In addition to Gunung Palung National Park in Indonesia, Health In Harmony works in three additional project sites in Indonesia, Madagascar, and Brazil.
Indonesia: Bukit Baka Bukit Raya
In September 2018, ASRI and HIH initiated work at Bukit Baka Bukit Raya National Park (BBBR), a 234,000 hectare protected area in West and Central Kalimantan. BBBR is part of the Arabella-Schwanner forest complex, which is home to the world’s largest wild Bornean orangutan population but is increasingly degraded due to a number of socio-economic factors. As in Gunung Palung National Park, communities that live close to the rainforest participate in logging and hunting to pay for their basic needs, particularly healthcare, because they have limited alternatives to generate income.
In 2019, ASRI conducted Radical Listening™ sessions with the Dayak communities living around BBBR, who asked for midwives to support maternal and child health due to very high infant and maternal mortality rates, and training in financial management, in organic farming, and in alternative livelihoods options.
Work at BBBR began with the provision of healthcare through monthly mobile clinics and the placement of two midwives in the local villages. ASRI is now working to emphasize community health by providing basic health and dental services at two community clinics in two villages (with a total of 9 sub-villages) and is focusing on conservation interventions, including alternative livelihood training, organic farming, peer-to-peer training support, and establishment of alternative payment methods for healthcare, including handicrafts, seedlings, and manure.
Madagascar: Manombo Forest
Madagascar is a global biodiversity hotspot and conservation priority. Though it covers only 0.5% of earth’s land, it contains 5% of earth’s species, and 80% of its species live nowhere else. The Manombo Forest is one of the last old-growth rainforests in southeastern Madagascar, serving as a critical habitat for nine lemur species and a source of clean water, tempered weather, and forest products for the indigenous communities living on its border. Ninety-four percent of Manombo households believe the rainforest should be protected for future generations, but due to food insecurity and lack of quality healthcare, they are forced to log, hunt, and make charcoal for money. Yet these communities are also a powerful barrier, protecting the rainforest from outside loggers and poachers who would deforest the land and push critically endangered wildlife toward extinction.
To understand precisely what the communities living around the Manombo Special Reserve need, in 2019, Health In Harmony conducted Radical Listening™ meetings with 778 community members representing 13 communities. These community members told HIH that if they have access to high-quality and affordable healthcare, regenerative agricultural training, options for alternative livelihoods, and education, they will be supported to protect this essential part of Madagascar’s rainforest.
Responding to community-proposed solutions, the medical team now provides healthcare twice a month to the 31 communities surrounding Manombo Special Reserve by organizing mobile clinics in 11 villages selected by the communities and accessible for all villages, performing maternal and child health services, basic consultations, and referrals. Community-designed training in regenerative agriculture focuses on fast-growing rice varieties, composting to regenerate soil fertility, and vegetable gardening to support diverse diets, and a focus on fruit trees and cash crops such as vanilla and pepper in agroforestry systems will provide additional food and financial security.
Brazil: Terra do Meio
The Amazon is essential for the wellbeing of all living beings and the planet at large. Home to hundreds of distinct Indigenous Peoples and Local Communities (IPLCs) and one-fifth of the world’s biodiversity, it is also the world’s largest carbon sink and plays a critical role in global climate and hydraulic cycling. Covering 18 million hectares, the Xingu River Basin is a critical cornerstone of the Amazon Rainforest, yet has been subject to significant degradation and deforestation. Xingu forests must be protected to ensure their resilience and avoid crossing the tipping point of no-return for the entire Amazonian rainforest and ultimate transition to a non-forest state. Riverine and Indigenous communities are not the main agents of forest loss or degradation; in fact, their rights to collective land and economic activities based on low-impact extractivism have been instrumental in keeping away invaders who would destroy the forest.
To prevent further deforestation of the Amazon Rainforest, Health In Harmony turned to the Indigenous peoples and riverine communities who steward and protect this critical ecosystem. During Radical Listening™ meetings in 2020, communities in the Terra do Meio region of the Xingu River Basin told Health In Harmony that they often leave their land to seek medical support in the city, leaving the land vulnerable to encroachment from illegal logging, mining, cattle ranching, and agribusiness. In order to continue to defend the Amazon Rainforest, they need access to high quality and affordable health care, including support for emergency evacuations, local nurses, telemedicine access, and visits at least three times a year from health professionals such as doctors, nurses, midwives and dentists. Communities also asked for support to grow a thriving forest economy system, which allows them to sell non-timber forest products and handicrafts made from forest materials and source healthy food.
In Terra do Meio, Health In Harmony is working with communities in the Iriri, Rio do Anfrísio, and Xingu Extractive Reserves, as well as with communities in the Cachoeira Seca and Xipaya Indigenous Territories. In addition to promoting development and commercialization of new products, services, food security, and business arrangements for forest communities, the Health In Harmony team in Brazil conducts health expeditions to provide basic health services, vaccinations, and dental services to indigenous and riverine communities.