A Month in Berlin:
Lessons from a Public Health Exchange
I recently had an incredible opportunity to spend time in Berlin on a public health exchange program, thanks to the support of UnitedForHealth. Alongside three students from
Ecuador, I immersed myself in Germany’s healthcare system, comparing it to healthcare in my home country, Kenya. The experience was both eye-opening and deeply rewarding, leaving me with valuable lessons I will carry forward for years. Here are my reflections on this fruitful program, informed by my learnings abroad and my experiences in Kenya.
Patient-Centered Care at Helios Emil Von Behring Hospital
My rotation at Helios Emil Von Behring Hospital—a leading institution for respiratory medicine—was a powerful introduction to patient-centered care. Most of my time was spent in the lung cancer department, with a few days in the tuberculosis unit. Each morning began with an 8 a.m. team meeting to discuss patient cases and updates, followed by a shorter meeting within the oncology team to review the day's patient list.
One of the standout aspects was the level of patient engagement. Patients here are well- informed and actively involved in their treatment decisions. I observed patients examining their CT scans with curiosity, asking thoughtful questions that reflected both their knowledge and empowerment. Doctors took time to explain treatment steps, ensuring patients understood every part of their journey. This emphasis on patient education reminded me of the need for robust cancer literacy initiatives back home. An informed patient is an empowered patient, and that empowerment can significantly impact health outcomes.
The Power of Digital Systems in Healthcare
Germany's efficient digital health systems also left a strong impression. Nearly all medical records, imaging, and prescriptions were managed digitally, minimizing paperwork and allowing doctors and nurses to focus more on patient care. Though there is room for improvement in interoperability between facilities, the system is a model worth emulating. As Kenya builds its digital health infrastructure, a similar approach could help streamline services, reduce wait times, and make healthcare delivery more efficient.
Equitable Access Through Health Insurance
Germany’s approach to healthcare financing was equally impactful. Nearly every patient I encountered had health insurance, making access to care seamless and affordable. Systems are also in place to support those who aren’t insured—including migrants— ensuring they receive treatment without financial hardship. Out-of-pocket costs are minimal, so people don’t need to worry about the financial burden of their care. One
doctor shared a phrase that captures the spirit of Germany’s healthcare philosophy: “Treat first, ask for payment later.” This principle exemplifies their commitment to health as a fundamental right. Adopting a similar mindset in Kenya, where out-of-pocket expenses often pose barriers to care, could have a transformative impact.
A Strong Stance on Tuberculosis Control
Another highlight was my visit to Berlin’s Tuberculosis Control Centre. With a tuberculosis incidence of roughly 5 cases per 10,000 people, Germany’s TB cases are mostly among foreign-born residents, who account for about three-quarters of all cases. The center prioritizes contact tracing, screening in shared accommodations, and other preventive measures. Germany's approach to TB control is stringent; under the Infectious Disease Act, failing to follow quarantine protocols is a criminal offense that can lead to imprisonment. This rigorous approach highlights the value of strong public health policies. Many low- and middle-income countries, characterized by high burdens of infectious diseases, could benefit from similar preventive measures to establish a more functional public health system.
Comprehensive Sexual Health and Family Planning
During my time in Berlin, I also visited the Centre for Sexual Health and Family Planning. This facility provides a full range of services, from sex education and maternity care to contraception and abortion services. Abortion is permitted up to 12 weeks but requires consultations with both an OB/GYN and an independent psychologist (though I would prefer a system that allows for quicker access to services). This system emphasizes thoughtful and informed decision-making. Contraception is widely available, though Germany still faces challenges in ensuring sexual rights, particularly in addressing homophobia. Witnessing the center’s commitment to inclusive and comprehensive care reinforced my belief that similar models could greatly benefit Kenya. Issues like high rates of teenage pregnancy, HIV transmission among young people, gender-based violence, and limited access to abortion services remain pressing in our country.
Experiencing Germany’s History and Culture
Beyond the hospital, Berlin’s rich history added another layer to this exchange experience. Visiting sites like the Brandenburg Gate, the Topography of Terror, and the Memorial to the Murdered Jews of Europe offered insights into Germany’s resilience and commitment to learning from its past. I also visited Leipzig, Stuttgart, and Tübingen, gaining a broader understanding of the country's culture and diversity. These cultural experiences made my month even more meaningful, offering insights not only into Germany’s healthcare system but also into its approach to remembrance, inclusivity, and community.
Gratitude for a Life-Changing Experience
The kindness and support I received from everyone involved made this experience unforgettable. I am deeply grateful to the UnitedForHealth team—Dr. Lukas, Philipp, and Hannah—for their support, and to my colleagues from Ecuador, Dayam, Pamela, and Domenica, for sharing this journey. The many doctors at the hospital who generously allowed me to join and learn from them—Dr. Monica Schäfer, Rebecca, Philip, and Myles— also contributed immensely to my experience. Every person I met added something valuable, and I leave Germany not only with new professional insights but also with lifelong friendships.
Final Reflections: Lessons to Bring Home
Looking back, this exchange has given me a deeper understanding of what makes a healthcare system effective. Germany’s commitment to patient education, digitalization, and equitable access to care are principles that I believe could drive positive change in Kenya. The experience has reinforced my commitment to advocating for healthcare as a right, not a privilege, and I am excited to bring these lessons into my work back home.