Medicine not chainsaws: Indonesian clinic keeps villagers and forests healthy

In Borneo, offering affordable healthcare to villagers living near forests is helping to reduce illegal logging and fight climate change.

Three nurses stand for a portrait near Gunung Palung National Park in West Kalimantan, Borneo, Indonesia
Three nurses stand for a portrait near Gunung Palung National Park in West Kalimantan, Borneo, Indonesia. Image: Health in Harmony via Thomson Reuters Foundation

Offering affordable healthcare to communities living near forests could help reduce illegal logging and fight global warming, researchers said, as an organisation running such a service in Indonesia won a UN climate award on Tuesday.

A new study led by Stanford University analysed the health centre serving 120,000 people, set up by US-based Health In Harmony and a local nonprofit adjacent to Gunung Palung National Park in West Kalimantan on the Indonesian part of Borneo island.

Using satellite images and patient records from 2009-2019, researchers linked the health programme to a 70 per cent fall in deforestation compared with other national parks, equivalent to protecting more than 27 sq km (10 sq miles) of forest.

The more engaged the villagers were in terms of how many times they visited the clinic or participated in conservation programmes … the more impact we saw.

Susanne Sokolow, scientist, Stanford Woods Institute for the Environment

Study co-author Susanne Sokolow, a scientist at the Stanford Woods Institute for the Environment, said the researchers had observed a strong reduction in the rate of forest loss.

“Importantly, we also found that the more engaged the villagers were in terms of how many times they visited the clinic or participated in conservation programmes … the more impact we saw,” she told the Thomson Reuters Foundation.

The largest drop-offs in logging occurred next to villages that used the clinic the most, the study said.

Globally, about 35 per cent of protected natural areas are traditionally owned, managed, used or occupied by indigenous and local communities, yet they are rarely considered in the design of conservation and climate programmes, according to Stanford.

Seeking solutions, Health In Harmony and its Indonesia-based sister organisation Alam Sehat Lestari (ASRI) first questioned local communities and found that a key reason why they cut down trees was to pay for healthcare.

With this information, they established an affordable clinic in 2007, serving thousands of patients by accepting a range of alternative payments, such as tree seedlings, handicrafts, manure and labour – a system created with the communities.

Through agreements made with district leaders, the clinic also provided discounts to villages that could show evidence of reductions in illegal logging.

In addition, it offered training in sustainable, organic agriculture and a chainsaw buy-back scheme.

Health In Harmony was named winner of a UN Global Climate Action Award on Tuesday for its work to reverse deforestation, meet the health needs of communities and empower women farmers.

Alongside the Borneo clinic, it runs a kitchen garden programme that has helped about 325 women grow and sell vegetables, as well as providing more than 280 goats to elderly widows to promote their financial independence.

The Stanford study, published in the Proceedings of the National Academy of Sciences, said the 70 per cent fall in deforestation was equivalent to an averted carbon loss estimated to be worth more than $65 million, using European carbon market prices.

The researchers also measured significant falls in infectious and other diseases, such as malaria and tuberculosis.

Monica Nirmala, executive director of the clinic from 2014 to 2018 and a board member of Health In Harmony, said the data in the study supported two important conclusions.

“Human health is integral to the conservation of nature and vice versa, and we need to listen to the guidance of rainforest communities who know best how to live in balance with their forests,” she said in a statement.

Stanford researchers are working with the two nonprofits as they look to replicate the approach with other rainforest communities in Indonesia, Madagascar and Brazil.

This story was published with permission from Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, climate change, resilience, women’s rights, trafficking and property rights. Visit

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