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July 8, 2023

PaRx People: A Conversation with Dr. Anna Gunz and Dr. Kawmadi Abeytunge

Dr. Anna Gunz is a Paediatric intensive care doctor at the Children's Hospital in London, Ontario, and Founding Medical Director of the Ontario Children’s Environmental Health Clinic (ChEHC). This clinical service directly relates to her other advocacy and research endeavours in planetary health that span health monitoring of climate change, meaningful supports for youth with eco-distress, and increasing community and healthcare facilities' understanding of and action on planetary health, including the holistic benefits of nature-based solutions.

Dr. Kawmadi Abeytunge is a Paediatrics resident at Western University with a strong interest in environmental health and health equity. Connecting with nature has been an integral part of her own wellness and she has seen the benefits that time with nature has for patients. She is thrilled to be working with ChEHC and aiding development of the Prescriptions for Nature program at Children’s Hospital.

Together, they help lead the Nature for Healing program at the Children’s Hospital at the London Health Sciences Centre in London, Ontario.

PaRx Director Dr. Melissa Lem sat down with Dr. Gunz and Dr. Abeytunge to learn more about their individual journeys into the nature and health field, how outdoor time has helped with their own health challenges, and their innovative work to connect young patients and families to nature within their hospital.


Tell me about your early experiences in nature, and how they contributed to your career and interests today.

AG: I have always been someone who needed to be outside. When I was a baby, my mum would put my pram under a big tree at the bottom of our garden, and I'd watch the leaves to fall asleep. I thought that's what everybody did with their babies, so when my own kids weren't sleeping, I'd put them under a tree, and think, you're supposed to be looking at the leaves and falling asleep! I didn't understand (laughs). But I think I was primed from a very young age.

Anna (far right) on a country walk with family in Lincolnshire, England in the 1980s. Photo supplied.


When I was really little we lived in the city of Manchester, just under the rainiest part of England. But when we travelled to rural Lincolnshire in the north, where my family is from, I would spend all of my time outside. My uncle had this little meadow which is hundreds of years old, and he would keep it wild to let the flowers grow. I wanted to spend all my time in a little patch of trees there. Every time we left the city I could feel myself exhale. When we moved to Toronto, I again felt very unsettled in a big city. It wasn't until I was up in northern Ontario for the first time that I thought, oh, this is how it feels to be settled.

All of the major decisions in my life have involved a tree somehow.

In university in Montreal—my undergraduate degree was in Earth Sciences and Geography—I would spend my mornings on Mont Royal, studying outside in the snow. Spending time outside was something I had always done, even though I didn’t really understand the science behind it, or why; I just knew that's where I needed to be.

My epiphany about needing to go into medicine happened when I was doing fieldwork in Alberta in the Kananaskis Mountains with a tree we were studying at the time, the limber pine. It’s a super durable tree; even in years when other trees around it don't do well, the limber pine grows a lot. It was at least a two-hour hike up these big scree slopes to get to the sites where they would grow. I remember sitting there at lunch looking over a mountain valley with my friend and professor, and saying how much I loved fieldwork because of the authenticity. “If you laugh, you laugh. If people are angry, they're angry. I just love that about fieldwork!”

And they both started laughing. My professor, who was a glaciologist, said, “I like fieldwork because rocks don't talk to me,” and my friend who then did a PhD in botany said, “I like fieldwork because plants don't talk to me.” And then I went, oh no, I have to go to medical school—all thanks to the limber pine.


Anna on a scree slope in the Kananaskis Mountains with a limber pine. Photo supplied.


When I started medical school I remember feeling very disconnected from nature. When questions about climate change or the environment came up I almost felt like I had to chop off my arm to continue studying human health. And in the meantime, I was seeing so many patients who were affected by climate change, and trying to figure out how I could help. These were all happening at the same time.

And that's where I started to really become more aware of the work that you do, Melissa, and the evidence about nature and health and healing, even though my entire life I felt nature time was a necessity. I never wanted to live in a city; if I was going to be a doctor I would have to live on a lake in the middle of nature. Today I practise medicine in London, Ontario. I live 15 minutes from the hospital, and I’m lucky to live on three acres that we've naturalized and reforested.

KA:  I don't know that my story is going to be as interesting as Anna’s with the limber pine (laughs). I was born in Colombo, the capital of Sri Lanka. My parents always had an appreciation for nature and outdoor space, so they were intentional about the home they created for us—they literally built their house with their bare hands. It was so important to my mom to have natural space inside that they designed a giant hole in the ceiling so sunlight could shine onto a pond inside with fish and plants around. My mom in particular loves gardening, and so she curated our garden. Our yard in Sri Lanka had mango trees and jackfruit trees, and our dogs lived out there. And that is how I spent the first four years of my life.


Baby Kawmadi at home in Sri Lanka with her brother and mother. Photo supplied.


Then we moved to Windsor, Ontario, with my brother and my grandma who helped raise us while my parents were working and going back to school. That meant we had a pretty small diameter around our house where we could hang out while our parents weren’t home. My favourite thing to do was to dig for rocks and Fool’s gold—when I think about my childhood that was the activity of choice.

I went back to Sri Lanka for the first time in 2004 as a fourth grader, which just happened to be when the 2004 tsunami hit Southeast Asia. I remember seeing the impacts on my community there, and my family members, and thinking, wow, what an incredible and catastrophic impact the physical environment can have.

And then growing up and getting into the University of Windsor, I feel like I stepped back from that side of me. I didn't spend as much time outside as I do now. I worked a lot, went to school and tried to do a hundred and one different things, and Anna, like you said, it felt like my arm was chopped off. There was just something missing.

I ended up studying Biology and Philosophy, which acquainted me with social justice, environmental ethics and health equity, which I think opened a door again.

But it really wasn't until medical school at Western University when things started to get busy, and words like wellness and burnout and work-life balance started popping in, that I said, okay, I need to find something for me. I need to get back to who I am. And for me that was spending time outside.

Year one of residency was tough. Year two got tougher. So I made a very conscious choice to carve out lots of time to run outdoors, which was my free space to think and decompress. That was around the time that I was reading a little bit about PaRx, and starting to think about my patients who don’t get to see the outdoors. I feel like my relationship with nature and environmental health has been a much more conscious one over the last few years.


Anna training with the Paediatrics Critical Care Transport Team in the Simulation Lab at London Health Sciences Centre, with her daughter playing patient. Photo supplied.


What benefits have you seen in your own patients and their families when they spend time outside?

AG: When I got into clinical medicine, I noticed how isolated patients inside hospitals were, and how often they couldn't even see out a window. When I was a resident, I took care of one patient who had spent his whole life in the hospital. He was born prematurely, and needed to use a medical device, so couldn't go home. His mum had a lot of issues to deal with too, so every time she would get trained to use the device and say, okay, I can take him home, then something would fall through and his new foster family would need training. And things would go back and forth. He was finally ready to go home just before he turned three years old.

The day before he left, one of the physiotherapists got a red wagon to take him outside, and he went around on the ground just collecting things. He would carefully pick up a piece of grass, or a stick or rock, and put it in the wagon, selecting every one of them. When he got back into his room he called people over one at a time, and then he'd look in his wagon and find a stick and give it to them. It was somewhere in all of that we realized he'd never been outside, because he’d spent most of his life on the Paediatrics ward. He knew all the nurses, all of these healthcare providers around him, but this was a kid who'd spent three years of his life inside. I didn’t feel like I had a ton of agency, as a resident doctor, but after that experience kept trying to get patients outside.

As you know, babies’ metabolism of antibiotics is not the same as in adults, so when they're very young and need IV antibiotics they often can't go home because of the frequency of dosing. So some mothers are in hospital with their newborn for six weeks. Their baby’s healthy now, and yes, the first week was scary, but now they're just kicking around in the hospital post-partum for six weeks, often in a double room without a window. When I was working on the floors as a paediatrician, I would tell mums, you can take your baby outside, but they were reluctant to.

Hopefully our nature prescriptions will help with that conversation and make it easier for them, by providing structured and tangible evidence that says, these are the reasons you should go outside. It’s not selfish, and it is actually incredibly important for your health that you do.


Anna camping on the shores of Lake Huron with her family, waiting for sunset. Photo supplied.


KA: My aha moment was when a toddler came to the ward from the Paediatric Critical Care Unit. Their parents had just found out their child had a mediastinal mass, so they were of course really anxious. They'd also been stuck in the hospital for a long time. It was a beautiful day, and their child was stable, so I asked them, “How would you feel about going outside?” And they were excited about it. They said yes, and spent two hours at a park together. I came back a few hours later just to check in on them and see how it went, and they were so happy that they cried. It honestly caught me off guard. It was a small thing I didn't think would have that profound of an impact, but it was so, so special to them to get to go outside with their child for the first time in a long time and just let him be a toddler.


What projects are you working on right now to bring the nature and health connection to the forefront?

AG: Our Paediatrics residents have to do an advocacy project. So when Kawmadi said, “I want to do this for my advocacy project,” I remember thinking that sending patients outside was something I always did and tried to encourage, but there was a learning curve to get people to actually follow through. For example, in an ICU, it depends on how busy it is. I had been saying for six or seven years, let's get patients outside, but when I saw momentum building with other staff sending patients outside too, I thought it would make a ton of sense to try and make it more systematic.

Part of the motivation for our Nature for Healing program is that it's so hard to get people, at least in our hospital, to engage in planetary health and sustainability. Trying to help people understand that climate change is a health emergency was an uphill battle, so I kept stopping and walking away.

But as we started Nature for Healing, I realized it was 100% about culture change. I used to walk around with a recycling bin talking about recycling, and people would stop and say, oh thank goodness, I'm so glad we're doing this, but you couldn't really engage them. But when people heard we were doing work with nature, they said, yes this makes so much sense. There are all these other motivations for it, like humanity for our patients and staff well-being, but we're also hoping it can really implicitly bring that relationship to nature into the hospital space, to allow people to engage in all the other things that need to happen as well. And now it all completely fits together.

Working in planetary health, and creating space for that, and being able to acknowledge the environment in the context of health in a very intentional way makes me feel like I've got my arm back.

Our Nature for Healing advisory council includes physician, parent, nurse, pharmacy and Obstetrics & Gynaecology members. We have some funding now too from our Hospital Foundation. We’re using quality improvement methodologies so we can measure things and help make the program more systematic.

The program has a few different components. One is developing more natural spaces and different activities indoors and outdoors where patients can connect with nature, because not all of our patients can go outside; one activity is just looking out a window. A key piece is also nature prescriptions. We realized that to actually have people order nature time, and to measure prescribing, that we had to do it within our electronic medical records—otherwise it would never happen within our hospital system. Even when people look up a medication and have to click on a box that directs you to an external site they groan. So now we actually have an order called Nature in our EMR.


Nature for Healing program infographic. Image supplied.


We’re at the launch phase where we've got the order going—there was this whole ridiculous build up with trying to get the order in the computer—and now we're rolling out with our physician champions to actually start ordering nature time. It has the same elements as other nature prescriptions: a conversation with a family and patient where they help choose what kind of nature connection activities they want to do, and a dose and frequency. There's either an order that stays in an inpatient’s chart, or outpatients will actually get a prescription that can be emailed to them or be given a paper copy. Part of what we're trying to encourage is also for people to informally prescribe to each other, during their work day.

Throughout the first year we’ll be measuring how often people prescribe nature, and who is prescribing. We also have targets for the number of prescribers and prescriptions we want to see. And then we have feedback surveys we're going to get from families, patients and staff about their experience.

That's our plan to measure the culture change. What we're really doing is quality improvement. There are things that happen in a hospital that are barriers for nature prescriptions, like not knowing when your x-ray is going to be, or when the doctor is going to come. So if we're collecting this information, we can connect to other quality improvement committees, and see if this can springboard us into other important things we should be doing anyway.

This is the second year we've done a planetary health survey at the Children’s Hospital, and this time we explicitly included nature and health questions. And we saw in the surveys that people thought, this is important for my work day. This is important for my hospital stay. This is important for my well-being, and the reputation of the hospital.

The survey also asked about barriers. One of them is education, so we’re going to roll out some training and education. We have a student who's doing focus groups and meeting with different stakeholders about nature prescribing and Nature for Healing, and what the limitations are.

Our hospital serves the entire northwest to southwest of the province, all the way down to the US border, including families from really remote communities. So we want to make sure that what we're doing is inclusive across languages and cultures.

We also have an Indigenous healing service. I was in the Indigenous healing center talking to my colleague who directs it, and he told me he was trying to get natural spaces inside the hospital, because you can't have a birthing suite without plants in it—and we’re working in partnership with them. We need more culturally sensitive areas. We’re also hearing from youth in our hospitals that they want plants indoors; and there’s good literature around the safety of this. So we're going to talk to all of these stakeholders and get it ironed out from an infection control perspective.

As we gather momentum it’s pretty awesome. I bumped into one of the hospital managers, and we were talking about the beautiful murals a high school had painted for the hospital, with icebergs and lakes and polar bears, all Canadian wildlife. And she said we really needed to get nature images on all the hospital doors. There’s already a nurse trying to put life into patient rooms and waiting rooms. It’s this kind of infectious buzz as it rolls forward.


Anna watching ice break up with her daughter after a walk on Lake Huron. Photo supplied.


We've also had these conversations with other people we wouldn’t even expect, like one of our critical care nurses who's really run down. She was going on and on about how she would love to take her patients outside, how important nature is for her well-being and how she spends her time looking outside the window at the life that’s out there.

ML: I love this. You never know what kinds of conversations, what kinds of movements, what kind of care for each other and the planet and the natural spaces around us this work will spark. I call nature prescribing a gateway into bolder climate advocacy. It’s very friendly and approachable, but it really opens our eyes to how important the more-than-human world is for our well-being. And then you can't help but want to conserve it, and make sure that people and plants and animals are healthy. How about you, Kawmadi?

KA: My inspiration to work on the Nature for Healing program was reconnecting with nature myself. Just seeing how beneficial that was for me inspired me to look past myself at the patients and families we work with and treat every day. That was an aha moment, to be like, wow. It sucks being trapped inside of a hospital. It sucks.

As Anna was saying, as a resident I needed to do an advocacy project, and nature was something that came to mind. Part of my role started with doing a literature review on the health benefits of nature, applying for the Quality Improvement exemption, and coming up with what we wanted the prescription to actually look like on the EMR.  Then came the more difficult process of actually getting the prescriptions onto the EMR and coming up with surveys to see if they are working, if they have been beneficial and what the barriers are. We plan to touch base at different points to see how we can continue to improve.

We’re still in the education phase of letting people know that A, this exists, and B, this is something everyone should absolutely do and is of great benefit. We were able to get Dr. Robert Zarr (Paediatrician and Founder of Park Rx America) to do a Grand Rounds presentation, and then tacked on the end of it we created a video that talked about nature prescriptions on our EMR and how to use them. Going forward, beyond prescribing nature, I hope to help advocate for more resident medical education within our curriculum on environmental health.

Anna's also heading up the Children's Hospital Environmental Health Clinic, which I’ve been able to sit at the table for as the Resident Chair. I've been very, very, very lucky to get to work with Anna on some really cool things .


Kawmadi taking a break outside London Health Sciences Centre. Photo supplied.


It’s so exciting to see medical learners engaging in the nature and health field, because it was far from mainstream when I was doing my medical training. Kawmadi, why do you think it’s important for learners to do this kind of work?

KA: I think that's a twofold answer for me. When I think about why I went into medicine in the first place, it’s because I wanted to care for people and their health. And with experience and time I realized that you absolutely cannot separate health and environmental health. Time and time again I was seeing patients and families who were so directly impacted by the environments they lived in, whether it was their housing, access to food, or the water they were drinking. It takes a toll on not just their physical health, but also an emotional and spiritual toll.

And then separating out the medical piece of things, and just looking at how challenging medical training can be, it became a necessity for me to incorporate nature into my life in order for residency to be sustainable.

For me, that looks like running. For context, I'm not an athlete, but by the end of last year, after carving out time to run outside nearly daily in the fresh air, I ran a marathon! And while that was a big milestone for me, the actual time spent training, outdoors, between 1-in-4, 26-hour call shifts provided true solace. I also think spending that time outside made my clinical practice better too.

Being on call during a year of Paediatric surge and seeing not only myself, but also peers I care for getting burned out, I reckoned outdoor time would be helpful for others too. At Western University we get to be senior residents on call as second-year residents. So something I did was take all the pagers and say to my juniors and medical students, “You should go outside.”

At first it was posed as a question, and then more like a statement: There is not an emergency going on here. I am very capable of holding down the fort. You have the ability to go outside so you should do so, and don't come back for at least an hour. And it was so appreciated. At one point someone came back and said, “Thank you so much for my mental health walk.”


Kawmadi (upper left) with her co-resident group doing Paediatric Advanced Life Support training in London, ON as a first-year resident. Photo supplied.


The coolest thing is now, in my third year, my juniors are becoming seniors, and they’re already adopting that same practice. It's really cool and special to see. They knew it made a difference to them and are passing it along.


Anna, how does spending time in nature contribute to your health and wellbeing today, as a healthcare professional?

AG: I mean, it's everything. Where I choose to work and live allows me to have an outdoor reprieve all the time. Even if I'm getting out of my car at four in the morning on call, I stop and look up, and just the fact that I can see stars makes my stress go down all of a sudden. I feel less tired.

And being in my garden, and weeding, and watching things grow is joyful and interesting and exciting. I’m constantly covered in dirt—there's dirt in my nails right now. I do not have a green thumb, but I like watching things grow. Some trees we planted eight years ago are so big now. I think, oh my gosh, they're like our teenagers towering above us.

I also see how getting my kids outside changes their behaviour and moods. Especially my daughter, who feels very connected to nature; we've used that in tools for her to cope with her own anxiety. When they’ve had medical issues, nature has been really protective.

I’ve actually been off work with Long COVID since October. And I honestly think the reason I have my mental health is because even on days I could barely get out of bed, at least I could go and water something, or look at the trees, and know I would get better. I have hope because I can see things growing. However, I will say the frustrating part is that I can't do as much, but having Kawmadi and the whole Nature for Healing team be able to keep moving it forward feels good.  I can't wait to be better, and to really pick up all the loose ends.

I have a lot of gratitude for Long COVID, in a way, because it's forced me to stop and look at what I value. Number one, I want to be a good mother. And number two, I want to be involved in trying to protect this earth.  Forget all of the career stuff. My daughter asked me the other day what year it'll be when she's a grandmother. I barely held it together as I counted ahead, and when she walked away I burst into tears.


Anna’s children running along a closed road next to their house. Photo supplied.


KA: Nature feels like an extension of me. It’s something that is a part of my every day. I am also actively picking dirt from my nails (laughs). This year I've been really into gardening, and I have a garden plot I’m sharing with one of my co-residents.

Every free moment I have, I'm trying to find a way to spend time outside, during vacation time, or after work, and sometimes dragging my co-residents with me to do that. It’s just become so embedded in my everyday routine.


What are your favourite places to spend time outside near home, and in the world?

KA: In the London area, my apartment is situated right next to the Thames River and the Thames Valley Parkway in South London, near to where Storybook Gardens is. That has been my running route and me and my partner's bike route for the last two years.

In the world, the first place that comes to mind is out West. I have high hopes of living there one day. We had our honeymoon out near Vancouver, and hiked Panorama Ridge in Garibaldi Provincial Park in a day because all the campsites were flooded. That is probably one of my favourite places.


Kawmadi and her partner hiking Panorama Ridge in Garibaldi Provincial Park, BC. Photo supplied.


AG: Locally, I mean, I love where I live, just east of London on the Antler River. It flows into London, and a lot of people canoe or use their paddle boards to go down the river. I live in the town of Dorchester, and we've put up a sign saying that anybody from the public can use our property to access the Antler River. That was probably one of my favourite things to do when I was better.

If it’s anywhere in the world, one really special place for me is Killarney Provincial Park in Ontario, on the Canadian Shield. There’s a huge quartzite rock face that comes right out of the lakes, and when the light hits it, it just sparkles like diamonds everywhere—pink and all of these different colors. And now the lakes are thankfully returning to life, but they used to be dead because of the acid rain from the way Sudbury used to smelt nickel. It was surreal, because it meant the lake would be this aquamarine blue colour, and you could see right to the bottom.


Anna enjoying the view in Killarney Provincial Park, ON during medical school. Photo supplied.


Access to nature is far from equitable across Canada. Can you describe how your work reduces barriers to nature access among your patient population, and what work still needs to be done?

KA: On a very micro level, trying to make access to nature equitable and inclusive within our hospital is a big part of this project. It’s very important for us to have voices that represent a diverse array of communities, especially Indigenous voices. In terms of our outpatient prescriptions, a lot of the activities we include are things you don't need to travel far to do, and you can do essentially anywhere.

There’s lots of work to be done at a more macro level. Something I'm very interested in is environmental inequity, and trying to be part of the change.

I feel like we can't talk about spending time outside in nature without thinking about the land, and the policies that govern the land, and the way the land is distributed. I think this in some ways will open up a much larger conversation.

AG: The first thing Nature for Healing does is open dialogue. As Kawmadi said, Indigenous voices are essential to it. There’s active reconciliation within it. Part of the reason for our work is to help support what our colleagues are already doing, and use the system to help the Indigenous health service get the items they're trying to advocate for.

If you're a racialized person and have experienced acts of racism outdoors, there’s a question of safety, and there might be reluctance to participate—which is why I think focusing on indoor activities is really important too. Our disability advocate also spoke to issues with accessibility around that. Part of it is also about the connection. So there are some nature meditations that will be developed; looking at images, looking out windows and really trying to focus on the fact that nature is not just this pristine, untouched, kind of colonial thing. It's everything. It's basically all life.

And this links to other work we're doing in planetary health with the university as well as the city; we have a web of connections within London. There's cross pollination and cross promotion that happens. Nature for Healing is another brick that fits in with all of these other pieces.


Do you have any tips for parents or kids who are trying to fit more nature into their lives?

AG: I think the first part is to be very intentional about screen time, because that’s what limits a lot of things. When kids wonder whether screen time is a possibility, it becomes a complete fixation and they can't do anything else. So one strategy is to be very deliberate and intentional about when it's okay, and when it isn't. Even having full weeks of no screen time, which I know sounds hard for parents—but it's amazing how when we've said no screen time, all of a sudden there's less “I’m bored!” I think integrating nature into everyday activities is also important. If you're going outside, just notice, hey we're going to the park now, and help your children notice that too.


Anna on her walking paths at home in Dorchester, ON in the wildflower meadow her family is cultivating. Photo supplied.


It’s important as parents to be really mindful and critical of our kids’ and our own behaviours. We can have a lot of hesitation and worry about if they’re going to be cold or wet. Like if it's raining, we can't go outside. But most kids have the ability to understand when they can. We have to make sure that our own concerns about mud and dirt are not inhibiting them. And it often makes parents’ lives easier because kids have better behaviour.

For me, learning that aggression, bullying, ADHD symptoms, physical activity, emotional health and well-being, that all of those things improved with nature exposure in children, was striking. There’s a huge evidence base that with even minimal exposures to nature, like with minimal greening of a playground, behaviour in children is strikingly different.

Talking as a parent myself, even when she was three years old, my daughter would have a lot of worries at night. So we would say, “Okay, let's just take some breaths and blow them out.” And I'd put them in my hair, and breathe them in, then go to the window and blow them out of it. I would say, “I'm going to go outside after you're in bed, and Mother Nature will take them out of my hair, and take your worries away.” We would do this routinely and holistically. Probably just the fact that she was taking deep breaths and blowing them out, and getting the sense I'm giving away my worries was helpful to her.

And it was just amazing how this one little thing I started has become a dialogue about worries and anxiety and my daughter's relationship with nature. One time she said, “Hey Mum, remember how last year we were talking about my worries? Two weeks later I saw a tulip growing where it's never grown before, and I just knew those were my worries.” Even my son, who is Mr. “I want to be an engineer” will say, “I need to go outside now because I can't concentrate!”

It’s so natural for kids. It's so intuitive for them to care about the earth; they learn about this in school. As parents we need to be intentional about how we talk and cultivate our time outside, and also our own relationship with nature.

KA: I agree that educating families about the benefits of kids spending time outdoors is so important, because I don't know that many people know the evidence behind it. I think there's this intuitive idea that spending out time outside in nature is good, but sharing those more tangible tidbits of scientific literature that show all the health benefits is a great place to start.


Kawmadi watering plants on her balcony garden in London, ON. Photo supplied.


I myself am not a parent, and so I imagine that any advice I give is a lot easier said than done, but I agree that being intentional is really important. Scheduling even 30 minutes outside, and allowing for boredom, allowing for exploration, can make a big difference.


What role do you think health professionals have to play in inspiring kids and their parents to protect nature and the planet?

KA: I think we can play a really big role. I'm going to go back to that gateway analogy you made: when we’re talking about the benefits of spending time outside in nature with patients, we should simultaneously be encouraging the protection of nature. And this is a position where we, as health professionals, have power. We have to use that power for good and lobby against policies that negatively impact our environments, whether within a hospital setting, or your own clinic, or at the government level.

AG: Planetary health is health, right? So putting planetary health, environmental health and sustainability in the forefront through nature prescribing, for example, provides a foundation for patients and families to make it a priority.

I think a first step is for healthcare providers to see this as part of health, and nature is that great gateway tool. Putting nature at the centre of care is a very gentle way to have conversations about our whole health. On top of the environmental advocacy piece, it's a way to reframe and re-educate people about what actual health is.

Nature really brings humanity back to health care. That's what we say about Nature for Healing: it's bringing humanity into the hospital again. And it’s amazing to see how people react to it.

Is there anything else you want to add that you haven’t expressed yet?

AG: Yeah. I want to say thank you, Melissa. Honestly, I think your nature prescription work has had such huge ripple effects. It is just so powerful and important. I hold a lot of gratitude for it and I've learned a lot. Even this Nature for Healing project wouldn't have come up if Kawmadi hadn’t mentioned nature prescriptions and Dr. Lem, and the work that you and the BC Parks Foundation have been doing for so many years.

KA: I'm going to echo that. I often remind myself that none of what we're doing is new, and it's really, really wonderful to have a path already paved for people like me to follow. So thank you.

ML: We’re all following in each other’s footsteps! I think this is the beginning of a broader movement—a really necessary movement within healthcare and the public consciousness. You are two amazing leaders in this space. It's such an honour to speak with you, and so moving. Thank you for teaching us about the important work you’re doing, and for being on the same team.


Sunset on the Thames Valley Parkway in London, ON. Photo credit Kawmadi Abeytunge.


Learn more about Dr. Gunz’s and Dr. Abeytunge’s Nature for Healing work here.

Have a question for us? Get in touch.


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