Anyone who doesn’t see a link between saving Indonesia’s—and the world’s—rainforests and providing health care for the underserved has likely not met Kinari Webb. An environmentalist and doctor, the 44-year-old is on a mission to stop the ravaging of the rainforests—often illegally logged by West Borneo villagers to pay costly medical expenses—by building remote-area hospitals and clinics that offer deeply discounted health care.
Webb also started a re-forestation program. She calls the work “saving the rainforest with stethoscopes.” And to help do it, in 2005, she founded the nonprofit group Health in Harmony, located in Portland, Ore. She also co-founded a West Borneo health-care provider, Alam Sehat Lestari (ASRI), with her husband, Cam Webb, a rainforest ecology researcher, and Indonesian dentist Hotlin Ompusunggu. The ASRI clinic currently serves 60,000 people.
Health in Harmony’s first major construction project—the 27,000-sq-ft ASRI Community Hospital and Training Center—is set to open in stages over the next several months, in Sukadana, in the Kayong Utara Regency of West Borneo, the Indonesian part of the island of Borneo.
Sukadana, with a population of about 20,000, borders on tropical Indonesia’s Gunung Palung National Park, a rainforest. The nearest hospital is in Ketapang, a two-hour drive away. But Ketapang can be up to 12 hours away for the rural villagers around the park, especially when they have to travel over rutted or muddy roads.
ASRI gives patients up to a 70% discount on health care, based on the amount of logging going on in the patient’s village. The discount goes up if the logging goes down.
Yet patients are never turned away. If they don’t have cash, they can pay with seedlings, which are used in ASRI’s re-forestation site; manure which is used by farmers or even labor.
Patients also can participate in a health-care savings program, where they can "sell" their seedlings to ASRI for later use in re-forestation and build up credit at the clinic.
Pro Bono Services
The $1.4-million ASRI hospital will serve more than 100,000 people. Construction of the six-building facility, 78% complete, might never have happened if not for U.S. design firms that donated all their services.
Architect Richard Ramer, founder of the five-person Ramer Architecture, Santa Monica, Calif., led the charge. Some five years ago, he had learned about Webb through his brother, Andrew, and became inspired to help because of his interest in the environment and his 20 years of experience in health-care design.
“I have so much admiration for what Kinari has done,” says Ramer.
Thinking big firms would have the resources to help, Ramer approached Englekirk Structural Engineers and mechanical-electrical-plumbing consultant ME Engineers to donate services. “It’s all pro bono,” Ramer says of the three firms. The tally of donated hours of work was never kept, he adds.
The mostly one-level hospital, on course for completion in October by general contractor PT Cipta Pilar Persada, consists of a series of linked buildings with cast-in-place concrete structures, concrete-block infill walls and light-gauge-steel roof trusses. Except for the laboratory and operating rooms, the buildings are naturally ventilated. There will be 35 beds that can be increased to 50, if necessary, says Ramer.
For the project, Health in Harmony has raised funds mostly from individuals, the U.S. Fish and Wildlife Service, Arcus Foundation and WaterHope Foundation.
Ramer, who plans to visit the hospital for the first time this fall, says the distance from the Los Angeles-area design team to Sukadana was the most difficult part of the project. “We didn’t speak the language and had to figure out local customs and methods of construction,” he says.
Webb agrees that the balance between local standards of construction and the pro bono design team’s higher standards was tricky. But the most difficult aspect of the development effort, which started in 2007 with a big idea and the purchase of land, was “getting the permit without paying any bribes.”
“We are uncertain if the community threatening to protest, if the central government in Jakarta making contact with the local government or if the local government’s compassion won the day, but, in the end, we got the permit" just days before construction began last August, Webb says.
If Webb has her way, the hospital will pave the way for other medical facilities in underserved areas. “We are looking at other sites within Indonesia and around the world to replicate this model,” says Webb.
The immediate plan is to build Indonesian clinics, not hospitals, also in partnership with ASRI. Webb hopes the clinics will be financed by the Indonesian government’s health insurance system. “We have been told we will be able to sign up for this by the end of the month,” she says.
Ramer is eager to do more projects, saying his work on the hospital opened doors for him. “I would definitely be involved in the next one,” he says. “If I had to choose, I’d take passion over profit.”
Webb has even bigger plans for the future, in terms of helping to save the planet: In 10 years, she imagines working on systems to take key principles learned in Borneo and apply them globally. The principles, she says, are “trusting communities to know the key solutions to make their lives better and protect the ecosystem in which they live and working together to meet those needs on a global scale.”