Has beans. is well.

• Author: Bower, Hilary
• Position: FieldWatch - Cultivation of beans may help pay for health care in Kisanfu, Congo - Brief Article

It takes more than bricks and mortar to improve public health and bring back patient confidence in a country where state health services have been starved for 25 years.

Kisanfu health centre has seen the number of patients using it over the past year quadruple, from 15 visits a month to over 60. It is neither an outbreak of disease nor a takeover by an international organization with free drugs and expatriate doctors, but the slow home-grown resurrection of a facility which, until recently, had very little to offer its community. Kisanfu is part of a just completed $3-million project, funded by the United Nations Development Fund and implemented by the World Health Organization (WHO), which not only rehabilitated health facilities in six health zones in the west of the Democratic Republic of the Congo over the past year, but targeted the ability to provide, sustain and pay for these services.

A big part of the programme has involved renovating and re-equipping parts of district hospitals, such as the operating theatre, maternity ward and pharmacy in nearby Manieka District Hospital, supplying significant amounts of essential drugs to the health zones to trigger cost recovery supply, and reinforcing health zone management to allow it to start functioning again.

In Kisanfu, it's not the lick of paint, the cheerful hand-painted health promotion posters, or the epidemiological graphs on the wall indicating new training knowledge that have made the difference. It's medicines and ... beans.

Like other health centres in the zone, Kisanfu has benefited from the injection of essential drugs, which have allowed it to get back into the cycle of selling at cost recovery prices and restocking. When drugs are available, people come to the centre. They are also more willing to pay the small consultation fee that tops up the poor salaries of the centre's workers, which in turn makes them more motivated in essential tasks, such as vaccination and disease surveillance.

But if the patients do not have money to pay, the whole system collapses again. Which is where the beans come in. With a $1,500-grant from the project, the health committee bought three 60-kilogram sacks of haricot beans and fertilizer, and with volunteer labour cultivated a two hectare plot. Last month, they harvested 24 sacks of beans. Three sacks were paid to the harvest team and three more will go to replant the community land. The remainder has been divided between local small farmers in...