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Saving Rainforests with a Stethoscope

by Health in Harmony
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Saving Rainforests with a Stethoscope
Three former loggers from Pangkalan Jihing
Three former loggers from Pangkalan Jihing

As a part of Health In Harmony’s Conservation Stimulus Package to address the pandemic, we are ramping up efforts to buy back chainsaws. This package provides former loggers with financial support to create or grow their own sustainable businesses.

In Pangkalan Jihing, three loggers recently participated in our Chainsaw Buyback program: Pak Syamsir (logging since 2015), Pak Sariman (logging since 2012), and Pak Asri (logging since 2003). These community members had already started transitioning away from logging, but they were still occasionally renting their chainsaws to friends who wanted to log in Gunung Palung National Park (GPNP). The ASRI Medical Center's Forest Guardians and a park ranger approached them and told them about our Chainsaw Buyback program.

In the wake of COVID-19, these loggers decided to participate so they could receive additional support for their businesses: a coffee shop, animal husbandry business, and agroforestry business (fruit trees and vegetables).

In Pelerang, former logger Pak Idris decided to participate after a national park officer found him logging inside GPNP. The officer took the time to educate Idris on the impact that logging could have on his health at age 62, as well as how detrimental it is to the forest and the communities that live around it.

After thoughtful consideration and support from his wife, he decided to participate in our microenterprise program as the 56th participant and received 10 million rupiah in exchange for his chainsaw. With these funds, he will a start a new business. Idris has decided to open a small shop, with help from ASRI’s Chainsaw Buyback Coordinator in purchasing materials and items he would like to sell.

In Rantau Panjang, former logger Abdulah had been logging since he was 15 years old, in order to financially support his family. However, working with a chainsaw for the past 25 years has negatively impacted his health and posture: he cannot stand up straight due to constant back pain.

Abdulah was approached by the ASRI Forest Guardians with an opportunity to give up logging and still support his family through an alternative livelihood. At first, he was unsure due to so many orders for timber from outside sources. However, Abdulah finally decided to participate in the Chainsaw Buyback program and begin working in a new industry.

We are incredibly grateful for Mahardika Putra, ASRI Conservation Director, for sharing these stories from now-former loggers who live in and around Gunung Palung National Park.

We also appreciate our many donors, supporters, and followers who contributed to our COVID-19 Emergency Fund, which enabled us to make emergency healthcare and conservation programs like this one reality!

Pak Idris posing with his deconstructed chainsaw
Pak Idris posing with his deconstructed chainsaw
Former logger Pak Abdulah
Former logger Pak Abdulah

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Dr. Alvi
Dr. Alvi

Dr. Alvi is a doctor at ASRI, Health In Harmony’s cornerstone partner in Indonesia. He recently participated in a four-month professional exchange program at Yale University where he learned more about internal medicine and shared his knowledge of the connections between human health and the health of rainforests. His journey is a great example of partnership and planetary health in action. We hope this interview with Dr. Alvi inspires other physicians and institutions to see their practice in a new light.

WHAT INSPIRED YOU TO PURSUE MEDICINE?

I was inspired by my mom, a midwife, who dedicated herself to caring for people in an underserved area in West Java. Once, while performing a complicated delivery, her patient was diagnosed with eclampsia (life threatening hypertension in pregnancy). My mom struggled to find help due to a lack of human resources and tools. Thanks to her diligence, she was able to give the patient the correct initial management and then transfer her, in time, to a bigger facility. After that, I decided to pursue medicine, hoping to do my part to improve health regulations and make healthcare more accessible for all.

WHAT ARE THE MOST VALUABLE LESSONS YOU LEARNED AS A PHYSICIAN AT ASRI?

At ASRI, I discovered that human health and environmental health greatly impact each other. I also learned how to pilot a rural medicine project by working at ASRI’s second site near Bukit Baka Bukit Raya National Park – processes like surveying, Radical Listening, hiring, training, and more.

HOW CAN THESE LESSONS FURTHER THE PLANETARY HEALTH MOVEMENT AND MEDICAL FIELD?

Doctors and other medical professionals have an important role in influencing and making change in society. By helping more professionals realize how much climate change impacts patient health, they will start to make a positive environmental and societal impact.

WHAT ARE THE MOST VALUABLE LESSONS YOU LEARNED AS A STUDENT AT YALE?

I participated in many studies and advanced procedures, including some new ones. The term “medical mystery” seems impossible to use in the U.S. because of the advanced testing available to diagnose patients. The opportunity to observe physicians performing diagnostic studies sharpened my clinical sense, since medical histories and physical exams are always confirmed by advanced testing. These experiences will help me establish a better standard of care now that I am back at ASRI.

WHY IS HEALTH IN HARMONY’S PARTNERSHIP WITH YALE IMPORTANT TO YOU?

This partnership has great potential. Many students at Yale were interested in learning about the methods that ASRI and Health In Harmony use, like Radical Listening, and our central approach – to address healthcare and conservation simultaneously. Doctors at ASRI now have full access to Yale’s medical library, some of the best resources for medical information and updates. Plus, physicians at Yale continue to share their medical knowledge with ASRI in unique ways – for example, an emergency medicine attendant recently video-chatted with ASRI doctors to discuss ultrasounds.

WHAT WAS LIFE LIKE IN THE U.S.?

Did you face any challenges?

At the start of the exchange, it was challenging to master the differences in the U.S. medical record system compared to Indonesia’s. In the U.S., all medical information is processed within an electronic system; in Indonesia the system is paper-based. It was also challenging to understand American jokes and expressions, sometimes. Over time I adapted to these differences.

Are there any successes you are especially proud of?

I spoke about planetary health and climate change at the VA Hospital of Connecticut to physicians and residents. They were very interested in to learn about climate change and planetary health.

Do you have a favorite American food yet?

I tried some American food, such as New Haven pizza, deep dish Chicago style pizza, Philadelphia cheese steak – they are okay.

WHAT IS NEXT FOR YOU?

Now that I have returned to ASRI, I will maintain my relationship with Yale and continue to collaborate with them – especially in research and publications related to planetary and public health. Yale is a great place to study and I would like the chance to visit again the future.

ASRI
ASRI

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In late August, in partnership with eyewear company Essilor, ASRI organized three optometry clinics for the residents of Sukadana and nearby Melano and Siduk, all of which are located within the Kayong Utara Regency in West Kalimantan. Patients who attended were eligible for a free eye exam and a free pair of prescription and/or reading glasses. The clinics were in very high demand. Over 1,800 patients were served over three days.

The clinics were made possible through a partnership with France-based Essilor’s 2.5 New Vision Generation initiative, which aims to expand access to vision care to underserved populations around the globe.

The Mayor of Kayong Utara Regency, Citra Duani, who is very supportive of ASRI, attended the first clinic, which was held at ASRI’s headquarters in Sukadana. He delivered remarks that helped kick-off the three day event. He encouraged parents to protect children’s eyes by limiting their use of electronic gadgets. He pointed out that vision problems can limit children’s futures, e.g. if they are unable to meet the vision standards required to become a police officer.

Participants in ASRI’s planetary health education program for adolescents, ASRI Teens, were trained by Essilor staff to do basic eye exams. In addition to evaluating patients’ vision, they also helped with patient intake and clinic setup and cleanup. 

As part of Essilor’s partnership with ASRI, two local students and ASRI Teens participants, Rusli and Yuli, received scholarships that will fund three years of optometry school in Indonesia’s capital, Jakarta. After graduating, the students plan to return to the Kayong Utara Regency, hopefully to the ASRI medical center, to practice optometry and provide this vital service to the community. 

These clinics reached people from all walks of life. Patients were genuinely excited to get new glasses (or to get their first pair ever!), and many waited several hours to be seen. Clearly, the clinics met a real need in the communities of Sukadana, Melano and Siduk. The whole ASRI family came together to set up the clinics each day and to see as many patients as possible, despite considerable challenges, such as limited electricity in the Melano and Siduk clinic sites that made it impossible to evaluate patients after sundown. It was truly a team effort!

ASRI Teens scholarship recipients in blue jackets
ASRI Teens scholarship recipients in blue jackets

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The ASRI team
The ASRI team
Last month we celebrated the 12th anniversary of our Indonesian partner organization ASRI (Alam Sehat Lestari). In 2007, when Dr. Kinari Webb and Hotlin Ompussunggu founded ASRI, they based their work on hundreds of hours spent talking with the communities surrounding Gunung Palung National Park, a huge rainforest park in Borneo that was subject to rampant logging. When Dr. Webb and the rest of the team asked these communities what they needed to be able to give up logging as a means of survival, the answer was both simple and revolutionary: the first thing they needed was good health.

Cut to 12 years later: Health In Harmony and ASRI are leaders in the emerging field of Planetary Health. ASRI has been providing high quality and affordable health care, allowing families to break their dependence on illegal logging. As of mid-2019, medical staff at ASRI have treated over 32,000 patients who otherwise would have little or no access to care.

What's more, the non-cash payment program -- which allows patients to pay with seedlings, reforestation supplies, labor, or handicrafts -- is an extraordinary solution for the community’s economic and health care needs. These alternative payment options allow patients to pay for their care in ways that help ASRI to conduct forest conservation and reforestation.

In just the first half of 2019, ASRI received more than 15,000 seedlings from patients. These seedlings are then cultivated and planted in logged or degraded areas. More than 250,000 seedlings have been planted to date. And that's in addition to the 21,000 hectares of forest that have grown back naturally since logging dramatically declined, due to the availability of affordable, reliable medical care!

In addition, the value of our Planetary Health Education programs cannot be stressed enough, as the future of our health and the health of the planet depend on the next generation. Through community outreach and education efforts, ASRI and Health In Harmony have provided environmental education for more than 10,000 adults and kids surrounding Gunung Palung National Park.

Meanwhile, our Chainsaw Buyback program, which offers incentives for loggers to switch to sustainable livelihoods, has taken 128 chainsaws out of commision so far. ASRI buys their chainsaw, and the former logger gets to use the funds to start a new business. We even include vocational training in fields such as organic farming and gardening, fish farming, and goat husbandry. So far, this program has protected almost 20,000 trees -- and the number goes up every day!

In these 12 years, ASRI has helped save the precious rainforest ecosystem of Gunung Palung National Park while simultaneously making the local communities healthier and more prosperous. In fact, the ASRI model - and your donations to Health In Harmony, which supports ASRI - have made our whole world healthier!
Chainsaws taken out of circulation
Chainsaws taken out of circulation
Planting seedlings at a reforestation site
Planting seedlings at a reforestation site
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Our ambulance driver Pak Romi!
Our ambulance driver Pak Romi!

What if patients at our medical clinic need special equipment, intensive care, or other special services? When that happens,  we speed the patient to a larger medical facility in the nearby city of Ketapang. Thanks to support from donors like you, we are able to provide this service to patients without unexpected fees or bills. That way, communities don't need to log in the rainforest -- or participate in the illegal timber trade -- to pay for an ambulance ride. In fact, many patients pay for these rides with seedlings or other supplies for our reforestation sites.

Medical transportation is one of the most significant barriers to treatment for rural communities in Borneo. That's why it's so important that our Indonesian partner orgization Alam Sehat Lestari (ASRI) operates two ambulances. This small fleet represents the only realistic option for emergency transportation for the communities near Gunung Palung National Park. And because patients can pay for their ambulance ride with seedlings or other barter items, the ambulances are affordable for even the poorest families.

But transportation is not just a barrier to emergency care - for many patients, remote locations prevent them from accessing primary care as well. Diarrheal diseases, HIV, and polio are some of the most common causes of death in Indonesia. And all of these can be prevented through access to basic healthcare knowledge and services. That's why ASRI's monthly mobile clinics are an important complement to the two ambulances - since regular checkups help ensure that chronic, treatable disease don't become life threatening!

Each month, ASRI medical staff travel into the countryside to visit communities that would otherwise have little or no access to healthcare - in fact, some of these villages are more than 5 hours away. By bringing the doctor to them, the clinics offer another way to eliminate transportation as a barrier to care.

But these services don't just benefit patients. With the same vehicle that ASRI staff use to run mobile clinics, they also collect seedlings and supplies from patients around the community. Years from now, the seedlings that patients give us today will stand tall in the forst, helping mitigate climate change and also keeping the area less vulnerable to malaria and waterborne disease. In this way, we are helping humans and the ecosystem be healthier together! 
Loading seedlings to be planted in the rainforest!
Loading seedlings to be planted in the rainforest!
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Organization Information

Health in Harmony

Location: Portland, OR - USA
Website:
Project Leader:
Trina Noonan
Portland, OR United States

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