Regenerating Rainforests

by Health in Harmony
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Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
Regenerating Rainforests
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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Dewi - a midwife with Health In Harmony
Dewi - a midwife with Health In Harmony

Meet Dewi, a midwife at our new program site in Beloyang Juoi, a remote village on the outskirts of BBBR. As a mother herself, Dewi knows the challenges of childbirth without access to medical care – and she’s committed to helping mothers have safe and healthy deliveries. When we first travelled to BBBR to explore the possibility of bringing health care to villages there, pregnancy and childbirth were dangerous and even life-threatening conditions. Now, with Dewi and X# other midwives and staff on duty, women don’t have to dread their deliveries anymore.  Just having access to care has lifted the spirits of the community as a whole.  Recently, Dewi even organized an ingenious way to prevent malaria throughout the village. Every three days, all the women get together, turn on some music, and clean the village from one side to the other. They sweep up plastic, leaves, and anything else that could hold water for mosquitos to breed in. After they're done, Dewi leads everyone in Zumba!

Even though Dewi's job title is midwife, she is so much more. She has been able to address health conditions that have been untreated until now, including tuberculosis, and advocate for women's health and safety with village leaders. As Dewi is able to improve health in the community and reduce maternal emergencies, it will relieve the pressure to go into the forest and cut down trees for money. Dewi is creating a healthier Beloyang Juoi in more ways than one.

Everyone working hard to clean the village!
Everyone working hard to clean the village!
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Dr. Sarah Walpole reflects on her experience visiting our Indonesian partner Alam Sehat Lestari (ASRI) and participating in their Mobile Clinic program.

In the village

Our day started as usual with the 8 am meeting at ASRI in Sukadana. Then, Docter Ela, the driver and I climbed into the car and set out. We stopped to collect Efan, the nurse, and Aulia, the pharmacist, from their homes. Soon after, we stopped at a council office to collect a projector. In a village further on our car was joined by that of the team who would be projecting a film about orangutans and forest protection to the waiting patients.


The Journey

Palm trees have a beautiful form, their long leaves splaying out evenly from the center. Yet the glow of warmth that I felt as we entered the outskirts of what I thought would be deep forest quickly faded as I saw that this was what has been described as a “dead forest”. The plantation was two-tone, from orange to a browny green with nothing outside of the spectrum. Even the sky seemed to take on a monotony that I hadn’t noticed before.

Palm tree in a "dead forest" | Photo: Sarah Walpole

I dozed off, waking up as the car turned onto a path that was not made for four-wheeled vehicles. The car’s wheelbase could just about sit on the raised concrete walkway with half of each wheel jutting over the edge, a few centimeters above the bare earth to either side. “Are we here?” I asked, wondering if there was any way that we could proceed without damaging the villagers’ front gardens. Even our experienced
driver couldn’t direct our enormous load with such precision, and the car jolted heavily down to the left. A moment later, the car stopped, and I found out that “not yet” meant “not for another one hundred meters.” We had arrived.

We climbed out of the air-conditioned car into the heat of the afternoon. There was hardly a person to be seen, but the village felt alive. The walkway was built for people, not for metal boxes on wheels, and left homes on either side connected in a way that a road would not have permitted.

The village at the end of the road | Photo: Sarah Walpole

Exploring the Village

It wasn’t until we arrived that I understood the relaxed start to our journey. After unloading the boxes from the car, we met the house owner and learned that the clinic would not start until the evening. This left us four hours to relax and prepare ourselves. I encouraged Ela to come exploring with me but we quickly reached a river, with no bridge to cross it. Ela explained that this was the end of the road; the last village for miles.

After the short walk back, Ela and I spent an inordinate amount of time pulling leaves off what ended up being a very small quantity of ferns for dinner. Then, we rest and learn from large red blotches over Ela’s hands and arms that the mattress we were to sleep on that night had bedbugs.

Leaves pulled off of ferns for dinner | Photo: Sarah Walpole

Opening the Clinic

So here we sit in a circle on the floor eating dinner. I look behind me and see that the television isn’t just playing the background, its reel is being devoured by the intense gaze of four individuals. “Patients?” I guess. “Yeah,” replies Efan, as he pulls the pan of stew towards him.

The team eating dinner before the clinic opens | Photo: Sarah Walpole

By the time we finish dinner, fifteen patients are already waiting. They sit clustered around Efan and Aulia, who have erected a fort out of the plastic boxes containing the medicines and medical equipment. The patients at the back lean on the wall, while those at the front drape their arms over the plastic boxes, leaning in to catch the details of Aulia’s movements and words.

An older man - the sickest, I can tell by his breathing - moves forward, giving up the wall’s support for proximity to the woman calling out names and the nurse. Seconds later, a younger man stepped in and took up the vacated space at the back. Aulia begins to work through the pile of medical notes, calling out patients’ names as she goes. Once a patient receives their folder, Efan takes their vital signs and writes the chief complaint on their card.

Patients sitting around the "fort" made out of plastic boxes containing medical equipment and medicine | Photo: Sarah Walpole

Seeing the Patients

The first patient we see has extremely high blood pressure. She hasn’t taken any medication for two weeks, so Ela restarts her usual medication and invites her to sit for a while before rechecking her blood pressure. We are seeing patients at the back of the living room, where they sit on one of two curved benches perpendicular to each other. At the far end of our bench are two chairs, which make up the third side of a ‘U’ surrounding a low table. Ela tells the patient to sit on one of the chairs as the next patient approaches the bench opposite to be seen. I suggest to Ela that maybe the waiting patient could sit with the bulk of patients to allow more privacy. Ela gives me an exasperated look and begins to take a history from the next patient.

This patient is about thirty years old and presenting what sounds like gastro-esophageal reflux disease and constipation. As the patient tells her story, a third patient joins the queue, which starts on the bench right next to the patient who is currently with the doctor. Patient number three has to stand to allow for the examination to take place. The bench is just about long enough for the second patient to lie down on with her legs stretched out straight. When she does this, sure enough, Ela finds that she has tenderness just below her ribs, right over her stomach.

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Chainsaws we have collected from former loggers!
Chainsaws we have collected from former loggers!
Staff at our pilot program Alam Sehat Lestari (ASRI) have witnessed a dramatic decrease in logging in Gunung Palung National Park over the past 11 years. By offering affordable health care and training in organic agriculture, ASRI has enticed almost all of the loggers who used to operate in the park to put away their chainsaws for good. But that has left a minority - about 12% of logging households according to our latest calculations - who have continued to log.

Last year, ASRI launched a new business development program called Chainsaw Buyback to help those remaining loggers find a livelihood other than illegal timber.  This is how the program works: in exchange for their chainsaws, loggers and their families receive seed money, mentoring, and business planning assistance from ASRI staff. They get everything they need to successfully transition to small business entrepreneurship. So far over 65 logging families have "sold" ASRI their chainsaws and switched to a sustainable livelihood!

Some former loggers are being trained in efficient organic farming techniques. Others are raising livestock like chicken or catfish.  With increased income from these businesses, they're able to afford life's necessities without having to resort to logging the rain forest. Thanks to this compassionate approach, and support from the local community, more loggers have been coming forward, wanting to switch professions.

"Being a logger is not easy," one program participant told us. "It's dangerous and illegal. And you have to constantly be worried about what will happen if you are caught by Park Rangers." While law enforcement is extremely important, we focus more on the "carrot" and less on the "stick." And our approach has been successful because we can offer loggers and their families a real opportunity to break their dependence on illegal timber.

Right now ASRI staff are continuing to find and engage with illegal loggers to help them transition away from logging.  This has changed the landscape in more ways than one. As more families participate in Chainsaw Buyback, we've seen improvements across the board in quality of life, the local ecosystem, and the local economy.
Dropping his saw for good! (Photo: Stephanie Gee)
Dropping his saw for good! (Photo: Stephanie Gee)


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Health in Harmony

Location: Portland, OR - USA
Facebook: Facebook Page
Twitter: @HIHngo
Project Leader:
Devika Agge
Portland, Oregon United States
$53,572 raised of $75,000 goal
1,115 donations
$21,428 to go
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