I remember the first time I ever saw a patient pay for medical care with tree seedlings at the ASRI Clinic. Pak Hamsu, a patient from the village of Laman Satong where our main reforestation site is located, had amassed medical bills totaling over $375 at the ASRI Clinic after he had a severe stroke in April 2013. When he finally died, his family did not have enough money to repay the debt. So his nephew Jhony repaid the debt the only way he knew how: raising tree seedlings, grown from the seeds collected in the nearby forest that his village has protected for generations.
That got us all thinking. It is a terrible feeling to ask a poor patient’s family to settle outstanding medical bills after the patient has died. But we also have to cover costs to keep our clinic’s doors open so that we can keep treating patients. What if we starting attacking the debt problem more creatively, by making it easier for patients to repay debt with tree seedlings that we could later plant in degraded areas of Gunung Palung?
Fun Fact: If you just remove one letter from the word for “debt” in Indonesian – hutang – you get the word for forest – hutan. It’s like it was meant to be easy to turn debt into forest.
So we discussed this idea with our community partners, especially the Forest Guardians. They were totally enthusiastic – but they also reminded us that being in debt is a huge social stigma and a shameful condition that people will go to great lengths to hide. To remove the association between tree seedlings and debt, they suggested another option – why not prevent debt in the first place by allowing patients to create “savings accounts” with seedlings?
Again, this was totally brilliant. Our goal at ASRI is to make sure that the sudden, unexpected cost of a health emergency does not bankrupt families or bankrupt the forest. Banking seedlings in advance could also help chronically ill patients or pregnant women who need routine medical checkups.
Since we started offering this option, over 50 patients have banked 4,256 seedlings representing 28 species and worth a total of Rp. 25 million (about $1,900). We hear reports that there are thousands more seedlings in the pipeline from villagers setting up their own “savings accounts” at ASRI.
The “seedling banking” option has been wildly popular in the villages where ASRI runs the mobile clinic. These places are rich in natural resources but do not operate on the basis of a cash economy because few people have cash-paying jobs. Our Reforestation Coordinator Pak Frans just went to the village of Pangkalan Jihing last week to pick up 2,000 tree seedlings (and it took him 8 hours to get there because the road is flooded and practically impassable). Because there is no medical care there, the villagers depend on ASRI’s mobile clinic and with the seedling payment option they literally depend on the forest to be able to pay for medical care.
From an ecologist’s perspective, this system has been fabulous for increasing genetic diversity within the site. Rather than planting thousands of red meranti seedlings from the same parent tree, we are getting meranti seedlings from parent trees throughout the landscape. This increases the site’s resilience to disease and helps re-create the biodiverse richness of the natural forest that we are trying to restore.
This system is also helping to build our stock of hard-to-obtain tree species, like belian or Bornean Ironwood. One of the first patients to create a savings account last year, Pak Saifal Akhyar paid with 213 ironwood seeds collected from his family’s own traditional tree garden (you may have read about him in Health In Harmony's year-end mailing in 2015). This was a rare gift – Ironwood trees are one of the slow-growing giants of the rainforests of Borneo – their timber is prized for construction and boat building, and they are undoubtedly the most highly targeted species for illegal logging in Gunung Palung (which means it is almost impossible to get seedlings!). Every time I visit the nursery, I notice a new belian seed has sprouted even after almost a year of lying dormant, and I feel thrilled that we will be able to plant healthy ironwood seedlings to replace the stumps of the forest giants that remind us of the forest the site used to be before it was logged.
For just $2.00 you can buy a seedling and pay for a patient’s health care and cover the cost of planting, watering and maintaining the seedling for a year.
Purchasing 12 tree seedlings ($24) can offset the cost of the average medical bill at the ASRI Clinic. 50 seedlings ($100) pays for multiple ultrasounds and pre-natal care for an expectant mother. 125 seedlings ($250) can ensure that five nights of inpatient care for serious illnesses will not force a family to choose between food and medicine – or medicine and the forests that safeguard their future. Donate to turn debt to forests today.