Kristien Brouwers and Koen De Decker

A deep-seated commitment to society, passion, and the desire to make a difference as a doctor: that is what drives Kristien Brouwers and Koen De Decker. This is also what brought them to Alice Springs (Australia) 22 years ago, where they now work as GPs for First Nations communities.

From Africa to Australia

Koen De Decker and Kristien Brouwers both dreamed of making a difference as doctors, working abroad. “As a child, I dreamed of Africa,” Koen says enthusiastically. “After doing our PhD, we ended up moving to Bophuthatswana, where they faced an acute shortage of doctors. Unfortunately, we were forced to return to Belgium due to the emergence of AIDS and increasing political instability.” But they were unable to resist the urge to make a difference and change the world.

“Although Australia felt like a leap into the great unknown, it turned out to be the right choice,” Kristien says. “The health issues among First Nations people are quite complex. Their life expectancy is around 10 years less than non-indigenous Australians. This is shocking. We have been working to change this now for over two decades, but structural problems persist.” The pair remain optimistic, nonetheless. “We have seen many doctors come and go, but we have chosen to stay on because we are convinced that our efforts are anything but a drop in the sea,” Koen adds.

Work-lifebalans in the outback

Alice Springs also proved a great place to raise a family. “It is located in magnificent nature, with spectacular views, breathtaking sunsets, and all the amenities are within easy reach,” says Kristien. “The only thing we still haven’t gotten used to are the temperatures, which regularly exceed 40 degrees!”

1. After secondary school, I went to medical school because…

KOEN: “I had long dreamed of going to Africa. Becoming a doctor seemed like the most meaningful way to fulfil my dream.”

KRISTIEN: “I knew since the age of 12 that I wanted to be a doctor. Preferably abroad, because the thing that attracted me to the medical profession was the meaningful social impact you can have.”

2. What made studying in Diepenbeek so special…

KRISTIEN: “The family atmosphere on campus. Everyone knew each other. We were a close-knit group, facing the same challenge together.”

KOEN: “The 10-week system was also revolutionary. I had taken Latin and Greek in secondary school, so I did have some catching up to do on the science level. So this system proved quite beneficial for me, although it did mean that I was studying almost continuously.”

KRISTIEN: “The pressure was constant. I found this quite tough, to be honest.”

3. My favourite spot on campus was …

KOEN: “The agora. It was the place to be, to meet people. You could also often find me at the ping-pong tables during breaks.”

KRISTIEN: “Or in the cafeteria. That’s where everyone headed between classes for a coffee.”

4. The teacher who inspired me the most was ….

KOEN: “We had so many passionate and capable professors in medical school. I still have fond memories of them all.”

KRISTIEN: “Julia Creemers made quite an impression on me. She was the first-ever female professor at LUC. She was a tremendously inspiring teacher. A phenomenal role model.”

5. As a student, I was…

KRISTIEN: “Rather insecure with a fear of failure. One professor – definitely not the one who inspired me the most (laughs) – started his first lecture by saying: “Look at the student to your left and the one to your right. Only one of you will make it into the next year.” That was a bit of an eye-opener. The students I encountered in the smaller working groups, who were retaking the year for the second and even third time and who seemed to know so much more than me, also made me feel insecure. One thing is certain, I worked like a dog in Diepenbeek.”

KOEN: “I was also very focused on my studies. I had no choice because it was tough. We had to absorb huge amounts of very complicated content.”

6. If there’s one thing I learned at UHasselt, it’s...

KOEN: “Taking notes (laughs), because although the art of printing had been invented centuries ago, we mainly had to make do with our own notes. Leuven was no different in this respect.”

KRISTIEN: “The copier was always in overdrive during breaks because if things went too fast and you had missed something, you ended up having to ask other people for their notes. At the same time, you also learned how to work with others and share with them. You really needed each other to get to the finish line.”

7. How would you describe your job in under 5 sentences?

KOEN: “Our job as GPs in Alice Springs involves so much more than just providing medical care. We work with a vulnerable community where health is inextricably linked with social and cultural challenges. It requires a lot of patience, flexibility, and a holistic view of medicine. We treat chronic and acute conditions, but we also try to integrate preventive care and education into what we do. It may sound like a demanding job, but it is also very rewarding.”

KRISTIEN: “First Nations people are not exactly the healthiest population. On the one hand, we still see patients with acute rheumatoid arthritis, bronchiectasis, severe skin infections, syphilis or trachoma. Today, these diseases are hardly a problem in the Western world. On top of that, well-known, chronic diseases such as diabetes, kidney failure and hypertension are also much more common among First Nations people. Combined with poor housing conditions, alcoholism, low literacy and patient non-compliance, this makes for very complex pathologies. There is an awful lot of work to do here. Here, people often suffer from typical Western chronic diseases from a very young age. Many children and teens suffer from kidney diseases – often caused by very poorly controlled diabetes. There is a reason why the largest kidney dialysis centre in the southern hemisphere is in Alice Springs.”

8. What do you find most enjoyable/challenging about your job?

KRISTIEN: “Without a doubt, the most challenging aspect of our job is the complexity of the medical problems and socio-economic conditions of our patients. Besides treating the disease, you also have to take into account cultural habits, low patient compliance and difficult living conditions. This can sometimes be frustrating, but it is also very satisfying when you see that you can really make a difference in someone’s life. The gratitude and the bond we build with the community make this an incredibly rewarding job.”

KOEN: “Our job here is also extremely varied. Besides consultations in our practice, I also work in the emergency department and in a dermatology practice. It is this variety that ensures that there’s nothing routine about this job. In addition, the contact with the First Nations communities is very special. We feel privileged to have a role in their healthcare and to better understand their culture.”

9. In my opinion, the key to success lies in…

KRISTIEN: “A broad motivation. You need more than a deep-seated fascination for medical science to become a doctor. There needs to be something that motivates you to keep charging full steam ahead.”

KOEN: “You can be motivated by the social commitment to your patients, the rich personal experiences you have working as a doctor, and the intellectual satisfaction you get from solving complex medical problems, but... At least you can be motivated by many different things.”

10. If you were able/want to do something or give back to your alma mater, what would it be?

KOEN: “I hope our story will inspire future doctors to consider a career in international healthcare.”

KRISTIEN: “Medicine in an international and multicultural context can be incredibly challenging but also tremendously fascinating. Here you can really have an impact.”