Compassion-retention and culture change

Today I read a hope-giving article about the potential to ameliorate climate change through simple water-retention measures. Pioneering activists have transformed large areas of desert into fertile land, where the springs and rivers now flow year-round, and the local climate changes to deliver more steady rain, thus sustaining the cycle. Why did this idea spark my interest? Because I think the same principles have application to healthcare, in retaining and replenishing compassion and caring.

The geological problem is that urban intensification, deforestation, and intensive farming practices have turned once-absorbent land, that stored water and replenished aquifers, into hard surfaces that shed rainfall in uncontrolled torrents. Not only is the water lost from the landscape, the precious topsoil is torn away in the floods. Deep droughts alternate with catastrophic flooding, as we saw in California recently. The widespread loss of absorbed water in the landscape, and rapid run-off, both contribute to sea level rise. The parched and overheated landscape inhibits cloud formation and rain, so locking the local ecology into a death spiral of heat, drought and desertification.

But create hundreds of small water retention structures and the vicious cycle can be reversed. Trapping and holding the water allows the aquifers to replenish. Long-dead springs come to life and the rivers flow again. Then the landscape greens and the hard, dry water-shedding surfaces are replaced with water-absorbing meadows and forests. This re-greening alters the local climate and brings back the rains.

This is no mere theory. The article shares a striking example of success with this technology:

“In addition to scientists understanding and formulating this phenomenon, there are fascinating attempts at a solution being carried out on almost all continents—examples which can be scaled up worldwide. Rajendra Singh, the “Water Gandhi” from Rajasthan, India, is one of these. Thirty years ago, he began greening parts of the Thar desert. He succeeded in completely revitalizing an area of 3300 square miles of extremely dry desert. Singh mobilized the village communities to build thousands of water retention spaces according to traditional methods, so called “johads.” The scant precipitation (around seven inches) that still fell annually, often coming down all at once in a very short period of time, could thereby be captured and sink into the ground, and sufficed to reanimate nature. His initiative allowed 1200 villages to obtain a secure material basis. A hundred thousand people are now self-sufficient in terms of water and food. Five rivers that had been completely dried out were brought back to life, and are constantly flowing the entire year through.”


What of the climate in healthcare?

In healthcare we have stripped away the fertile soil of human relationships and created a sterile, clinical environment. Acts of kindness and caring are not absorbed and stored within the healthcare geography but run off the hard surfaces and are lost.

We created many hard surfaces in medicine, from the hardening of the hearts of medical students, to the brutalisation of young doctors and nurses, the harshness of the built clinical environment, and the imposition of so much technology. There is no softness left in healthcare. In this overheated climate we witness widespread bullying and burnout among health workers. The bleak healthcare climate harms everyone – the patients, families, and health workers alike. The flooding away of human kindness left deep fissures in our caring landscape. Our aquifers and springs of compassion and caring ran dry.


What can we do?

We can reverse the process. Each of us can create small compassion-retention measures in our workplace that together can change the climate in healthcare. How do we do this? The practices are simple and they are personal:

Each time we decide to be still and to listen, we fill the wells of kindness.

Every act of kindness becomes a spring that feeds the rivers of caring.

Each act of caring fills the lake of compassion.

Every act of compassion replenishes the aquifer of healing.

Every time we remember our deepest purpose is healing, we change the climate.

Each time we express gratitude for the gifts of other, we nurture the landscape.


All ecologies have the capacity for self-healing if helped back to the tipping point where change becomes self-sustaining. The same is true in healthcare. Restoring the springs of kindness and rivers of caring will allow our new graduate health workers to flourish and flower, not shrivel and wither. Compassion is contagious, gratitude is generative, kindness is nourishing. Restore the ecology and we all flourish.

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“When all members of an organization are motivated to understand and value the most favourable features of its culture, it can make rapid improvements.”