courtghoward

Although I trained mostly in large academic centres, I’ve spent much of my medical life practicing at the remote end of bumpy highways.  There is an elegance to it—an instant humility brought about by limited resources, a ‘we’d better stick together or we’re sunk’ solidarity amongst staff that evaporates much of the posturing that can

Chainsaw Buyback: Just Transition in the Bornean Rainforest   One of my take-homes from attending the COP23 climate change negotiations in November was just how strongly environmental and labour groups are now, rightly, pushing for a “Just Transition” to ensure that workers are supported as we move from a fossil-fuel economy to a low-carbon one.

Morning Meeting All staff, including people in charge of healthcare, conservation, agriculture, driving, education, finances and more, get together at 8AM Monday to Friday at ASRI for morning meeting. Hoping to be as helpful as possible during my visit, I’d emailed my friend Dr Anne-Marie Pegg, who has a tremendous amount of experience heading up

Consistent with rapid deforestation rates in much of the Bornean rainforest, more than 70% of the lowland forests within Gunung Palung National Park’s buffer zone were deforested between 1988-2002. During sequential surveys done by ASRI/HIH, they found 1,350 logging households around the park at baseline in 2007.  ASRI’s clinic and conservation program opened in 2007—and

ASRI/Health in Harmony take data from their village surveys to determine which widowed women in the area may benefit from goats. The women receive 1-2 goats, then repay ASRI in goats once the animals procreate. There are about 200 widows in the program. A goat sells for about 2-2.5 million rupiah in an area with

Paying for Healthcare With Manure? For real. ASRI-Borneo’s head MD Dr Nomi explains how rainforest-conservation incentives are built into their hospital’s payment scheme. Imagine if all healthcare systems took Planetary Health into account?

We arrived here last week, sweaty, towing our children, to find two giant posters of icebergs (I took them to be the Arctic on our first day–it is possible they are at the South Pole.)  It was astonishing to come to the jungle and find icy iconography.  We definitely don’t have any photos of orangutans

Why did we come all the way to Borneo?  Well…I was intrigued enough by ASRI/Health in Harmony’s integrated health and conservation project in Sukadana that I wanted to see it for myself.  The basic idea is that in this rural area in Western Kalimantan, Borneo, providing affordable healthcare allows people to stop cutting down the

We arrived in Sukadana at  Alam Sehat Lestari ‘s hospital about a week ago.  We made the 2-2.5 hour drive from Ketapang along a two-lane road, driving on the opposite side of the street as we do in Canada. We saw lots of palm trees, quite well-kept houses. Corrugated metal roofs, tiled ones; tile and stucco

At some point in my life as an ER doc in a small town I started noticing sirens…but only when I’m within a day or two of working a shift.  The rest of the time my brain blessedly filters them out completely. I hadn’t noticed any since leaving Yellowknife, and then we got off the

As Jenie described it and his cousin Andy later showed us, as you head to Camp Leakey, the park is on your right, and a series of research stations and villages are on your left. Branching off every so often on the left are irrigation channels about 2 metres wide. They supply water to palm

We wanted to spot some orangutans in Tanjung Puting National Park before heading to Health in Harmony and ASRI’s hospital in Western Kalimantan, Borneo, so we carried life jackets for the kids with us all the way from Yellowknife.  (ER MD job hazard=safety police tendencies…yep– everyone loves to travel with me!) Mr Head-Packer sighed, but

“Di manakah toilet?” We put our 4 year-old Vivi in charge of learning how to ask directions to the bathroom in Indonesian.  Important job.  Needed the best possible chance of being remembered.  I figured she has the youngest mind, so given language-learning aptitudes it was most likely to stick there. And it did.  For both