Taking planetary health on the road (and river)

Bukit Baka Bukit Raya National Park is the kind of rainforest you might imagine when you hear the word “Borneo.” It is 180,000 hectares of protected land, home to towering tropical hardwoods and critical habitat for reintroducing wild orangutans. This park, spanning the center of Borneo, is even larger than Gunung Palung National Park, where Alam Sehat Lestari (ASRI) first began work in 2007.

Our boat captain takes us up the sungai (river) that begins in Bukit Baka Bukit Raya National Park and flows past nine villages.

In 12 years around Gunung Palung, ASRI has achieved great success by integrating healthcare with reforestation, including an 88% decrease in logging households and a 67% decrease in infant mortality. Now, ASRI is ready to scale up. The Bukit Baka Bukit Raya project, abbreviated “BBBR,” is ASRI’s first replication site. It has the potential to help heal thousands of people and protect thousands of hectares of rainforest. It’s also a question mark: Will ASRI’s model of planetary health work around other parks in Indonesia?

On the drive in to BBBR, we passed this pile of legal timber being extracted from a concession in central Borneo. We didn't see any piles of illegally-harvested timber (the kind ASRI is trying to keep from getting logged) because it's floated down the river and kept out of sight.

In March, I had the honor of accompanying an ASRI Mobile Clinic on its monthly visit to BBBR. The team included ASRI founder Dr. Kinari Webb, general physician Dr. Fitriyani “Fitri” Simangungsong, Forest Guardians coordinator “Hen” Henriadi, and nurse “A’an” Anius.

Just getting to the site took three days: one day flying from Jakarta to the coastal Bornean city of Pontianak, another day flying to the inland city of Sintang, and one more day driving up the red, muddy, rutted, steep road to BBBR. The drive alone took six hours. We rolled across ravines on wooden-board bridges that creaked under our weight.

Every time the truck crossed a bridge, the boards creaked so loudly I thought they might come crashing down.

We got temporarily stuck in the deep, water-filled ruts that form in the mud road.

In 2017, ASRI conducted Radical Listening meetings with nine villages around BBBR and asked, “What resources would you need to be able to steward your forest?” The answer was similar to the one ASRI had heard 12 years earlier around Gunung Palung: healthcare and farming training, plus cell service and a paved road.

The primary need, the communities said, was midwives to help mothers deliver babies safely. Nearly all births take place in the home, hours from medical service, so any emergency during birth can become life-threatening. These nine villages, with a total population of around 2,000 people, reported that two to three women were dying in childbirth every year.

Preventing unwanted pregnancy was also a concern. To access birth control, women had to make a five-hour round-trip to the government clinic in Menukung. The cost of the birth control, added to the cost of transportation, was prohibitively expensive.

So, midwives became ASRI’s first priority. In the summer of 2018, ASRI hired and trained two midwives, Vini and Dewi, to run clinics on the border of Bukit Baka Bukit Raya National Park.

These two women are, in a word, superheroes. Meet them in the next post, coming soon!

Vini on the right, and Dewi with her daughter Belva.