#192 Prescribing Fruit and Veg on the NHS with Dr Chi-Chi Ekhator

11th Apr 2023

Dr Chi-Chi Ekhator is a GP in London and probably one of the most motivating people I’ve ever met. You’re in for an absolute treat today, especially if you’re a passionate medic with a penchant for nutritional medicine like me.

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Chi-Chi is also a GP Appraiser for NHS England and Vice Chair of Ascension Trust, an organisation known for initiatives that seek to help the vulnerable in society. And leads the AT Beacon Project, a health initiative of Ascension Trust working on the ground in the heart of neighbourhoods to address health inequalities.

We met up at one of their health and wellbeing hubs in the inner city estate of Brixton, but they also operate out of social supermarkets, barber shops, churches and wherever you find vulnerable people that they can help to live healthier, flourishing lives.

As we were in the middle of an outreach clinic you’ll hear some activity during todays recording and if you want to see it in action, check it out on YouTube!

Episode guests

Dr Chi-Chi Ekhator, MBBS, MRCPCH, MRCGP

Dr Chi-Chi Ekhator, MBBS, MRCPCH, MRCGP

Dr Chi-Chi Ekhator is a GP in London and a GP Appraiser for NHS England. She is Vice Chair of Ascension Trust, an organisation known for initiatives that seek to help the vulnerable in society.

Dr Chi-Chi leads the AT Beacon Project, a health initiative of Ascension Trust working on the ground in the heart of neighbourhoods with key partners and stakeholders to address health inequalities. Their health and wellbeing hubs are in sites such as a social supermarket, a barber shop, churches, and an inner-city estate. Their aim is to help vulnerable communities in South-East London live healthier, flourishing lives.

Dr Chi-Chi has also led several medical projects in less resourced countries and communities around the world and is part of the Bishop of London’s Health inequalities action groups (HIAG), an interfaith group of leaders exploring health inequalities in the capital and how faith groups contribute to supporting health.

Dr Chi-Chi also takes an active role in her community and was previously an elected school governor overseeing special educational and disability needs, aspects of health and safety and welfare of the school community.

References/sources

Link to At Beacon Project

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Podcast transcript

Dr Rupy: Dr Chichi Equator is a GP in London and probably one of the most motivated people that I've ever met. You're in for an absolute treat today, especially if you're as passionate about nutritional medicine as I am, because this doctor is making some huge, huge waves. Chichi is also a GP appraiser for NHS England and vice chair of Ascension Trust, an organisation known for initiatives that seek to help the vulnerable in society, and she leads the AT Beacon project, which works on the ground in the heart of neighbourhoods to address health inequalities. And that's exactly where we caught up today. We met up at one of their health and wellbeing hubs in the inner city estate of Brixton, but they also operate out of social supermarkets, barber shops, churches, and wherever you find vulnerable people that they can help to live healthier, flourishing lives. We talked today about their association with the Alexandra Rose project, prescribing fruit and vegetables, why she's so passionate about that, her journey being a GP, and what she loves about being a GP as well. And I've never really heard someone talk about medicine in this way before, getting out there in the community, walking the streets, chatting to people and essentially turning the model of people coming to see you in the surgery on its head. She's really doing the exact opposite, and it's wonderful to see. There was a real buzz and energy at the health hub that we were at today, and as we're in the middle of the clinic, you'll hear some activity during today's recording. And if you want to see it in action, go check it out on YouTube and make sure you check out the Alexandra Rose charity. We're going to be doing more podcasts with Jonathan Pauling and the wider team at the charity because I'm just so passionate about what they're doing, as you can tell. Check out the YouTube and IG posts that we're doing around getting the conversation going around whether medics, health professionals up and down the country should be able to prescribe fruit and vegetables for free. This is something that I really think can happen in the next couple of years, especially on the back of the pilot that Dr Chichi is part of.

Dr Rupy: Dr Chichi, thank you so much for sparing the time to chat to us here. Tell us where we are. This is not usually where we do the podcast. We usually do it in a soundproof studio, everyone's silent, but there's going to be loads of activity. Where are we today?

Dr Chichi: We are in Angel Town. So that's an estate in Brixton, so South East London. So yes, we're in Lambeth in the middle of the neighbourhood, delivering the fruit and vegetable on prescription. So you will see people walking in off the street, from their homes, from school run, from their businesses. We're about being where people are. So it's not your posh surgery, but it works. Absolutely works.

Dr Rupy: Epic. So exactly where are we right now? What is the centre? What is the purpose of it and why will people inevitably be coming in and out?

Dr Chichi: Absolutely. So we're the Ascension Trust Beacon project. We were established as a health initiative, as a health arm of Ascension Trust, which has been going for over 30 years. Our flagship initiative is Street Pastors. And so we've come back to the birth of where we launched Street Pastors and we actually recognised that people want to know more about their health. They want to engage with health professionals. They want to see people that they feel that they can trust. But most of all, we recognise that there are so many barriers to people accessing health in a convenient way, in a convenient format. So the Ascension Trust Beacon project has partnered with the Alexandra Rose charity. It's been a wonderful partnership and we deliver fruit and vegetable prescriptions to patients who may be, you know, have health conditions, hypertension is one that we are really homing in on because we understand the impact that eating well, having access to healthy food, it can, it can just change your health dramatically. So that's what we're doing here today, prescribing. I'm a GP, so I prescribe by nature. So but actually we're prescribing fruits and vegetables. So you will see people come in, grab their vouchers and then head off to the local trader in Brixton market. So we're also in other sites across Lambeth. We're in a barber shop on Streatham High Road. The other site that we deliver the fruit and vegetable prescription is in a social supermarket. So alongside where patients, well, let me not say patients, where clients can come in and get healthy fruits and vegetables, healthy food. We know that access to fruit and vegetables, even at this point, is a big issue. So we try to remove that barrier and it's been wonderful, the fact that we can support 50 people across both sites with accessing healthy fruit each week for their family. I mean, I'm Lambeth born and bred, so I know a lot of the traders. And actually, you know that things like plantains, which is a staple within the Afro-Caribbean diet, has gone up 100% in price. Now for somebody who is receiving very little in universal credit, in benefits, in a zero-hour contract, that's huge. And what we don't want is for people to make the choice of either getting their prescriptions or eating. We know that people are having to make that choice, do I heat, do I eat? So for people to get their blood pressure prescriptions, that is falling way down the list. And we're seeing that as a GP, I'm seeing that.

Dr Rupy: When you started med school and when you became a GP, did you ever think that you would be prescribing fruit and vegetables?

Dr Chichi: I had no idea. Absolutely no idea that I'd even be doing this. As I said, I went to school not far from here. I actually trained as a paediatric doctor to start off with. So I've always been passionate about family, family medicine, children, the, you know, cradle to grave model. I'm about getting into people's business, going into their homes. You know, when I do a visit as a GP, I want to see what's going on here, because actually, if you don't know what's actually going on in the home, you, it won't help to explain what you see in surgery. So I've envisaged myself as somebody who's always been out and about in communities. I do a lot of what we call mission work abroad in underprivileged countries or where they're struggling in health, in their wellbeing, socially, economically. So I've always done that as a doctor. It's helped me to keep going. It's helped me to just to, I see medicine as a passport. And, you know, would I have envisaged that I'm prescribing fruits and vegetables in Angel Town? No. But, you know, did you envisage you'd be doing this?

Dr Rupy: Absolutely not. No, when I started, I thought I was going to be a surgeon.

Dr Chichi: Oh, okay.

Dr Rupy: And I was going to be a psychiatrist.

Dr Chichi: Oh, there you go. Yeah.

Dr Rupy: So it's amazing how our paths meander through different specialities. And I think had it not been for my own health issues where nutrition and lifestyle had such an a massive impact on recovery, I probably wouldn't have veered down even the general practice path, let alone the sort of concepts of prescribing nutritional medicine. And that's essentially what we're doing here today. And we're going to have loads of people going in and out.

Dr Chichi: Absolutely.

Dr Rupy: So and I love the fact that we are literally in the community because when I'm practising medicine, I'm in surgery. You don't get to see any of this stuff.

Dr Chichi: You don't get to see this. You don't get to see how people are living. You don't get to see the the impact of actually us prescribing a medication that somebody's going to have to pay a prescription for. You don't see the impact of the fact that if a patient's on two antihypertensives, what impact does that have on them economically? So you might see them pitch up and they're not taking their medication and you're saying, well, why aren't you taking your medication? Do you know your blood pressure is high? Number one, you're not considering the fact that there might be an affordability issue where they're not qualifying for free prescriptions. It might be the fact that actually they're not getting in to see their local nurse because they're on a zero contract hour job. So we also do Sunday outreach, so we go to churches, we go to faith groups. I'll give you one classic example. So I saw a gentleman, he came up to see me, he's had a stroke in the past, he's got cardiovascular disease, hypertension, diabetes. So I saw him, his blood pressure was completely through the roof. And I said to him, look, you would be a really great candidate for our fruit and vegetable on prescription. Now, he works as a sort of zero-hour contracting workman via some sort of app where you have to quickly get the job that's comes up on the app. And he said, I literally can't come to get the vouchers. I can't go to my GP. I don't go for my annual diabetes check. I don't go for my retinopathy screening because I have to work. So I said to the team, look, no, we need to make this work for this gentleman. We know he lives locally in the area. Can we make sure that he can come even if it's just once a month and we can give him the vouchers, we can ensure that at least we're helping him so that he can manage his diabetes, he can manage his hypertension. We're able to encourage him and signpost him to all the NHS services and say, look, you can go into here, you can go into the local pharmacy on your way to work, you can have this conversation, you can do this. So it's so important that we are thinking laterally, we're thinking innovatively. We're not just pushing policies. We're not causing more barriers because actually there are already enough barriers. And what we need to do sometimes is just get out there where people are. And as I was saying, this has been one of the most amazing years of my career as as a doctor.

Dr Rupy: Yeah, let's talk about that because when we were walking on the way from the church to here, a short walk, all I got from you was a big smile for everything you were talking about here today. And you said exactly that, this has been one of the best years of your clinical career.

Dr Chichi: It has been.

Dr Rupy: Talk about that.

Dr Chichi: It's been like I've been able to paint a picture of what health looks like to communities. I've been able to really tackle issues that matter to communities. Trust is a big thing and I usually say to people that trust is becoming a fast determinant, a social determinant of health. I've been able to launch health hubs in a barber shop on Streatham High Road. I can't contain my excitement. Everything in me tingles, you know, not because of, I'm a married woman, not because there's men in there, but these are, these are young men I would never see. These are middle-aged men who have high risk of prostate cancer that I would never see. These are people who are diabetic, who I won't see them in my surgery until they crash out in renal failure, until they have their strokes. But the fact that I can take highly specialised nurses, highly trained health ambassadors into that domain and we can begin and engage about their health, not just about hypertension, but we could talk about what are you eating? You know, how about your activity levels? How about your blood pressure? Do you think you might want to consider going to have your PSA checked? Do you think you might want to consider your risk, family risk of diabetes? How about your eyes? Have you had an annual eye check? Do you know you could just pop down the road to Specsavers and and have a conversation? How about stress? How how are you? You know, I'm always amazed when people ask me as a doctor, Dr Chichi, how how are you doing? But actually, we know that people have been through so much and we do need to ask those questions more. So it's been an amazing year because I've been able to innovate and see results, see the success, see people coming in. Look, I mean, this is amazing. This is my dream. Maybe I didn't know my dream, but seeing people come here as these ladies are, getting their fruits and veg prescriptions, speaking to a nurse, we engage them on all issues to do with health. We signpost them to the correct place. Does it get better than that?

Dr Rupy: Yeah, I in that word you use innovative is exactly how I describe this because the way I see what you're doing is you're flipping general practice on its head. Instead of creating a small hub where people have to go to, you're basically inverting that and saying, it's okay, we're going to be where you're at because we realise the time constraints and all the other barriers that exist that prevent people from actually coming to our little surgeries wherever they are.

Dr Chichi: Absolutely. And we know that in the pandemic, everybody had to sort of modify the way that we were doing health and we're still working that out. What does health look like these days? But what does health look like to somebody who doesn't have credit on their phone trying to wait on the line for a GP? What does health look like when they just need to go and quickly drop off a child to nursery? They need to go to work. They can't be called back at a time. I know that we're changing the way things are done, but actually, we know that, you know, 15,000 people are walking around with undiagnosed high blood pressure since the pandemic. We know, you know, not 15,000, we know that half a million are walking around with high blood pressure. We know that that equates to about 15,000 strokes. They're there. Are we going to wait till they end up in in secondary care costing thousands to the NHS purse? They may be the breadwinner for their family and they've been removed from activity. I've seen that happen. You know, people deserve better. They really do. You know, they pay their taxes, they work really hard. They work hard for themselves, they work hard for their families. Surely an £8 voucher a week to go and get fruits and vegetables. Surely they deserve that. Surely they deserve the extra £2 per dependent so that their families can eat well. You know, unless you're in it and actually know how people live, you you will not know what that means to them. And actually for me to be able to be in the midst of people's lives, okay, I'm not on the ground every week, but my staff are. They're on the streets. They're stopping people. I'm out on a Sunday with the team. So you just need to understand and be able to feel how people live. And then we understand the impact of these policies. It makes a huge difference. And actually, our participants speak for themselves. And I've never had a clinic where every patient turns up. But actually, when we're at our sites, you know, we have 25 people that we're supporting at the social supermarket in West Norwood. We are quickly building up the list here. We had to sort of take it slowly because when we launched the first site, on the first day, everybody was enlisted, 25, because the demand was so huge. So here we're just carefully trying to work in this community, get people out, get people talking. And they turn up every week and they will see a nurse, have their blood pressure checked. As I said, we're not a blood pressure testing or screening or monitoring service. It's a carrot. It's a carrot to be able to talk about everything else.

Dr Rupy: Yeah. Yeah. And when you said that you're literally on the street, you are on the street. We just walked past and we saw people walking around, they have their jackets on. You can spot them a mile off. And then I'm sure they're just approaching people, asking them how they're doing.

Dr Chichi: Absolutely. We approach people, we talk to them, we engage them. We also have a full-time mental health and wellbeing outreach worker. So we work alongside public health in Lambeth. She's based on their wellbeing bus once a week and it just goes to different sites across Lambeth. She's based in our hubs at the other times. And you just need to go out there and engage. People aren't scary, they want to talk. If you say to someone, look, can I have a chat with you? You have a visible uniform, you have a visible badge, you're credible, they know you, you have been in the community. They stop and they talk. As I said, our initiative, Ascension Trust was birthed here, right here. And actually our flagship initiative called Street Pastors has gone, you know, global. It's across the UK. We have 240 different sites across the UK. We've trained over 20,000 volunteers. Communities know us. This year we're celebrating 30 years.

Dr Rupy: 30 years?

Dr Chichi: 30 years as an organisation, 20 years of street pastors. And I could be wrong, I think we've done more than 30 years, but definitely the 20 years of street pastors. I'm actually vice chair of the organisation as well. So I speak with a lot of passion, but I speak as somebody who, you know, I was born in Lambeth down the road. Would I have ended up a doctor if my mum wasn't that hard-working nurse who worked literally seven nights to ensure that I had what I needed, that I had the educational opportunities. I didn't know any doctor growing up except my GP. And I didn't even know I was allowed to visit him because I didn't know it was free. So that's me as a child growing up in South London. How much more now, you know, where people aren't quite sure how to access health. They're not quite sure what it all means. They're not quite sure, can they get an NHS dentist? Can they go for an eye check for free? Can they, can they be registered with a GP? You know, you have people who are new to the country, new to the whole system. They've come from countries where you have to pay for everything. And so therefore they don't make an approach. And if they don't speak English, how much more? So our surveys have been also translated into Spanish because there's quite a large Spanish and also Portuguese community around here. So it's about understanding what people are going through. I could talk on and on and on. As I said, I'm so excited about being a doctor right now at a time when it's tough out there. We know it's tough. I also appraise doctors, I'm a GP appraiser. So I do hear of the burnout, I do hear of the sort of, you know, it's difficult. People's lives are difficult. It's just a difficult terrain. And actually to be able to inspire other doctors to say, look, use what's in your hands. And that's what I did. We were launched as a health initiative off the back of COVID. It was, you know, the fire was ablaze in my community. As a black doctor, I felt the need to go out there and engage my communities. I lost three aunts to COVID in the space of two months, pre-vaccine. So when the vaccine came out, immediately I wanted to ensure that my mum was safe. You know, it was tough for her to digest. Well, this is a new thing. I'm not sure. There've been all sorts of things happening in the past. Mistrust is rife or distrust. So being able to go out there and have conversations with people and actually understand the fact that when someone says to you, well, I live in a house, in a room with six, seven other adults, it's a very low standard. There's mould, it's it's awful. My child has respiratory conditions. You do understand that actually that might be the thing that it's a massive concern to them or the fact that they can't access fruits and vegetable or they can't, they just don't have the money. So actually, it's about speaking the language of the communities, not the physical, not the actual language, but actually you need to go there and understand what matters to them and then you begin to address that.

Dr Rupy: I think that's a really good point because there seemed to be a lack of empathy for anyone who was distrusting of the medical profession, particularly when the first suite of vaccines came out without really understanding the reasons behind that. And I think what we were talking about on the way over here with the priorities being aligned more to shelter situations, social housing issues, access to fruit and vegetables or food in general, you know, those are much higher along the list rather than the other things that might have been more important to medical professionals at the time.

Dr Chichi: Yes. I totally agree because we do know that, unfortunately, you know, many people, you know, lost their lives who perhaps, if we had been there all that time, and I say that with a lot of respect for my job as a GP, but if we had thought about health in a different way and been there really for them, we could have made more inroads than we did. So actually, we do need to look at the models that were used during the pandemic and that's how we started to establish our models. I began to understand that, right, what I do as a doctor is probably about 5% of health. What and do I have power? No, I don't. Who who has power within the communities? Who are the influencers? It's your imams, it's your gurdwaras, it's your pastors, it's your vicars, it's your, you know, Jewish leaders, it's your community leaders, whether you whether you have a title or not. So for instance, my mother, once she decided to take some proactive steps to protect herself, whether that's actually wearing a mask or or considering the vaccine, she's an unofficial community leader because she's an elder in her community. So she has influence over literally hundreds of people. So the fact that if you engage those people and you say, look, can you have a chat with your your followers or your tribe or your, they do. And they're the ones that have power. And as a doctor, you know, you have to, you know, eat humble pie and say, perhaps I should be aligning myself a bit more closely. Hence why we deliver our hubs through places like St John's in Angel Town, which has been here far longer than I've been here. They they people are there every Sunday, they're there midweek. They trust their vicar. We're also in St Mark's in Kennington. We're in the barber shop. People trust their barber shop leaders. You would not imagine the level of footfall we have over a thousand a month. People just walking past, coming in. It's a hub. I don't know if you remember the, maybe you're too young. Do you remember the programme Desmond's?

Dr Rupy: Yeah, of course I remember Desmond's. I'm not that young.

Dr Chichi: Desmond's was just, people came there and they talked about their issues, whether it's about a relationship stress, whether it's about a new diagnosis, all type of issues. And actually, we're recreating that. And it's been absolutely amazing.

Dr Rupy: You know, there are going to be thousands of medics and GPs who listen and watch this. They're going to feel as inspired and motivated as I am right now. How can people up and down the country and maybe even abroad mimic what you've been able to do in your town, in your area, in your community? Like where do people even get started? Because I think the frustration and the burnout comes from the inability to feel like you're enacting change. And like you just said, 5% of what you do as a GP is health actually, all the other stuff is happening out here.

Dr Chichi: Exactly, exactly. I think first of all is recognising, as I said, for me, I saw medicine as a passport, a passport to be able to reach people, because once you say, look, I'm a doctor. So when I'm out on the street on Streatham High Road, I've got my clipboard with the team, people are busy walking past and, you know, they think we're just doing a questionnaire. And I say, hey, stop, I'm a doctor, have a chat to me. And they stop and they look at you and think, what are you doing here? But that's good. Just stop and talk to me. And then before you know it, I've told them everything that they need to do, you know. So I think it's beginning to look at what's in your hand. People who are listening, you know your communities, you know your patch, so to speak. You're highly trained, you're highly skilled. You can make a difference. Whether that's lifestyle medicine, that's an area that I've began to, you know, I've started to have great interest in. I'm doing a lot of reading, a lot of research into it. I'm attending conferences, I'm networking, I'm engaging with people. And actually, it's also about networking and hearing how different doctors are working all across the country. I've met lifestyle doctors who have approached their PCN and they've launched clinics and they don't know what, how to start, but they've started. They're saying once a once a week, I'm going to have a clinic where people can come and talk to me about their blood pressure. And I think you just need to innovate and think about doing things differently because we know that actually that's what's going to make the difference. So last year, I did, I was part of a programme called the Southeast London Primary Care Leadership programme run by the London South Bank University. And it was about the PCN leaders in South London, Southeast London coming together and actually looking at how do we deliver health because it's not working. We know that I can't remember the statistics, but it will be say 10% of patients on a GP's list are using up 50-60% of the resources. I suppose using up is not the word, but it's about what about the 90% or the 80% that never come to see their GP? What about the young people? Can we reach them earlier? Do we need to wait for them to come and see us? What is a young 20-year-old going to come and see a doctor about? Obviously, if it's a, a, um, somebody who's on a contraceptive pill, yes, they do come for annual checks or regular checks. But actually, why wait till they're 50, 60 and end up in a health with a health problem? How should we be reaching out to them? So these are conversations that are happening. We just need to encourage more of that conversation happening all across the country because we know we need to do health differently. It has to change. It has to change from a point of the doctor actually enjoying their job. It has to change from the point of patients actually feeling that the doctor has an interest in them when they're not knocking on the doctor's door. Why don't we send them a card or something? I know it sounds really random. My mind just churns with different ideas.

Dr Rupy: You're thinking laterally. I can definitely tell the way you, you know.

Dr Chichi: Absolutely. So I, I, it has been an amazing year. It's been amazing working with a fantastic team of nurses. You know, I have, you know, four highly skilled nurses that work with me on this project. I've got accountants working with me on this project who want to do this. I've got people who've worked for the Met police at really high level and actually they want to be part of this. So our health ambassadors look different. They're normal people from all walks of life who actually feel that they want to make a big difference. Our nurse Margaret, who was one of our founding nurses, she's in the background smiling sweetly. You know, she's worked in Lambeth for 40 years, Margaret? And she knows the community. She's worked as a school nurse, school's immunisation lead. So as we go through Angel Town and you see us wave at people, it's probably because she did their school ins when they were two. We also have another nurse who's also school immunisation nurse lead in Lambeth. Our mental health outreach worker is a, you know, she was a community psychiatric nurse in Lambeth for over 25 years. So I'm really, I feel I'm just really lucky. I've got great staff. So they, they make it look easy.

Dr Rupy: That's amazing.

Dr Chichi: And I do probably a small part of what they do, but we motivate each other. We ensure that we're well trained. We're not remodelling general practice. We're not breaking down general practice and saying it has to be this. But we're working alongside general practice. We're saying to people, look, the door is open, go to your GP. They're not going to kill you. They want to see you. And actually, as we have more and more of those conversations and show people that actually we care about what you care about, then it the whole system begins to work.

Dr Rupy: Totally. Totally.

Dr Chichi: You can tell I can go on and on and on.

Dr Rupy: I know, no, that's great. Whilst we bring this conversation to a close, I could talk to you for a lot longer. Specifically with the fruit and vegetable on prescription scheme, it's with a small number of individuals, families. What's been some of the highlight moments for you and give me the two your two cents on whether you think this scheme should be available to everyone up and down the country, because I know where I am on that. I'm really for this just from the the small bits of the results and stuff that I've heard from Jonathan, the team, yourself. Give us your your perspective on that thus far.

Dr Chichi: Yeah, I think a highlight moment was for me was when we had the Deputy Chief Medical Officer for for England visit our one of our hubs at the community shop. And actually we invited two of the participants to come and speak about their impact of the project, the fruit and vegetable on their lives. As much as I can talk and, you know, give all the statistics and the facts, it's about the qualitative feedback. And when this lady who had just come off a night shift, waited for us to sort of have our guests arrive, and she stood up with her piece of paper, feeling very proud that actually she's part of this project. She's a participant. She is, she has got ownership of the project. She feels that this project is really impacting her and she's going around telling everybody in the community, look, come and engage with AT Beacon project, come and get your fruit and vegetable on prescription vouchers. It's making a huge difference to me. She's talking about how her blood pressure is much better controlled. She's talking about how she's reduced the salt in her diet. She's talking about the fact that she's cooking from scratch with healthy food that she's been able to get from traders that she's known for 20, 30 years in Brixton, in West Norwood, in Streatham. She's talking about how now she can feed her family of five with lots of healthy things. What else do I need to do as a doctor? I mean, come on. You know, that's amazing. If somebody can go out there and replicate your passion and they're not clinical, for me, that's the battle, it's won. So that's been a key highlight. I just felt so proud. I just sat back and I thought, wow. And the second participant stood up and said the same thing. And I just thought, you know, they were saying it on my behalf, but actually they meant every word. And they they put it into perspective. It it felt it felt like it put flesh on the whole project. And I just thought, keep going, just keep going. So should this be all across the country? Of course, it should be. Sorry, my arm movement was like, yes, of course. Of course, of course. There's so many different things that we can prescribe fruits and vegetable for. This morning, we were debriefing as a team and we were talking about some very deep and sensitive matters that had been disclosed to us from some of our participants. Of course, someone who is having chemotherapy or or they've just received a diagnosis of cancer and have to stop work and, you know, surely if we can support them in this aspect of life, it's important. Of course, somebody who, you know, can't afford toothbrushes and toothpaste for their family and children, because we know the statistics are there, dental poverty, tooth decay is massive in children because through the pandemic, it's just the sweet things, cheap things that people have purchased for their families and that habit is still going on. Of course, we should help out there. You know, of course. So what, what else? I mean, everything. Why can't somebody come to their GP and be prescribed fruits and vegetable? Is that a lofty ambition? It might sound a bit crazy to people, but I do like doing the crazy things. I do like being in a barber shop and say, yes, this is health. It works for communities. Let's do this.

Dr Rupy: Amazing. You've given me so much life. I appreciate you. I appreciate you so much, Dr Chichi. It's amazing. I will 100% be back and I will, you must come to the barber shop.

Dr Chichi: I will come to the barber shop. Yeah, yeah.

Dr Rupy: I think it would be a bit more rowdy then.

Dr Chichi: It's interesting. I remember one of the barber, one of the people who was getting their hair cut one day said to me, oh doc, you need to be on Tik Tok. That's where it is. You need to be on Tik Tok. You need to get the health promotion out there on Tik Tok. And I was like, what do you want me to do? But actually, it's important that we understand the language that people speak these days. I'm there sending text messages to patients, come and have your blood pressure checked. Well, maybe I should be telling them on Tik Tok. Maybe you should. Do a little dance with it and pointing fingers. It was so funny. When he came the next week ready, I was like, I don't do this.

Dr Rupy: We'll hold you to it. We'll hold you to it. We'll keep an eye on that.

Dr Chichi: Okay, barber shop doc.

Dr Rupy: The barber shop doc. I reckon that could go viral.

Dr Chichi: Oh my goodness. Wow.

Dr Rupy: We'll be back. We'll go and check in on that. But thank you so much. I appreciate your time.

Dr Chichi: Thank you for having me. And it's been wonderful. It's been wonderful. And thank you to Alexandra Rose charity. It's been a pleasure to work with Jonathan, Hannah, and the whole team.

Dr Rupy: Amazing. Amazing. Thank you. Thank you so much.

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