As humans, we like to think in categories, but the truth is we’ve never lived in a world where the health of humans, ecosystems, and the planet could be effectively addressed in silos. The severe and wide-ranging effects of climate change — the biggest health threat of the 21st century according to the World Health Organization — force us to confront and address this reality.
We must attend not only to human health but also to planetary health. As defined in 2015 by the prestigious medical journal, The Lancet, planetary health is “the health of human civilization and the natural systems upon which it depends.”
Human Dependence on Planetary Health
In its timely Declaration Calling for Family Doctors of the World to Act on Planetary Health, the World Organization of Family Doctors (WONCA) urged doctors around the world to “communicate to patients that their health ultimately depends on the environment, both in their immediate vicinity and globally.”
According to WONCA, “With planetary health in mind,” doctors should “be aware of and monitor local environmental factors, such as heatwaves and other natural disasters, land clearing, and air quality, which may affect your patients’ health or response to treatment. [And] advise patients about important co-benefits — everyday choices and key changes that they can make in their own lives to simultaneously benefit their own health and that of the environment, including food choices and a transition to a more sustainable plant-based diet.”
Practicing Planetary Healthcare in Borneo
Attending to this degree of complexity can seem like a tall order for busy doctors and nurses. For more than 10 years, however, the practitioners in our nonprofit organization, Health In Harmony, have practiced a planetary health approach in our medical facilities in Borneo, where we provide healthcare to the more than 120,000 people living around Gunung Palung National Park (GPNP).
A decade ago, Borneo was experiencing one of the fastest rates of deforestation the world had ever known, and GPNP was losing tree cover at an alarming rate. This was mostly due to illegal, small-scale logging by people in marginalized communities on the edge of the park — people who had no other way to pay for their basic needs or healthcare.
In 2007, Health In Harmony spent over 400 hours listening to people in 40 villages bordering the park to understand the critical connection between the health of people and the health of the surrounding forest. Per the consensus decisions of these communities, we provide access to affordable, quality health services and training in sustainable agriculture, as lack of health access and income opportunity were key drivers of deforestation in the park.
Understanding Local Community Needs
Our work is similar to what people expect in a conventional hospital, yet different. Healthcare providers such as doctors and nurses find themselves teamed with farmers, foresters, and educators. Community members can pay for their healthcare costs in our clinic with barter (such as tree seedlings for reforestation). And the costs are tiered based on their village’s commitment to reduce logging.
Furthermore, our doctors, nurses, and midwives understand their patients’ asthma, TB, dengue, malaria, and nutrition status are reflections of the integrity of the local rainforest ecosystem. They discuss this every day with their patients.
This approach is working. Health In Harmony has seen an 88 percent decline in the number of households participating in illegal logging in GPNP, and a significant decline in infant mortality. The loss of primary forest has ceased, 50,000 acres of forest have regenerated, and habitat for 2,500 endangered Bornean orangutans has been protected. Our doctors’ stethoscopes are helping heal this amazing rainforest, an important lung of the Earth.
Linking human health with ecosystem health is reversing the rainforest destruction that contributes to the acceleration of global warming. To put this in perspective, the trees in the park that were saved from logging safely sequester an amount of carbon that is equivalent to 14 years of carbon emissions created by human activity in San Francisco.
Health In Harmony is now expanding to other rainforest sites globally, attempting to replicate this planetary health approach in locations as varying as Madagascar and Brazil. What would it look like if, as we did with the logging-dependent communities in Borneo, healthcare providers spent hundreds of hours listening to the concerns of coal-mining communities and communities in fracking-heavy regions?
Prioritizing Family Health & Earth-Friendly Jobs
What if we listened, and then designed health systems that put family health as a primary outcome, while simultaneously enabling family earners to find the alternative livelihoods they require to feed their children today — and protect the planet for their children’s future?
As societies’ most trusted sources of information, healthcare providers globally can advocate for bike lanes to increase activity levels and decrease air pollution, or help patients learn the skills necessary to transition to a more plant-rich diet. They can advocate for healthy, low-carbon energy systems, and for the protection of urban green spaces, and can encourage patients to benefit from the healing effect of being in nature.
By becoming planetary healers, healthcare providers can optimize the health of not only this generation of patients — but of all those yet to come.
About the Authors
Dr. Kinari Webb is the founder of Health In Harmony. Dr. Courtney Howard is an emergency physician, North American co-chair of WONCA’s Working Party on the Environment, and a Health In Harmony board member.
Editor’s note: This article previously appeared in The Hill.