Lessons From The Rainforest: Human Health Leads To Planetary Health

The Covid pandemic is making it impossible for us to ignore the link between health and environmental degradation. Ashoka Fellow Dr. Kinari Webb, founder of Health in Harmony, has been working at that intersection for decades. We sat down with her as part of our series on the future of Planet & Climate.

Kinari, how did you get started with your work?

I first went to Indonesia when I was an undergraduate to study orangutans, and I thought I was actually going to be a primatologist. But when I showed up in the Rainforest in Kalimantan in West Borneo, I fell in love with the orangutans and with the forest, but I also really fell in love with the people, and I was horrified to see what was happening. Borneo, at that time, was just at the beginning of this massive wave of deforestation – the fastest rate of deforestation that the world has ever seen. They were cutting down enormous trees that were sometimes 22 stories high. Giant, giant trees, and it felt like a little earthquake when they hit the ground.

It just broke my heart. And at first, I just hated these guys. How could they possibly do this? But as I got to know them, they told me that they were often logging to pay for healthcare. One medical emergency costs an entire year’s income, and when you’re a subsistence agriculturalist and you don’t have much cash and no savings, one of the ways to pay for it is to log the Rainforest.

I felt like we just can’t have a world where this is happening. I struggled a lot to figure out should I do conservation? Should I do healthcare? I really wanted to do both. How could I? That didn’t exist in the world, but I felt like that’s what needed to happen. So I decided to go to medical school with the plan to return to Indonesia and do some kind of combined program.

What did you do when you returned to Indonesia?

The one thing I knew for certain was that I wouldn’t know what the solutions were. The local communities would. That was particularly driven home to me when I went and helped after the tsunami in Indonesia to do medical relief work, and I was just horrified by the way all the NGOs were working. They weren’t listening at all. They knew what the solutions were and didn’t care if it didn’t match the need.

I decided to start Health In Harmony in the US, and then I moved to Indonesia, and I teamed up with a group of Indonesians. We started an Indonesian non-profit as well called Alam Sehat Lestari, or ASRI for short. Both are based on the principle that it is actually the communities who are the experts.

I spent time traveling across all of Indonesia first, looking for the right place for the program, and what I found was that this intersection between human needs and particularly health care needs and destruction of the environment was nearly universal. I ended up choosing the place where I studied orangutans called Gunung Palung National Park, and then we did what I call radical listening.

What is radical listening?

It is the most important principle behind our work, which so few organizations follow. It is listening to the community with love and total respect. It’s like reciprocity. It’s this idea that they are the experts. They know exactly what the solutions are, and they are the guardians of these precious resources that are valuable to the whole world.

In return, they may need thanks from the world community, which, from my perspective, is also like an anti-colonial return of resources to these communities who are very poor because of a long history of colonization.

What did they tell you?

Every, single community independently came to the same conclusion: that they needed access to affordable, high quality healthcare, and they needed training in sustainable agriculture, in organic farming. Now, that second one just totally shocked me. I was like “why don’t you just talk to your grandparents? What do you mean, you don’t know?” And they said, “No, no. The traditional form of agriculture here is slash and burn and that isn’t working anymore because there isn’t enough forest and there are too many people. The only way that we know to plant in one place is to buy expensive chemical fertilizers, because that’s what we’ve been taught by the government. We can’t afford them, and we often have to log even to get the money for planting.”

Right next door, on the island of Java, there’s a many-thousand year tradition of sustainability agriculture, and it was very easy for us to just bring over trainers from there. It wasn’t a need for money. It was a need for knowledge and a need for resources that just weren’t available locally.

And then we hired all young Indonesian doctors and Indonesian medical providers, but we trained them. The physicians themselves are incredibly brilliant and desperate to learn, but they often have had poor educations, so we were able to get lots of volunteer doctors to come in from all over the world who would pay their own way and then come and teach the young doctors. We brought them up to an international standard really quickly.

Other than radical listening, what guides your work?

We not only need to work in multiple aspects of the system in order to change it, but we need to make the connections visible.

For example, you can pay in our clinic for your healthcare with non-cash payment options, because we never want anyone to have to log to pay for their healthcare. This makes it very visible that a healthy environment is important for healthy humans. People can pay for their healthcare with seedlings, or with traditional handicrafts that are sustainably harvested from the forest, or they can pay with manure that we use for the organic farming. They can also pay with labor in our organic farm right behind the clinic and see very directly that healthy food is feeding the patients. We also give discounts to communities for their healthcare based on the logging status of the community. If there is no logging they get a 70% discount – so they just have to pay with fewer seedlings. This makes the “thank you” from the global community also very visible.

So what has changed?

After 10 years, we had a 90% drop in logging households. We had a 67% drop in infant mortality. We stabilized the loss of primary forest and had 52,000 acres of forest grow back. Stanford recently looked at the difference carbon value in the primary forest between our national park and other national parks across Indonesia. It is worth $65 million USD. So it is not a small gift that these communities are giving to the world. And of course, that’s just counting carbon, right? That isn’t counting all the biodiversity, or the hydrological benefits of the forest.

We are really interested to see if this model works elsewhere, and if it does, how do we scale it? So we started in another national park in Borneo. Now we’re also working in Madagascar and we’re starting in Brazil this year.

Do people see this connection between harming the environment and harming their own health?

Most outsiders assume that Rainforest communities that are massively logging don’t care about the forest, but that’s not true. We did a baseline survey, and over 90% of people wanted to protect the forest. They wanted it to be there for future generations.

So then why does it still happen?

Well, if your family member was going to die if they didn’t get healthcare, what would you do? Even if you loved the forest. Everyone of us would make the same choice. It’s not about convincing people that they need a healthy ecosystem. They know that. It’s just when you do not have a choice, you will do whatever it takes to take care of your family.

So how do you make these choices easy? Is it regulation? Economic incentives? Something else?

I think if we rely on top down solutions or we believe that that is the only way we’re going to get there, we might as well just give up now. It’s hopeless. The answer is: listen to the local communities about what the solutions are in their context.

And the other thing that we really need to be aware of is if we lose the Rainforests of this Earth, it’s game over for the human species, like completely game over. Deforestation releases as much carbon every year as the entire transportation sector of the entire world. And the forests of the world absorb 1/3 of the carbon that we emit every year.

How do we multiply bottom-up initiatives fast enough?

Because we only have 10 years. Right?

Yeah.

It’s no joke. We got to move fast. I’ve been systematizing this process of radical listening, which is not that difficult but it is based on some principles which many people do find difficult to really internalize. We’re all racist and we’re all colonized. It takes a huge amount of work for us to undo that and teach ourselves a different way. Imagine a world where you could see on a technological platform, the radical listening needs of rainforest communities and then partner with those communities to meet those needs. Eventually, it could be everywhere.

Do you think Covid helped people see this connection between human and planetary health?

It looks like people are just as worried, if not more worried about the climate. The message that we’re really trying to get out there is Covid is the symptom of a sick planet. Our planet is not well, and more epidemics like this are likely to happen. There are so many symptoms of a sick planet, and the cure is planetary health. The cure is to begin to really think about human and environmental well-being as intimately interconnected. There is no way to separate them. I think that sadly that is something Covid is teaching people exquisitely.

Dr. Kinari Webb is the founder of Health in Harmony which she founded in 2005 to address planetary and human health in Rainforest communities. She graduated from Yale University School of Medicine with honors. Kinari also co-founded Alam Sehat Lestari (ASRI) with Hotlin Ompusunggu and Antonia Gorog. Kinari currently splits her time between Indonesia, international site assessments, and the San Francisco Bay Area. She became an Ashoka Fellow in 2013.

Corina Murafa is leading Next Now/Planet & Climate and is also the Director of Ashoka Romania. Prior to joining Ashoka, she advanced long-lasting positive change in Eastern Europe as a public policy expert on energy and sustainability. She has worked for the World Bank, OMV Petrom, Deloitte, national governments and think tanks.

Next Now: Ashoka is mobilizing the strength of its community on climate action. Next Now/Planet & Climate connects unlikely allies around shared visions of the future that bring people and planet to a new equilibrium. This Ashoka series sheds light on the wisdom and ideas of leaders guiding the field. Read Part 1, Part 2 , Part 3, Part 4, Part 5, Part 6 and Part 7 of our series.