Turning Trash into Health Care in Indonesia



Like many developing countries around the world, Indonesia is faced with a difficult and growing garbage problem. In 2010 alone, the coastal cities of Indonesia created 10% of the world’s plastic waste, and on average, each Indonesian produces 1.5 kilograms of waste per day. Urban cities like Malang in East Java produce tens of thousands of tonnes daily, but only half of it is ever collected. Government-run waste management services cost a monthly collection fee, and as a result, many poorer households cannot afford to pay.

While all of this trash can lead to illness and diminished quality of life, many Indonesians must also cope with the high cost of health care. In 2010, a doctor in Malang, named Gamal Albinsaid, devised a new idea to help people access badly needed health insurance and manage their waste and sanitation.

Dr. Albinsaid realized that many people who were sick were not going to the doctor simply because they didn’t have the money. However, they did have garbage, so he created an insurance program, called Garbage Clinical Insurance (GCI), which uses garbage as a financial resource.


Social Innovators


Members of the program collect about 10,000 Indonesian Rupiahs worth of garbage per month and drop it off at one of five GCI-accredited clinics. Members can then access the clinics for treatment, medicines, health education, and preventive and rehabilitative sessions. The garbage can be dropped off every Saturday, or members can pay with garbage whenever they visit the clinic. The clinic then turns the organic waste into fertilizers and compost, and sells the inorganic waste to collectors and recycling companies. Most of the patients who participate in the program are poorer farmers who work in the rice paddies just outside the city.

So far, GCI has helped 3,500 uninsured people in Malang get access to health care. GCI has also recruited 88 volunteers, 15 doctors, and 12 nurses, all who are paid with money generated from collecting the community’s waste. In 2014, Dr. Albinsaid won the Prince of Wales Young Sustainability Entrepreneur Prize, awarding his work with about $68,000. He has also been honoured with the Inspiring Scientific Award from the Research and Technological Minister of Indonesia, an AusAID Indonesian Social Innovator Award, and is an Ashoka Young Changemaker.

Beyond basic treatment, preventive, and education programs, GCI creates and distributes a health book, holds nutrition consultation services, conducts home visits, and conducts telemedicine to provide people with health counseling by telephone. In addition to providing healthcare, Dr. Albinsaid’s insurance program has created a group of cleaners to clear the streets around Malang, and has changed people’s perception of household waste.


Empowered People


trash1The program has been successful because only 10-15% of people who collect garbage use the services in a given month, meaning there is enough money to run the center and fund all of its initiatives. Dr. Albinsaid hopes to expand the insurance scheme three more cities in Indonesia, and the government has also taken an interest in getting involved in his work.

Other entrepreneurs in Indonesia have taken notice too, and are considering modifying the system to help poor families gain access to better education. But Dr. Albinsaid takes the greatest pride in the fact that he has given people greater access to healthcare, which he believes is a fundamental human right. He’s empowered poor people to consider previously overlooked resources to help them manage their health financing. Not only that, but he’s helping to change waste habits and clean up the garbage problem in Indonesia too.


Valerie Busch

Valerie Busch

Valerie is a development professional based in Toronto, Ontario.

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