The Right to Health: Part 2

This is part two of a two-part series exploring the right to health, how the right is connected to our mission and to our goals for scaling-up, and how your support is vital to our work. You can read part one here.

In the prior post, I talked about the major sacrifices that many people around the world must make to ensure their health. Sacrifices like choosing to stay in their home, even though harmful activities pollute their only source of drinking water, thus, shortening their lifespan, because moving somewhere else isn’t a financial option. Or choosing to participate in a certain line of work, even though dangerous conditions are present, harmful contaminants and chemicals are used, and the risk of death is shockingly high because safer jobs just aren’t available. I pointed out that, while these sacrifices might provide shelter and food for the present, they do not ensure long-term well-being, and reminded us that, because they do provide people with the opportunity for making choices, we can’t really call them sacrifices.

I also talked about the right to health – an internationally recognized fundamental part of our collective human rights and of our understanding of a life in dignity. I described the right to health in detail – explaining how it includes more than just the right to see a doctor in a hospital. That it extends to the underlying determinants of health – those factors that decide whether it is even possible to be healthy where we live – and contains certain freedoms and entitlements. I then detailed right to health challenges, described how developing nations compare to the US when it comes to addressing and overcoming these challenges, linked the right to health with our conservation goals, and listed the ways in which we might apply a right to health framework moving forward. If you haven't read part 1 yet, you can read the full post here.

Today, I don’t want to talk about right to health in a hypothetical way, because, for many people, right to health challenges are not hypothetical – they are real. They harm families. They harm children. They harm our global communities and our ecosystems.

Instead, I want to talk about the right to health challenges that community members face in a real place – a place close to where we work now. This past July, your support made it possible for Hotlin Ompusunggu, co-founder of Alam Sehat Lestari (ASRI), and I to conduct a site visit at Bangka-Belitung (Babel), an island province located on the east of Sumatra. We visited Babel with the right to health in mind – recognizing the connection between conservation value and right to health challenges present in the region and considering whether Babel might be a site where we can scale-up our model.


This July, Hotlin and I conducted a site visit at Bangka-Belitung (Babel), an island province located on the east of Sumatra. | Photo: Bethany Kois

The Location

Bangka-Belitung (Babel) is an Indonesian province on the east of Sumatra. It consists of two main islands – Bangka and Belitung – measuring 1.6 million hectares along with other small islands such as Lepar, Pongok, Mendanau, and Selat Nasik.

In total, there are 470 islands, of which only 50 are inhabited. Surrounding these islands are critical marine ecosystems and mangrove forests. On the islands themselves are terrestrial forests that are home to a diverse array of plant and animal species including the endemic Belitung tarsier. The International Union for Conservation of Nature (IUCN) has classified the Belitung tarsier as Endangered, “due to a severe restriction of its geographic range on Belitung Island” meaning that “its extent of occurrence is less than 5,000 (square) kilometers and the known populations are severely fragmented." Babel is also home to a human population of approximately 1.26 million people and its economy is highly resource-dependent, relying on fishing, plantation agriculture, tourism and, most heavily on it's largest sector – tin production. While tin mining is important for Babel, it is equally or more important to the continued production of the global tin supply – Indonesia is a top five producer of refined tin.

Refined tin consumption falls into three main categories: tin-based solders, tinplate, and tin stabilizers. The manufacture of tin-based solders, used in the electronic products industry, primarily in the production of semiconductors, makes up for more than half of tin consumption. Semiconductors are key components of nearly all the electronic products sold, including products such as computers and telecommunications equipment. Tinplate, used in packaged food, accounts for approximately 17 percent of the tin market and tin stabilizers, used in pharmaceuticals (medical devices) and food packaging, accounts for about 15 percent.


The Right to Health Challenges

Babel is under threat from numerous large-scale mining activities. Three-quarters of the area is under mining license by PT. Timah, PT. KobaTin, and other local mining companies whose numbers fluctuate. Each year, 5,400 hectares of forest and agricultural land in Babel is converted into mining areas. This mining encroachment presents serious right to health challenges.


The child of a woman who participates in artisanal mining in Babel playing in the contaminated mine site. | Photo: Bethany Kois

Mining in Babel violates the right to health by reducing healthy environmental conditions as well as access to safe drinking water and adequate sanitation. Abandoned mines cover approximately 1,053,253.19 hectares or 64.12% of the land in Babel. The worst destruction is on Bangka itself, which has a surface area of 810,059.87 (76.91%) hectares. Most of the destruction is caused by tin mining operations abandoned by PT. Kobatin and PT. Timah, as well as by the community’s artisanal mining. The damage has caused:

  1. pollution in the Rangkui river
  2. destruction of protected forest in Bukit Menumbing and Mount Muda
  3. devastation along the shorelines
  4. heavy damage in the watershed

A typical alluvial mining site, predominant in Southeast Asia where shallow deposits of fine-grained minerals accumulate in riverbeds and deltas. Gravel pumping, pictured here, uses high-pressure water jets to break up and dislodge the tin-bearing sand. A submerged gravel pump then sucks up the slurry and transports it along to a series of sluices. As the slurry moves, the heavy minerals, including tin, fall into baffles while the lighter minerals flow into the waste sluices. | Photo: Bethany Kois

The effects of mining on the marine ecosystem and on the lives of local fishermen is told by Mr. Hasan from Sungai Liat village and Mr. Sidik from Belinyu village,

“Before the coming of Suction Vessels (KIP), villagers here were operating some 2,000 vessels of 3-6 GT size. The pollution caused by mine tailings from KIPs has turned the water muddy and killed many coral reefs. This has caused a decline in the quantity of fish we are able to capture and led the fishermen to fish further down at 10-20 miles offshore. Most fishermen vessels, however, do not have that kind of range, so only a small part of the fishermen stick with the profession while most others turned into miners and modified their vessels to become PIPs. This has driven fish catchment even further down causing fish prices to become very expensive.”

Mining in Babel also violates the right to health by reducing access to entitlements such as the right to prevention and control of diseases. Indonesian law requires reclamation of mining sites to prevent, among other environmentally destructive problems, increased mosquito populations that rapidly reproduce in locations containing standing water – like abandoned mines. Unfortunately, due to the lack of law enforcement regarding reclamation of post-mining locations, mining pits have become a source of diseases like dengue fever and malaria. Bangka and Belitung’s Health Service data show that Sungai Liat and Mendobarat have the highest levels of dengue hemorrhagic fever (DHF) and these levels have increased annually since 2005.

Further, there is increasing evidence that mining in Babel violates other human rights including the rights of the child to be protected from economic exploitation. A 12-year-old child from Mengkubang village said,

“I’ve been collecting tin since the age of 10. Easy work, easy money. I used to get 80 to 100 thousand rupiah (about $6 to $8 USD) per day. I can buy snacks, clothes, and help my parents. Nowadays, more people are mining, so I can only get 30 to 60 thousand rupiah ($3 to $5 USD) per day. I want to be a tin miner when I grow up. No need for school.”

These challenges are unacceptable. Human rights violations negatively impact all us – our collective global communities and our ecosystems. It is on us to stand up for each other, to push for change, to offer help, and to work toward global solutions.


A days worth of hazardous work provides this woman with a handful of fine-grained cassiterite (SnO2) minerals. | Photo: Bethany Kois

The Potential Partners

It seems clear that improving the health of Babel’s environment means also improving the health of the community. But, what can we do? Our historic success – our impact – has been in reducing illegal logging among the communities living around Gunung Palung National Park. How do we begin to think about remedying the right to health challenges that Babel community members face? Hotlin and I weren’t sure. We knew we needed more information and that the best way to gather information is directly from the source. So, we met with a number of local, passionate social entrepreneurs living and working in the region.

First, we met with Kelompok Peduli Lingkungan Belitung (KPLB) – an organization founded by Budi Setiawan in November 1997. The structure of KPLB consists of three divisions:

  1. advocacy and environment campaigning
  2. education for youth
  3. community empowerment and alternative livelihoods

KPLB believes that, in order to save the environment, advocacy and campaigning work must happen, but it must happen alongside education and motivation of young people and that this education is most effective when it demonstrates practical examples – like livelihoods that are alternatives to unsustainable mining – of how using natural resources in a sustainable manner can have positive economic social impact on society. KPLB has worked with numerous partners to develop and implement their projects including UNDP, UNEP, GEF Small Grants Programme Indonesia, Telapak Indonesia, Lembaga Ilmu Pengetahuan Indonesia (LIPI, the Indonesian Institute of Sciences), and various offices of Indonesia’s government.


Meeting with members of KPLB | Photo: Bethany Kois

Second, we met with Wahana Lingkungan Hidup Indonesia (WALHI) – an organization established in 1980 in response to the injustice in the use and access of natural resources and basic essentials that support livelihoods in Babel. WALHI advocates for a fair and democratic social, economic, and political system that guarantees basic rights to livelihoods and a healthy environment for Babel’s people. WALHI’s successes over the years include climate changes studies, discussion and introduction of energy and climate change programs, environmental awareness campaigns, and active involvement in the negotiation rounds of the UNFCCC, REDD advocacy and climate finance as well as safety mainstreaming of women in climate change resolution.

We also spoke with Telapak Indonesia – an association with extensive experience in investigation and monitoring on the use and management of natural resources in Indonesia. The mission of Telapak is to raise a natural resource management regime that advocates for justice between human populations and elements in nature. Telapak has worked with Apple Inc. to investigate Babel’s mining communities with a goal of collecting untold stories, identifying the real problems and needs of the local people – including their ideas about long-term solutions for the problems they face, for the mining companies, and for the environment.

These passionate social entrepreneurs learned, through research, community discussions, and focus groups, that, in locations where family economics depend on the tin supply chain, practical solutions must be aimed at creating alternatives to tin mining livelihoods in order to improve and guarantee the ability of local people to provide for themselves. After our meetings, Hotlin and I realized that, like us, these organizations truly focused on listening and on doing things right at the village level. This observation was exciting! It meant that, in Babel, there is potential for collaborative partnerships between these local organizations and ours. We may have an opportunity to assist in overcoming Babel’s right to health challenges.

What’s more, we learned that the groups we met with had also talked with major corporate players associated with or directly involved in the tin supply chain. They learned that, for many of corporations, financial gain is not the only aim – circumstances are changing and corporate shareholders are beginning to recognize that financial sustainability has much to do environmental and social resilience. This is also exciting because it means there is potential for positive collaboration between corporate players and communities. I don’t think we could have said that five years ago.

The bottom line is this – there is a tidal wave of change happening in the world. It is kept moving by passionate people like these and by people like you! Together, we are beginning to raise all ships. That is huge.

Your donations helped support the site visit Hotlin and I made to Bangka-Belitung this past July. For that, we are immensely grateful!

Let’s not stop there. Let’s keep the momentum going. Let’s work to implement solutions where it matters most.

Where do we go from here? We’ll keep you posted on whether we think Bangka-Belitung is a good location for scaling-up, and about what we might do next. Please share your thoughts and ideas with us too! If you'd like to help us take this life and planet-saving model around the world, please donate today to ensure that we can continue making site visits to potential locations for scaling-up.


About Bethany Kois | View all posts by Bethany Kois

Bethany is the Research Director at Health In Harmony, based in Charles City, IA.