There are some people whose presence leaves an impression on you long after they are gone. Their voices, smiles, mannerisms, and the way they treat others remain somewhere in your memory. Dr Ruth Pfau was one such person.
Soft-spoken, gentle in voice, and graceful in manner, she had deep eyes in which one could see her passion for serving humanity. Whenever I met her, there was an innocent smile on her face, and her voice reflected genuine love and affection. She was compassionate, disciplined, prayerful, and deeply committed to her mission.
Dr Ruth Pfau devoted her life to people whom society had largely rejected and, in many cases, even their own families had abandoned. She chose to stand beside those suffering from leprosy at a time when fear, stigma, and ignorance often separated such patients from the rest of society.
Several years after her death, I finally gathered the courage to write about her. Perhaps I hesitated because personalities like Sister Dr Ruth Pfau seem increasingly rare. They remind us of a kind of leadership that is difficult to define through conventional measures of success. It is leadership without the pursuit of power; service without the expectation of recognition; and influence built not through authority, but through love. Dr Pfau may no longer be physically present among us, but she continues to live in the hearts of countless people. Her message of compassion continues to challenge us.
I often wonder: how do some people learn to love humanity so deeply? Perhaps the answer lies in their relationship with their Creator. Those who are filled with divine love often find a way to express that love through service to others.
Throughout history, there have been individuals who have transcended boundaries of colour, caste, language, ethnicity, geography, and religion. Their lives remind us that suffering has no religion and that compassion should have no borders. Pakistan was fortunate to receive one such person.
More Than a Humanitarian
Dr Ruth Pfau became much more than a doctor working in Pakistan. Over the decades, she became part of the country's identity.
Her services earned her numerous awards and honours, and several books have been written about her life. She came to be remembered as the “Mother Teresa of Pakistan.”
Yet even that description seems inadequate. What should we call someone who leaves her homeland, arrives in a country that is not her own, encounters people living in unimaginable conditions, and then decides that this is where she belongs? Dr Pfau's life also deserves to be examined through another lens: leadership.
She understood something that many well-intentioned social workers sometimes overlook: a good heart needs a good system, and without organisation, resources are wasted
I was fortunate to speak with Cardinal Joseph Coutts, who knew Dr Pfau closely and spent considerable time with her. He described her as a very good leader. His understanding of leadership was simple but profound: a true leader is someone who, when asking others to do something, is also prepared to do it herself. Dr Pfau embodied this principle.
When her workers saw Dr Pfau moving forward herself, they willingly followed. She was not someone who simply stood at a distance giving instructions. She was prepared to enter difficult places, confront suffering, and do the work herself. Her example reminded people: “If she is doing it herself, why shouldn't we?” I have seen the same quality in other great Pakistani personalities, particularly Abdul Sattar Edhi.
Leadership becomes powerful when people see the leader doing what the leader asks others to do. A leader who sits comfortably in an office and tells others to serve will rarely inspire the same commitment as someone who is willing to stand beside those doing the difficult work. Dr Pfau led by example. And people followed because they trusted her.
When a Delayed Visa Became a Life's Mission
Dr Pfau's journey in Pakistan itself contains an extraordinary lesson about purpose. She was originally expected to travel to India. Her visa, however, was delayed. Her superiors suggested that she travel to Pakistan while waiting, where members of her congregation were already working among poor communities.
When she arrived in Karachi in 1960, she asked the Sisters what they were doing. They told her about their school and their visits to poor communities. She responded simply:
“Take me with you.”
One of the Sisters was a pharmacist and another was a nurse. Together they went to what was then McLeod Road, now I I Chundrigar Road.
What Dr Pfau saw there changed the course of her life. She encountered a settlement of people suffering from leprosy, living amid extreme poverty and terrible conditions. The Sisters were doing what they could, but Dr Pfau immediately recognised a fundamental problem. These people needed a doctor.
She understood that her medical training was not simply an academic qualification. It was a responsibility. She came to believe that her delayed visa was not merely an inconvenience. It had brought her to a place where she was needed. She communicated this conviction to her superior. And she stayed. That decision transformed not only her life but the lives of thousands of Pakistanis. There is a powerful leadership lesson here.
Sometimes purpose becomes visible only when we are willing to look carefully at the circumstances in front of us.
Vision: Seeing What Others Cannot
A leader needs a destination. Dr Pfau had one. Once she committed herself to fighting leprosy, she did not treat the work as a temporary assignment. She understood the scale of the challenge and began thinking about what could be done, how it could be done, and how the work could be sustained. Her vision extended beyond individual patients. She wanted to address the disease itself. She understood that treating one person was important, but building a system capable of reaching thousands was even more important.
This distinction separates charity from sustainable social change. Charity can respond to immediate suffering. Leadership asks: Why does this suffering exist, and what can we do to change the system that produces it? Dr Pfau increasingly worked at that level.
Another remarkable aspect of Dr Pfau's leadership was her ability to bring people together. The work associated with the Marie Adelaide Leprosy Centre brought together people from different religious, ethnic, linguistic, and cultural backgrounds.
Muslims, Christians, Hindus, and people from different regions of Pakistan could work together because they were united by something greater than their differences: a shared humanitarian mission. Sindhis, Baloch, Punjabis, and others worked side by side. In such an environment, people did not need to ask: “What is your religion?” The more important question was: “How can we serve?”
This is a lesson Pakistan desperately needs today. Our differences are often made larger than they actually are. Dr Pfau's work demonstrated that a meaningful shared purpose can bring people together where politics, prejudice, and social divisions often fail. She created a culture in which people could say: “This is our mission.” That is leadership.
Discipline and Prayer
Dr Pfau's leadership was also rooted in personal discipline. She would arrive at St Patrick's Cathedral early in the morning, around 5:45 a.m., maintaining this routine for years. She prayed before beginning her day.
For her, prayer was not separate from her work. Faith provided the foundation from which she approached service. This is another dimension of her leadership that is sometimes overlooked. Professional competence can tell us how to do something. A sense of purpose tells us why. Dr Pfau had both.
She knew her profession. She understood the science and the administration required to combat disease. But she also possessed a deep conviction that her work was a form of service to God and humanity. That combination gave her extraordinary resilience.
Compassion Needs Systems
It is easy to remember Dr Pfau primarily for her compassion. But compassion alone cannot sustain a nationwide humanitarian effort. Dr Pfau was also an exceptional organiser and administrator. At one stage, the network associated with her work extended across Pakistan, with centres in different regions of the country. She maintained detailed records and paid attention to patient numbers, treatment, and progress.
She understood something that many well-intentioned social workers sometimes overlook: a good heart needs a good system. Without organisation, resources are wasted. Without records, progress cannot be measured. Without planning, good intentions eventually disappear. Dr Pfau combined compassion with discipline, vision with administration, and service with measurable action. That is one reason her work survived beyond her lifetime.
Perhaps one of the most striking examples of her leadership came when she noticed changes in patient statistics during the period of the Afghan refugee crisis. The number of patients suffering from leprosy and skin diseases had increased. Instead of simply accepting the increase, she asked a basic but important question: Why?
She studied the figures and noticed that many new cases were coming from the northwestern regions. She began to understand the connection with Afghan refugees. But she did not stop there. She asked another question: Why are these cases coming from there? Her thinking moved from the immediate problem to the root cause.
If the disease was prevalent in Afghanistan, treating people only after they crossed into Pakistan would not solve the larger problem. The problem had to be addressed at its source. She therefore sought permission to work in Afghanistan. She eventually met General Zia-ul-Haq, who asked what he could do for her. Her answer was direct: if Pakistan wanted to control leprosy, work also needed to be done inside Afghanistan. She was given permission to go.
She went. She trained doctors and helped establish a framework through which the work could continue. The lesson is relevant far beyond healthcare. Great leaders do not merely respond to problems. They search for their causes.
The Leader Who Planned for Her Own Absence
Perhaps the greatest test of leadership comes when the leader is no longer there. Dr Pfau understood this. Years before her death, she was already thinking about succession. Who would continue the work? Who would take responsibility? How would the organisation function without her? She understood that no individual lives forever.
A leader who builds everything around herself may create an impressive organisation, but that organisation becomes vulnerable when she leaves. A leader who develops people creates a legacy. Dr Pfau prepared others. She helped build an institutional structure, developed staff, and ensured that the mission could continue beyond her own lifetime. When she died, the work did not simply stop. That is one of the clearest signs of successful leadership. If everything collapses when the leader leaves, the leader has built dependence, not leadership. Dr Pfau built continuity.
In an age when leadership is often associated with position, wealth, visibility, and power, Dr Ruth Pfau offers a radically different definition. Her leadership was built on:
- Purpose
- Service
- Discipline
- Compassion
- Courage
- Vision
- Teamwork
- Faith
She did not seek to become powerful. She became powerful through service. She did not ask people to follow her because of her position. People followed because they trusted her. She did not build a legacy around her personality. She built institutions and people capable of continuing the mission. That is perhaps the greatest lesson of all.
Dr Ruth Pfau gave medical treatment to people suffering from leprosy, but her contribution went far beyond medicine. She restored dignity to people who had been pushed to the margins. She looked at people whom others feared and saw human beings. She entered places from which others turned away. She gave hope to people who had been forgotten. And perhaps this is why her story continues to resonate. We live in a world where it is easy to speak about humanity. It is much harder to serve humanity. It is easy to post about compassion. It is much harder to spend a lifetime beside people society has rejected. Dr Pfau chose the harder path. She did not simply talk about love. She lived it.
In her book To Light a Candle and Keep It Burning, Dr Ruth Pfau referred to a line by the German poet Maria Luise that she chose to have written on her grave: “Blessed are those who lived before they die.” Those words describe her beautifully. But if I were to write a sentence for Dr Ruth Pfau, I would put it differently:
“Blessed are those who live forever in the hearts of people.”
Dr Ruth Pfau lived before she died. She lived with purpose. She lived with discipline. She lived with faith. She lived for people who had been forgotten. And because she lived for others, she continues to live in the hearts of those who remember her. Her story is not merely the story of a German doctor who came to Pakistan. It is the story of a human being who discovered that service could become a life's purpose. It is the story of a leader who demonstrated that compassion can be organised, that faith can inspire action, that one person can build institutions, and that a life devoted to others can transcend nationality, religion, and time. Perhaps this is the leadership legacy we should remember most.
A leader does not become immortal by living forever. A leader becomes immortal by creating a difference that continues after they are gone. Dr Ruth Pfau left this world in 2017. But the lives she touched, the people she trained, the institutions she helped build, and the values she embodied continue to speak. And perhaps that is the most beautiful definition of a life well lived: to leave the world a little better than you found it—and to leave behind people who can continue the work. Dr Ruth Pfau did exactly that.