When Associate Professor Hans Meij would go to Africa, he would shave his head. Years later when he visited Africa again for a short visit, he le his hair untouched. A local woman who had seen him before expressed her curiosity.
“Dr Hans,” she asked, “do you have grey hair?” He replied yes.
“You are so stupid! Why do you shave off your hair?”
Dr Meij explained that cropping the hair on his head ensured that the scorching African sun wouldn’t a ect him as adversely as it could. “Now you lose respect since grey hair signifies ageing, and to be aged is respect,” she said. Like any researcher, he stopped to ponder the concept and realised that the moral of the story was two-fold: age is esteem and deserves respect, but in some cultures age is a sign of the outdated. “That’s when I learned to look at ageing in a completely different way – ageing is merit, as something earned, and something to be proud of,” he said.
Dr Hans Meij is the Director of the Melbourne Academic Centre for Health in Parkville, Melbourne. He works as a broker for corporations between the university and the teaching hospitals around the universities for improved healthcare, research and for translation of basic research into clinical care. He hails from Amsterdam, Holland, went to school in a very rich suburb (“I shouldn’t have been there, but I was there”) and then attended the Royal School of Nursing. He had set his sights on medicine, but the Dutch course selection process at the time saw students being selected by draw (high school students submit their grades, and their names are then drawn), and Professor Meij wasn’t selected. He ventured to then complete his nursing qualifications, went to University and finished his masters in medical anthropology (a combination of medicine and anthropology). Completing his MBA in Hospital Management, and a after a long hospital management service, he saw it was time to commence research, and left Holland for Ghana and Burkina Faso.
For four years he looked at DNA selection in younger and older people, discovering that in Africa there is a clear relationship between the number of offspring and longevity. The more offspring conceived, the chances of a longer life are significantly diminished, explained Meij. This is comparable to mice and elephants. Where elephants usually have around two offspring (which takes about 22 months to deliver) in their lifetime, they are extremely strong, and will almost never die from infectious diseases. Mice, on the other hand produce many offspring, around 17- 20, and from those, a maximum of one will survive. They never make it to the end of their potential lifespan, which in a laboratory could be five or six years. In the wild, explained Meij, they never found a mouse over two years old. So even though they have much more capacity to live, they will never make it in the wild, whereas elephants make it easily up to the end of their potential lifespan. Both have their make up and reproduction strategies in line with the environment they live in.
Another important factor for survival is the environment that we are born in and live in. Take for example some immigrant groups in the UK, some of which contain a high number of individuals with cardiac problems including high blood pressure, obesity and other cardiovascular problems. Their immune system and genetic makeup were meant to be functional in their homeland where they would still be in equilibrium with their environment. In the remote villages in Burkina Faso and Ghana, Africa, Dr Meij and his team didn’t find one person with cardiac problems nor did he encounter obese inhabitants. They were still in equilibrium with their environment. You can predict that if you relocate this African tribe to Australia or Holland, health problems which were previously non-existent could become a harsh reality. The base factor for mitigating these effects is for the genome to adapt, usually by selection, to the new environment but that takes thousands of years.
This is why advances in gathering our own biomedical data are imperative to monitoring our own health, and working with our doctors. Devices that collect personal biomedical data, such as FitBits and iPhones, are ubiquitous and allow patients to very easily collect their own healthcare data. is gives them the power to work with their doctors. “The connectivity that we have is so big, that everyone can literally be their own doctor, and this will only increase in the coming years. We should understand that we should provide the cover around it, instead of controlling it, because we can’t.” He elaborates: As a patient leaves the doctor’s office, he is free to do whatever he wants. But with the data that is available at the tap of a screen or from the internet, he can control his health much more then ever before, although he needs the knowledge to act properly, and that is what healthcare workers should provide. “We need awareness. That’s what will really change. Electronic medical records can change all that.”
It was spending time in Africa, conversing with the locals, and exercising his knowledge as a medical anthropologist and researcher that Associate Professor Meij was able to construct a meaningful ethnography that really informed his perspective on healthcare. “Going to Africa, I was just interested in the older people living there and how they survived without any healthcare or vaccination – they were really out there on their own. at made me aware of the pride of ageing,” he said. “People always think that ageing is a problem, but ageing is the result of a strong genetic make-up or, in most cases in our era, the result of proper healthcare. Why is there healthcare? Because we want people to become older. at’s healthcare! So the aim of healthcare, the only goal we have, is ageing,” he asserted.
He is a self-proclaimed advocate for ageing, disheartened at the way that it is problematised in our society. If we want to continue with an investment in medical care, he explained, we need to look towards the ageing population and change the way that we handle it: how do we maintain healthy living, and how do we change healthcare to provide? Why are we doing the things that we are doing and how do we know if it’s right? “We put people in bed for 21 hours a day, yet we know that’s not good for patients, but we still do it,” says Meij.
During his years of nursing he became sensitive to the humanistic approaches to healthcare that are sometimes subverted by bureaucratic pressures. The best outcomes in healthcare, he explained, are when really taking into account the needs of the person – not just the medical needs per se, but equally important is seeing the patient as a person. “If you treat someone without taking into account their needs, it’s not good for them. When you put the needs of the patient in the centre of your work, you have the best output, the best patient care, and you have the most joy in work.”
Communication is key. is is the advice that Meij passes on to medical students because without getting to know patients and understanding their point of view, healthcare professionals rob themselves of a fundamental skill integral to being a successful healthcare practitioner. He wants you to forget all the things you know about structural healthcare, and start being a little more idealistic. “Think about what my mother or my neighbour needs as soon as they become a patient. Just start by thinking what you need and if you don’t know, ask someone. We don’t listen enough to patients. We speak to them, we tell them what to do, but we don’t listen to what should be done,” he said. Most of what he has learned comes from spending time with his patients and working with them. “My whole idea about humanity, or about individuality, healthcare and people, comes from listening to the stories of people. It’s wonderful. If you take the time everyday to try and listen, even for five minutes, to someone that you don’t know and just let them tell you what they think is important, you get another feeling of the world.”
featured image: Wajahat Mahmoud, One valley, one thousand dreams!