Health and Harmony: Population, Health, and Environment in Indonesia
Borneo’s Gunung Palung National Park is a microcosm of both the island’s ecological wealth and vulnerability. More than half of the park is undisturbed forest; the remainder, however, “is being torn down day after day” at an alarming rate, said Health in Harmony’s Nichol Simpson at an event on integrated approaches to population, health, and environment (PHE) programs in Indonesia. Alene Gelbard of the Public Health Institute’s Company-Community Partnerships for Health Indonesia (CCPHI) program joined Simpson on September 29 at the Wilson Center. Both speakers emphasized that no matter what issue a group works on, engaging local communities is essential for success.
The Destructive Cycle: Poor Health, Poor Environment
For Simpson, “the intersection between human and environmental health” is at the heart of Health in Harmony’s work. Health in Harmony opened Clinic ASRI in 2007, aiming to provide improved healthcare to villagers throughout Gunung Palung National Park while ending their dependence on illegal logging as a means of financial survival.
The area’s inhabitants were all too easily trapped in what Simpson called “the destructive cycle.” When faced by an unexpected medical emergency, families would go into debt to pay their medical bills. Health in Harmony found that of 232 local households surveyed, 13 percent had recently experienced a major medical emergency, at an average cost of $360. Most households in the area only hold around $260 in emergency savings, so to make up the difference, about a third turned to illegal logging to pay down their debt.
By deforesting the park, illegal logging worsens the health of nearby communities. For example, Simpson said that Clinic ASRI has seen a rise in cases of malaria and tuberculosis in the surrounding communities, in part because deforestation has increased the level of mosquito activity. The link between human and environmental health is clear, said Simpson: the people ASRI serves are “living it every day. They know the cause of this. And…they want it to stop.”
Protecting Natural Resources By Improving Health
The Health in Harmony clinic located in Sukadana, a small village sandwiched between Borneo’s coast and Gunung Palung Park, helps break the destructive cycle by treating patients regardless of their ability to pay. If patients do not have cash, they can barter for their care. In one case, a girl named Yani came to ASRI after her family incurred $500 over two months of visiting hospitals and traditional healers, none of whom could treat her condition. ASRI diagnosed and treated Yani for scabies. In exchange, her mother signed a pledge to protect Gunung Palung from logging and made the clinic a floor mat to cover the $1.50 bill.
By providing affordable, high-quality healthcare that is contingent upon pledging to protect the environment, Clinic ASRI improves human and environmental health in one fell swoop, said Simpson. “Because the infant mortality rate has decreased and you’re not overcompensating,” said Simpson, families can choose to have fewer children, using free birth control provided by ASRI.
“When you have fewer and healthier children, you’re investing in your education,” said Simpson. “When you’re investing in your education, you’re investing in your country and your community. This is the virtuous cycle. I didn’t invent it, but we are proving it in Sukadana.”
The communities around the clinic have embraced ASRI’s work, partnering with them to expand their services to address additional community needs, like training farmers in more productive organic methods and providing mated pairs of goats for widows, who pay ASRI back with kid goats and manure for fertilizer.
All but one of the 23 villages that ASRI services have been consistently free of illegal logging, according to monitors who visit them on a regular basis. “We’re proving the theory that we can protect natural resources by improving health,” Simpson said.
“Health Is Key to Sustainable Development”
Gelbard took a step back to talk about CCPHI’s experience establishing multi-sector partnerships among NGOs and corporations by building trust and enabling dialogue between the communities.
With corporate responsibility becoming more popular, “everyone’s talking about partnerships these days, and everybody’s partnering with everyone,” said Gelbard. “I don’t care what they call it – I care what they’re doing” and what results they achieve, she said. A successful partnership involves “all partners doing something more than just giving money.”
Gelbard said the 2004 tsunami reinforced the notion of corporate responsibility for a lot of companies operating in Indonesia. They saw that unless they branched out beyond their own walls and “did things to help strengthen communities,” efforts at corporate responsibility simply “would not benefit them in the long-run,” she said.
Through CCPHI, companies and NGOs have partnered on a wide range of efforts, including improving access to and funding for reproductive health services, improving sanitation by increasing access to water, and combating human trafficking by empowering girls and women.
Achieving the Millennium Development Goals will require increasing access to health care in a manner that reflects the needs of communities, she said. At its core, CCPHI’s work and the partnerships it facilitates are “based on the knowledge that health is key to sustainable development,” said Gelbard.
Sources: Alam Sehat Lestari, American Journal of Tropical Medicine and Hygiene, Company-Community Partnerships for Health Indonesia, ExxonMobil, The Guardian, Health in Harmony, National Geographic, PBS News Hour, Public Health Institute, Republic of Indonesia Ministry of Forestry, United Nations, World Wildlife Fund.
Drafted by Kate Diamond and edited by Schuyler Null and Meaghan Parker