Grand River Community Health Centre (GRCHC), Brantford

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Grand River Community Health Centre

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Access to healthy food   |   Public / Governmental   |   Golden Horseshoe

Sarah Gill, Health Promoter and Gloria Ord, Community Garden Facilitator

Phone Interview (with Sarah Gill) July 11, 2011 (Lisa Ohberg), site visit August 17, 2011 (Lisa Ohberg)

Reviewed and Approved by Interviewees

*  Community health centre with a food systems focus on health promotion

*  Builds the capacity of the community to manage their own food security programs by facilitating initiatives and transferring ownership to the community

*  Since 2009 initiatives have included: the Community Garden Project, the Community Food Advisor Program, and the Community Food Systems Coalition

 

Organizational Overview

The Health Centre

The community health centre model of care combines clinical practice with health promotion and community development. Physicians, nurses, nurse practitioners, and health promotion and community development staff serve primarily priority populations and work in the community to address community health needs in a holistic way. The Grand River Community Health Centre (GRCHC) was created in 2009 after community stakeholders in health and social services identified a need for this model of care in Brantford.

The Health Centre has been involved in the Community Garden Project since the centre’s inception in 2009. The garden project is one way that the centre’s health promotion staff addresses the issue of community food security as a social determinant of health. Involvement in the garden project “led to Grand River really looking at and supporting food security as a major focal point in the work that we do in health promotion”, says Gill. Two staff members dedicate their time to community food issues as a part of their health promotion portfolios, improving the Garden Project in the last two years and recently being involved in facilitating the creation of the community food systems coalition.

 

The Projects

The Community Garden Project was originally “created by community members and supported by the local Brant-Brantford Poverty Roundtable, “says Gill. The garden created by that initiative was originally on leased private property. Gill explains that “having a social determinants of health focus”, the GRCHC “saw a community garden as a way to be progressive on the food security landscape and therefore supported the lease of the private owner’s land [on which the garden was built] so that the garden could be created”. In the next year of the project the original garden’s lease expired and the GRCHC took up the position of project manager. At this time the GRCHC decided they could manage the project and its resources more effectively by assuming the role of consultant, resource allocator, and educator “so that the community could create their own gardens”, explains Gill. Ord, the Community Garden Facilitator is responsible for “resource allocation, the workshops, the teaching, [and] the liaison with the actual gardens”, while Gill manages the program’s administration and finances. “The onus is on the community to create the garden with our support,” explains Gill. In their first year the project only worked with a single garden, but now supports 12 gardens and continues to support new gardens.

Through her work with the community garden project as an employee of the GRCHC, Gill became interested in community food security in Brant. As part of the requirements of her Master’s degree in Health Promotion completed part time via correspondence during her employment with the Health Centre, she researched and compiled a Community Food Continuum for Brantford and Brant County. The continuum document presents an environmental scan of all food related assets in Brant, organized along a continuum of short-term, emergency access needs, and long-term, food system sustainability needs. The continuum also identifies gaps at each stage. One of the gaps identified by the continuum was a “mobilization of community support through food systems networks”.

The GRCHC’s most recent food initiative is supporting the establishment of a group of stakeholders’ representative of community food needs at all stages in the continuum to begin a dialog on community food issues in Brant. The group is referred to in this report as the Community Food Systems Coalition though the initiative is still in its infancy and the name has not yet been finalized. Stakeholders are still being identified and invited to the table. The group aims to define and discuss community food goals and work on action projects.

The Health Centre also facilitated the “revitalization” of the Community Food Advisor training program. Thirteen new community food advisors have been trained and join two long-time community food advisors to educate the community of healthy, nutritious and safe food practices.

 

Human Resources

The Grand River Community Health Centre’s most important human resources are the employees who work on community food security issues, namely Ord and Gill. Ord’s staff time is divided equally between client advocacy  and work as the Community Garden Facilitator. As a full time health promoter, Gill is responsible for the rest of the Health Centre’s community food initiatives: “the largest part of my portfolio is food security. This is one piece of a food security pie, I also manage the community garden project, I also manage the community food advisor project. So there is a bunch of food system s initiatives that we’ve initiated as part of that continuum that we’re trying to fill gaps [in] as well as looking at the very long term and getting that facilitation along the way”.

In addition to the dedicated staff at the GRCHC, Ord pointed out that the commitment of community members involved in the different food projects is paramount to their success: “The people that come to the table… there’s a lot of dedication. There may not be a huge amount of people (although when they all get together there’s a fair amount) but they’re very dedicated as well to the project and seeing the project evolve”.

 

Physical Infrastructure

At present the clinical and health promotion staff work in adjacent buildings due to renovations but, “in a year when our final building is done we will all be under one roof” says Gill. In the new space, clinical health practitioners will work side by side with health promotion staff in the same office space. This proximity facilitates conversation and knowledge sharing between clinical staff and health promotion staff about community health needs and issues.

 

Natural Resources

Although each community garden is responsible for its own creation and maintenance, the Health Centre has developed helpful partnerships with community businesses to provide natural resources like seed and soil to gardens at lower costs. The Garden Project helps connect potential garden facilitators with such resources. The Garden Project, primarily through Ord (a seasoned gardener herself) provides gardeners with knowledge on organic gardening methods, which are promoted by the Health Centre.

 

Financial Resources

The Grand River Community Health Centre provides the salary for the 1.5 staff dedicated to food initiatives (comprised of Gill’s employment as a health promoter and the half of Ord’s staff time spent on Community Garden Facilitator duties). Although staff time is funded by the GRCHC, funding for the work related to the Community Garden Project is obtained from “outside resources from the GRCHC”, explains Gill, including funding from the community, grants, and fundraising. This funding is used to provide workshops on various garden topics and to purchase supplies. When needed, the Community Garden Project will provide start up monies to community gardens that come from these external funding sources or donations solicited from local businesses.

 

Community Resources

Some businesses in the community have played an active role sponsoring the community garden program and providing funding or resources “McKenzie Seeds donated five hundred dollars worth of seeds, we had Lowes that came in and built several gardens for us, smaller companies that gave us the soil at a lesser cost and threw in the delivery free, and so all these kinds of things keep the cost [of supporting 12 community gardens] quite low”, explains Ord.

 

The Community Food Continuum

As a part of her Masters degree requirements, Gill embarked on the environmental scan of the food system in Brantford and Brant County that resulted in the creation of the Community Food Continuum. Gill identified this document as a resource in itself in moving forward with the coalition and other food security initiatives: “doing some of the evidence based work has really grounded the credibility of the work that we do, both within the community and with Grand River continuing to support it”.

 

Policy and Program Resources

The GRCHC became interested in food security health promotion activities such as the Community Garden Project because the community health centre follows an alternative model of care that has a social determinants of health focus. “Community Health Centres tend to come out of grassroots movements,” explains Gill, and “it’s a long road to actually get the community health centre started, but there was [support for this model] through the Minister of Health who made a commitment to increase the number of community health centres”. Without the Ministry of Health committing to the Community Health Centre model, the Brantford community may not have been successful in their campaign to create a community health centre. This policy support for community health centres was crucial in creating an organization whose holistic view of healthcare lead it to focus on community food security, and that is able to provide sustainable staff and financial resources to these initiatives.

 

Desired Assets

The community food systems coalition is still in its infancy, and was still in the process of obtaining stakeholder input at the time of writing. Further representation from some community stakeholders was still desired including for example, input from the municipality of Brant County and land use planners. This input will be sought as stakeholders continue to be identified in the ongoing process of developing a stakeholder profile.

 

Constraints/overcoming them

The Community Garden Project was originally structured in a way that “was not sustainable”, Gill describes. However, by shifting the role of the project manager to one of education, consultation and resource allocation, the GRCHC was able to overcome this structural barrier and has successfully supported the creation and maintenance of many more gardens in the community.

With respect to the food systems coalition, Gill notes that the work is very heavily “relationship-based”, adding that she had built relationships with food stakeholders in the community when doing her prior research on the Community Food Continuum that made it easier to begin assembling a stakeholder profile for the coalition. One challenge this initiative faced at the time of writing, was that Gill’s temporary maternity leave  replacement must now begin building these stakeholder relationships and trying to begin a food security dialog. Gill noted that one way she attempted to preemptively overcome the constraints this temporary transition might bring was to actively seek out a temporary replacement staff member who had the capability to continue the task of building relationships with community members.

Having the coalition see small successes or tangible outcomes early on in order to maintain the support of the community stakeholders is a challenge that Gill anticipates in the future of the coalition. To overcome this, Gill has suggested that one of the coalition’s (which the GRCHC facilitates but the stakeholders and participants are responsible for) first activities should be to identify a few priority community food needs and then work on action projects to address these needs.

 

Successes

In regards to the community garden project, Ord and Gill found that they could be more efficient and useful in a support role, rather than being responsible for running an individual garden. They attribute the project’s current success to the fact that they “run on minimal funds to create multiple gardens in a year because the onus is on the community to create the garden”.

Gill emphasizes that the key to success in all food initiatives the GRCHC is involved with is the ability for the GRCHC to assume the role of facilitator, but to allow the community to drive the initiatives: “The whole thing that underpins it whether it’s the community garden or the community food advisor program or the food systems coalition is building capacity, you’re just building it a different levels…Our role is that stable facilitation of continuing to build capacity within the community so…you take [the community] to a certain point and then [the community] owns it and takes it further”.

 

Relevance

When asked about how the GRCHC’s experiences working with community food systems initiatives would be relevant to other organizations, Gill and Ord responded, “everything is relevant!” “If you want to do this work,” Gill explains, “you’re going to have to learn from other people’s successes and challenges, and your community is going to have their own, but hopefully you can curtail some of the challenges up front, or you can bring foundational knowledge to a group”.

The GRCHC clearly has some unique assets that have contributed to the success and sustainability of its community food systems initiatives. Notably among these are the sustainable funding for dedicated staff time to address food security issues and the rich human resources provided by the particular staff that currently work on GRCHC’s food portfolio. The staff dedication to food security was made possible in part by the organization’s ideological commitment to the social determinants of health, which encompasses food security issues. The particular choice to dedicate resources to food security was driven by the early involvement of the GRCHC with the Community Garden Project, the relevance of food security as an underlying cause of health issues in the Brantford community, and finally by Gill’s interest in food security and ability to conduct research into the community food system afforded by her simultaneous employment and education in health promotion.

The GRCHC community food security model also has many transferable success factors relevant for other organizations. Linking food issues to social and public service organizations that are well funded (such as health in this case) can be one way to overcome the lack of financial sustainability non-profits and grassroots initiatives often find in trying to employ the necessary staff for a successful food endeavor. Both Gill and Ord emphasized the importance of research – both initiative specific and community specific – that allowed them to build stakeholder relationships in the community, learn about other communities’ successes and challenges in similar endeavors and gain credibility and support for their initiatives both within the community and from the Health Centre.

Finally, Gill stresses the importance of building community capacity for the community to take ownership of its own food endeavors. The GRCHC’s most successful food security initiatives (and the model they continue to use with new initiatives) are those  where they first initiate a project as a facilitator and administrator, bring together key stakeholders and resources, and provide knowledge and education. Then as the community becomes more involved and confident, the GRCHC’s role shifts to one of continued support while the ownership of the initiative is transferred to the community itself. This model balances the need to provide a starting point and a resource base for an initiative to the community with the need for sustainability that can be achieved when the community itself defines an initiative as important and takes charge of maintaining it.

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