«When humans invade an ecosystem, viruses spread»

Kinari Webb (48) is a physician and the founder of Health in Harmony, an initiative that integrates healthcare and conservation in Kalimantan, the Indonesian side of Borneo. In 1993, she completed her undergraduate studies in Biology and went to Borneo to study orang-utans. After realising how the needs for healthcare led to deforestation, she decided to attend medical school in Yale, returned to Kalimantan and founded Health in Harmony in 2005. She splits her time between the San Francisco Bay Area and Indonesia.

BMF: What are the connections between environment and health?
Kinari Webb: I actually feel that this is a false question. This question assumes that human beings are not also embodied animals. It assumes that there could be a separation between humans and the natural world. That is impossible: we breathe air, we drink water, we eat food. It is impossible to separate them. It is a belief from the Enlightenment that somehow the mind is separate, and this is just not true. This pandemic is teaching us also very profoundly just how inseparable we are from the natural world, but so is climate change: without reasonable temperatures to live in, without enough oxygen in the air, without good air to breathe, without clean water to drink, without unpolluted food to eat, we cannot be healthy, we cannot survive.

We work on Borneo, what does deforestation do to the health of local communities there?
Where I work in Borneo and in the communities where you work, every single person 100% understands that their future well-being depends on there being forest. They understand that the forest produces water and that the water feeds the rice fields and that these feed them. They understand that without clean water, they are much more likely to get diseases. They understand that when the forest is logged and people spend a lot of time in the forest in unhealthy ways, like logging, then that destabilises the balance of the ecosystem, which then leads to more diseases. There is a lot of data that shows that when you log the forest, you will get a lot more malaria, for example.

Globally, what do environmental destruction and the destruction of the rainforest mean for human health?
When people think of climate change, they think it is merely an issue of combustion of fossil fuels, and that is definitely one problem, but it is not the only problem. If you look at the entire transportation sector in the entire world, it releases about as much carbon as deforestation does. When you log and burn the forest, this releases a huge amount of carbon into the atmosphere. There is also underground carbon, which is contained in so-called peat swamps. These are very important, particularly in Borneo. You can think of them as early oil-fields. They store millions of years worth of carbon in the leaves and the branches stacked underground where they don't rot, especially when they are covered with water. But if the forest is logged and dries up, then they begin to rot and start emitting carbon. Quite amazing, the forests in Indonesia store more carbon than the entire Amazon, even though the area is much smaller. It is an enormous amount of carbon. The Gunung Palung National Park, where we work, has as much carbon in it as 14 years of carbon emissions of San Francisco. Trees serve a double function: They store all this carbon, but they also continue to suck more carbon out of the atmosphere as long as they are standing. The forests of the world actually absorb a third of the global CO2 pollution. In fact, I would like to be very clear about that: if we lose our global rainforests, it is game over for the human species. It would be an uninhabitable planet for humans, probably for most life, in terms of heat.

How does COVID-19 come in here? It is a zoonotic disease, what does that mean?
A zoonotic disease is a disease that transmits from wild animals to humans. One has to understand that in a natural ecosystem, which is healthy and in balance, there is going to be very little zoonotic transmission. But when humans invade an ecosystem, put it off balance and eat wild animals, viruses spread. The greatest threat are these wet, live markets. That is where most of the zoonotic diseases have originated: if you take wild animals from one part of the world and put them together with other wild animals in such markets, you really stress these animals out. Their immune systems start to fail and the viral loads get very high. Then, the viruses can jump between species — and to humans — and be very dangerous. It is not just COVID-19, it was the last SARS, MERS, Ebola and actually HIV, as well. It is very important to realise that there is an enormous danger to not honouring the ecosystems.

Consequently, a lot of people now question the consumption of wild animals. What is your perspective on rural communities consuming wild animals in Borneo as they have always done?
It is also a risk when these communities consume wild animals, but if they consume wild animals from ecosystems that are in balance, it is much less of a risk. There is some thought that COVID-19 jumped from bats to pangolins and then to humans. Now, pangolins come from all over Southeast Asia, but many of them come from Malaysia and Indonesia, they are captured from the wild there, then they are shipped to China alive and then, they are combined with lots of other animals in these wet markets. That is a very different thing than consuming wild animals when you live in balance with the ecosystem. People, who live in these communities and who have been eating these animals for a very long time, are likely to have been exposed to those viruses. So, the virus does not become a pandemic. People already have an immune system that can handle such viruses.

What about animal farms?
Those are also a big risk, but not for a totally new virus. The rainforests of the world cover 2% of the surface of the earth and they contain 50% of the world’s species. That is an incredible treasure for us, but also more of a risk for new viruses, especially if you start shipping them around the world. But the huge factory farms, like pig farms, are dangerous too. You can have a virus, like an influenza virus, which can jump into pigs. There, they have an incredible breeding ground for mutations within these extremely stressed animals with their immune systems down and packed closely together. I imagine in the future we will look back and we will wonder how we could have done such a thing.

What kind of human practices would result in more pandemics like COVID-19?
When ecosystems are protected, intact and very diverse, they thrive, everything stays in balance. When you damage an ecosystem and take animals from one part of the world to another and you stress them out, that is going to cause more trouble. It is just a matter of time, it will happen again.

You work at the intersection of healthcare and environmental conservation through your own project, Health in Harmony. What is the project about?
When I first went to Borneo to study orang-utans, I fell in love with the forest and with the people, but I was horrified to see that many of the local communities, who actually love the forest, were logging to pay for healthcare. One man cut down 60 trees to pay for a C-section. That just broke my heart, and I thought that we cannot accept a world, in which people just try to get their basic needs met, and are therefore damaging their future well-being and the future well-being of the world. I went to medical school, came back to Indonesia and did what I call Radical Listening. Radical Listening is listening to communities and asking them what the solutions are. Trusting that they are the experts in their communities and that they know what they would need to protect the forest. They said that they needed access to high quality affordable health care and they needed training in organic farming. We did these two things. We also allow people to pay for healthcare with non-cash payment options, they can pay with seedlings, with handicrafts, with labour and then, we also give extra-discounts to communities that are protecting the forest. After ten years, we had a 90% drop in logging households, we stabilized the loss of the primary forest and we had 21,000 hectares of forest grow back. We had a 67% drop in the infant mortality and people were doing much better economically. Even I was shocked that they knew exactly what the best solutions were. When we implemented them, they were able to protect the forest.

Impressive. Learning from your experience, what is the solution globally?
What we showed was that humans and the natural ecosystems can thrive side by side. And that is what we have to do. We have to look at the world in a planetary health approach. We have to understand that the well-being of people in Malaysia, who capture a pangolin because they don't have enough of their basic needs met and ship it to China, the well-being of the people in China and the well-being of people everywhere in the world all depend on each other. We are all dependent on healthy natural ecosystems. It is possible for both to do well. Most people view it as a competition. They say: "But how can we protect the forest when people need to eat?" It doesn't work that way, in fact, it is the other way around: If you ask people what the solutions are and you partner with them around the world to meet those needs, then they can thrive. In the end, the ecosystem will do better, not worse. Imagine, everyone gets universal health care, but we all have to pay some small amount towards it. Imagine the amount you paid in depended on your carbon footprint and it would be a progressive tax. If you were flying all over the world, you would have to pay a lot more into the health care system because you are damaging the health of the world.

Thank you very much for taking the time.