Hello again, fellow knowledge-seekers! It’s been approximately two weeks since I left Senegal and stepped foot on American soil. After the culture shock—and digestive shock—of being back home, I’ve been able to assess and analyze my observations from Senegal.

About half of my time in Senegal was spent in the hospital observing the consultations of the diabetes doctor. Thankfully, she spoke English and could explain everything to me, and as someone interested in public health, I enjoyed being able to see how patients interacted with the hospital.

The biggest thing I discovered was how intricately economics are woven with health. Unfortunately, there were many patients who couldn’t control their diabetes. Some patients complained, with sad or cynical smiles, that diabetes was the disease of the wealthy. When you break down what is needed to manage diabetes, it certainly seems like it. If a household had a diabetic patient, the family needs to be able to pay for extra food, since the diabetic patient can’t eat the same meals as the rest of the family. In addition, the patient needs to pay for their medication; a glucometer, and the lancets and test strips needed to maintain consistent use of it; regular blood tests as recommended by their doctor; the hospital consultation bills; and any other costs that arise from not being able to manage the disease properly—including surgery and prosthetics for amputations.

This is the same case for diabetics here in the U.S. I’ve long known and been taught at Penn State that health is largely impacted by wealth, and even something as minimal as housing can have a dramatic impact on well-being. Surprisingly, however, witnessing it firsthand in Senegal and seeing the human faces behind this problem has really put this problem in perspective for me.

The question that follows from knowing this is, “Where do we go from here?” And that’s complicated. I’ve been studying the way culture impacts health; incorporating this economic components further puts public health issues in perspective, but also makes solving them more difficult by having to consider more factors. So, I don’t have a clear answer right now.

However, it is good that I’m considering these factors now, because that means I’ll have a greater impact on public health in the future. And that increased potential for impact is all the proof needed to confirm that this experience was worthwhile.