In Borneo, healthy people equals healthy forests

Gunung Palung National Park on the island of Borneo is home to diverse species found nowhere else and is beloved by the people who live on the Indonesian island. But like many people who live near tropical forests, the local population has at times had to resort to illegal logging just to pay for healthcare.

Now, the nonprofit Health in Harmony is providing healthcare that patients can pay for with a simple trade of labor, seedlings or manure so that no one ever has to log to pay cash for essential health services.

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Health in Harmony founder Kinari Webb first went to Borneo as an undergraduate student. She spent a year deep in the rainforest studying orangutans.

“Gunung Palung National Park is considered the jewel in the crown of all the Indonesian national parks,” Webb says. “It is just the most beautiful place I’ve ever been on Earth.”

The 60,000 or so people who live in communities surrounding the park call it their “mother” and understand that their well-being comes from the forest, largely because of its water, Webb says. They also say that logging in the forest pushes disease down into the communities. “They understand, kind of in a spiritual way, too, that if you log the forest, that might also make you sick, just by disturbing the forest herself,” Webb adds.

“When I first went there, it was like the forest stretched to the horizon and then it was just shrinking and you could hear the chainsaws all the time.”

Nevertheless, Webb found, as much the people honored and respected the forest and wanted it to be there for future generations, logging was rampant. “It was completely out of control,” she says. “When I first went there, it was like the forest stretched to the horizon and then it was just shrinking and you could hear the chainsaws all the time.”

At first, Webb was simply angry. But when she talked to people, she discovered that in many cases they have no choice. If a child or other family gets sick, they told her, logging is one of the only ways to get cash to pay for medical care.

“At another national park where we recently just started working, one woman told me, ‘If anyone ever tells you that they have not logged to pay for health care, they are lying to you,’” Webb says. “Because there is no other way to get that much money and one medical emergency can cost an entire year’s income.”

“That just broke my heart,” she says. “How can that be? And how can we be allowing that to be? I ended up going to medical school and returning to Indonesia so that I could try to work on this intersection between human and environmental health.”

Webb calls Health in Harmony’s style of working with the local population “radical listening,” but it’s only radical, she says, in that “we actually do what people say.” “That is wildly unusual in the way that development and conservation are done,” she explains. “It’s sad that it’s unusual, but it is very, very unusual.”

They typically meet with a group of about 50 people, men and women, leaders and ordinary folks and ask, “What would you all need as a thank you from the world community so that you could actually protect this precious forest that you all are guardians of?”

Everywhere they work, a community in a given region will independently come to the same solution, Webb says. Around Gunung Palung, it was access to healthcare and training in organic farming. If we have those things, the people told her, we can stop logging.

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“In the beginning, I just trusted on faith that they truly knew what the solutions were,” Webb says. “Ten years later, we had incredible data that showed a 90% drop in logging households; stabilization of the loss of primary forest, which had been shrinking like crazy; a re-growth of 52,000 acres of forest; and a 67% drop in infant mortality.”

When Webb began working with these communities in 2007, there was one small government clinic that rarely had a doctor. Health in Harmony started its own clinic, added mobile clinics and provided ambulance service. They’ve now had over 90,000 patient visits.

To make the care affordable, Health in Harmony has to get creative. They allow people to use non-cash options for payment, such as seedlings, labor and even manure for organic farming, so no one feels they have to log to get cash. They also give community-wide discounts to villages, based on the amount of logging.

“So, no logging at all and they get a 70% discount in the clinic,” Webb explains, “and that discount is paid for by folks from all around the world who want to say thank you to them for protecting this precious rainforest that’s incredibly valuable to the whole world.”

Health in Harmony partners with American doctors who want to give back or just want the experience of working in the developing world, as well as with young medical school graduates and agricultural experts from other parts of Indonesia.

Webb says she was surprised when local communities asked for training in organic farming. Java, the island next door, has a many thousands-year-old tradition in sustainable agriculture. But in Borneo, they told her, the traditional form of agriculture is slash-and-burn. “They said, ‘We know we have to plant in one place, but the only way we know how to do that is with very expensive chemical fertilizers and we just can’t afford them,’” Webb explains. Former loggers have now become farmers because they no longer need startup money for chemical fertilizers.

Health in Harmony also began a chainsaw buyback program to lure some of the “hardcore” loggers into another profession. Most of these people did not own land but did own their chainsaws, which is a huge investment.

“It’s kind of like angel investing,” Webb says of the program. “We give them some money to start a small business and they also put in money, but the money they put in is their chainsaw, which we buy from them. And then they start these small businesses, which have been wildly successful.”

In addition to the reduction in logging, people are now much healthier, Webb says. When Health in Harmony started, malaria was common. Webb hasn’t seen a single case in her community in the last six years. They have also seen a 50% drop in cases of diarrhea. In fact, she says, scientists who have studied the relationship between forest cover and diarrhea find that where there is more forest, there is less diarrhea. They have also seen a 42% rise in children finishing grade school. 

While large, multinational companies contribute greatly to deforestation, Webb says, a recent article in Science showed that in the tropics, 69% of the loss of carbon is from degradation — which is to say, removing individual trees. “We call it small-scale logging,” Webb says, “but it’s not really small scale. It’s enormous.”

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“Without question, we should be avoiding palm oil and we should be pressing for more sustainable agricultural techniques from these large companies. … But if we are not also addressing the needs of individuals — who really don’t want to destroy the forest; they just don’t have a choice — then we’re missing the boat.”

“Without question, we should be avoiding palm oil and we should be pressing for more sustainable agricultural techniques from these large companies,” Webb says. “But if we are not also addressing the needs of individuals — who really don’t want to destroy the forest; they just don’t have a choice — then we’re missing the boat.”

“And if we miss the boat on saving rainforests, it’s game over,” she says. “Even if the entire world went to alternative energies, if we lost our rainforests, there’s no way we could deal with climate change.”

This article is based on an interview that aired on PRI’s Living on Earth with Steve Curwood.