I grew up as one of the few anglos in a small Hispanic farming community in northern New Mexico. I am grateful for this experience, though as a child it was, at times, extremely difficult. I was teased relentlessly and marginalized for being different. “¿Que ése bruja? ¿Que ése cabron?” I began school unable to speak Spanish, incapable of giving my classmates the English words for these and even less polite words, which I eventually figured out. As a white person, it is impossible for me to ever completely understand what it is like to be a member of a minority group that is constantly discriminated against. However, my experiences as a child, and the fact that our family income was well below the US poverty level, gave me empathy for those who have been unfairly disadvantaged. I think these experiences have been partly responsible for my involvement in programs to assist the poor and my desire to become a doctor and work with under-privileged peoples.
I attended college at Reed in Portland, Oregon, an experience that provided me with many intellectual opportunities. As major in biology with an interest in primatology, I decided to take a year off between my junior and senior years to study orangutans in the rain forest in Borneo. That time greatly changed the way that I perceive and relate to the world. Perhaps the biggest change was that I decided to pursue a career in medicine rather than in primatology. In the Bornean rainforest, I had a luxury that very few people ever have: large amounts of time with which to explore the contradictions of life. Every day before dawn I would hike through the forest to where the orangutan I was following had made a nest the previous evening. I would settle quietly at the base of the tree and wait for the ape to stir. When it woke, the orangutan would often simply climb over to the next tree and rest lazily for a few more hours, apparently similarly contemplating life.
In my many hours alone, I thought often about the inequalities I saw every time I went through the villages on my way from the forest to the city. I hadn't realized children still get polio or that, in a place without antibiotics and tetanus immunizations, a small cut can be life-threatening. The tiny Hispanic farming community where I grew up was considered poor by US standards. Nevertheless, I never lacked for anything significant in life and always had access to good medical care. Looking around me in the Indonesian villages I visited, I knew that opportunities such as I have had would never be available to these people, no matter how intelligent they were or how hard they tried. I realized that to be poor in the US was to be wealthier than these people could likely ever imagine.
I have been blessed throughout my life with an excellent education and numerous opportunities. When I decided to test my interest in primatology, I found an enviable position studying the ecological effects of orangutan behavior and managing a research station. During that year, I awoke to the magnitude of the injustices of the world. I began to feel that I could not justify doing the research I was doing no matter how interesting I found it. Surely the intelligence and love of learning I had been given could be put to much better use. After much thought, I came to realize that nothing in life is more important than love, and I committed my self to living a life in the service of others. It was at this time that I began to seriously consider medicine as a career choice.
I had little idea, though, of what being a doctor really entailed and even less of what being a physician in the developing world would be like. Towards the end of that first year in Borneo, I visited a rural hospital that was founded thirty years ago by two Americans who are committed to serving the poor. I was extremely impressed with the high level of patient care on limited resources. I decided to return to the hospital and find out whether being a doctor in underserved areas was indeed the path that I wanted to follow. After completing my BA, I trained as an EMT in a special course that emphasized handling medical emergencies in remote locations, and then I returned to the hospital in Borneo for eight months. Because I already spoke the Indonesian language, I was able to help with a village health care program that provided immunizations, pre-natal exams, monitoring of child development, and treatment of common illnesses. I was also privileged to be allowed to scrub in and assist in the operating room and to be involved in post-operative care. I saw unusual tropical parasites and cases of diseases that had advanced to a stage that is rarely seen in the US. It was at times frustrating to know that if a patient had come to the hospital earlier he or she could have been cured, but the frustration was outweighed by the many patients who were successfully treated. In helping to prepare a report to donor organizations, I also statistically analyzed the morbidity and mortality data for the village health program and found that the mortality rate for children under five was halved from 25% to 12% during the six years of the program.
After eight months at the Borneo hospital, I returned to the US to apply to medical school. I was accepted by Yale School of Medicine, from where I graduated with honors four years later. After medical school, I attended residency at Contra Costa County Regional Medical Center. I finished in 2004 with a specialty in Family Medicine. This field suffers a reputation as one of Western medicine’s less “sexy” specialties, but I chose it for its commitment to considering the whole human organism, versus the tendency of other fields to sub-sub-sub-specialize; the former is critical for practicing medicine effectively in remote areas where one is the only medical resource, and doctors cannot simply tell their patients, “Sorry, I only care for adults” (or ENT, or skin, or hearts).
Immediately after finishing residency, and 13 years after the year following orangutans in the forest, I founded Health In Harmony as a US-based 501(c)3 organization committed to supporting the setup of a program in Indonesia that would work to protect the link between human and environmental health. I then returned to Indonesia and began island-hopping in search of a location where poverty and poor health appeared to drive deforestation – no shortage of those – and where logistics where such that I would stand a reasonable chance of success in establishing a joint healthcare-conservation program. I came full circle, back to Gunung Palung, the national park where I had explored my intended career in primatology. And that’s where ASRI was born. Currently, I live in Sukadana, a town wedged between the coastal hills of Gunung Palung National Park and the South China Sea. Here, I work with my team of Indonesian medical workers and conservationists to tie together healthcare and rainforest protection. I laugh sometimes to think that I now live only about 20 kilometers from where I worked 19 years ago studying orangutans. I couldn't be happier in my work, and I feel privileged to be able to work together with people here to both improve local health and also help save rainforest.
