November – December 2011
Giving the gift of life
Healthy children, clean water, and healthy forests
Imagine holding your third child in your arms and panicking. She has the same illness that killed your first two babies – diarrhea. Your baby is floppy and looks like she also might not make it but you rush her to the best health care anywhere around, Health In Harmony’s Klinik ASRIin Sukadana, West Borneo. There the team immediately rushes your baby in, recognizing she is really sick. Your newborn gets an IV, loving care, and oral rehydration. Within one day she is laughing and giggling again, and you breathe a huge sigh of relief.
A mother and her baby at Klinik ASRI
But at this strange clinic, it doesn’t stop there. The nurses come and talk to you about boiling your water, and ask you where you get your drinking water. Two hours from the village you answer. “Wow, no wonder you sometimes have to make do with river water.” Then the nurse checks with the baseline survey which measured health statistics and attitudes about the rainforest. “Hmmm,” Wilfrimus says, “Yes indeed, we measured high rates of diarrhea in your village and it is one of the villages which we recently got a grant from Water Hope to put in some wells.”
But a well is not enough – a well needs a pump. Because Health In Harmony believes in sustainability and health for the whole planet, they have been working with a volunteer, Patrick Ryan, on developing foot-powered treadle pumps that can be fixed and maintained right in the village. These pumps also do not require expensive, polluting gasoline.
“Wow,” you think – “This is great, not only was my baby’s life saved, but I can look forward to a well going in in my village soon to prevent diarrhea in the first place!”
So now, you are ready to pay. The cashier sits down with you and explains about payment at the ASRI clinic. You can pay with cash if you choose but you can also pay with seedlings or manure. “Are you kidding?” you ask. Nani, the cashier explains why the clinic accepts such strange items. “We use the seedlings and manure for reforestation. This year we planted another 17 acres of destroyed land in the National Park with over 25,000 native tree seedlings. We have now reforested a total of 45 acres over the last three years!”
(For even more detailed program updates, see below)
By working together, Health In Harmony and the local communities in West Kalimantan, Borneo are re-growing rain forest, critical habitat for orangutans and an essential watershed for the surrounding villages – ensuring healthier communities locally and a healthier planet for us all.
But all of this is only possible with your help! Please consider a donation to Health In Harmony. You will save lives and save rain forest, helping make a healthier planet for us all.
This holiday season we wish you all Health and Harmony.
- Kinari, Nichol, Toni, Kari, Rosevan and the HIH team
More Detailed updates from our programs in Indonesia:
Reforestation – Klinik ASRI – Water Hope partnership
Year 3 of Forest Reforestation Plantings is completed! Over the past six weeks, reforestation efforts have focused on the planning, land preparation and plot layout for the planting of over 17 hectares of reforestation plots in the Imperata cylindrica (highly invasive exotic grass) dominated lands inside Gunung Palung National Park. The seedlings have been planted adjacent to our 2010 and 2009 efforts and brings the grand total of plantings to over 45 acres, half of which incorporate experimental trials and monitoring to determine the most cost effective and successful methods. As plantings took place, we took a look around to see how the seedlings were doing from the past 2 years.
 Cam Webb admires the 2011 stock of native tree seedlings before planting commences. |
 Seedlings from 2009, now 2 years old, are towering above the invasive grass we are trying to combat. Once shaded, the grass can no longer thrive. A forest is taking root! |
 Tim Treuer, long term reforestation volunteer, surveys an experimental plot of Sungkai (Peronema canescens) pole plantings from 2009. The cut poles, less than 1 meter tall when planted, are beginning to create a canopy taller than Tim's 2 meter height! |
KLINIK ASRI
David Karam, a recent medical volunteer, comments on his experience at Klinic ASRI.
‘Six weeks ago I was graciously welcomed into the ASRI family. In that time I’ve met fascinating patients and encountered incredibly interesting and diverse diseases. Some fall into the category of “tropical medicine,” though most of the diseases we treated during my time here were cases of “bread and butter medicine” — diseases affecting all people of the world, regardless of their latitude. Here are a few recent cases I have found noteworthy.
- We had a 32 year old father came to the clinic, who ten hours before arriving at clinic ASRI was, by his own account, entirely healthy. His symptoms started suddenly with paroxysms of flank and pelvic pain, so severe that he lost consciousness twice while at home. For ten hours he was unable to urinate, except for a few drops of bloody fluid. His symptoms suggested some kind of a urinary tract obstruction, but if you were to look up the causes of such an obstruction in American medical texts (I’ve checked several) the etiology of his ailment would likely not be found. Even so, his diagnosis was suspected immediately by the Indonesian doctor on call, and confirmed with a single question. ”Did you recently eat djenkol?”
Few foreigners are aware of djenkol (also spelled jengkol), a bean commonly eaten this time of year in the region. Nor are they aware of it’s potential toxicity, a well described phenomenon which occurs sporadically and, for unknown reasons, disproportionately affects men more than women. Djenkol toxicity involves precipitation and crystallization of djenkolic acid, found in the bean, within the kidney tubules and urinary tract. Untreated, this can rapidly lead to
renal failure. In this man’s case, with prompt placement of a urinary catheter and aggressive intravenous hydration his symptoms improved with time. He remained at ASRI for a few days before returning home, and when seen in clinic for follow-up one week after discharge he was feeling well, already back to work as a driver.
- Then we had a 36 year old male, new to ASRI, who presented with a chronic cough. He sought medical attention for this problem four months before in a larger city, where a workup yielded no answers. We observed he was notably thin, with wasting around the areas of his temporal bones – both potential signs of chronic illness. Though his symptoms may seem minimal, an isolated cough, he was incredibly sick. Luckily he brought with him a chest x-ray taken four months before, which showed that the upper portion of his right lung was heavily diseased. The left lung appeared normal, though upon listening to his chest, we noted abnormalities in both lungs – in all likelihood, his disease was spreading.
The x-ray findings, coupled with a chronic cough, were strongly suggestive of TB, though cancer and many other infectious and non-infectious processes can have similar radiographic findings and clinical features. He tested negative for tuberculosis in a special staining of the patient’s sputum, but our suspicion for tuberculosis remained high. Though he was initially reluctant, we convinced him to return to ASRI the following day with a first morning sputum sample, which he would collect at home and bring to clinic. Such samples typically have higher diagnostic yield when searching for TB. Though he had to drive a great distance to clinic, he did return the following day, and our suspicions were confirmed when microscopic
analysis of his second sample showed heavy tuberculosis burden.
There is nothing strange about this particular case: the way he presented or the way in which his infection was identified. Many cases of TB are diagnosed and treated at ASRI every month. The story highlights something even more poignant. Frequently patients come to Klinik ASRI for a second opinion after not improving or not knowing what ails them. In many cases we are able to identify the ailment, and in this case it is fortunately a treatable one. ASRI is a fully functioning clinic, capable of urgent care needs and equipped for long-term, longitudinal care. In this man’s case we were not only able to make his diagnosis, but also arrange for him a DOTS worker to help coordinate his antibiotic therapy. Lastly, this case speaks to the quality of the Indonesian doctors working at ASRI, who knew that one negative test should not affect one’s search for a particular disease when clinical suspicion for that illness is strong.’
Through a Water Hope grant, funds have been earmarked to help provide rural communities improve water quality and accessibility. Thanks to the efforts of numerous people, and the perseverance of a dedicated volunteer, Patrick Ryan, the first prototype is complete! The pump works hydraulically with one person “walking” on two boards, similar to the elliptical at your local gym! Recently we showed of the modified Treadle Pump to our Forest Guardians, who were impressed on how easily clean water can be pumped to a high storage tank. They discussed the issue of keeping water supplies potable and were eager to both try the prototype and provide suggestions on how to perfect the model. Once we tinker with the design, the forest guardians will be implementing a pump in each of their villages to replace the present open wells.
 The pump utilizes hydraulic force to draw water up the cylinder as the operator stair steps. Genius! |
 Forest guardians test out the prototype pump. |
Thanks everyone for your continued support.
We wish you and yours a Happy Holiday Season,
The Health In Harmony Team
Consider a gift of Health this Holiday Season. Donate online at www.healthinharmony.org.