progress has been made, but the progress (as is so often the case) is inadequate. The fight goes on.