Working together towards a healthier future

"Are you looking for the parents' group?", asks Eva Weirich. She is standing at the door of the Berlin Health Collective - or Geko - in the Neukölln district. It's mid-January, just before ten in the morning, and on this winter's day, the otherwise grey city of Berlin is cloaked in white. The man at the entrance nods. Eva Weirich holds out her hand to him with a smile: "Hello, I'm Eva. Glad you made it despite the snow and ice. The group meets in the back room." The man steps into the warmth of the district healthcare center - a place where people, their health, and daily interaction are viewed in a new light. The tea is already ready. Arrived? Feeling comfortable? This happens quickly here in Neukölln: Health and well-being are understood differently here compared to the standard German healthcare structures.

The Berlin Health Collective, funded by the Robert Bosch Stiftung, was founded in 2016. It is one of eleven so-called PORT centers in Germany that laying the foundation for a new healthcare system. This particular center was built on the site of the former Kindl brewery in the Rollbergkiez neighborhood in 2022. In the 500 square metres of floorspace, various healthcare professionals have come together; cooperation in multi-professional teams is a central feature of all of the PORT centers. The upper floor of the new building houses the pediatric and adolescent medicine department of the Berghafen practice, the district practice for general practitioners and internal medicine, as well as a therapeutic practice for children. Downstairs in the Café Praxis, where visitors can inform themselves about various leisure activities or events, or chat over coffee and cake. There are also various advice centers in the building. Together, they are committed to quality healthcare for everyone - regardless of origin, age, gender, or education level.

One of the informational events, for example, is the parents' group meeting today. The course is new to the collective and is still being developed, but the offer has already been well received. The aim is to give parents the opportunity to discuss the development and health of their children. Eva Weirich leads the group together with her colleague Kim Quistorff. Weirich is a nursing specialist and health scientist. As part of the collective, she offers advice in the field of health and care and is involved in establishing the Community Health Nursing department at the center. Anyone who faces challenges in the healthcare system or is unable to cope with their diagnosis or illness comes to her. We are meeting her today to observe a day in the life at the health collective.

Quistorff is responsible for family counselling in the collective and, as a psychologist, heads the children's therapy on the upper floor. She also welcomes the father joining the parents' group for the first time and shows him around the course room. She hands the newcomer covers for his street shoes; she herself wears slippers. This is fitting, because the entire healthcare collective feels like a large home.

It was a conscious decision to locate this feel-good place in North Neukölln. Despite the high population density, there has only been a limited supply of pediatric care and medical support here in recent years. Visiting the doctor is not always easy for the residents of this socially disadvantaged neighborhood filled with immigrants - many have to contend with language barriers and blatant discrimination. The health collective wants to create a balance, to break down old structures and treat all patients fairly in solidarity.

Initiatives like this one in Neukölln are laying the first building blocks for a new healthcare system: the development and establishment of local and comprehensive health centres in Germany. They are intended to cover the primary and long-term care of patients in the respective regions. Experts assume that the number of people with chronic and multiple diseases will continue to increase in the coming years. At the same time, the number of healthcare professionals is falling. A look at countries such as Canada or Sweden shows that local health centres can successfully meet these complex care needs. To further promote this approach in Germany, the Robert Bosch Stiftung developed the "PORT - Patient-Orientated Centres for Primary and Long-Term Care" concept in 2016. As part of the funding program of the same name, which is now being continued by the Bosch Health Campus, eleven initiatives of this kind are being supported throughout Germany in their further development into PORT health centres. The centres are adapted to the needs of the respective region.

Eva Weirich and her colleagues build bridges, and that is the biggest difference between the collective and standard healthcare in Germany. "It is often only during the consultation that we discover that the patient does not yet have any pediatric care for their newborn, or is afraid to consult their family doctor for fear of rejection. Then we help", explains Weirich. This reduces inhibitions and makes it easier to provide care. Events like today's also provide insights into family circumstances and needs.

It’s time to think about individuals as a whole. Here in the collective, the realities of people's lives are considered and taken seriously. Often, health complaints do not appear out of nowhere, but are directly linked to the patient's circumstances.

"We are currently providing information here in the collective on the topic of mold, for example. The residents of the Rollbergkiez often struggle with mold in residential complexes. This is also reflected in their health complaints", says Weirich. She is able to show that people with a low socio-economic status have different health struggles than those with a higher socio-economic status. It is important to get to know the neighborhood and its particular complaints in order to help.

If you know your patients, you can adapt to their needs - also linguistically. The collaborative can help in various languages: Brochures in Arabic or Turkish are just as common as in German, and modern e-health devices help with all other languages. The holistic approach not only leads to healthier, but also happier patients.

Accessibility is the keyword at the collective. It is also important to the Geko employees that they, and the help they offer, can be found. "With our concept, we want to create many access routes to health and well-being. People seeking advice can contact us directly if they have any problems. The café is another opportunity to get in touch with us. And there are other points of contact in the area; for example, we are also represented in the neighborhood councils in Rollbergkiez to raise awareness for our activities", explains Weirich.

With its four pillars - medical care, community work and projects in the neighborhood, advice and self-help, and research and evaluation - the collective is more than just a medical care center. Their scope also includes prevention and health promotion measures, alongside fulfilling a social mission and bringing people from the community together.

The aim is not only to strengthen the healthcare system, but also to reduce social inequalities. Today’s parent group is another piece to this puzzle. Here, parents can build up a network and discuss challenges. It is up to the parents themselves whether they want to bring their children or not, and the two consultants are definitely prepared: Crawling blankets, toys, children's books - everything is ready in the middle of the circle of chairs. Today’s topic is "feelings, crying, autonomy, care, and boundaries". This class is about people and their individual needs. Two parents are here: A mother of twins and the father of two children, whom we met at the entrance. At the beginning of the class, everyone introduces themselves and the two parents explain their respective family situations, why they are here today, and what they are currently struggling with. Their situations are different, but the overlap in the ages of their children connects them. The father says that his son often rejects him at the moment and only wants to spend time with his wife. That hurts. Quistorff tries to mirror the child's feelings. "We can only see what the child is doing. We only ever have one perspective. But what is happening within the child?", she asks.

Halfway through, Quistorff once again hands out fresh tea. With the new round, the atmosphere becomes more relaxed and everyone laughs a lot. The conversation also changes and flows in a different direction; people are now talking more openly. "Corona meant we missed out on connecting with other parents", says the mother of twins. The father-of-two also confirms that they have had little contact with other families and find it difficult to make friends in the playground or at daycare. "This makes places like this all the more important", says Weirich. "Not having a network increases stress." When the time is up, the counselors ask for feedback: What else do parents want? How could the course be changed? "We only provide the ideas. You choose which ones suit you", says Weirich.

Eva Weirich's working day is far from over. She will hold a few more counseling sessions, fine-tune new ideas with colleagues, and discuss patient reports. At the end  of her day, there will be an exchange with the Health Community Nurses in Hamburg. You can still feel her cheerful and energetic nature from this morning. She wants to approach the future together with others and in a good mood: "The center has been well received and the people here in the neighborhood are getting involved. That is a huge gain." Growing together, and therefore working together, is something that needs to be further strengthened in the future. "The new way of working also has to do with trust - getting that is very valuable."