What Does Planetary Health Mean to You?

We interviewed the members of our Executive Director’s Advisory Group: Dr. Alex Domingo, Dr. Monica Nirmala, and Jeremy Pivor. We asked them to share how their time at ASRI impacted their personal and professional lives. We also asked each member of the team to explain what planetary health means to them, and how putting it into action can have a positive impact on humans and the world we live on.

Dr. Alex Domingo

Dr. Monica Nirmala

Jeremy Pivor

Dr. Alex Domingo

The following is a story Alex shared with us about his personal and professional journey, and his discovery of the academic discipline of planetary health.

When my family arrived to take care of my grandparents’ farm, my father took me on a walk around the property. He described childhood memories of sinking to his knees into the farm’s dark, rich topsoil. What remained there were a few centimeters of black soil on top of brown, dusty clay that was no longer productive without the addition of fertilizers.

“As a child, I felt the conventional farming practices responsible were acts of violence, robbing the Earth of its fertility with unfortunate, if not ignored consequences for human health.”

At about the age of 10, while participating in a Lakota sweat lodge ceremony on our farm, it was my turn to give a prayer. I asked the Great Spirit to guide me in working to help humans live more consciously and in greater harmony with Mother Nature. As the son of two spiritual healers, I was also inspired to find a way to work individually with patients.

In college, I began the journey toward my vision by pursuing a combination of pre-medical and environmental coursework, along with research in public health and sustainable development. It was far from clear how I could weave these subjects into a cohesive career path that satisfied my heart, and even less clear in my first years of medical school, when environmental courses were no longer available.

By then, I had spend a lot of time in both college and medical school trying to fit into what my institutions seemed to want of me, which was doing research in more well-established fields of inquiry that felt tangential to my passion. Luckily, in my final year of medical school, I was able to spend 6 weeks on a medical rotation at ASRI.

There, I was exposed to my first (and what remains the most) powerful example of how caring for the health of people could be effectively coupled with caring for the planet. I came back feeling incredibly inspired, empowered, and reconnected to the vision that had started me on my journey from childhood.

What does planetary health mean to you?

Since my visit to ASRI, an entire academic discipline called Planetary Health emerged, which gives further shape to the topic of human health in the context of our ecosystem. Within this body of literature, authors have called upon physicians to help communities understand and address health problems caused by interactions between humans and our environment, such as those related to air pollution, climate change, and zoonotic disease – issues that also tend to disproportionately impact our society’s most vulnerable populations. [1]

I cannot express how thrilled I am to be alive today to answer this call, and to begin my career in medicine at such a pivotal point in history.

1. Xie, E, Falsetto de Barros, E, Abelsohn, A, Stein, AT, Hains, A. Challenges and Opportunities in Planetary Health for Primary Care Providers. The Lancet: https://www.thelancet.com/journals/lanplh/article/PIIS2542-5196(18)30055-X/fulltext

What field and role are you working in now?

I am currently a 3rd year Family Medicine Resident at Oregon Health and Sciences University (OHSU).

Aside from the gratifying work of providing full spectrum patient care from the prenatal period to the end of life, I’m honored to serve on OHSU’s Sustainability Steering Committee, as well as its Curriculum Subcommittee. Through this work, I’ve had the opportunity to give OHSU’s first lectures on Climate Change and Healthcare to both the School of Medicine and the Family Medicine Residency classes of 2020. I participated in the creation of the first university-wide course on the topic.

I also have the privilege of working with Health In Harmony and ASRI by assisting with their Planetary Health Curriculum and serving on the Advisory Committee to the Executive Director. I’m excited to see what the future holds as I prepare to graduate from residency next year.

I’m forever grateful to ASRI and Health In Harmony for helping me to reconnect to my calling, and for the inspiring work they are doing around the globe.

Dr. Monica Nirmala

How has ASRI influenced your life?

Tremendously. I have grown professionally with ASRI since I finished dental school in 2012. Six years of work in Sukadana has shaped my views on environmental issues, rural health in Indonesia, and the power of teamwork – and friendships! In particular the power of teamwork among both local communities and people 10,000 miles away across the oceans, cultures, and all ways of life.

I’m so grateful for the people I was able to connect with through my work at ASRI and for all the experiences that have shaped me to become the person I am today.

This invaluable experience has also opened up multiple doors of opportunities for me, including becoming a Fulbright scholar and obtaining an MPH degree from Harvard University.

On a personal level, the experience has brought more clarity on the purpose and trajectory of my life. I think this is especially important, as I’m now embarking on a new career journey after completing my studies.

What field and role are you working in now?

I’m mostly working on the COVID-19 response in Indonesia at the moment. I’ve been advising at both the national level and at a number of district level task forces. I was also invited to speak quite a few times for national TV and professional webinars.

I’m glad for the opportunities to share my views on public health, and more urgently, planetary health, especially as Indonesia is entering the “new normal.”

During this interesting time (AKA lockdown), and while trying to help in various capacities, I’ve also spent a lot of time reading journals, listening to webinars and podcasts, and pushing myself to write more.

What does planetary health mean to you?

To me, planetary health has key guiding principles:

  • What is good for nature, is good for myself.
  • What is hurting nature, is eventually hurting myself.

COVID-19 is a perfect example of this.

Life is full of trade-offs – we can’t have it all. Planetary health is about prioritizing the greater good over my selfish immediate wish, which will eventually turn to my own good too in the long run. It is about choosing health for all.

“Health is (or should be) a public good. It should be non-exclusive and non-competitive. The air we breathe, the water we drink, the planet we live in should stay healthy, so that everyone can live healthy lives. This is planetary health to me.”

Jeremy Pivor

How has ASRI influenced your life?

ASRI has influenced me in profound ways. Having spent six months working and living alongside the ASRI team, I went from feeling like a stranger to a member of the family. Their kindness, empathy, love for life, and appetite for delicious foods are all qualities I try to emulate every day.

As the research coordinator for the 2017 community health and environment survey, I not only spent time in Sukadana, I also traveled to 23 villages surrounding Gunung Palung National Park. The health and environmental disparities that were shared with me, and those I saw firsthand, strengthened my resolve to dedicate my life towards health and environmental justice.

Yet, the wonderful thing about my time at ASRI was that the focus was on the solutions, not the problems. It was the first time I saw how community-driven solutions to address human and environmental health could be collaboratively set into practice through innovative strategies, and developed with the ability to replicate them.

As someone working directly in the planetary health field, I feel incredibly fortunate to have spent a significant amount of time at ASRI. By doing so, I not only know that planetary health is possible, but also what it looks like in action.

What field and role are you working in now?

I am the Senior Program Coordinator with the Planetary Health Alliance (PHA). PHA is a consortium of over 200 partners from around the world committed to understanding and addressing global environmental change and its health impacts.

As PHA moves into its new phase of development, my role, along with the PHA team, is to steer the Alliance towards transforming knowledge to action as we continue to grow the planetary health field. This among other activities includes community building, education, and outreach.

What does planetary health mean to you?

For me, planetary health simply means the health of people and the natural systems we all depend on. It includes not only our relationship to the Earth, but also our relationships to each other.

“It is a society in balance with the Earth, which we are all a part of.”

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