Why men avoid doctors like the plague

John Ndulu considers himself a ‘healthy’ man in his early 40s. He cannot recall the last time he saw a doctor, not because he has never fallen sick, but the very thought of getting a scary diagnosis has always put him off the doctor’s office.

“I fear the results of a diagnosis,” Ndulu says. “What if the doctor tells me I have a terminal condition? That will mean unbearable stress and perhaps a change in my normal routine.”

What then does Ndulu do when he falls ill? “I take lots of fruits and vegetables. I also try to limit unhealthy foods and increase physical exercise,” he says.

For others, skyrocketing medical expenses in Kenya have made many men shy away from seeking medical attention. With a shaky public health insurance system, few are willing to spend their cash on treatment, preferring ‘over-the-counter’ medication despite a lack of proper diagnosis.

“We fear the loss of income for those days we would be under medication. We are also unlikely to seek medical help if we suspect we have underlying conditions that are embarrassing to talk about and that would escalate medical bills,” says Jasper Omondi, a health worker.

Like Ndulu, Omondi would prefer to self-medicate and only seek medical attention if the situation turns critical.

While Ndulu and Omondi exemplify the long-held notion that men tend to downplay their health issues, recent studies show that men would like to reverse the trend with almost nine out of 10 men interested in taking a proactive role in managing their health.

A survey by Sanofi’s Consumer Health Care together with Global Action on Men’s Health, Men’s Health Network, Men’s Health Forum of the UK, Australian Men’s Health Forum, and Men’s Health Education Council shows that men’s health has been overlooked by policymakers and has become far worse than it ought to be.

Life expectancy between men and women, the report adds, has been widening over the years as men shun medical examinations that would otherwise reveal treatable medical conditions.

“In 1980, men’s lives were, on average, four years shorter than women’s; by 2015, the difference was six years; and, by 2030, the male-female health “gap” is predicted to be seven years. This large difference is not just a problem in low-income countries. In 2015, men died five years sooner than women in the wealthier countries too,” states the report, Men’s Health: Perceptions from Around the Globe.

According to the report, men also take on risky lifestyles that compromise their health including smoking, heavy drinking, poor diet, and dangerous driving, all the while giving health services a wide berth. However, 32 per cent of those surveyed considered sexual health as the most important part of their overall health and wellbeing.  

“The risks are compounded in many countries by men’s sub-optimal use of primary care services. The nature of many men’s occupations, which exposes them to a wide range of hazards, is also a significant factor. Poor health is not inevitable for men, however. It is not genetic in origin, except perhaps to a small degree,” adds the report.

Despite any contrary professional results, men in low-income or developed countries rate their health as “very good” with those in America returning the highest score of 88 per cent.

Of the men who participated in the survey, 32 per cent turned to over-the-counter medication due to poor health and had more ailments to treat. Another 29 per cent trusted their pharmacist to make over-the-counter recommendations to treat their ailments.

Yet another 26 per cent said seeing a pharmacist was more convenient than seeing a doctor while another 19 per cent said over-the-counter treatments cost less than prescription medication.

Generally, though, more men surveyed want to take more control of their health and perhaps narrow the life expectancy gap. Health management, according to the surveyed group, came second after household financial supervision.

The survey shows that while men feel confident in managing their health, “there is a disparity between this belief and the way they tend to do it.”

“The good news emerging from the survey findings is that a large majority of men want to take charge of their own health, and feel confident in being able to do so. Men have a well-rounded view of what constitutes good health, looking to address issues such as fitness, energy levels, diet, stress, and sexual health,” states the survey.

So are the majority of men in Kenya about to change their attitude toward personal healthcare?

Not really, according to Mungai Ngugi, a senior surgeon, and urologist in Nairobi.

“It is not the men’s fault,” he says. “It’s about our culture, how men are brought up. Men are supposed to be the strong sex who protect and provide for the community, while women are vulnerable and to be provided for. From an early age, a boy is sent out there to look after the cows where he meets all adverse elements including disease. A girl, on the other hand, was supposed to stay home and look after herself and keep safe,” says Dr Ngugi.

According to the doctor, a man at 70 and who has never been hospitalised thinks he is okay. He says stereotypes associated with men being the strong gender hinder them from seeking medical attention unless an issue becomes critical.

Ngugi says oftentimes men present themselves late for some treatable diseases, but whose reversal may be challenging.

“It seems like a badge of honour not to be seen by a doctor. Even a man’s children do not expect him to seek medical attention. We hear of cases where family members are shocked to hear that the man of the house is in hospital, yet he has never seen a doctor in his entire life,” says Ngugi.

The survey says policymakers now know enough about how to support men in taking better care of themselves and improve the accessibility of health services.

But as Ngugi says, it all depends on what men do with such information. “We may be in the information age but you may have information and be uneducated. Some men feel the information does not relate to them but applies to others,” he says.

And as the world marks International Men’s Day today, perhaps men in Kenya will be moved to place their health among their top priorities.