Health In Harmony: Protecting the critical link between human and environmental health
This entry has been selected as a finalist in the
Innovations for Health: Solutions that Cross Borders competition.
HIH is dedicated to protecting planetary health by locally protecting the critical link between human and environmental health.
About Your Organization
Health In Harmony
United States, OR, Multnomah County
Country where this project is creating social impact
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
Has the organization received awards or honors? Please tell us about them
Dr. Hotlin Ompusunggu, who both manages our program in Indonesia and serves as its clinic dentist, received a prestigious Whitley Award in London last year. In addition, Health In Harmony was recently featured in Outside Magazine as one of the top 30 organizations "making a difference": http://www.outsideonline.com/outdoor-adventure/nature/Health-in-Harmony.....
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Nancy Angoff, MD, MPH, MEd, FACP
Nancy Angoff is the Yale University School of Medicine Assoc. Dean for Student Affairs and an Assoc. Professor of Internal Medicine. She has known Kinari Webb since Kinari was a medical student at Yale, and she currently serves on the board of Health In Harmony.
Alison Norris, MD, PhD
Alison Norris is an Assistant Professor of Epidemiology at Ohio State University. She attended medical school with Kinari Webb and currently serves as the President of Health In Harmony's board of directors.
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Select the stage that best applies to your solution
Growth (your pilot is up and running, and starting to expand)
How long have you been in operation?
Operating for 1‐5 years
Which of the following best describes the barrier(s) your innovation addresses? Choose up to two
The Need: What problem are you trying to solve?
I believe that human and environmental health are critically linked, and that the key to protecting planetary health is guarding those links at the local level. In many parts of the globe, poverty, poor health, and ecosystem destruction spin together in a downward spiral. I am working to stop that spiral by injecting high quality, accessible, affordable healthcare into the picture. My current focus is Gunung Palung National Park in West Kalimantan, Indonesia. I intend the model I build there to be replicable in other areas where poverty and poor health tip local resource use to the unsustainable.
The Solution: What is your solution? Be specific!
In 2007, Health In Harmony established the Alam Sehat Lestari program (ASRI) in a village called Sukadana on the border of Gunung Palung National Park. We opened a clinic and began community outreach activities to raise awareness about the local link between human and environmental health. The clinic promotes the protection of the park, an important conservation area for Borneo’s forests and wildlife and a vital watershed for local communities. Local villagers can trade seedlings and participation in conservation-promoting activities, such as reforestation, for healthcare, rather than paying with cash. In addition, communities that help protect the park, rather than log it, are given additional healthcare rewards of their own design, including discounts at the ASRI clinic, discounted mobile clinic service, and ambulance service at cost.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Sometimes 14-year old Ayu struggles to breathe. The problem was worse when Ayu and her family still lived in polluted West Java. Ayu’s father lost everything covering the cost of medical bills. At a loss for other options, four years ago he brought his family to West Kalimantan through a government-sponsored transmigration program. Ayu’s asthma attacks lessened in the clean air of one of Indonesia’s least-developed provinces, but did not disappear. Once when Ayu suffered a dangerous episode, her father learned about HIH’s ASRI Clinic. The staff treated the girl and now, each month, they provide her with inhalers that are effective, but costly. The father is able to pay clinic bills with work in ASRI’s seedling nursery two days a month. There, he plants rainforest seedlings in poly bags and waters them in preparation for reforestation work that ASRI’s conservation staff will coordinate with local communities during the wet season. As director of ASRI, my role includes training and overseeing the Indonesian medical staff who treat Ayu, conducting community outreach to design medical incentives and trades for conservation (such as the father’s nursery work), and designing the reforestation effort that will use the seedlings the man is cultivating.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
ASRI’s "competitor” is the local government clinic, but we have turned this relationship into one that is mutually beneficial. The Health Department Head told us, "I did not know it was possible to provide quality care in a remote place. Now [in ASRI] I can see that it is, and it makes us realize what we can achieve if we try hard enough." ASRI works with the government healthcare workers to identify and meet training and equipment needs, and to teach a new way of looking at health largely focused on preventing illness by maintaining a healthy natural environment.
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
In 1993, when I was working as an assistant researcher in Gunung Palung National Park, my field guide, Tadin, accidentally slashed his hand with a machete. I saw dread in Tadin’s eyes when he looked at his bleeding palm — fear that he might be unable to work and support his family. I realized that villagers living near valuable natural resources can be empowered to protect those resources only if they are healthy and have stable livelihoods – the dangerous spiral of poor health, poverty, and ecological destruction became clear to me, and the incredible power to disrupt that dangerous cycle with accessible healthcare. I decided to become a doctor, using healthcare to simultaneously reduce the threat of illness and motivate forest conservation.
Please describe the goal of your initiative; outline what you are trying to achieve
HIH aims to demonstrate a model with the power to protect planetary health by locally disrupting the cycle of poverty, poor health, and ecosystem destruction that prevails in places where unmet needs result in unsustainable resource use. The ASRI project in Indonesia represents HIH’s first implementation of the model. ASRI uses its clinic to promote protection of Gunung Palung National Park, an important conservation area and watershed for local communities. Through an incentive system of healthcare rewards to communities that cease illegal logging, villager participation in conservation work in exchange for healthcare, and education, ASRI links healthcare to environmental protection.
What has been the impact of your solution to date?
My project, ASRI, is designed to break the destructive cycle of poverty, poor health, and deforestation around Gunung Palung National Park. To date, the ASRI clinic has served 20,000 patients, who are invited to pay for treatment by participating in conservation work – bringing better health without incurring debt. ASRI has also brought organic farming to five communities, reducing the costs of farming, increasing yields, and discouraging slash-and-burn agriculture that destroys the park. ASRI has reforested fifteen hectares of damaged parkland, beginning to revitalize the local watershed. ASRI has saved countless lives and has improved livelihoods for 22 communities.
What is your projected impact over the next five years?
>Demonstrated success of ASRI model, spinning off a replicate in another area of Indonesia.
>Enabled the provision of high quality healthcare to the 60,000 villagers around Gunung Palung, as well as the training of Indonesian healthcare providers, by building a full-service hospital in Sukadana.
>Measured a significant reduction in illegal logging in Gunung Palung, thus protecting a watershed needed by 60,000 villagers.
>Measured significant improvements in both health and livelihoods of villagers around the Gunung Palung area connected to ASRI’s healthcare are sustainable agriculture programs.
What barriers might hinder the success of your project? How do you plan to overcome them?
We must make a constant effort to maintain positive relationships with the local government and health department. We never, ever pay bribes – our positive relationships are built on common courtesy, respect, and generous efforts to provide training to local government medical workers at every opportunity. In this fashion, with will overcome the somewhat onerous hurdle of obtaining permits for the construction of ASRI’s hospital.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Measure ASRI's impacts on health, cessation of illegal logging, and healthcare worker training to date.
Identify three major tasks you will have to complete to reach your six-month milestone
Repeat ASRI’s baseline health survey in communities around Gunung Palung in early 2012. Compare results to 2007.
Conduct monthly monitoring of illegal logging through regular joint patrols with village Forest Guardians.
Analyze ASRI Clinic patient database figures to design strategies to improve training of our own staff and government staff.
Now think bigger! Identify your 12-month impact milestone
Begin construction of ASRI's hospital and spread knowlege of sustainable agriculture in the Gunung Palung area.
Identify three major tasks you will have to complete to reach your 12-month milestone
Obtain hospital construction permit from the local government.
Hire a trustworthy contractor and break ground.
Train an additional eight communities in organic farming and sustainable agroforestry.
Tell us about your partnerships
HIH partners with Yale University, Stanford University, Johnson & Johnson, and other supporters to bring high quality medical care and volunteer medical professionals to the Gunung Palung area. In addition, we partner with the Arcus Foundation, US Fish & Wildlife Service, Conservation Food & Health Foundation, and other conservation donors to support ASRI’s healthcare incentives for conservation, as well as activities to protect and restore Gunung Palung’s forests.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
Our intention is for the ASRI project to be replicable in other areas where natural resources important for global health are threatened by insufficient healthcare locally. We hope to both provide guidance to other organizations wishing to implement the model we have created in West Kalimantan, and to create additional ASRI-type projects in other areas. To date, we have begun to explore options for replication in northern Sumatra and Papua New Guinea.
What type of operating environment and internal organizational factors make your innovation successful?
Two factors are critical in maintaining the ASRI project’s success: ASRI’s excellent staff, and continuous intensive outreach to ensure open lines of communication with communities around Gunung Palung and community support for ASRI’s initiatives. Staff quality is kept high by excellent training provided by myself and skilled volunteers from the US, and a staff gathering each morning keeps all of the team personally involved and invested in programmatic decisions. Frequent gatherings in villages around the park ensure that each ASRI initiative is created in response to local needs and constraints – this is a critical feature of our success. We listen and respond.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
HIH is poised to offer guidance to organizations with a serious interest in using ASRI's combined health/conservation model to improve local health and protect natural resources.