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Hospital food--an infelicitous term evoking gray peas, dry chicken, Jell-O--is a near oxymoron. The connection between good food and good health is so obvious it's almost not worth mentioning. Yet from the first days of corporate health care, too many well-intentioned professionals have focused on the wrong thing--food prepared days, even weeks earlier; frozen, unpacked, zapped in a microwave--food that serves the gods of efficiency, scalability and low cost. Institutional requirements have uncoupled food from the nurturing it does best, stripping it of its power to delight. The result is a missed chance to let the healing begin. Tracking day-to-day medical progress may be difficult for families, but you don't need a degree to read the meaning in "She didn't touch her tray."
Railing against all this can sound clueless. Don't you understand how hospitals are? Have to be? Kaiser Permanente's Dr. Preston Maring, associate physician in chief of the 346-bed Oakland Medical Center, surely understands. Nevertheless, a simple "What if?" moment Maring experienced three years ago led to an exciting pilot program, launched this August, to serve fresh, local, sustainably grown produce to patients in Kaiser's 19 northern California hospitals.
But much had to happen before gorgeous strawberries could make it onto those trays. "For years I've looked for ways to make the experience of being here better," says Maring. "I like to cook, I like to shop at farmers markets, I wondered, What if we brought a farmers market to a work site?" He contacted John Silvera, head of the Pacific Coast Farmers Market Association, who was enthusiastic. There was surprising corporate buy-in.
The KP farmers market became a reality in spring 2003 and for four hours every Friday since, six to eight small, sustainable produce farmers set up their white-tented booths. Some 4,000 hospital staff, along with outpatients and their families, plus the surrounding Oakland community, can buy Marlene Gonzalez's Asian pears, pomegranates, persimmons and peaches from her family's farm, Lone Oak Ranch, in the San Joaquin Valley. Today there are farmers markets in 32 Kaiser hospitals in six states.
But that was just the beginning. "I kept thinking," Maring says, "we use 250 tons of fruit and vegetables in our northern California hospitals, 100 tons of it imported from around the world. And here are all these urban eaters; what can we possibly do to connect with a sustainably grown rural supply? I never knew how in-patient food services worked. I just knew that food showed up and people complained about it. I had never even met the director of National Nutrition Services."
Eight months ago Maring sat down with that director, Jan Sanders, and light bulbs went off. Maring asked more "What if" questions. What if we no longer ordered grapes from Chile in December? What if we just started ordering seasonally? And what if we sourced the fruits and vegetables locally, from small, minority, sustainable farmers? Sanders's instant reply: "Why not?"
It took Sanders's endorsement from deep inside the corporate structure to send out the necessary signals. "We were lucky," she explains. "All our meals, some 5,000 to 6,000 a day, for 19 hospitals, are prepared at one central commissary in South San Francisco." Which is where Food Service Partners' Ralph Rico (whom Maring describes as a saint) came in. FSP had to agree to process from a less predictable flow of fruits and vegetables. To carry out their goal of sourcing from small, sustainable, minority farmers, Maring turned to Community Alliance with Family Farmers, asking CAFF's director, Anya Fernald, to take on a study of Kaiser's produce patterns and needs. "It's far easier to buy from a farmer who has 40,000 acres in carrots than a small farmer with nine acres of mixed crops," says Fernald. "It's not about spending more money. It's about accepting a greater degree of inefficiency." On Aug. 7, Kaiser launched the pilot program that tests the new farm-to-tray system with eight sustainably grown fruits and vegetables, such as cherry tomatoes, kiwis, cantaloupes, mandarin oranges, even broccoli. Fruits such as the glorious red strawberries, sourced from farmers represented by CAFF, are delivered to FSP. Then, a half dozen of those strawberries, with their green hulls intact, are piled into a small cup and put on every patient's tray. They are so beautiful they make your heart beat with joy. Which is, of course, the point.