SARAH: This is At the Core of Care. A podcast where people share their stories about nurses and their creative efforts to better meet the health AND healthcare needs of patients, families, and communities.
I’m Sarah Hexem Hubbard, executive director of the Pennsylvania Action Coalition and the National Nurse-Led Care Consortium.
As part of our Access to Care series, we’re going to spend this episode at Sanctuary Farm with Andrea Vettori.
Andrea is a nurse practitioner and started Sanctuary Farm to help meet a wide range of needs around nutrition, wellness, social and economic justice, and community safety.
ANDREA: Digging deep to harvest healthy lives. That's our tagline. So the idea was, you know, obviously digging deep in the soil, but just digging deep in terms of the relationships that we build with people and digging deep in terms of really understanding who are you and tell me about yourself and what's your life like? And really trying to understand, and then that reciprocal effect of really again, relationship getting to know one another and that process then heals, you know, it has to. You know, there's no way we really get to know people at that deep level that we're both not healed by that somehow.
SARAH: Sanctuary Farm consists of several different growing lots, which were previously abandoned and neglected, in the North Philadelphia neighborhood of Sharswood.
Andrea is the organization’s executive director and runs the operation with a handful of staff members and volunteers to maintain the garden beds, grow produce and operate a farm stand.
In just a bit, we’ll hear more from Andrea about how she got into nursing and how Sanctuary Farm is a form of community-based health care.
But first, Andrea’s going to tell us about some of the vegetables being grown.
ANDREA: We've just got a variety of lettuce greens, red leaf, green leaf. We've got okra coming up in this bed. We've got carrots that are ready to be harvested over here in these two beds.
We've got garlic, ready to be harvested. Green beans, Swiss chard, More green beans.
Collards, collards, and collards. There's one thing I learned from this community is I better have collards all year round, or else they will kick me out of the neighborhood. So, every year we plant more and more collards because it is it is our number one produce item.
But okra was another thing they wanted. So, we started growing okra. And then different types of there are some there's some African communities in this area, and they requested particular types of eggplant. So, we did some research, got some of those seeds, and we grow that for people in the community. Lots of potatoes, onions, kale.
SARAH: Sanctuary Farm also has a large new greenhouse and another nearby location in the neighborhood where more crops are grown.
ANDREA: We started with one lot. Yeah, this is the first lot right here. This is 5000 square feet of property. So, we started with this lot, on we broke ground on Mother's Day 2017. So, we consider that our birthday. And then the following year, we gained a second lot. And then the third year we got another lot. And then last year, we received a grant from through the farm bill that trickled down to the state. So, the farm bill now is for the first time allotting money to urban agriculture, which is huge. And so, the state awarded grants last year. We won the grant to put up a greenhouse and then we acquired those the two properties that the greenhouse is sitting on. The rest of this is not ours, but we'll try to we're going to try to get back we're going try to build a little park for the community next to the greenhouse here. So, whatever whenever we start a new garden, we you know, we always try to think of, you know, how can also the community benefit from the open space. So, we're, we keep trying to redesign things a little bit and make it more accessible to the community. And you know, this lot over here as well, we're going to be building instead of just raised beds, we'll build elevated beds for people who experience some disabilities.
SARAH: Andrea has worked primarily in community-based nursing settings for most of her career. And as a nurse practitioner, she continues to see patients once a week at a health center near Sanctuary Farm.
Andrea says she talks a lot about nutrition with her patients and lets them know how they can access fresh free produce at Sanctuary Farm.
ANDREA: I purposely transferred from the health center that I was at, in Center City to the health center out here to be closer to the community. So, there's a lot of the same folks I see. I'm a family practitioner. So, you know, I treat the array that everyone sees, you know, the acute stuff, too. Diabetes, hypertension, obesity.
SARAH: But before Andrea became a nurse, she had been in another line of work.
ANDREA: I went into social work school first. And I graduated as a social worker started working as a social worker. And, you know, like a lot of young, idealistic people, I was pretty impatient with the change the pace of change. And I thought, you know, what, I needed to see something more concrete at that point in my life. And so, I thought, well, let me let me do nursing because then I can see some immediate change and it's funny because when I my very first day of nursing school, they talked about systems approach to care. And I thought I am home this is it, it merged the best of both worlds.
I also knew I didn't want to work in a hospital, I knew I wanted to do community-type nursing, so you know, and it just all came kind of full circle. So, I did that for a number of years, I worked on an Indian reservation. I worked with migrant farmworkers, homeless in DC. And then finally back to Philadelphia, worked in the shelter system in Philadelphia for a number of years, got my nurse practitioner license, and started working in the health centers. And for the most recent seven years, I was the clinical director at Mary Howard Health Center, which is our homeless Health Center in Philadelphia.
But gardening has always been kind of a passion of mine. And, you know, the older I got, and the wiser I got, I realized, you know, it's really healing. And I think sort of parallel to that sort of realization was also the realization that what I do in my 15 minutes with a visit with a patient in a health visit, is just really not affecting change the way that I want in their lives. That most of what affects a person's health care happens outside of that 15-minute interaction that I have with the patient, maybe once a month, once every three months.
And so, sort of those two parallel realizations were happening at the same time. And this idea of having an urban farm where people could not only benefit from the fresh produce but also benefit from the healing effect of nature in general, gardening in particular. And then, you know, the whole aspect of creating spaces that are beautiful in a community like this, where they often are just surrounded by empty lots that are full of trash. So that dream kind of percolated for a number of years, and I was fortunate to receive a grant as for a social enterprise project and through the Public Health Fund, which is the philanthropic arm for PHMC, which is where I was working at the time. So they awarded me the grant, I partnered with Project Home, they provided the first lot where we're at right now, and then the rest kind of took off.
Everything that we grow here, in our all of our lots, we give out to the community free of charge.
Right now, we run the stand two days a week for two hours each time. And once we get more produce, once the summer really gets going on, we'll start a Saturday stand. And then we supplement too what we grow. We've gone from our first year, from around 25 people a week to now we're serving over 100 people a week at the stand. So, we can't possibly grow enough food for all of those folks. So, we do supplement from some of the local farmers in the area. But, you know, we keep expanding, we're, you know, now growing on our fourth lot, we have the greenhouse, so we'll be able to grow all year round. And there's certainly plenty of other opportunities in this community to grow more food.
When we first started, the site that we're on now, I think, we harvested somewhere around 1500 pounds of produce our first year. And last year, with all of the sites, and with improvements in the way that we farm, we've harvested over 7800 pounds of fresh, sustainably grown produce, organically grown produce. And we have served over 300 families in the community. Yeah, the impact, since we started in 2017, just continues to expand and to grow. And I think we can probably come close to hitting 9000 pounds of produce this year. And like I said we’ll be growing for the first time all season round now.
And then we also partner with two health centers right now. And we do various programs that involve basically nutrition education patients who then can come and get vegetables from the produce stand. We have one particular program that we call veggie scripts, where we supply the health center and the providers with prescriptions for vegetables. They do the hands-on nutrition education, then the folks come out to the stand, get their vegetables, and we try to engage them in a variety of ways. We have a walking group, exercise group, we do, we do a lot of before, before COVID, we were doing a lot more of cooking demonstrations and nutrition programs sort of on-site. And we hope now that we're hopefully on the other end of COVID, that we can start, you know, restart some of those because we really see the value of people coming out, you know, we can deliver the produce that spine, and we do that to some shut-ins in the city. But you know, the value of people coming out and seeing what we're doing here and realize that the food that's coming here is all grown organically from their community really gives them I think more of a sense of pride. People tell us that all the time.
We also hire folks from the community, we're very committed to a livable wage. So, we're hoping to expand on that we can only hire so many because of our budget, but we have two people right now that we've hired, both are transitioning through homelessness and drug and alcohol abuse. And it's giving them you know, some job skills, and some, hopefully, a way to get over their addiction and start working on their own.
SARAH: Sanctuary Farm has also become a place where kids can come play and explore. There’s a tire swing hanging from a branch of a tree and arts supplies are available for them to use and sit down at one of the picnic tables under a shaded area.
ANDREA: We, of course, consulted with the neighborhood, when we approached this community with the idea that we had, and the adults in the community loved it. This was the property that was available. So, we really had no choice. This was the property that they wanted us to use, but it was also the property where the kids played ball. It's so when we first came here, the kids were not happy with us, and they eyed us rather suspiciously and, and then they would come and they would stand on the corner and just watch with that, you know, kid-like curiosity, and then they would slowly come in, and then we'd hand them a shovel. And then we would buy them some ball equipment, we'd play ball at the end of the day with them. And before you know what they're out here working with us. So, it you know, and then we go over there we play ball...The kids are wonderful here. Yeah.
One of the things that we do is we just allow the children to come in, we have rules, and they know the rules, and they get permission slips from their parents. And then they come in and we try to keep the area sort of open so that the kids can play. They know they have to ask permission before they go into the shed, they know how to handle the tools, you know which tools they're allowed to handle, they know that they're not allowed to curse or fight. But they come in and they play and, and we have hash marks on the on the polls for their heights over the years. And we know that one of the ways that children overcome this chronic trauma that they experience is resilience. And we know that resilience is fostered from those relationships of caring individuals. And it doesn't have to be a long-term relationship. That's what the literature tells us. It can just be one or two simple interactions that say to a kid your life matters. So, this to me, this is nursing at its best. I've never felt more of a nurse than I do now.
And the parents in the neighborhood know us, and they know, you know, when they send their kids out, if they're coming here, then that's okay. The kids know, when they leave, they have to go straight back home, if that's what the parents are expecting. So yeah, you know, it's a safe place for kids to gather, it allows them to just tap into that natural curiosity and that natural sense of creativity, and they're learning, and they don't even know they're learning, and they're eating produce, before you know it, I've got kids playing with the bees over there, who they used to crush them when they saw them. Now they understand they're starting to understand the relationship between, you know, all of the parts of the environment, you know, the bugs and the soil and the worms, and you know, why all of this makes a difference? And who knows the impact that that's having, you know.
SARAH: Interestingly, Andrea doesn’t think of Sanctuary Farm as a community garden or an urban farm for that matter. But rather as a form of health care outside the clinic.
ANDREA: And nurses get that. I think you ask any nurse and to get out of the get out of the health center, get out of the hospital, and impact people where they live. No one's going to dispute the effect of that. And, you know, we think of our whole farm as an alternative form of health care. You know, to me, this is just an open-air health center. That's how I look at this.
And, you know, people say, Oh, you're leaving nursing is like, No, I have not left nursing. I am just doing this nursing in a different way than I envision, and I think it resonates with people deeply.
You know, there's that relational difference. That's to me, that's the key to all of this, it's the key to good health care, it's the key to nursing if you don't develop a relationship with the people that you're working with, and really get to know them, and let them know you. I mean, it's got to be mutual. It doesn't matter what you say to them, they're not going to believe you. And that's been true. It's one of the values that we place on everything that we do here. So, whenever we get new volunteers whenever we get new workers, one of the first things I say to them when we're doing orientation is your neighbor comes up, stops to say hello has a question.
You stop everything you're doing it doesn't matter and you engage them, you know, answer their questions, talk to them, whatever. If they never come back again, they never come back again.
But it just develops that relationship.
One of the things we’d like to do, which would be a slightly different model is help people to do this themselves in the community here.
So, there's a lot of people in the community that live next to, you know, vacant lots. And they'll come up to me and say, you know, how do we do what you're doing? And it's like, ooh, that's not a sidewalk conversation, you know, so, of course, we’ll give them some advice. But we would to teach people how to garden, and then provide them with the tools that they need to be successful to do this themselves. You know, everything they need, the raised beds, the soil, the seeds, the plants, and working with them throughout the whole season as mentors to help them be successful.
SARAH: Special thanks to Andrea Vettori for taking time to talk with us.
Funding for our special Access to Care series comes from the Center to Champion Nursing in America, which is a joint initiative of the Robert Wood Johnson Foundation, AARP, and AARP Foundation along with the National Nurse-Led Care Consortium.
At the Core of Care is produced by Stephanie Marudas and Emily Previti of Kouvenda Media and mixed by Brad Linder.
I’m Sarah Hexem Hubbard of the Pennsylvania Action Coalition. Thanks for joining us.