‘The voice of that boy is still trickling in my ears’: Ethnography and the epidemiology of compassion

Abstract

There is growing interest in understanding compassion not only as an individual feeling but as something that circulates through communities and institutions, shaping decisions, relationships, and commitments over time. Recent calls for an epidemiology of compassion suggest that compassion be treated as a population-level phenomenon, with its own patterns of emergence, transmission, and lasting effects (Addiss et al., 2022). Yet there is little empirical research showing how compassion actually works in practice, especially within global health policymaking.

This paper draws on an ethnographic study (2020–2025) of people within global health networks working on neglected tropical diseases (NTDs), to explore how compassion arises, spreads, and endures. Using in-depth interviews, participant observation, and creative anthropological methods, the study examines how compassion becomes ‘catching’ in certain moments. Vignettes include: a boardroom silenced by a woman’s tears recalling classmates with podoconiosis; a long-held memory of a suicidal teenager shaping advocacy decades later; and a foot washing involving Ethiopian patients and UK parliamentarians.

These emotionally charged moments are fleeting, but their effects are not. They act as exposure events, shaping motivating memories, disrupting hierarchies, and sustaining long-term motivation. The study suggests that compassion can, perhaps, be thought of as behaving epidemiologically: with triggers (first-hand or second-hand exposure), vectors (stories, touch, shared rituals), patterns of distribution, and protective effects (re-energising slow advocacy work).

This work supports calls for an epidemiology of compassion by showing how compassion is felt, transmitted, and remembered across people, places, and time. It also argues for integrating more qualitative, sensory, and story-based methods into global health research to help trace the emotional energies that may underpin collective change.