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From Tomatoes to Parkinson's: Dutch Innovation Inspires World
The Washington Diplomat / September 2015

By Larry Luxner

THE HAGUE, Netherlands — Souvenir shops sell wooden shoes, bright red tulips grow all over the Dutch countryside, and windmills actually do line the highways of this crowded Maryland-sized nation of 17 million. But these days, the Netherlands is far more likely to grab headlines for its scientific advances in industries ranging from agriculture and biotech to renewable energy and health care.

Earlier this year — as King Willem-Alexander and Queen Maxima prepared for their first official visit to the United States — the Royal Dutch Embassy in Washington invited six American journalists to Holland to see these advances first-hand.

The May 17-22 trip included field trips to a dozen factories, research labs and corporate offices, as well as a half-hour audience with the 48-year-old monarch himself at Noordeinde Palace (whose official protocol forbids photographing, videotaping or directly quoting the royals).

Despite its tininess — Holland ranks 134th in area among the world’s countries — the Dutch are the world’s second-largest exporters of agricultural products, eclipsed only by the United States. In 2012, the Netherlands surpassed Mexico to become the planet’s top tomato exporter, selling the world one billion kilos of tomatoes worth $1.8 billion.

Where better to appreciate this colorful bounty than TomatoWorld, a quirky little educational center in out-of-the-way Honselersdijk that covers 1,500 square meters and attracts thousands of visitors from schoolchildren to foreign backpackers every year.

“Why TomatoWorld?” mused tour guide Annemiek Mirrewijk. “We are very proud of our sector and we want to tell our story. Here you have the whole process from seed to end plant, and what you must do to have a good-tasting tomato. We’re very innovative and we grow tomatoes in a biofriendly way — no pesticides anymore.”

Mirrewijk’s brother happens to be Jos van Mil, managing partner of Greenco, which along with other corporate partners helped establish TomatoWorld in 2008. The company produces some 30 million tomatoes a week on only 25 hectares of land.

Honselersdijk is located in Westland, a district in the Dutch province of South Holland that boasts 40 square kilometers of glass-enclosed greenhouses. It’s also home to the world’s leading flower auction. What’s especially interesting is that while the country’s area cultivated with crops has decreased by 20 percent, productivity has jumped five-fold since the 1950s. Today, greenhouses are using 60 percent less water.

“Innovation is one of our main points. You must surprise customers all the time,” said the 51-year-old van Mil, a fourth-generation tomato grower. His best innovation so far has been Sweet Tommies, which are cherry tomatoes sold in clear plastic 25-gram bags for €1.50 each and marketed to children like candy to get them to eat their veggies.

Even the royal couple’s three daughters — ages 11, 9 and 8 — eat Sweet Tommies, King Willem-Alexander told us during our meeting.

In the southern Dutch town of Venlo, Gus van der Feltz, global director of city farming at Philips Horticulture LED Solutions, explained how artificial lighting might someday dramatically boost the cultivation of food crops and even avert mass starvation.

“At least 70 percent more food will be needed by 2050,” he said. “We must find better ways to grow crops and address urbanization issues as the amount of available land is reduced. You can address these things through vertical farming and get amazing yields from the area you have available.”

Feltz then guided his group of journalists through Brightbox — a futuristic warehouse-like 4,153-square-meter production area on only 800 square meters of floor space. Here, on seven levels, rows upon rows of delicious, crunchy lettuce grow under glowing red and blue light-emitting diodes, or LEDs.

“Sunlight is free and plants have been living off sunlight forever,” he said. “We’re trying to make LEDs the most efficient reproduction of sunlight at the best price we can.”

Among the benefits of LEDs: improved plant quality and uniformity; higher yields; less waste during the distribution cycle, and shorter production cycles as well.

“Our customized modules allow crops to be grown without daylight, so they can be stacked in trays on top of each other,” he said. “There’s no need to use pesticides. This technology lends itself well to addressing food requirements anywhere in the world.”

For now, Philips has grown only lettuce and strawberries, which will obviously not feed the 9.5 billion people expected to inhabit Earth by 2050.

“This is great for plants that don’t need massive amounts of light,” he said. “We have a road map of crops we want to do later on. Real foods like rice or potatoes will be more difficult to grow, or never at all. But now, we’d be very happy if we could do fresh vegetables with higher nutritional content than just lettuce and strawberries.”

In Hertogenbosch, a one-hour drive northwest of Venlo, PlantLab has converted the former Gruyter Fabriek coffee warehouse — a 20,000-square-meter empty shell — into a high-tech complex of 16 growing chambers equipped with red and blue LEDs shining above trays of plants.

“This building was used for storage. Rock bands played in this warehouse. It was a mess,” said Ard Reijtenbagh, PlantLab’s chief partnership officer. “So far, we haven’t come across a crop we cannot grow indoors. The question is, what is economically viable at this stage? That varies by country and by crop.”

Ticking off a list of common misconceptions, Reijtenbagh — whose company has only 40 employees — said it’s possible to produce, in one square meter, 200 grams of fresh vegetables and fruit per person per day.

“Growing horizontally takes a lot of land, water and pesticides. But if you have a closed system and you’re stacking, you can have much higher yields per square meter,” he said. “You’d need two soccer fields 10 layers high to feed an entire city of 100,000, and an area half the size of the Netherlands could feed the whole world.”

Meanwhile, in the town of Wateringen, not far from The Hague, one of Holland’s largest orchid growers is about to take its first plunge overseas — in the form of a sophisticated greenhouse to be constructed later this year in the highlands of Guatemala.

“We built this company with sustainability in mind,” said CEO Richard Ter Laak as he showed off the 4,800 solar panels on the glass roof of his 78,500-square-meter greenhouse, which produces six million phalaeonopsis plants a year.

“This daylight greenhouse saves us 50 percent on energy costs, on top of other savings,” said Ter Laak, whose grandfather founded the company in 1955. “It’s double-glass and in between the glass is a lens that projects direct sunlight and keeps temperatures under control. During the day, we save energy, and at night we use it.”

Ter Laak has annual sales of €29 million ($32 million), with exports to Western Europe as well as Turkey, Poland and Russia.

He said the company investigated China, Brazil, Eastern Europe and even the United States as part of its first foray overseas, “but we were looking for a place where the market is still in the early phase,” and therefore decided on Guatemala. Partly flowering plants will be sold locally, while semi-finished plants will be exported to the U.S. and Canadian markets since it’s considerably cheaper to export them on pallets when there are no spikes or shoots to get in the way.

Ter Laak plans to invest $2.5 million in its Central American venture and employ 15 to 20 people initially, said the CEO.

“Hopefully it’ll grow to 200, but that will take a few years. We will start with one hectare — a little less than 10 percent of what we are doing here,” he told us. “For us, since it’s our first international experience, it’s high-risk, so it was difficult to find good, reliable partners. But it’s very exciting to take this step.”

In Utrecht, our press group visited the Hubrecht Institute, which has 20 research groups, 225 employees (including 175 scientists from 40 countries) and an annual budget of €20 million. The institute specializes in basic biomedical research that forms the fundamentals for clinical applications in cancer, diabetes and regenerative medicine.

The institute was founded in 1916 and is part of the Royal Netherlands Academy of Arts and Science, said its director, Alexander van Oudennarden.

“It started with embryology, but our focus is now on stem-cell research. We have fewer restrictions here than in the U.S.,” he explained, while an associate guided visitors through a laboratory of aquariums filled with tiny genetically modified zebra fish. “There are two different types of stem cells, adult and embryonic. All the discussions are about embryonic stem cells. The adult stem cells just fall off; you can reprogram an adult stem cell back to the embryonic state. Here, no embryos will die, so in terms of ethics, it’s not a problem at all.”

At nearby Delft Technical University (TU), Henk Jonkers — who started as a marine biologist — is making a name for himself in the unlikely field of self-healing cement.

“In 2006, we decided to start a completely new direction of research, something completely novel that could put the Netherlands on the map,” he said. “We decided to develop self-healing materials, mimicking nature. We have lots of examples of organisms that can repair a certain amount of damage.”

Eventually, Jonkers and his team received €10 million from the Dutch Ministry of Economic Affairs and launched seven research projects in concrete, metals, asphalt, polymers and ceramics. He knew that certain spores will germinate if they come into contact with enough water and the right type of food.

“If you feed this material to the bacteria, they’ll basically poop out limestone. And limestone is a material that is part of concrete, so it’s concrete-compatible. Epoxys are very poor compatibility. After time, the repair detaches again, which is why we use limestone. It gives very durable repairs.”

Even so, said Jonkers, it took several years to find exactly the right bacteria and the right type of feed.

“You cannot just mix any type of food source,” he cautioned. “Sugar, for instance; the tiniest amount mixed in concrete results in problems. It will not set. This bacteria needs food, so it took quite a long time to find a suitable food source which does not have negative effects on the concrete mixture.”

Another challenge, he said, was to prevent bacteria from becoming active during this stage and activating it only once the concrete cracks and water gets in.

“Together with Corbion, a calcium lactate company here in the Netherlands, we’ve developed a self-healing agent and have already done field tests with companies interested in selling concrete,” said Jonkers. “We also get a lot of questions from companies saying this is only suitable for new construction, not existing structures. So we developed two self-healing materials: a mortar and a liquid spray.”

These products won’t fix everything, however. In northern Holland, the energy industry extracts enormous quantities of natural gas, triggering earthquakes which the country has never experienced. This causes structural damage, which cannot be fixed with self-healing cement.

“Our bacterias make limestone fill up cracks. It is a solution against leakage problems, and helps to protect steel reinforcement against corrosion. At the same time, you avoid a lot of excess manual repair, saving money. The granules we’ve developed are suitable for new construction.”

Problems are particularly acute with parking garages, where cars often bring in snow and salt during winter months. When the snow melts, the concrete suffers water damage.

Asked how its products are marketed commercially, Jonkers said he and his colleagues filed patents for this technology. Last November, they put all these patents in a company 100 percent owned by Delft University of Technology.

“It’s not really in the contractors’ interest to make construction last for 100 years if he’s not asked to maintain it,” he said. “And it’s not in their interest to have self-healing unless they’re made responsible for certain aspects of maintenance and repairs.”

Jonkers, who studied at Germany’s prestigious Max Planck Institute, said one cubic meter of wet concrete costs €80. The healing agent adds €40 to that — meaning a little expense up front but long-term savings in the long run. Once the university builds its own on-site factory, Jonkers thinks he can further reduce the cost to around €10 to €20 per cubic meter.

“Any contractor will say this is impossible,” he said. “However, if you calculate the construction of bridges and the like, the cost of concrete is only 1 percent of the total. The rest is labor and other things. Even if you add 50 percent to the concrete’s cost, that still adds only 0.5 percent to the total. You will earn this back in three to four years.”

In another building on the same campus at Delft TU, the focus is on healing damaged patients rather than damaged concrete.

At the center of the IMDI NeuroControl lab is a bright red chair attached by harnesses and metal pipes to a TV monitor. The weird-looking contraption — designed for those suffering from Parkinson’s, cerebral palsy and other conditions — allows physicians to see whether the damage is in a patient’s brain or in his muscles, so they’ll know where to focus the therapy.

Agaath Sluijter explains how her company, IMDI NeuroControl, uses neuroplasticity technology to diagnose and treat neurological disorders.

“We are focused on movement disorders,” said Sluijter, business director at IMDI NeuroControl, which was established in 2011. “We want to improve existing technology and accelerate the development and application of new technology for assessing and treating neurological diseases such as Parkinson’s.”

Given that seven million people around the world are living with Parkinson’s, and that another 33 million suffer from the results of strokes, it’s crucial to know exactly where in the brain damage occurs — and whether this damage is reversible or not.

“Sometimes, especially children with cerebral palsy, you have to make a choice what to treat,” she explained. “If we can pre-select which treatment to pursue, the burden on the patient will be less.”

To that end, IMDI NeuroControl, in the presence of King Willem-Alexander and Queen Maxima, signed a memo of understanding with the Rehabilitation Institute of Chicago (RIC) to collaborate on an extensive research program to advance the clinical application of neurorehabilitation using Dutch technology.

“We try to help patients by offering tools for better rehabilitation,” said Frans Steenbrink of MotekForce Linnk, which was part of the RIC memo of understanding. “In everyday life, you’re not aware of your locomotion or balance control until you lose those functions. We live in an aging society, so we need to think about how we’re going to optimally treat these patients and keep them mobile for as long as possible.”

He added: “Our company tries to bring technology and knowledge to the patient. If it stays in the university, no patient will ever benefit. That’s why we’re happy with this consortium.”

One of the world’s top experts in Parkinson’s and other movement disorders is Bastiaan Bloem, a professor at Radboud University Nijmegen Medical Center.

Bloem, who’s published more than 180 scientific papers and book chapters on the subject, is a towering figure in his field — and not only because he’s 6-foot-7.

“Health care is now seen as an export product of Holland, not just wooden shoes and tulips — and Parkinson’s is a recognizable disease affecting Muhammad Ali, Michael J. Fox, the former pope and other famous people,” said Bloem, who played volleyball on the Dutch national team in his youth. His 11-minute Ted talk, “From God to Guide,” has drawn abundant praise on YouTube.

“I strongly believe the future of health care is specialized networks, where specialist treat high case loads,” he said. “Leaving specialized care to the hands of generalists is a thing of the past.”

Bloem is the brains behind ParkinsonNet, an acclaimed Dutch health care concept that involves 12 disciplines, 66 regional networks and 2,800 trained professionals. ParkinsonNet is credited with lowering costs associated with Parkinson’s care by more than 5 percent, from €8,208 in 2010 to €7,698 in 2011; that’s equivalent to a total of $27 million. That’s partially because the care needed for injuries associated with Parkinson’s fell sharply.

Interestingly, he said, the top three concerns of Parkinson’s patients don’t involve tremors or gait, but rather revolve around sleep, sex and relationships.

“Our starting point was listening to patients. There’s a tremendous movement in health care to see patients as an invaluable source of information,” he said. “With many neurological conditions, some areas of the brain are damaged, but others aren’t. If you’re a specialist, you can use this to your advantage.”

Bloem said that King Willem-Alexander, whose father had Parkinson’s, is a warm supporter of his project; so is the Dutch Health Ministry.

Among other things, Bloem’s team has developed, which brings patients and professionals together online. “We are now extending this to Kaiser Permanente, and with Google Translate, a doctor in California can ask a question which will be answered by a therapist in the north of Holland,” he said.

“When people try to innovate in health care, the insurers always say, ‘prove to me it works, then we’ll innovate it.’ This is a Catch-22, because you cannot prove it works unless you first test it,” he said. “Our true message is, cherish the value of imitation. We value innovation, but let’s stop blindly innovating all the time. Look around, see what’s good and copy it.”

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