Healthcare in the Jungle: Traveling to ASRI

This is the first in a series of posts from guest blogger Jane Lester. Jane is a pediatrician from Seattle who spent five weeks with our pilot program Alam Sehat Lestari (ASRI). She shared with us her experiences planting native rainforest trees, working with ASRI doctors and living at the clinic.

Dr. Jane Lester (with ASRI's famous "kissy face" orangutan mural!)

After my speedboat ride from Pontianak, we took the short drive to the ASRI Clinic and a downpour started. I settled into my wonderful house with six female staff members from ASRI. We each had our own bedroom, a kitchen, dining area, sitting area, bathroom with squatter toilet and bathing facilities (water tank) and, lucky for me, a little room off the laundry area with a sit toilet! ASRI welcomed me with a fan, box of Cocoa Puffs, oatmeal, cookies and milk for breakfast. Spongebob and Patrick were painted on my walls and my bed had a huge rectangular mosquito net which makes it look like a princess bed! I ate a delicious dinner made for me by our cook, showered and went immediately to sleep to the sound of rain on the roof and my housemates talking in the common area,.

The food here is wonderful. Early on I realized many dishes include little fish with bones or chicken parts, and since I do not like bones or chewy bits, Nina suggested I go on the vegetarian plan. Now I get tofu, tempeh or eggs at every meal. The rice and noodle dishes and curries are amazing. I learned that tempeh was invented in Indonesia, and at little stores you can buy a warm-to-the-touch, bubbly, fermenting pack of tempeh.

Enjoying a well-deserved break on the beach

On my second day we visited the main reforestation site, where the ASRI is replanting hectares of rainforest. It is an impressive operation! The foresters collect seeds from nearby Gunung Palung National Park in seasons of heavy fruiting, and grow them in a shaded sort of greenhouse. They also collect seedlings from the park and grow them; these are affectionately called wildlings. (That word always makes me want to break into song: Wildlings, you make my heart sing, you make everything, groovy.) The coolest thing is an orangutan corridor completed over seven years. There was cleared farmland in Gunung Palung National Park, as well as pockets of communities living in the park that cut off the orangutan’s access to other sections of the park. The ASRI replanted native species across this corridor in order to connect the park’s islands of land. Camera traps set up in order to monitor orangutan movement now show orangutans moving across the replanted corridor. We hiked through re-planted areas and saw baby ironwood trees (the granddaddy of the rainforest, some trees are 3000 years old), as well as stumps of logged trees. We were each able to plant one of the 30 native rainforest trees that the ASRI plants.

I just picked “water spinach” for tomorrow’s lunch from the ASRI garden (note water bottle and fan in hand...always!)

One day near the end of lunch time (both medical staff and conservation staff at the ASRI, eats a home-cooked lunch together) we heard squeals from people downstairs. It turns out a six-foot monitor lizard had just waddled down the main hallway of the building and was now trapped in the future operating room. Everyone gathered around to see. A bit later she vomited up a frog and the frog hopped away. We then left the doors to the outside open and closed all the others, and pretty promptly she made her way back to the forest.

Patients at ASRI pay in three ways: national health insurance, cash, or non-cash payments. The latter includes manure, seedlings, rice husks or eggshells used for compost, handicrafts or labor. ASRI relies on big grants for about 50% of their funding, and private donors for the rest. There are four Indonesian family practice doctors seeing patients, without appointments; patients arrive early in the morning and wait on the front porch until they are checked in. Each doctor has an exam room, and sees patients when they are ready. They invite me in to consult when they have a question, and between patients we talk about interesting cases. The building has five inpatient beds, a labor room, emergency bed area, busy dental clinic, and limited lab and X-ray. Yesterday a man in his thirties arrived with history of fifteen days of increasing fever and stomach discomfort, and is being treated for typhoid fever, which is endemic here. It is contracted by drinking the tap water, which comes from the river. This patient was admitted and will stay until he is well enough to travel home.

At the beautiful beach!

I sometimes wake up very early, get up and shower, have breakfast, and go on a morning bird-watching walk behind ASRI. One morning there were huge crashing movements high in the trees and I spotted a red monkey. Took me a few moments to get my binoculars focused through all the branches on the monkey, and as soon as I did, she was looking right at me! Then a second red monkey: a male and a female with a baby clinging to her chest, moving about and eating leaves high in the canopy. As I was enjoying this, more crashing happened, and a troop of a dozen smaller gray monkeys with crests of fur on their heads cruised along the treetop highway, one by one, in the opposite direction. Once again, whenever I trained my binoculars on an individual monkey, she was looking right at me. I was being watched. Turns out the red ones are maroon langur monkeys, or maroon leaf monkeys, not super common. The gray ones are long-tailed macaques which have become pests; they live near people and are crowding out other species. Better than the zoo!

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About Emily Ausman | View all posts by Emily Ausman