Show me your neighbours and I will tell you how healthy you are. And also, how old you’ll probably be. Sounds weird? In fact, this principle prevails today in many parts of Germany: There are huge inequalities in the disease rate and health. In some Problem where the income is very low, dying, the people will, on average, five years earlier than in the more prosperous city.

That’s about to change. The break begins in the Eastern city of Hamburg Billstedt and Horn parts. The income is 40 percent below the Hamburg average, there are especially many pensioners, and the life to a large extent close to the poverty line. The level of education is comparatively low. The Worries of everyday life for large.

Thus, in the case of the 31-year-old Samira Afalid*. Every few weeks, sometimes even every couple of days, she was a doctor in the last few years with your wife. For two years she wants kids. So far, she was three times pregnant, on the 23. Pregnancy week they came out but never. In the case of the investigations by your gynecologist and no physical limitations. But Samira is significantly overweight and this can affect the ability to conceive and the course of pregnancy.

This Text is part of the project Rethink Health.

The woman’s doctor knew quickly what it was that Samira: you needed someone to deal any longer with her, accompanied her for weeks and helps to reduce your excess weight. Someone that can help you to gain self-confidence. But the time the Doctor had not.

district of Hamburg Billstedt

The gynaecologist, the practice in the district of Billstedt/Horn is for years, due to the tremendous patient rush, under Stress. More and more Doctors exit Billstedt/Horn, to settle elsewhere, where the Job creates less pressure and more private patients to live with higher fees. The remaining Doctors have to take care of as a result of this development of even more patients.

Add to that the people in Billstedt and Horn go more often to the doctor. Because they lack health education. The ability to assess your own Are correct. The Doctors don’t have the time, your patients educate. A Vicious Circle.

a Lot more talk-time than in the normal consultation

the gynaecologist Samira at the end could still Help, by a tip. Not far from your practice, a new institution has opened a “health kiosk”, situated in the centre of Billstedt. Where Samira is normally shopping, the large glass front of the health kiosk, and a clear view of the inviting and bright interior spaces. As she enters the health kiosk and imagine that the staff already know, you were informed of Samira’s gynecologist. Samira agreed upon an appointment, a day later, she was sitting in a consultation room and speak with a midwife. Not five minutes, as is the case with your wife’s doctor, not even ten minutes, but almost three quarters of an hour.

The midwife explained to her what role the Psyche plays in the conception, why Obesity can act as a restrictive practice and what it takes else. The two agree that Samira the week comes from now on, once, and that you created by using a nutritionist in a health kiosk with a Plan to lose weight.

Four months later, Samira has the first experience of success: she has lost 25 pounds.

“The health kiosk is a centerpiece of the project,” says Alexander Fischer, who developed the concept of “health for Billstedt/Horn”, the Doctors, the insurance companies, the city of Hamburg and various companies support. In the health kiosk no Doctors, but Health professionals, including dietitians, Nurses, and midwives. Anyone can come without an appointment to the Kiosk, and often receives an immediate initial consultation. “We want to keep access to the health care system as low-threshold as possible,” says Alexander Fischer. Due to the high migrant share of the employees here are almost always there, speaking several languages, including Turkish.

Why is caramel sugar?

the Team at The health kiosk is supposed to do, what the Doctors don’t have time: impart knowledge, advice and Health. The approach of trained health staff decreases the Doctors work, there are more and more frequently in Germany. Those home visits, the Routine can be done especially in rural areas, in the meantime, physician assistants, or physician assistants. However, such a comprehensive approach, such as in Billstedt, which will relieve Doctors in the health education to the greatest possible extent, there are hardly any.

the challenges in Billstedt and Horn are particularly large: Often the employees of the kiosk must convey to the basics. The absence of many of the people in the district. So a diabetic Patient was surprised recently that he got his blood sugar in control. And, although he pour any more sugar into his coffee, as he said. The Problem was quickly found, as he mentioned that he used instead of caramel. “We have to explain to the people, often things we take for granted,” says Fischer. For example, that sugar doesn’t always look as white crystals.

“In the vast majority of discussions, a rule for this in the patients’ rights enthusiasm,” says Fischer. Not only because people are glad that someone takes the time for you and your health. “It flipped a switch in my head,” he says.

The health kiosk is changing the people – positive

This has also changed the everyday life of the practicing surgeons Gerd the barrel of “health for Billstedt/Horn” from the very beginning. “Before that I had during the day in practice, sometimes the feeling of the anticipation of the same patient with the same questions being crushed,” says barrel. As an example, the barrel is called a patient who came in with back pain to him in the practice, but despite extensive advice not to be understood complaint image.

the barrel has sent him then in the health kiosk – a win-win for both sides. The Patient comes in frequently, which relieves the barrel. But above all, the Patient benefits, “He has taken a very different attitude, way of The doctor makes me healthy’, to ‘What can I contribute, to be healthy’. This is quite remarkable,” says barrel.

This approach is in the framework of the project on the health kiosk. “We offer regular training courses for employees of more than 100 in-house facilities,” says Alexander Fischer. Only doctor’s offices but also nursing facilities, sports clubs, parents ‘ places of education. The “power” it is called. And it’s supposed to fishing in the truest sense of the word people and to the health system. What easier in the last few months, the work of the project, his popularity in the district. 2017 is launched “health for Billstedt/Horn”, now you know, in the district of the health kiosk and also other offers.

The goal: a higher life expectancy

The hope is that all of this reflects in a couple of years in the life expectancy or of the disease rate of some of the Suffering. The goal: The concept of “health for Billstedt/Horn” in Germany. No evaluable statistics. In addition, it is questionable whether the extensive additional expenses to expect at the end. It may well be that the project as anecdote of the type “Nice, but not affordable” in the history of the model projects, the disappear again.

not Yet, currently it is still then. The population’s satisfaction with health care is increased and thus also the Motivation to take care of their own responsibility for health. This could actually lead to a health educated population must be less for the doctor and thus in the end lower costs.

Samira Afalid is not the way to become pregnant again, since she changed her diet. Since then, but passed only a couple of weeks, you want to try it. Because you now know what it takes. And has taken new Confidence.

*Name changed by the editors