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Saving Lives, Saving Forests

How Indonesian Communities Help their Forests and Themselves

New America Media, Commentary, Brita Johnson Posted: Nov 11, 2008

Editor's Note: In West Kalimantan, Indonesia, local communities have managed to integrate high quality, affordable health care with strategies to protect the threatened rain forest. NAM contributor Brita Johnson is executive director of Health In Harmony.

The tragedies of environmental destruction and poverty are locked in a dangerous cycle in West Kalimantan (Borneo), Indonesia. For the vast majority of people in the region, basic medical care is financially out of reach. Many suffer - and die - from preventable and treatable diseases. An urgent need for medical care contributes to debt, and a shortage of work opportunities leaves people with no option but to destroy their local natural resources for short-term economic survival.

eric danzerIn the context of economic pressures like these, illegal logging has devastated an estimated 40 million acres of Borneo's forests in the last two decades, unleashing landslides, increasing crop pests and vector-borne disease, and contributing to global climate change - all of which negatively impact human health.

If families living in and around threatened forest ecosystems could afford healthcare without the false promise of illegal logging, could the forest be saved? Health In Harmony (HIH), a U.S.-based non-profit organization, is supporting Indonesian communities in proving that it can, by linking healthcare with rainforest conservation. In a corner of West Kalimantan, toothbrushing lessons, wound care, tuberculosis treatment, and a hundred other things that, on the face of it, have little to do with saving the rain forest, are doing just that. Here's how HIH is combining healthcare with conservation to protect West Kalimantan's Gunung Palung National Park, and to provide a new model for conservation in other threatened ecosystems:

Ten year old Suliastri had been unable to walk for over a year. A year before losing the ability to walk,eric danzer she'd contracted a bone infection in her knee that caused excruciating pain with even small movements. Her family simply couldn't afford the medication to cure the infection. When her mother heard about Klinik ASRI's pay-through-labor program, she was very excited and brought her daughter to the clinic. After a week of daily antibiotic injections, Suliastri was free of pain; after two weeks she was hobbling along well on a pair of homemade crutches. By working at the clinic and at a seedling nursery that will support future reforestation efforts, her family has now stored up enough credit for many months of medical care.

The pay-through-labor program is just one element of this project that is empowering the communities around Gunung Palung to preserve the park, on their terms. Clinic prices keyed to the local economy are helping to break the cycle that pits human needs against nature. Community outreach is enforcing an already present understanding of the devastating effects - on health, wealth and climate - of deforestation. And a series of community meetings, with village leaders from the nearly two dozen villages surrounding the park, has resulted in the creation of a unique incentive program that rewards villages when they prevent illegal logging in the regions of the park that border their homes.

eric danzerThese community-designed healthcare incentives are making a tangible link between human health and a cessation of logging. Based on the priorities expressed by local communities, the incentive program provides mobile clinic visits, low-cost ambulance service, discounts on medical services at Klinik ASRI, and instruction in organic farming.

To take one example from among the incentives, mobile clinic visits are showing great promise in impacting communities' choices about illegal logging. In the first round of mobile clinic visits, Klinik ASRI staff saw hundreds of patients, diagnosing untreated malaria, tuberculosis, cystic fibrosis and epilepsy. The value of accessible, affordable healthcare brought to the village "doorstep" was deeply felt. "It is mostly people from outside who come in and log," one patient said, "They get all the benefit and we get all the negative effects. For health care we are willing to tell them to stop."

A second round of mobile clinic visits, one month later, confirmed the power of healthcare incentives. Many villages had signed on to the agreement and reported that they were "red" - inhabitants had logged or burned, or allowed others to log or burn, in the park, in the last month. One village was insistent: they were "green" this month. "We have made sure there is no more illegal logging or burning," the village leader said, "and we want our health care benefits." He had personally monitored the park's borders in his jurisdiction, and reports from the park bureau's monitoring program confirmed his assertions. This village represented the hotspot of illegal logging around the park for the last 15 years - an area where little success was expected.

"The fact that the villages in our region are willing to trade logging income for the financial security provided by access to affordable healthcare gives us great hope," says Dr. Kinari Webb, Health In Harmony's founder. "We started this work with the belief that human health and environmental health are tightly linked. The communities we serve are proving that when we work together on solutions that improve standard of living, we can create a lasting impact on habitat conservation."

The clinic and conservation effort in West Kalimantan is just a starting point for Health In Harmony's vision. "We want to provide a model," says Dr. Webb, "to be used in other threatened ecosystems where human and natural communities are in conflict, and where basic human health needs go unmet."

photo credits: Eric Danzer

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