Health in Harmony

The vision for Health In Harmony began more than 15 years ago in the forests of Gunung Palung National Park where Dr Kinari Webb recognized the direct link between the environmental destruction wrought by illegal logging, the desperate state of human health in the communities around the park, and the impact of rain forest loss on health worldwide. Our comprehensive approach works at the intersection of human and environmental health to provide sustainable change in communities around the world.
Nov 25, 2014

Orangutans are using Sedehan reforestation site!

An orangutan nest in Sedahan
An orangutan nest in Sedahan

I always say that ASRI’s two reforestation sites are like two children: Laman Satong, our older reforestation site that had the fire last year, is like the difficult child that needs constant love and attention in order to thrive. In contrast, Sedahan, our younger reforestation site, is the precocious child that constantly delivers amazing surprises, unasked.

Every time I go there, I am amazed at how tall the trees have grown in less than two years. The site’s peatland soil is far more fertile than the degraded, dry soil at Laman Satong. Many of the planted trees are already over two meters tall. One species in particular, petai (stink bean) has been consistently shooting up like a rocket wherever we plant it.

“We need to plant more of this!” I keep telling the team. They laugh back at me, “But it’s hard to find seeds! The community loves to eat the beans and collects them all before we can plant them!”

Luckily, we happen to have a health clinic that can solve these types of problems. We raised the price of petai seedlings in our list of non-cash payment options. A patient can now cover their entire medical bill with just a few stink bean tree seedlings. (I hope we get a flood of them.)

Also, not only is the site growing well, but it is legitimately changing the worldviews of the community members who work there. Many are former illegal loggers that have been tasked with returning this small piece of the world back into forest. Our site coordinator Yayat says that the workers have told him they can’t bear to think of cutting down a tree ever again after their work on the reforestation site. And believe me, they are extremely proud of what they have accomplished. They really want Sedahan to become an environmental education site so that others can see what the site has become.

Last year, we asked them to replace the old bridge into the site with one safe for school-children to cross. They responded by building an elaborate bamboo bridge with two sets of benches. Benches! The old bridge was so precarious that I used to leave all of my electronic devices at the clinic assuming that I would fall off the bridge into the river. The gorgeous new bridge is stable enough to host 8-person photo ops.

“I had almost nothing to do with it!” Yayat told me at the time. “It was all their idea!” And by the way it took them only 2 days to build. 

The workers were also instrumental in stopping further land clearing. In previous years, one community member cleared the 2 ha area next to the site for farming. With the constant coming and going of the reforestation workers, he became afraid of getting reported to the police. So he stopped clearing land. He didn’t plant any rice. Instead, he planted durian and rubber tree seedlings. That piece of land will also become a forest again.

Lastly and most incredibly, the site is already fulfilling its initial purpose — providing a corridor for orangutans to cross between forest fragments and the main body of the park. A few days ago, our newest conservation volunteer Adam came back from a day of cleaning out weeds at the site with news: the workers found orangutan nests. Three of them. He went back the next day to take some pictures. Sorry, he said. There are actually four nests. FOUR!

The Sedahan site continues to remind us that sometimes all the love, sweat and bug bites that go into reforestation work can yield the elusive results we hope for – even a few years earlier than expected. In fact, I just heard today that one of the Forest Guardians visited the last active logger in the community where the Sedahan site is located. The logger is ready to stop. But he wants a job.

He wants to become a reforestation worker.

Adam and the reforestation workers
Adam and the reforestation workers
Seedlings going into the ground
Seedlings going into the ground
The Sedehan reforestation site - Chelsea Call
The Sedehan reforestation site - Chelsea Call

Links:

Aug 25, 2014

Sometimes all you need is a pair of ducks

TB Program Dropout Rates
TB Program Dropout Rates

Sometimes you start things but you have no idea where they will go. That is what happened when we hired Ibu Hamisah to be one of our village health workers six years ago. She was a shy woman from a village about half an hour away from our clinic who had very little self confidence. Six years later, you won’t believe what has happened to her! 

We were trying something very unusual in 2008. We wanted to hire women in the villages to help our tuberculosis patients take their medicines. This was critical because when we started treating tuberculosis about 50% of our patients dropped out of treatment. That meant they had a high chance of developing drug resistance and not only dying of TB but also spreading the resistant tuberculosis to others. What was unusual was that we were so strict about the rules of working for us. We fired our village health workers if they missed even one visit to their patients. So in the first few years we went through a lot of women, but then it settled down and we ended up with an amazing group of incredibly dedicated ladies who took great care of their patients.

We also gave them the book “Where there is no Doctor” in Indonesian and we conducted health training sessions every month in lots of different critical health topics — like how to treat diarrhea in the villages with oral rehydration solution, or how to know when a child probably had pneumonia.

After two years of Hamisah working for us, we were so impressed that we asked her to interview for the position of coordinator of the program. I still remember in that interview how much she lacked confidence and finally at the end she told us, “I just can’t do this. I would be afraid to talk to the department of health and other government officials, and I have never used a computer. I only have a middle school education. You will just have to find someone else.”

I was sad, because I thought she would be good, but we did end up hiring Ibu Lia who had a college degree. The TB control program continued to be a roaring success and every year the drop-out rate decreased until last year it was just 0.6% (in 2009 we stopped treating anyone with infectious lung TB without a DOTS worker, and in 2010 we stopped treating anyone without a DOTS worker).

Hamisah told me about how she managed to keep her most difficult patient from stopping his medicines. After cajoling and explaining the importance for months he finally just refused to take another pill. “I feel all better, I’m sick of taking these medicines! I’ve stopped coughing and gained weight. Stop coming here!” He said as he slammed the door in her face. Undeterred she came back the next day with a pair of ducks as a gift to him. Seeing the ducks, he calmed down and agreed to take his course of treatment. She says that now every time she sees him he warmly greets her and proudly tells her how healthy he is and how many ducks he now has from that original pair.

Then, you won’t believe what happened. Hamisah’s village nominated her to be the head of the village. She tells me that this is because the village saw how much she cared for them all. People often came to her even in the middle of the night when they or their children were sick, and using her book she would care for them. Then if they weren’t better in the morning, she would bring them to the clinic for further care. What you have to realize is that her being nominated to be village chief was wildly unusual. At that time, there was not a single other female chief of a village.

She says she didn’t campaign and didn’t even want it, but out of over 140 households in her village more than 130 voted for her. She said someone else even put up her picture at the ballot box. And now, after two years, they all want her to become the head of a group of four villages, and people are even talking about her running for the position of head of the regency!

The reason everyone is so excited about her is all the innovative things she is doing in her village. She leads a group of 52 women farmers who are all learning organic methods (even without training from our team yet) and she got the government to give them two hand tractors. They have a meeting once a week and Hamisah also passes on to them everything she learns about health and conservation at ASRI. Hamisah also made a rule that there would be no logging in her village, and she has managed to get the last loggers to stop. “I think these men listen to me because I’m a woman,” she told me.  

Last year, we approached Hamisah again to ask if she would again consider the position of coordinator of our community health workers, because we wanted to promote Lia. This time she said yes! She has learned to use a computer and is so proficient at negotiating with the local government, she has gotten all six of the local government clinics to use OUR community health workers to help treat their patients with tuberculosis. She does a full day of work with us and then still takes great care of her village in the evenings and weekends. In the graph below you can see how TB rates are dropping in all the villages except in Siponti and Teluk Batang where we recently started working with the government clinics.

Is it any wonder, Ibu Hamisah’s village is so grateful to her? And we should all be grateful, because preventing drug-resistant tuberculosis is not just a benefit to the communities here, it is a benefit to the whole world because disease, like environmental disasters, don’t follow national boundaries. 

Ibu Hamisah and one of her patients
Ibu Hamisah and one of her patients
Ibu Hamisah
Ibu Hamisah
New TB Cases by Village
New TB Cases by Village

Links:

May 14, 2014

ASRI Capacity Grows and Grows

Hotlin signing the new MoU with the park
Hotlin signing the new MoU with the park

Hello Global Givers,

Two collaborative opportunities have come up at ASRI this spring that both recognize the impact your donations are having in the area, and both will make it possible for ASRI to do even more work to save forests with stethoscopes.

At the end of March, ASRI signed a Memorandum of Understanding (MoU) with the Gunung Palung National Park Office (BTNGP), which allows the two organizations to better work together to achieve their shared aim of ending illegal logging in the park. 

ASRI has partnered with the national park office since our founding in 2007, but without a formal relationship, they could not realize all the benefits of collaboration. Now, ASRI can more effectively share the results of the Forest Guardians' on-the-ground monitoring efforts to assist with enforcing logging laws within the park. Further, ASRI will use the systems already in place to maintain alternative livelihoods programs BTNGP is able to start with government funding. BTNGP can now also grant ASRI greater access to the park for educational purposes like ASRI Kids field trips.

The MoU is a critical step in conserving the rainforest. ASRI and BTNGP are two of most powerful actors in this fight and have now teamed up to pool their already significant resources. Together, we will be able to educate more, train more, enforce more - all leading to less desire, need and ability to cut down trees and destroy the precious Gunung Palung habitat. Please read more about the MoU on our blog.

Second, just last week, ASRI Cofounder Dr. Hotlin Ompusunggu and Health In Harmony Executive Director Michelle Bussard attended the Forests Asia Summit 2014 in Jakarta. Organized by CIFOR and co-hosted by the Indonesian Ministry of Forestry, the summit invited leaders and stakeholders from Southeast Asia to share knowledge and best practices for managing forests. ASRI was recognized by this group as a significant contributor to rainforest conservation in Borneo and asked to participate in this event to influence social and economic policy in a sustainable direction. I haven't heard their final take on the week yet, but I feel sure that, as with everywhere the HIH model is represented, people were impressed and inspired by what donors like you have accomplished with a small clinic next to a rainforest.

It has taken years of visionaries, like all of you Global Givers, who have seen the connections between human and environmental health then invested in the communities in West Kalimantan. The world is now taking notice of all you have accomplished in partnership with those communities. I am so excited about these two recent capacity-building opportunities because they represent the ways is which ASRI is growing to tackle problems the size of climate change, human health crises, and poverty. Thank you, thank you Global Givers for being the first to believe they have what it takes.

Til next time,

Trina

ASRI Conservation team outside the BTNGP Office
ASRI Conservation team outside the BTNGP Office
The Sedahan reforestation site
The Sedahan reforestation site

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