May 31, 2017

The Doctor Prescribes Farm Work

Laura Genello

Laura Genello

Guest Blogger

Johns Hopkins Center for a Livable Future

This post is the fifth in a series – Letters from the Low Country – about food and agriculture in the Netherlands, written by Laura Genello as she studies organic agriculture at Wageningen University.

My first summer working on a farm 10 years ago was hard: long days of physically demanding work under the sun. But there were moments that season—mulching peppers as the sun set, weeding carrots in an early fall breeze, or admiring the remarkable shapes and colors of a couple dozen tomato varieties—that were sometimes meditative and sometimes exhilarating. But they were always grounding and satisfying.

Tomato plants at Hoge Born, 2017.

The therapeutic aspects of farming and gardening have been recognized in the Netherlands for decades and are institutionalized into the practice of Care Farming. Last week, I visited the Hoge Born Care Farm in Wageningen, a community fixture beloved for its organic farm shop and well-maintained fields of vegetables. It’s a sunny Wednesday, and the four-hectare farm is alive with activity. Trijnie van Dijk, former Hoge Born intern and current volunteer, shows me around.

The Hoge Born does more than grow and sell vegetables, In partnership with two healthcare institutions, Zideris and Lievegoed, they offer a range of services to clients with mental disabilities, psychiatric issues or those who’ve been unemployed long-term. The farm hosts an on-site hospital and protected living spaces for some of its clients. Depending on their needs, clients receive the same care that they would in a more conventional care institution, but they also work in the gardens, greenhouse, shop and farm kitchen. The work provides a steady routine, a chance to learn new skills and a way to contribute to society.

Natural arbor at Hoge Born, 2017.

The Hoge Born is just one of more than 1,000 care farms that serve over 10,000 clients in the Netherlands. These farms collectively work with a wide variety of clients both young and old, from dementia patients to those suffering with addiction. While the first Dutch care farm started in 1949, the movement really took off in the mid-1990s. In the Netherlands, Care Farming arose in the context of agricultural modernization in Europe. As the scale and specialization of agriculture increased, small-scale farmers felt the pressure to go big or get out. This resulted in increased interest in multi-functional agriculture as a strategy for farm survival. From 1995 onward, Care Farms in the Netherlands could receive funding for offering care activities through the health insurance collective for long-term care. In order to receive that funding, Care Farms must carry an accreditation or work with a care institution that does. The practice provides a valuable, if unconventional, healthcare service, and it allows farmers to diversify their income.*

Since 2004, the Hoge Born care farm has operated as a foundation, and its funding comes from a combination of care activities and product sales. Trijnie says that the Hoge Born is a farm first and a care institution second. For her, this is an important distinction because it instills the work that the patients do with more value and meaning. However, finding this balance between farming and care is one of the primary challenges of the industry. Trijnie says that providing care naturally slows the speed of production. Fortunately, the team at the Hoge Born has learned to adapt their production practices to the needs of their patients. For example, several years ago, the team noticed that many of their long-term clients starting having trouble with the physical demands of most farm jobs as they aged; so the farmers introduced a flock of chickens. Egg collection and cleaning provided a low-intensity task for clients who struggled with psychically demanding jobs. Similarly, the Hoge Born now produces value-added products such as jam and dried beans, which can be processed in the winter to ensure that there is a steady supply of work year round. This diversification means that clients have the opportunity to work in four different aspects of the farm: gardens, kitchen (catering/hospitality), the farm shop or maintenance.

Berry plants at Hoge Born, 2017.

Trijnie explains that the Hoge Born and their clients have a synergistic relationship. For the clients, the Hoge Born provides them with meaningful work, access to nature, and a chance to learn new skills. For the Hoge Born, the clients shape the farm: the diversified production arises from the needs of the clients and the care activities help fund the growing practices. This can be reflected in the farm design; there are quiet secluded corners, such as the greenhouse, and busy social spaces like the farm shop. The variety helps meet the diverse needs of individual clients.

As an intern, Trijnie led work teams of clients in tasks like weeding, sowing and harvesting. She found coaching the groups rewarding, fun and challenging. Any given day farming would be filled with various problem-solving opportunities, such as communicating when to harvest strawberries for the best taste. When working with patients with mixed ability, Trijnie not only had to think about how she would solve a problem, but how she could find the best solution to keep the group happy and motivated. She’s learned to break up large tasks, such as weeding, into smaller, manageable goals to keep the group motivated.

Trijnie sees many benefits to care farming. It is a way to connect care institutions with the community, she says. She believes that for the clients, there is a concrete benefit to working on something meaningful. It provides an action-oriented escape from the difficult conversations that may happen in therapy sessions, and a chance to become grounded in work that is tangible, physical and connected with the earth.**

Illustration by Mike Milli. Photos by Laura Genello, 2017.

* To learn more about the history of Care Farming in the Netherlands, see Hassink et al., 2014.

** Read more about the effects of Care Farms in Elings, 2011.

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