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fixing the world. Hello

1:40

and welcome to People Fixing the World

1:43

from the BBC World Service with me,

1:45

Myra Anubi. On this program,

1:47

I find out about people who've come up

1:49

with great solutions to some of the many

1:51

problems we face today. And sometimes

1:53

we need to be incentivized to

1:55

change and do things that can make

1:58

the world a better place. So

2:00

today, we'll find out about

2:02

a special clinic that's motivating

2:04

people to stop cutting down

2:07

trees in the rainforest. Forests

2:14

are really important for people, animals

2:16

and for the fight against climate

2:18

change. But according to the UN,

2:21

the world has lost 420 million hectares of forests

2:23

since 1990. Now

2:28

to give you an idea, that's an

2:30

area roughly the size of India. Cutting

2:33

down trees or deforestation can cause

2:35

lots of problems. So for

2:38

starters, fewer trees means less food

2:40

and less shelter for animals. Also,

2:43

trees are really, really good at

2:45

soaking up carbon. But when they're

2:47

chopped down, all that carbon is

2:49

released back into the atmosphere, which

2:52

contributes to climate change. Now

2:55

most deforestation is due to illegal logging.

2:57

So that's where trees are cut down

2:59

and turned into timber for construction or

3:01

cleared so that the land can be

3:03

used for farming stuff like soy,

3:05

palm oil or just to keep

3:08

cattle. And this is where our

3:10

first solution today comes in. It's

3:12

an idea that's getting people to stop cutting down trees.

3:15

And it all started when one woman

3:17

came face to face with the

3:19

impact of illegal logging while

3:21

on a trip to the Indonesian part of

3:23

Borneo, a big island in Southeast Asia. You

3:27

know, it was this amazing and beautiful

3:30

and exquisite thing to be in the

3:32

rainforest. But I could

3:34

hear the chainsaws all around me. That's

3:36

Kinari Webb, who happens to be both

3:38

a medical doctor and an ecologist. At

3:41

the time, she was on a student trip

3:43

to study orangutans, and she

3:45

didn't understand why the local people would

3:48

want to destroy this beautiful place that

3:50

they called home, the Gunung Palung National

3:52

Park, which is a large area of

3:55

tropical rainforest on the island's west coast.

3:58

And it just broke my heart. And

4:00

then I talked to many

4:02

of these men and discovered that

4:04

they were logging often Crazily

4:07

to pay for health care access People

4:10

were destroying their future in order to get

4:12

their presence and it was

4:14

not only destroying their own future but

4:16

the future of the orangutans the future

4:18

of our planet and so I Really?

4:22

I felt like we just can't have

4:25

we can't have a planet where this is happening and Where

4:28

people have to make those kinds of horrible

4:30

choices Kinari went back

4:33

to the US and finished medical

4:35

school before returning to Borneo and

4:37

setting up a charity called Alamsahed

4:40

Lestari or as we along with

4:42

her co-founder hotlin on busungu The

4:45

aim was to preserve the forest and reduce

4:47

illegal logging So they started by sitting down

4:49

with the local people to ask them what

4:52

it would take for them to stop cutting

4:54

down the trees And protect

4:56

the rainforest around them the

4:58

Azure team spent around 400 hours

5:00

talking with local people and over

5:02

and over again People

5:04

said that the one thing they needed

5:07

most was good quality affordable health care.

5:09

It's okay. Well, we'll just you know

5:13

We'll we can't build you a hospital right

5:15

away Although we did eventually but

5:17

we will try our very best to build

5:19

a clinic and to provide services Kinari

5:22

and her team started building their clinic and

5:24

it opened back in 2007

5:27

however Kinari knew that

5:29

on its own the clinic might not

5:31

be enough of an incentive for people

5:33

to stop cutting down the rainforest So

5:36

together with community leaders, she came

5:38

up with another big idea What

5:41

if people could get a large discount

5:43

on their medical care if they stopped

5:46

chopping down the trees? And

5:48

this was designed by the communities. They loved it

5:50

They they saw it as a way that they

5:52

could address people who were still logging The

5:55

clinic started off by offering basic

5:57

care. So providing everything from consultation

6:00

with doctors and contraception right up

6:02

to doing major surgeries, with patients

6:04

getting a sizable discount if no

6:06

logging had taken place in their

6:08

village. 15 years

6:10

later, the project has grown bigger

6:12

than Kinari could ever have imagined.

6:15

It's really closer to being a small hospital.

6:18

We do inpatient care. We have

6:20

until very recently been doing 24-hour

6:22

emergency care as well and minor

6:25

surgeries. For major surgeries, we do

6:27

have a fabulous surgeon. Our reporter

6:30

Ade Mardiati went to see exactly

6:33

how it all works.

6:38

It's Monday today and I'm

6:40

at the Osteri Clinic in

6:43

Sukhadana. The clinic is

6:45

set in the foothills of the Gunung Palung

6:47

National Park. It's a small

6:49

wooden structure covered in colorful flowers

6:52

and surrounded on all sides by

6:54

a dense tropical rainforest, which

6:57

is home to wildlife like sunbears,

6:59

pangolins and orangutans. There

7:02

are around 30 people waiting to

7:04

be seen by

7:07

a doctor, mothers with their

7:09

babies, young children and

7:12

also the elderly. The Angiri

7:17

pharmacist is prescribing medicine to

7:19

a young child with a

7:21

stomach bug. This is for

7:23

nausea and

7:29

vomiting. Take it three

7:31

times a day before a meal but

7:33

only take it when she feels nauseous

7:36

and is vomiting. On a day

7:38

like today, the clinic sees up to 50 patients

7:41

coming in with everything from

7:43

toothache to flu and hypertension.

7:46

Today, they're being treated by Dr. Fari,

7:49

who has recently started working here.

7:51

I do enjoy my time here because

7:54

I do help

7:56

a lot of people. Before,

7:58

Kevin and I were in the clinic. no

8:01

other health center facility. Before

8:03

the clinic was built, the

8:05

nearest hospital was a long drive down

8:08

a dirt track, and that's

8:10

in good weather. And

8:12

even then, the quality of care

8:14

was poor. It's quite far.

8:16

You guys took four hours to go

8:18

there. One of Dr. Saris'

8:21

patients today is Matt Jais, who

8:23

is being treated for chest pains. When

8:28

Asri visited our

8:31

village, they told

8:33

us that they would give a different breath

8:36

if no logging takes place. I

8:38

used to work as a logger when I

8:40

was young, when I was 20 or 22

8:42

years old, to cover the cost of living.

8:44

We used to have a buyer that collects

8:47

his wood from us. Now, we don't do

8:49

that anymore. Nobody in our village that's down

8:51

trees anymore. Especially now that we

8:53

have Asri clinic, they come to visit

8:55

and educate us. So there

8:57

is no way we would do it again. Matt's

9:01

appointment with Dr. Saris would

9:04

usually cost 138,000

9:06

Indonesian Rupiah, which is

9:08

roughly 9 US dollars. But

9:10

as he goes in for his check-up, he

9:13

shows his ID card, which confirms that

9:15

he lives in a village where no

9:17

logging has recently taken place. This

9:20

means that his treatment and medicine

9:22

will be half-price. In

9:24

total, there are 81 local villages

9:27

in which Asri monitors whether logging

9:29

has taken place. And out

9:31

of these 81 villages, 15 are

9:34

entitled to the biggest discount, which is

9:36

70%. Only

9:39

3 out of the 81 villages don't

9:41

currently receive any discount at all. Matt

9:45

is happy he gets a discount for the health

9:47

care, but I wondered how he felt

9:49

about others having to pay for price for the

9:51

same treatment. It's not just

9:53

people who have contributed to logging themselves who have

9:55

to pay more. It's actually anyone who

9:57

lives in a village where trees are not allowed to be used. have

10:00

been cut down recently. This is to

10:02

encourage us to stop logging, and it is good. We

10:08

risk things when we cut down

10:10

trees. For example,

10:12

floods. That is why we were willing to

10:14

change. I guess if the advice

10:16

makes sense, we'll take it. Crucially,

10:22

patients aren't being denied health care if

10:25

they or their neighbors have been logging. But

10:28

they just won't get the discount. It's

10:30

also important to point out that the

10:32

clinic doesn't require payment immediately, and

10:34

nobody is ever turned away if they don't have the

10:36

money up front. Today, Matt

10:39

is paying in cash. But as

10:41

well as getting a discount, patients are

10:43

also able to pay with whatever they can offer.

10:47

Handicraft, siblings, manure,

10:49

or even volunteering their time.

10:52

So, if someone came in from

10:54

a village where logging had taken place recently,

10:57

and they offered their time as payment, they'd

11:00

just have to clock in more volunteer hours

11:03

than someone from a village where no trees

11:05

had been cut down. A

11:14

few meters from the clinic, Asri are

11:16

collecting payment in the form of seedlings from

11:18

another recent visitor to the

11:21

clinic, 42-year-old Martalina. That

11:24

one is on 30 centimeters yet. It's not ready. This

11:29

one is 30 centimeters. These

11:32

ones are good to go. And

11:34

this brings us to the second part

11:37

of our solution, using the

11:39

seedlings patients pay for treatment with

11:41

to regrow the rainforest. Martalina

11:44

has been paying for medical treatment for herself

11:46

and her family in this way for over

11:49

10 years. It

11:52

all began when my daughter was sick and we went

11:54

to see a doctor at Asri. I

11:57

had never been to Asri before then. actually

12:00

didn't have any money. Mardalena

12:02

was terrified. A nine-year-old

12:04

daughter had an abscess the size of an

12:07

egg at the back of her neck, and

12:09

the other local healthcare options could

12:11

even be dangerous. In

12:15

the past, people in small villages like

12:17

this would go see a witch doctor.

12:20

When I was feeling sick with a stomachache

12:22

or headache, I was told I was possessed

12:24

by an evil spirit. To

12:28

read Mardalena of the evil spirits,

12:30

the witch doctor chewed a

12:32

concoction made of turmeric and

12:36

bitumen and stabbed it on her

12:38

face. Like a lot of local people at the

12:40

time, she

12:42

believed this would cure her. But

12:45

by the time the Astri Clinic opened, she

12:48

tells me she knew better. Mardalena

12:51

wanted to ensure that her daughter got the

12:54

very best treatment possible. But

12:56

when she arrived at the Astri Clinic, he

12:59

wasn't sure whether they would be able to help. The

13:04

cashier said to me, you can

13:06

pay with siblings if you don't have cash. So

13:09

I did. I'm a single mother. So

13:11

I said to myself, if there was

13:14

an alternative to cash, I would do

13:16

it so that my daughter could receive

13:18

the treatment she needed. At

13:20

that time, the total bill was nearly 500,000.

13:24

500,000 Indonesian groupia is around 32

13:27

US dollars. And

13:31

so I began preparing the siblings to pay

13:33

for the bill. I had around

13:35

600 siblings. I

13:37

delivered them my siblings. Mardalena

13:39

says that she's collected more than 10,000 siblings

13:43

in total from the nearby forest.

13:46

A steady supply of siblings means she

13:48

has credit in the bank anytime either

13:50

she or a family member is

13:53

unwell and needs to visit the clinic.

13:56

Once back at home, she immediately puts

13:58

the siblings in putting for. and

14:00

grow back. Each day

14:03

she plants around 300 seedlings. Martelina

14:06

has been growing the ones

14:08

collected today for around six

14:10

months. After

14:13

this they are taken to a

14:15

nearby nursery run by Asri. I

14:18

met forestry manager Muhammad

14:20

Rizdadeh. So

14:22

the nursery in our

14:24

clinic, this nursery has

14:26

capacity for at

14:29

least 25,000 seedlings. We

14:32

have some workers here and then they

14:35

work every day to take care

14:37

of the seedlings until the seedlings are

14:39

ready to be planted. Yeah

14:42

that's what we do here. The

14:45

price for seedling is set by Asri and

14:48

the more endangered a particular plant or

14:50

tree is the more it's worth. Rizdadeh

14:53

monitors the rainforest around the clinic

14:56

and decides which parts of the forest

14:58

need to be replanted as well

15:01

as the type of plant that needs to be

15:03

planted in each area. The

15:05

idea is that the seedlings taken from

15:07

elsewhere in the forest are redistributed to

15:09

the areas which need them the most

15:11

such as where logging has taken place

15:14

in the past. One of

15:16

the trees which is almost ready to

15:18

plant is known locally as the Uba

15:20

tree. Its strong reddish

15:22

timber is often used

15:24

to build houses making it a target

15:27

of the illegal loggers. Rizdadeh

15:30

plans to plant it in an

15:32

area recently affected by a forest

15:34

fire. Well I wanted to join him

15:36

as he traveled into the national path to

15:39

plant the tree but unfortunately

15:41

the Indonesian government just

15:43

wouldn't give us access to the

15:45

protected area. So

15:49

instead he's taking me to

15:51

an area he calls the mini forest.

15:54

A small patch of land near the

15:56

clinic which is for all intents and

15:58

purposes just like the rainforest

16:00

across the border in the National Park

16:03

just on land owned by Astrid. It's

16:08

a bit wet from last night's rain. Yeah, yeah,

16:10

luckily we had

16:12

rain last night so it's good

16:14

for for us

16:17

especially for our reforestation program because

16:19

we need rain to clean the

16:21

seedlings. We cannot clean the seedlings

16:23

when no rain. So

16:28

we're entering the many forest area right now?

16:30

Yeah, so we are here and it's about

16:35

15 years after

16:37

Astrid funded. We can see

16:39

the difference, I mean the condition of

16:41

the National Park. The logging

16:44

is decreasing. Ruster

16:46

and his team have set up

16:48

13 cameras to both monitor

16:50

where the logging is taking place in

16:53

the National Park and to see

16:55

where the wildlife is returning to the forest.

16:58

All in

17:00

hidden locations so that they won't

17:02

be taken away or tampered with.

17:04

This is really wild already. We

17:07

have many species of birds here.

17:10

We can hear the forest every

17:12

morning almost all day

17:15

and if we are lucky we

17:17

can find given some

17:20

monkeys or even orangutan.

17:22

So it makes us feel relaxed. You're

17:42

listening to People Fixing the World

17:44

from the BBC World Service. We

17:46

just heard a report from Ade

17:48

Mardiati about a clinic in Borneo

17:50

that's cleverly giving people affordable health

17:52

care if they stop cutting down

17:54

trees and protect the

17:56

rainforest there. Now our

17:59

reporter Craig Landau. has been finding out

18:01

more about this project and just how

18:03

effective it's been. And Craig

18:05

joins me now in studio to tell us more and

18:08

as always it's great to see you Craig. Good to see you

18:10

Myra. Now I like this solution

18:12

because it's solving two problems right? It's

18:14

providing affordable health care but it's also

18:17

helping to stop people from cutting down

18:19

trees. Yeah exactly and one thing

18:21

that I found particularly interesting about this

18:23

is the whole psychology behind it and

18:26

so that's how you actually motivate people

18:28

to take an interest in something like

18:30

the environment around them and the idea

18:32

is that you know basic needs of

18:35

things such as food, shelter, security and

18:37

health need to be met before we

18:39

can focus on the things that might

18:41

not seem to be immediately affecting our

18:44

day-to-day well-being. So in this

18:46

case for example taking care of trees

18:48

wasn't necessarily a priority for these people

18:50

but health care was. Right yeah and nobody

18:53

wants to be that one person in a community

18:55

or in a village who goes off and chops

18:57

down some trees and then causes the price of

18:59

all of their neighbours health care to go up.

19:02

So I think that's quite a powerful motivator in

19:04

itself isn't it? It is, it is and

19:06

then you also end up having all the

19:08

community working to make sure the solution is

19:11

actually having an impact and speaking about the

19:13

solution Craig people were relying

19:15

on logging as a way of making money

19:17

so just giving them health care isn't enough

19:19

you also have to find a way to

19:22

replace that income. That's true Myra yeah

19:24

so some of Azri's other work actually

19:26

revolves around retraining local people so they

19:28

can find other ways to make money

19:31

as well as raising awareness around the

19:33

importance of protecting the environment too and

19:36

so for example they've got a small pot

19:38

of land next to the nursery and they

19:40

offer crash courses there in things like organic

19:42

farming and they also run

19:44

a chainsaw buyback scheme and what that

19:46

involves is Xloggers essentially being able to

19:49

sell their chainsaws to Azri for a

19:51

fair price and they can then use

19:53

that money to buy land or even to

19:55

start their own farm. I

19:57

mean Craig speaking about money money

20:00

doesn't grow on trees and

20:03

running a clinic is not cheap

20:05

so where do they get more

20:07

income to maintain this? So they actually

20:10

make money from the handicrafts that people bring

20:12

in because they sell those on and

20:15

they're an NGO so they also get

20:17

money from grants and charitable donations things

20:20

like that another thing

20:22

is that they recently won something

20:24

called the Ashdown Prize and that's

20:26

a prestigious prize for climate solutions.

20:29

Well so it's been about what 16

20:32

years since this clinic was built? Yeah.

20:34

Is there evidence that now shows that

20:36

this is working or that the rainforest

20:38

is actually coming back? That's a

20:40

good question Myra and that's something I've been wondering

20:43

about myself so I recently

20:45

came across a research paper by

20:47

an American team from North Carolina

20:49

State University and Samford

20:51

University. Skyler Hopkins was

20:53

the lead researcher on the project. After

20:56

10 years, Asri wanted

20:58

to quantify like is

21:00

this working right?

21:03

Like can we show that

21:05

this is improving the well-being

21:07

of these communities and then

21:09

also reducing deforestation? Just before

21:11

their clinic opened back in 2007 Asri surveyed

21:13

1,300 people living nearby asking

21:18

whether they were currently logging in

21:20

the national park. Skyler and her

21:22

team then followed up with these

21:24

same people 10 years later to

21:26

see if anything had changed. And

21:29

in 2007 almost 8% of

21:32

men were reporting that they were logging

21:35

on the international park and

21:37

by 2017 only 1% of men were reporting

21:42

that they were logging. We always have to

21:44

take this with a little bit of great

21:46

assault because these surveys were sort of

21:48

asking people to self-report behavior that

21:50

is negatively perceived right if they're

21:53

not supposed to be logging in

21:55

the national park and

21:57

they would like access to these

21:59

Asri services. right there could be people who are

22:01

afraid to say like yes I'm still doing

22:04

that but at least from that data

22:06

set there's a self-reported decline. They

22:08

didn't just rely on the self-reported

22:10

data though they also used satellite

22:12

imagery to determine whether logging had

22:15

actually reduced. You can get

22:17

pictures that are taken by a

22:19

satellite and quantify which pixels in

22:21

that picture have forested it

22:24

and which ones do not. Pixels

22:26

are those small units that make up a picture

22:28

when we view it on a screen like a

22:31

phone or a laptop. And so we

22:33

did that both for the

22:35

national park that is near

22:38

Asri and the medical clinic

22:40

and then also the other

22:42

national parks that are in

22:44

Indonesia because we wanted

22:46

you all to compare this national

22:48

park that has this intervention happening

22:51

with all the other national parks that don't

22:53

have a similar kind of

22:55

intervention. Each pixel represented a small

22:57

area of forest about 30 meters

23:00

squared. The researchers would

23:02

then examine each pixel year by

23:04

year to see when the forest

23:06

cover disappeared and the

23:08

results confirmed what the local people had said

23:10

in their survey answers. So after the

23:13

intervention started there was a 70% reduction

23:17

in forest loss. That's

23:19

a 70% reduction in forest loss

23:21

when compared to the other Indonesian

23:24

national parks included in the study.

23:26

And interestingly the researchers were even able

23:28

to break down the data on a

23:31

village by village basis to see which

23:33

of the 81 villages

23:35

monitored by Asri had cut back on

23:37

logging the most. And what we found

23:39

is that the villages that had

23:42

the high engagement with Asri were

23:44

the ones that really had reduced

23:46

forest loss within the boundary

23:48

near their village within the national

23:51

park. And then actually villages that

23:53

had pretty low engagement with

23:55

Asri we didn't see any change

23:57

there in their overall forest loss.

24:00

from 2007 to 2017. Skylar

24:04

found that the health of local people had

24:06

improved too, with a reduction in

24:08

rates of diseases such as TB and malaria.

24:11

And this is interesting, because we've

24:13

looked at similar projects using the

24:15

same approach of incentivising people, like

24:17

what we saw in Nigeria and

24:19

Turkey earlier this year. Yeah, so in

24:22

Nigeria, people were being offered health insurance, and

24:24

that was in exchange for going out into

24:26

the community and picking up litter off the

24:28

streets before taking it to be recycled. And

24:31

in Turkey, they were being offered points which

24:33

they could use to buy their groceries. Well,

24:36

to listen to that programme, just search

24:38

for picking up health care with litter

24:41

wherever you get your podcasts. But for

24:43

what we've heard today, Craig, thank

24:45

you. Thanks, Myra. That's

24:51

all we have time for today, but

24:53

before I finish, do you think that

24:56

this solution could work where you live?

24:58

Or have you come across any other

25:00

ideas doing something similar? Go

25:02

ahead and send us an

25:04

email to peoplefixingtheworld at bbc.co.uk

25:07

and tell us all about

25:09

them. I'll be back

25:11

next week with more great solutions, but

25:13

until then, thanks for listening.

25:20

Something mysterious plagues County Mayo on the

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west coast of Ireland, and its legendary

25:24

Gaelic football team. I believe in the

25:26

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