AmeriCorps Week: Addressing Food Security at Wallace Medical Concern

Through JV AmeriCorps member Peter Fink’s (’17-18 Gresham, OR) experience serving as Community Health Specialist, he has learned that food insecurity greatly affects his patients’ health and well-being. Wanting to better understand and respond to this issue, Peter focused a recent project on designing and implementing a workflow to more efficiently track and address food insecurity for patients at Wallace Medical Concern. Read his story below.

As an American Studies and PreMed major in college, I have always been interested in the intersection between society and health; clearly, the social and physical environments we construct have profound impacts on our health and well-being. Toward the end of my senior year of college, I decided to apply for a deferral for medical school in order to get more “boots on the ground” experience in healthcare and learn more about these social and physical environments before I hit the books. I wanted to gain a better understanding of our complicated insurance system, improve my competency in Spanish, and get experience interacting with the many social determinants of health. This led me to apply for the JV AmeriCorps Community Health Specialist position at the Wallace Medical Concern, a federally-qualified health center in one of Eastern Portland’s poorest neighborhoods.

Peter Fink Wallace Medical Concern

JV AmeriCorps member Peter Fink and his Co-Worker Suzana

My time serving at Wallace Medical Concern has certainly highlighted for me that promoting health extends far outside the doctor’s office. Specifically, one of the most basic factors in people’s day-to-day health is simply having enough healthy food to eat. Food insecurity has wide ranging impacts on patients’ overall well-being, causing problems like malnourishment, chronic diseases like hypertension and diabetes, job insecurity, and behavioral health issues. In Oregon, 1 in 7 of our neighbors is food insecure; that is, you are more likely to meet someone who is food insecure than you are likely to meet someone who is left-handed. Right from the beginning of my service here, I knew I wanted to make a contribution toward addressing food security in our patient population, as I felt it was a feasible way to address more complicated issues we see more “upstream” from the problems themselves.

Thanks to great support from my Gresham community mates and  supervisor, I was able to do a lot of research on how other clinics have most successfully tracked and addressed food security for their patients. Using advice from online resources, the Oregon Food Bank, and other local clinics, I helped create a workflow that involves different types of employees in our clinic and is both feasible to implement and effective in practice.

17-18_PeterFink_Gresham_Community

Peter and his Gresham JV community

Essentially, whereas before we entered the names of food-insecure patients into an Excel spreadsheet to cold-call, we now have our medical providers enter this information directly into our electronic medical records and do a warm hand-off referral to me directly after the patient’s medical visit to discuss food resources. I can then use the geographic information system I made using free online software to identify which food pantry in the area is the closest, best option for the patient to access. In addition, I can also refer them to contacts we have at other agencies to apply for SNAP benefits and discuss how to cook and prepare more nutritious meals.

Though it’s easy for me, as an inexperienced 23 year old, to get daunted by grand ideals like “promoting for human dignity,” I have come to see that starting with the basics– in this case, simply addressing the very basic need for food as a prerequisite for a flourishing and dignified life— can lead to encouraging results and deep fulfillment.  Although this new food tracking workflow is nothing grandiose, I am excited about its prospects for helping patients both economically and physically, and promoting dignity on a most fundamental and practical level.

Volunteer Nurse: A Year of Resistance and Radical Love

JV AmeriCorps member Mary Franz (Boise, ID ’16-17) serves as the Registered Nurse and Outreach Coordinator with Terry Reilly in Boise, Idaho. In our latest AmeriCorps blog, Mary shares her experience discovering the type of nurse she wants to be as she is called to serve, to heal, to advocate, to listen, and to love.

The expectations surrounding a new nurse involve being initiated via night shifts, charting every move you make, and being “devoured” by your elders. There is also the notion that the only “real nurses” are those that work in critical care. This is the standard by which nurses judge each other and are judged in turn. In fact, when you graduate from nursing school, everyone asks you the same question: “Which unit do you want to work on?”

Trying to answer this question throughout my last semester of college, I always found my responses insufficient for two reasons: 1. Not all nurses work on a hospital unit. 2. Nurses do not work for any particular hospital or unit, they serve patients. Service is at the very foundation of who we are as a profession. We are called to serve, to heal, to advocate, to listen, and to love. Those actions are not limited to the hospital; we can accomplish them anywhere.

In resistance to this narrow question, I would ask, “What if I don’t want to be a hospital nurse? What if no unit particularly peaks my interest? What if I don’t want to work the night shift?!”

Hush, you’re a new graduate. You have to gain experience and pay your dues. No one will want to hire you if you haven’t spent time in the hospital.

These pressures from the nursing world were almost too strong to oppose when I graduated last May. My heart screamed “RESIST!” as I scanned the job openings page on the websites for big-name hospitals and medical research centers. Those were the only destinations I could see at the end of the wooded path forged by the new-grad nurses before me, with the lumbering walls of trees on either side asking, “What unit do you want to work on?”

“RESIST!” my heart persisted. I listened. Last May, I stood at the entrance of that path and defiantly turned the other way.

“You’re going to be a volunteer?” questioned onlookers as I packed my bag to become a nurse at a small clinic in Idaho. The idea that I would turn down a hospital position, job stability, and a $50,000/year pay check made me a radical. As a matter of fact, “radical” was exactly the title I wanted to hold when I joined the nursing profession.

Maneuvering through nursing school, I quickly became aware of the enormous injustices in the healthcare system. I saw patients spin through the revolving door of the psychiatric unit and individuals experiencing homelessness sent away into the glacial cold. I witnessed the poor and the vulnerable receive substandard care once providers discovered they arrived without insurance. I interacted with nurses who had become jaded by the flawed systems in place; they no longer felt like they had the power to make change.

In the midst of these ongoing challenges, I found the warm embrace of Public Health. Reading Tracy Kidder’s Mountains Beyond Mountains early on in my education, I was swept away by the radical love of Dr. Paul Farmer:

If you say that seven hours is too long to walk for two families of patients, you’re saying that their lives matter less than some others’, and the idea that some lives matter less is the root of all that is wrong with the world.

Mary Franz (left) with her Boise community mates

It’s a radical notion to walk even an hour to visit a patient. It’s radical to resist the benefits of a hospital nursing position.  It’s radical to think that a nurse can be more than just a bedside caregiver. As I stood in awe of revolutionaries like Farmer, I became more aware of the nurse I wanted to be. I wanted to be a radical. I wanted to be a resistor. I wanted to work for social justice, not a paycheck. Naturally, those desires led me to be a volunteer.

Today, I serve as a public health nurse through the Jesuit Volunteer Corps Northwest AmeriCorps Program at a non-profit, Terry Reilly, which provides access to affordable health care for vulnerable and marginalized people in Boise and  surrounding cities. As a JV AmeriCorps member, I serve a variety of community members including immigrants, refugees, homeless, and low-income families. The majority of my patients do not have health insurance and are receiving primary health care from our organization at a significantly discounted rate.

In comparing my time in the hospital and in the community, I’ve noticed distinct differences in my role as a caregiver. As a public health nurse, I create visions for the long-term health of patients and communities. My goal is not to stabilize or to discharge. It is to empower individuals and communities to make meaningful change and give them the tools and the resources to do so. With this goal, I face extreme challenges because the patients and populations I serve experience disadvantage in ways I am still discovering.

In the United States, gaps in the federally-funded healthcare insurance system and lack of access to affordable private coverage for the working poor have left millions of residents, citizens and non-citizens, without access to health care. When individuals don’t have access to or can’t afford quality health care, many preventable chronic and life-threatening illnesses go undiagnosed and untreated.

“RESIST!” my heart continues screaming. But how do I respond?

For me, these last few months have transformed the word “resistance.” It now suggests something resilient and enduring instead of stubborn and short-lived. I am inspired by the ongoing efforts to resist decisions that disregard the dignity of each individual, that treat healthcare as a commodity and not a human right. It’s not enough that my service as a public health nurse opposes the tradition of new-grad nurses entering the hospital. It ultimately needs to respond in resistance to oppressions and injustices facing vulnerable populations. I must remember to not only undo the damage that prejudiced systems perpetuate, but to build something simultaneously. I have to join the collective counter force of both public health and hospital nurses who are serving, healing, listening, and advocating in the midst of uncertainty. I must continue to love.

Real love is radical because it cannot be earned or unearned. It is connected to inherent dignity – to the idea that everyone matters equally. It is invincible because it is determined to thrive no matter what walls are in place, no matter what scarcity demagogues design, no matter what fear they try to sow. Radical love must persist at the center of a nurse’s resistance. It is the driving force to which we accept the night shift, pay our dues, and become a volunteer. Radical love for our patients, our service and commitment to them despite all opposition, distinguishes our profession.

So, what if we asked different questions of new-grad nurses? What if, instead of pushing them to the hospital, we asked, “Which patient population do you want to serve?” Along with this question, what if we challenged new-grad nurses to consider the type of nurse they want to be? “Will you be a resistor? Will you be a radical?” But most importantly, in moments when patients feel hopeless and afflicted, when forces of injustice seem almost too strong, “How will you show love?”

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Feeding Hunger for Food and Community

JV AmeriCorps member Sarah Moore (Grays Harbor, WA ’14-15) shares her experience serving as Early Learning Specialist at the YMCA of Grays Harbor in Washington. Below, Moore reflects on her involvement with the Park and Play program.

Last summer, the YMCA of Grays Harbor partnered with the Aberdeen School District to provide a strong program for children that combines food and fun. Each day, our Park and Play program served anywhere between 50 to 150 lunches and snacks to kids at three parks in town.

It was obvious after only a few weeks of programming that these children are in great need of food. Without these lunches, many children would go without food or without proper nutrition. However, I think there is a greater hunger than for food among these children: there is a hunger for community, for friendship, and for opportunity.

Grays Harbor (9)

Sarah (far right) and her Gray’s Harbor JV AmeriCorps member community mates

After being given a lunch packed with a sandwich, fruits, vegetables, chips, and milk, the kids grabbed a seat around the park, usually at a picnic table. With only a few picnic tables available, kids often ended up eating with new friends. Conversation usually started about what was in the lunch that day: what they like, don’t like, or have never tried before. At times, there were even proposed trades for an extra bag of chips.

Food was only the starting point for finding commonalities among new friends. The conversations quickly evolved from food to what game or activity we would play after eating or even details about life at home or school. Conversation continued as we brought out rubber bands to make bracelets, play dough, or paint. We cheered for one another through hula-hoop contests, hand games, and running races. Through it all we learned each other’s names, languages, and stories. I believe this is the greatest thing we have to offer at the parks.

After only a few weeks of the Park and Play program, I was convinced that it was the moments shared around the table and beyond that kept the kids coming back day after day and staying for the duration of the program. Yes—we were hungry for food. But the food spoke to a hunger that was deeper; a hunger to be present with one another, to play, to laugh, to share, and to build relationships.

From Omnivore to Herbivore in Wenatchee

JV AmeriCorps Member Angela Bagnasco details her participation in the Wenatchee JV AmeriCorps Community 40-day Vegan Challenge. Community-mates Elena Barreto, Carrie Heiberg and Liz Haney contributed to the following post.

River time!

JV AmeriCorps Members Elena Barreto, Carrie Heiberg, Liz Haney and Angela Bagnasco enjoy a day floating down the Wenatchee River.

Eating in community is a big part of living in community. We began the year eating meals together every night, rotating who cooked. A strong sense of community was formed among us as we shared laughter as well as discussions on serious issues of justice and meaning in the world. We also always start the meal with a prayer or reflection. We all are also major foodies. We like to cook. We like to eat well. And we unashamedly go back for seconds (and thirds).

Mmmm, burger.

Clearly eating well, even with their challenging restrictions, Wenatchee house enjoys a veggie burger with fries every Sunday.

Midway through the year it became clear that we all agree that our food system is flawed, and that our health, our fellow humans’ health, and the health of the planet could be positively or negatively impacted by our food choices. Two key works inspired us to take the leap to what we did next: the documentary, “Forks Over Knives”, and the book “the Veganist.” Both explored the benefits of switching to a non-processed plant based diet. In short, we became Vegan purists.

As we were already eating vegetarian, the first things to go were dairy and eggs. Then, we cleared our pantry of anything containing sugar, white flour, corn syrup, more than a few ingredients, or unrecognizable ingredients. We were left with a few sad food items on a lonely shelf. We spent the night before our vegan shift binge eating Brie cheese (which we’d gotten for free), chocolate, and a multitude of other processed treats, to the point of indigestion.

“What have we done?” we thought in horror as we looked at our empty shelf. We had agreed to this experiment for a full 40 days; Lent, and thus our Veganism would conclude on Easter.

Even the stuff at the very top!

Angela and Liz work hard to remove all the prohibited food items from their community pantry!

Carrie writes, “I entered our community’s Lenten vegan experiment with hopes of learning more about the environmental and humanitarian impacts of my food choices. And, heck, I wanted to lose a few pounds, have more energy, and maybe even feel that pat-myself-on-the-back satisfaction I get when discipline prevails in the face of challenge. I’m pretty happy to say that I came out good on each of these goals. But I also gained something I really hadn’t anticipated—a significantly stronger bond with my community. We cooked and ate together nearly every evening, often taking opportunities to attempt interesting recipes or prepare from scratch something that we’d always bought prepared.”

Elena considers, “When the four of us first decided to go vegan I was willing to try it but also hesitant since I considered myself a cheese and chocoholic. When we decided to do non-processed foods I was super nervous! I entered veganism thinking it would be incredibly difficult to do, but the more we cooked vegan non-processed, and thought more about what we could eat vs. what we couldn’t, I realized I could definitely do this long term. I sometimes think of our 6 weeks as my rehab from dairy, since I now have a very different feeling when I eat dairy, not only because my stomach doesn’t like it when I eat it, but on a more conscious level I just do not enjoy as much anymore.”

Herbivorous trophies

Liz, Angela and Carrie display their non-processed, vegan acquisitions as they re-stock their shelves

Liz muses, “I felt healthier during our vegan stint. Is this a privileged position? I suppose so, with the funky sauces and spices we sometimes used, but often we got many of our calories from rice and beans or potatoes. We ate ‘whole foods’ that were largely unprocessed–whole grains, fruits, vegetables, nuts and beans. Some of these are more exclusive to folks with larger disposable incomes: fresh fruits and veggies and nuts can run into some big bucks, but replacing Rice-A-Roni with rice, dried beans with cans of chili can actually save families money.”

Carrie tells, “We commiserated as our bodies yearned for chocolate and we attempted to soothe cravings with tea and home-popped popcorn. We took turns investigating and sharing about food justice and health issues. We gave thanks for our bounty of food and community. We reflected on how to bring more food and community into the world in a just way. Most of all, I deepened my commitment to creating a healthy relationship with food because it’s intricately tied to my relationships with people—those I’m lucky enough to share a meal with and those I’ll never meet.”

In supplement to our new diet, we dedicated a time each week for one of us to educate the others on a food related issue. We explored specific foods in detail such as soy and coconut milk. It is important to do the research so that you know that you are in fact making good choices based on your values. There were certain bulk items that we made each Sunday that allowed us to get through the week. We made granola, hummus, bread, and almond milk. In the midst of our limitations, we ate like queens, trying vegan recipes from around the world and eating our lunch sandwiches on grain-rich homemade breads. We also discovered that veganism was not much more expensive than vegetarianism and certainly cheaper than a diet with meat would have been for us. We could also feel good about the choice that our diet had a much smaller environmental impact.

Granola, it does a vegan good.

The Wenatchee Community’s delicious, homemade granola

Elena writes of her food discoveries, “We all decided to continue cooking vegan for the rest of the year, with the exception of Pizza Friday (of course!). However, I’ve noticed I don’t eat as much pizza now as I used to, which if you knew me at all you would know is very uncharacteristic! I was surprised that by the end of our 6 weeks I was feeling better about what we were eating, not only because it was healthier but the social and ecological impacts behind the foods we were choosing or not choosing to buy and ingest. One of the biggest things I will take away with me from this year is incorporating food justice into my daily decisions and cooking. This is the beginning of a continuous learning process, and I look forward to continuing to discover new cooking habits, and lessening the negative impacts of my food choices.

It's not your screen that's grainy, but the picture!

a lotta whole grains = a whole lotta fun!

Liz confesses, “Before this year, I hadn’t really realized how many cans a canvas bag could hold or what

exactly happens to the meat that expires at the grocery store. Being a JV AmeriCorps Member in Wenatchee has brought my attention to food in many different ways. I’m not sure whether I fully realized to what extent wealth, transportation and education determine what’s on our plates for every meal. Our budgeting over the course of the year has allowed us to try a bunch of different new foods: from wasabi paste to seitan to kohlrabi. I discovered I could live without meat. I had had no idea.”

For my part, I hope that after this year I have a vegan dinner group where friends can rotate cooking a few days out of the week. I don’t think you have to live with four like-minded people to have this experience of delicious ethical food and strong community. However, living with such epicurean adventurers did help.