In Lahat Regency, Indonesia, women are at the forefront of a complex struggle against the impacts of coal mining. This study, using a mixed-methods approach, reveals their deep-seated resilience in the face of profound environmental and economic challenges. The findings highlight a significant emotional toll, with women experiencing ``solastalgia``—a sense of distress over their degrading environment. This emotional burden is compounded by a difficult economic paradox. While the community primarily falls into a lower-middle economic bracket (91.5% of households earn below Rp 5 million per month), and the majority (76.3%) prioritize their health, a notable minority (20.3%) feel that their job is more important. This decision is often born from a perceived lack of alternative livelihoods, trapping them in a difficult choice between immediate economic survival and long-term health.