I also tried to explain the importance of cooking outside rather than inside, which is the main cause of chronic obstructive pulmonary disease there, and I talked about the importance of using bed nets to help control malaria. We had a health fair, and people really appreciated that. We also did a community outreach program distributing eyeglasses from a van. We also brought a dentist who was able to remove abscessed teeth. It was so rewarding to be able to provide that kind of relief. Giving simple things like the ability to see or to take a bit of the pain away is one of the things I enjoy most about medicine.
What were some other differences in medical care in this part of Kenya compared with the United States?
There were no real expectations from the patient’s standpoint. In the United States, patients expect doctors to treat and cure them, but in Kenya there is no malpractice insurance or litigation. Whatever you can do to help, you do. Doctors are seen more as the source of medications.
Also, a lot of the health care we provide in the United States, especially in internal medicine and family medicine, has to do with the treatment of chronic disease. We do a lot of screening and prevention, but also a lot of tertiary prevention for things like diabetes, hypertension, or heart disease. Those chronic conditions don’t really exist in Kenya, because the food they eat is completely natural, and they live active lives out of necessity. They walk or run everywhere they need to go. So if they don’t develop cancer or an infection, they tend to lead very long, healthy lives.
There’s such a lack of health care there, but I think we could learn a lot from the Kenyans in terms of the simplicity of their way of life.
What can you take from your experience in Kenya that you will apply to your medical practice in the future?
As a Navy physician, my main priority for my patients is to help them maintain their physical health and readiness to accomplish the mission.
It’s all about keeping the active duty persons and their families healthy, so physical fitness and nutrition are top priorities, and I want to continue to stress making those things part of my patients’ way of life. We should try to live more like the Kenyans in terms of eating more unprocessed, natural food and being active and exercising every day.
Dr. Andy Baldwin in Kenya
I also want to continue to focus on helping my patients decrease stress to improve their health. I was never as stress free as when I was in Kenya, and there were no cell phones, no TVs, none of the distractions, and you are living in the moment and surrounded by nature.
All the high-tech things that we have in the United States keep our cortisol levels sky high all the time, and that’s not good for overall health.
My experience in Kenya also reinforced for me that I want to have a wellness-centered practice, with a holistic approach that includes physical trainers and nutritionists who provide good care and education about how to live the best life you can and be as healthy as you can be.
Working overseas can give physicians a perspective that you cannot get any other way. I think you become a much better doctor. You appreciate how good we have it in some ways, but also what we can learn from people who have less.
Think globally. Practice locally.
U.S.-trained internists who have practiced abroad will receive a $100 stipend for contributing to this column.