“The Land Where Our Parents Were Born”: Health on the Move among the Punan-Tubu

How climate change, development and shifting ways of life are reshaping health and territorial belonging among the Punan-Tubu in Indonesia.

Reaching Long Ranau, a Punan-Tubu village in North Kalimantan, Indonesia, is no easy task. After a day by jeep along winding mountain dirt roads to Long Pada, the first village of our study, we still faced nearly four hours by boat. Two boats and four boatmen transported the four people of the INDILEAD project upstream, crossing several rapids and waterfalls. While we made our way along the riverbank, most of the time the boats and the cargo were pulled by human strength or through skillful handling of the engine. That night, during the meeting to present us to the community, the chief Muliono welcomed us and thanked us for coming, saying, “We know access here is difficult, but we remain because this is the land where our parents were born.”

Dhole and Jefry pulling a boat up the Punan River to Long Ranau.

Moving and remaining with the Punan-Tubu

The Punan-Tubu are an Indigenous People — or Masyarakat Adat — who have historically inhabited the Tubu valley and its tributaries. While the term Punan refers broadly to hunter-gatherer communities across Borneo, the Punan-Tubu have their own language and cultural identity. Until the 1960s-70s, their way of life was semi-nomadic, deeply rooted in knowledge of the forest and the gathering of forest foods, with temporary settlements that shifted according to internal and external factors within a defined territory.

The sedentarization of these communities began in the 1960s with the arrival of Christian missionaries and was later consolidated through the Indonesian nation-state project. In 1970, the government forced the populations of this region to relocate to semi-urban settlements near Malinau, far from the isolation of the mountains and forests, so that they could be fully integrated as citizens. While the forms of movement chosen by the community as a way of inhabiting and managing the forest were treated as a primitive condition to be overcome, the displacement imposed by the State was presented as a necessary path toward progress.

The sedentarization of these communities began in the 1960s with the arrival of Christian missionaries and was later consolidated through the Indonesian nation-state project.

One year after this radical experience, several people rejected the model of civilization imposed upon them and returned to the mountains, forming the five villages known today — Long Pada, Long Ranau, Long Nyau, Long Tepu, and Long Titi. To this day, most families still spend much of their time in small temporary farms dispersed throughout the territory. Since 1996, these communities have also participated in the community-based collaborative management of Kayan Mentarang National Park.

A living room in Long Titi.

Of the five villages, Long Pada is the most “accessible.” The others require days of walking through the forest, driving muddy roads, or moving through rivers full of rapids. But despite this isolation, daily life in the villages does not seem so distant from life in the city: houses are similarly built, internet connection is available, there is some access to electricity, and some places even have large appliances such as washing machines. At the same time, there is a relative independence from monetary systems, and forest-based living remains an integral part of everyday life. As Levang et al described it, “they want to go wild boar hunting in the morning and watch television in the evening” - or today, TikTok. The Punan-Tubu actively move through these apparent contradictions, composing their own self-determined present.

The INDILEAD project: changing practices, emerging risks

We visited these communities between February and March 2026 as part of the INDILEAD field team, which included me, Shannon O’Brien, Vissia Ardiyani and Ratnawati (a Punan-Tubu nurse herself), as well as the translator Abbie and the park ranger Okto during the final two village visits. In Indonesia, the project is carried out through a partnership between UB/ISGlobal/UOC in Barcelona and Poltekkes Kemenkes in Palangka Raya. This work builds on previous fieldwork and relationships developed by the project PIs Martí Orta-Martinez and Cristina O’Callaghan-Gordo.

Long Nyau.

This tension between sedentarization and nomadism is central to the concept of epidemiological transition. Twenty years ago, Dounias et al described how the diet of the Punan-Tubu living in the mountains was generally more diverse and nutritious than that of their relatives relocated to the outskirts of Malinau, who also showed poorer health indicators. Today, the transition itself has clearly reached the mountains. Overall, people in the communities appeared to be in good health, with no evident signs of either malnutrition or obesity. However, in the health assessments conducted in parallel to our study by Ratna, anaemia, elevated blood pressure, and hyperglycaemia were occasionally observed.

The raising of chickens and pigs has become increasingly common, alongside the replacement of forest-collected sago by cultivated cassava or rice and the occasional consumption of refined sugar, seasonings, and processed snacks. At the same time, according to local reports, animal epidemics and climate change were affecting hunting, drastically reducing, for example, the wild boar population which had previously represented the communities’ main source of meat. While the diversification of meat sources may help reduce hunting pressure on the ecosystem, and crop diversification may reduce seasonal fluctuations and vulnerability to climate events, it is also important that these communities have access to the information and resources needed to face these transitions in the healthiest way possible.

The INDILEAD project studies how the transition to modern hunting methods, namely the use of lead-based ammunition, may be causing high levels of lead in Indigenous communities that rely on bushmeat as a protein source.

Recognizing these frictions between forest life and new technologies, the INDILEAD project studies how the transition to modern hunting methods, namely the use of lead-based ammunition, may be causing high levels of lead in Indigenous communities that rely on bushmeat as a protein source. Because lead exposure can affect children’s development and compromise the health of future generations, reducing this risk is also a way of protecting continuity. Through this research, the project seeks to explore, together with the communities, ways of reducing or preventing this exposure without undermining local forms of collective life — forms that protect the valuable ecosystems these communities inhabit but also enact other ways of living together.

Flooded horizons

Meanwhile, on the boat to Long Tepu, we could see how, in the middle of the forest, a massive wall was cutting through the landscape, announcing the future mega-hydroelectric dam that will power the Kalimantan Industrial Park Indonesia (KIPI), some two hundred kilometres away. Part of a network of five dams, the largest hydroelectric project of its kind in Southeast Asia, it will soon flood a significant portion of the still-preserved rainforest of the Bornean interior, including 244 hectares of protected area. Nevertheless, it is still being promoted by the government as part of a “green transition” strategy, in what is supposed to become the “largest green industrial area in the world”.

Dam construction site along the Tubu River.

Within a year, the waters are expected to flood part of the Punan-Tubu territory, especially Long Tepu and Long Titi, which will be totally or partially submerged. According to what community members told us, part of the affected population will be relocated to a new settlement to be created between the two villages, as well as to Long Pada, which is already building a new site in anticipation of a growing population. Fifty years ago, the State forced the Punan-Tubu to move closer to progress, but many returned to their origins. Today, progress arrives at their doorstep, reducing their managed and voluntary isolation and once again forcing the relocation of villages, as in the time of nomadism. The problem was never movement itself, but who had the power to decide when, how, and why people should move, and where they belonged.

The problem was never movement itself, but who had the power to decide when, how, and why people should move, and where they belonged.

One day, while passing through a younger forest, Silang, one of our crew members, explained that this had once been the site of Long Titi, and that in the past, during the semi-nomadic period, communities moved whenever a tragedy occurred. In an ecosystem where nothing is permanent, where matter succumbs to heat and humidity and river courses change from one day to the next, this way of facing change rejects fatalism or resignation, revealing instead a wisdom about how to belong within impermanence. But where does one belong when the forest canopy sinks beneath a single, still surface?

A territory to belong to

Challenging the developmentalist assumption that Indigenous and remote communities are populations waiting to be absorbed into a single model of society, the Punan-Tubu reveal something different: a people actively negotiating the balance through which they have long remained. Through a global health lens, the abrupt impact of mega-infrastructures, gradual changes in diet, and exposure to heavy metals brought about by technological change extend beyond what exposure assessment or health indicators alone can capture. Taken together, this reaffirms that health is part of a complex relationship between individual choices, state decisions, and global transformations.

Maret, Silang, Muly, and Santo arriving at Long Tepu.

And yet, none of this can be fully understood without territory, bringing us back to Muliono’s words, that declaration of belonging to one vast, living, and mutable land. The difficulty of access, the mastery of moving up and down the river, and the adaptation of new crops to old fields are all part of that place where their parents were born and where it still makes sense to remain. Defending such territories means protecting areas of immense biodiversity and ecological value, but also meaningful social horizons that differ from the dominant, extractive ways of inhabiting the planet. Like so many other Indigenous peoples around the globe, the Punan-Tubu remind us that another possible world already exists, continuously sustained by those who never ceased to live it.

Because health is planetary, it is inseparable from the territories, ecosystems, and collective forms of life that make it possible. In that sense, placing these ways of living at the centre of global health agendas means recognizing them as worlds to learn from, and joining these communities in their defence.

Children at the guesthouse, Long Ranau.