The roosters were still asleep when Sri Wayunisih woke her daughter, Puteri. They could not afford to sleep till dawn.

Wayunisih had taken a day off from working on the oil palm estates and Puteri had skipped school for this trip. The two of them were heading towards Sukadana, a coastal district in south-west Borneo and the capital city of North Kayong, home to the only clinic in the area, some 80 kilometers away.

An hour and a few wrong turns later, Wayunisih and Puteri reached the clinic. It was just past 5 a.m. By 8 a.m, a small crowd of 15 adults and children sat on the clinic verandah.

It was Friday, the least busy day of the week. Any other weekday would see all 40 chairs on the verandah filled.

Everyone in the room sat facing the eastern wall featuring a large white sculpture of a tree growing out of dense undergrowth, hornbills flying out of its canopy, the letters ASRI carved on its trunk.

ASRI stands for Alam Sehat Lestari, Indonesian for 'healthy nature everlasting' or 'harmoniously balanced'. It's the name of an Indonesian non-profit organisation based here in North Kayong on the western border of Gunung Palung National Park.

North Kayong is more than five times the area of New York City. The monthly income averages around 2.45 million rupiah (US$181), but one in ten residents make do with just 250,000 rupiah a month (<$20), much less than the World Bank's $1/day threshold for poverty.

The obvious fact is: people need to earn a living to survive. In desperation, many fathers and sons log and burn the edge of the national park for timber and farmland.

Conservationists speak of the park's 108,000 hectares of swamp, lowlands and montane forest, which together house sun bears, hornbills, gibbons and about 2,500 orangutans. But to local people strapped for cash, the trees look like fixed deposits to be withdrawn in entirety.

For many in North Kayong, healthcare is a dream and emergencies a nightmare. But if paying for a doctor is difficult, at least choosing one is easy: In 2016, there were only 168 nurses, 15 doctors and one dentist in the regency. Five of those doctors and that one dentist work in the clinic that Wayunisih and her daughter braved the dark road to reach, and it is here that ASRI has concentrated its efforts.

Since 2007, ASRI has been working with communities around the national park to improve the wellbeing of both humans and the environment.

It started by setting up a clinic that provides villagers with not just the most extensive healthcare services in the area, but also incentives to stop them from logging in the park. The clinic offers up to 70 per cent discounts on medical fees to villages that stop logging, and ASRI aims for this to pile pressure on loggers to stop.

Patients who cannot afford medical fees, and so might otherwise resort to illegal logging, can choose to pay with various non-cash options, including native seedlings or labour. ASRI also replants forests and trains ex-loggers to farm and run alternative businesses.

ASRI weaves healthcare, finances and conservation into one tapestry -- a vision printed on the uniform of its conservation staff: "Masyarakat sejahtera, hutan sehat" (Prosperous society, healthy forests).

This concept is now often referred to as 'planetary health', a term coined by the Rockefeller Foundation--Lancet Commission in 2015 to inspire research and action. But the beginnings of ASRI came more than a decade before that.


Selling trees to pay for medicine

Back in 1993, when the then 21-year-old Kinari Webb first visited Gunung Palung National Park to study orangutans, the locals "had nothing" in terms of healthcare. While she tracked orangutans in the national park, she regularly heard the sound of chainsaws in the forest. The ground shook every time a giant tree fell.

Webb wondered if there would be any forest left for the orangutans she was observing. She spoke to loggers and learned that they cut and sold trees to pay for medicine.

"What would you do to get healthcare? What would you do if your child is sick? Just about anything," says Webb, a medical doctor from New Mexico, USA, and the founder of ASRI.

In 2006, Webb formed a team and applied to open a clinic in Sukadana. The two-month application slowed to a six-month drag but finally, in July 2007, it opened.

Webb and her team went to all of the villages around the national park and conducted formal surveys -- or "radical listening", as she calls them.

The villagers requested two things: training in organic farming¬ -- meaning they wouldn't have to buy expensive chemical fertilizers and pesticides -- and quality healthcare that they could afford.


Engaging the village

At 9 a.m., Wayunisih was waiting by the room of Dr Alvita Ratnasari, a general physician. Wayunisih hoped the rumors about ASRI giving away free glasses were true, because she and her daughter hadn't been seeing well lately.

ASRI started giving out eyeglasses in early 2007, hoping the handouts would engage the villages around Gunung Palung National Park. In those early years of the program, there was not a day when you couldn't hear chainsaws, says Webb. It reminded the team of the urgency of their work.

ASRI first focused on healthcare and farm training in an attempt to sever the locals' dependence on illegal logging. Then, in 2009, the national park office assigned 20 hectares to ASRI's maiden reforestation project. By 2013, ASRI had reforested almost 20 hectares, only to suffer a ravenous fire that consumed all but half a hectare.

Since then, the conservation team has replanted 16 hectares. This feat has demanded much effort and about 121,000 seedlings, many of which were contributed by clinic patients. Since 2007, nearly 900 patients have paid their medical fees with native seedlings -- mostly from fruit trees growing in their villages.

It's worth saying that ASRI's belief in reforestation is not universal among conservationists.

Andrew Marshall, a tropical ecologist at the University of Michigan, describes ASRI's reforestation efforts as worthwhile, but thinks that protecting the remaining forests is a much cheaper and more effective approach than kick-starting regeneration.

"It's just really hard to grow back tropical forests," says Marshall, who has spent 21 years in Gunung Palung National Park, adding that we won't know if it works until well after we're both dead.

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