How Human Health Technology Is Improving Orangutan Welfare

Behind the scenes at the Smithsonian’s National Zoo’s Think Tank exhibit, Redd the orangutan settles into place and greets his keeper at a mesh safety barrier. 

The keeper lifts a handheld medical device next to Redd’s face. A soft mist drifts out, which Redd gently inhales at his own calm pace. Every few seconds, he leans forward for a reward from the keeper—a slice of grape, one of his favorites. After about four minutes, the device beeps. The last wisps of mist fade, the session ends, and Redd munches on one last grape. Thanks to this simple daily treatment, Redd relaxes, breathing a little easier.

To some visitors, this scene might look familiar. Redd has learned to use a device called a nebulizer—a piece of medical equipment commonly used in humans to treat asthma or chronic lung disease—as part of his ongoing care. 

His story is an example of how medical technology originally designed for people is becoming increasingly adapted to improve the lives and welfare of great apes at zoos.

Redd is one of the approximately 20% of orangutans in human care with Orangutan Respiratory Disease Syndrome (ORDS), one of the primary threats faced by orangutans in human care. It’s a chronic respiratory disease characterized by repeated infections of the lungs, sinuses, and laryngeal air sacs—the throat pouches orangutans use to make their long, booming calls. 

In mild cases, like Redd’s, ORDS may appear as coughing, nasal discharge, and mucus buildup. In severe cases, the condition can progress rapidly, damaging airways and reducing respiratory function. 

“The causes of ORDS aren’t fully understood,” said Dr. Alyssa Palmer, veterinarian at the Smithsonian’s National Zoo. “The research suggests there may be a genetic component to the disease, along with historical infections and environmental factors.” 

While ORDS does affect orangutans in the wild, it’s diagnosed more frequently in zoo populations. At the Smithsonian’s National Zoo, Redd and his mother, 29-year-old Batang, both have the condition. Their exhibit mates—Lucy, Iris, and Kiko and Bonnie—do not.

Treatment depends on how severe the clinical signs are, explained Dr. Palmer. “Redd’s treatment involves nebulized saline, which is essentially salt water, because he’s young and minimally affected by the disease, and it mainly helps hydrate his airways and break up mucus.” 

Orangutans share 97% of their DNA with humans, and many of their diseases — including respiratory ones —behave in similar ways to human conditions. ORDS is often compared to cystic fibrosis in humans, although the two conditions are not identical. 

Understanding and managing ORDS is essential from a conservation standpoint, too. Orangutans are a critically endangered species, and rapid deforestation in their native Indonesia is driving the species to the brink of extinction. While international efforts focus on protecting critical orangutan habitat in the wild, zoos maintain conservation populations that effectively serve as an assurance group—but that strategy only works if those animals remain healthy.

Zoos have long adapted human medicals tools for animal care, but great apes benefit from these tools more than most species.

“Humans are a species of great ape, so it’s relatively easy to look at medical tech and figure out how it might apply to gorillas and orangutans,” said Becky Malinsky, curator of the Zoo’s Primates exhibits. 

Not only are great apes physiologically similar to humans, their cognitive abilities allow them to pick up on training behaviors and allow them to participate in many of their own veterinary procedures.

 “And because gorillas and orangutans have such high intelligence, they make our jobs easier when it comes to training. They can quickly pick up on what they’re asking them to do.”

Through positive reinforcement training, Zoo staff teach animals to safely and voluntarily participate in their own care, often in exchange for a reward, like a piece of banana. 

• For example, the leading cause of death of male gorillas in human care is heart disease. So, keeper teams at the Smithsonian’s National Zoo train gorillas to voluntarily participate in blood pressure monitoring, presenting a limb to the edge of the enclosure so teams can get noninvasive readings using human cuffs and monitors.
• When Zoo staff want to confirm a pregnancy in a primate, they’ll train the animal to sit still for an ultrasound. And when staff want to make sure unplanned primate breeding doesn’t occur, they’ll administer the same pregnancy-preventing medications used in human medicine.
• At the height of the COVID epidemic, the Zoo’s apes were trained to hold still for nasal swabs, allowing keeper and veterinary teams to safely conduct viral testing.

When training isn’t enough, Zoo staff make use of human-grade medical equipment for extra preventative care—with just a few adaptations. To get a full picture of Redd’s pulmonary system and to ensure his ORDS wasn’t progressing, Zoo staff transported him to a nearby animal hospital under anesthesia. 

There, Redd underwent a full-body CT scan, using largely the same protocols that a human would undergo. Fortunately, the results from Redd’s day at the hospital showed no major progression of his ORDS. It did, however, reveal a case of seasonal allergies. Those are now being treated with—you guessed it—allergy meds that were initially developed for humans. 

In the meantime, Redd continues to receive daily nebulizer treatments while the Zoo’s animal care teams keep tabs on his condition. Animal care staff say his curious and playful personality—not to mention his eagerness for extra grapes—make him fun and easy to care for. 

Malinsky noted that even by orangutan standards, Redd was quick to master nebulization therapy. “We’ve been nebulizing Batang for most of Redd’s life. We think because he grew up watching his mom do it, he picked up the concept really quickly… it took two, maybe three sessions for him to understand it.”

For animal care and veterinary teams, Redd's story highlights how human medicine and primate behavioral science are evolving to meet the welfare needs of endangered species. And for visitors, it’s a reminder that orangutan conservation often starts close to home.