Feature Story October 2007

Image Slide Show

Plant Healthcare for Poor Farmers:
Previous APSnet
Features
An Introduction to the Work of the
Unfamiliar word?
Global Plant Clinic
See Glossary

Interested in
contributing an
Eric Boa
APSnet Feature? Head of Global Plant Clinic, CABI
Have a comment? Egham, Surrey, United Kingdom
Please contact e.boa@cabi.org
APSnet Feature Editor
Dr. Gary D. Franc

I’ve been a plant pathologist for 26 years, working in developing

countries, originally studying diseases of bamboo, clove, woody
legumes, and neem. In the last ten years the hosts and diseases
that have concerned me have broadened to include many major
crops. The hosts and diseases may change but one persistent
question remains: How can plant pathologists best help poor
farmers? Is it helpful, for example, to consider the need for
fundamental and applied research separately, a distinction
commonly made by scientists?
George Porter, a British scientist and Nobel laureate, made a
simpler distinction: there was applied and “not yet” applied
research. I like this approach since it emphasizes the need to find
answers to problems. Robert May, past head of the British Office of
Science and Technology, once said that scientists were good at
asking questions, suggesting that research is not going to find
answers easily. To help poor farmers manage their plant diseases
better we need to find new ways of putting theory into practice.
That is the simple idea behind the Global Plant Clinic (GPC). In
this article I want to show how an informal, multi-national network
of colleagues (mostly but not exclusively plant pathologists),
created and encouraged by the GPC, is attempting to use scientific
knowledge and skills to help farmers in developing countries. This is
an ambitious aim and one that a small network cannot do on its
own. To make the task more difficult, we learned quickly that
responding to plant diseases was not enough. Farmer demand is
not readily defined by scientific discipline. For most growers it is
symptoms that define problems and not causes, many of which are
invisible, such as viruses. Growers have one question: “What do I
do?” The GPC’s job is to find the best way of answering this
question for as many farmers as possible.
However, it became clear that gauging farmers’ demands is a
complex task in developing countries, as illustrated by a study in
Bolivia (7). The researchers note the importance of implicit
demands (those not expressed at first). An example from my own
experience was when staff from CIAT Santa Cruz in Bolivia used a
rapid diagnostic test for Tobacco mosaic virus, developed by the
Central Science Laboratory, on tomato plants with unusual virus-
like symptoms. The result was negative. The farmer never
“demanded” this particular test, yet it provided useful information
quickly on deciding what the farmer should do about the problem
(the explicit demand). Highlighting implicit demands in plant health
emphasises the role that molecular plant pathology, for example,
can play in helping poor farmers.

History of the Global Plant Clinic (GPC)

First, some background to the GPC and its origins. The 1970s
and 1980s saw a gradual rise in
agricultural projects in
developing countries. This was a
time when many gained their
independence and the previous
colonial agriculturists, a proud
and notable scientific heritage
paid for by the United Kingdom,
were becoming “technical
cooperation officers.” The colonial
service provided many of the
early records of plant diseases in
the tropics, as noted by Fig. 1. Doña Felicia of Pulquina Arriba,
Ainsworth (1). There was also a near Comarapa in Bolivia, holds tomatoes
with virus-like symptoms. She hasn't seen
notable tradition of research by
these symptoms before. A Pocket
scientists based in the UK, Diagnostics test from CSL shows
travelling overseas. The new immediately that this is not tobacco
cadre of post-independence mosaic virus.
agriculturists made valuable
contributions to important diseases such as lethal yellowing of palm
in Jamaica (12), Cocoa swollen shoot virus in West Africa [e.g.,
(10)], and the less well known but equally damaging Sumatra
disease of cloves in Indonesia (3).

Fig. 2. Host records of Colletotrichum

lindemuthianum. Handwritten for many
years, the records include material
received at the IMI Herbarium over the
last 90 or so years.
 Such projects often continued for many years. The clove project
in Indonesia began in the mid-1970s and did not end until 1990.
But the vogue for big disease projects began to wane, partly
because those who funded them (governments and multilateral
organisations under the United Nations, World Bank, and similar)
began to ask the same question: Is this science doing any good?
The unstated accusation was that researchers were “capacity
driven” and, as Robert May said, were “good at asking questions.”
Donors wanted answers and practical methods that solved real
problems, such as: How do you stop all these coconut palms from
dying?
A plant pathologist will rightly say that this is an unfair question
and that answers are not easy to find. It is less easy, however, to
explain why huge rural development projects failed to deliver, and
though plant diseases were a small component at best, the
tarnished reputation of such projects has fed notions that
development doesn’t work. That is the pessimistic view of William
Easterly in a recently published book (The White Man’s Burden)
while Jeffery Sachs (The End of Poverty) takes a more positive
view. Paul Collier, an economics professor at Oxford University
appears to fall between gloom and glory with his 2007 book The
Bottom Billion.
Does development work? In a nutshell, Sachs says “yes,”
Easterly “no,” and Collier says “sometimes.” My own view is that
development does work, based on our experience of plant health
clinics, which are at the centre of what the GPC does. Plant health
clinics offer new avenues for applying the results of plant pathology
research and for those results to make a positive contribution to
farm family livelihoods. We are, however, still at an early stage of
establishing clinics and more data is needed to assess their long
term impact. It is also important to state that plant health clinics
alone cannot overcome the many challenges of providing good
advice to all farmers.
Plant clinics are nothing new, but they don’t always perform the
same functions. The GPC grew out of a “diagnostic and advisory
service,” a unique facility that became a distinct part of the
Commonwealth Mycological Institute (CMI) in the 1980s under the
fine leadership of Dr. Jim Waller. The GPC name and identity is
more recent and has only become well established since around
2000. The GPC is managed by CABI. CMI became the International
Mycological Institute before being absorbed into CABI Bioscience.
The early history of IMI is described by Aitchison and Hawksworth
(2). The Bioscience label has been dropped and now scientific and
publishing activities are grouped under the single identity of CABI.
In the 1990s the diagnostic and advisory service expanded to
include phytoplasmas and viruses under Prof. Phil Jones at
Rothamsted Research. The virus identifications are now done at the
Central Science Laboratory (CSL). In 2001, Rothamsted Research
was funded under a single grant to CABI. CSL was formally included
in the three way GPC alliance in 2005.
 Fig. 3. Prof. Philip Jones of Rothamsted
Research and Dr. Yaima Arocha of
CENSA, Cuba share a curious delight in
finding a confirmed phytoplasma disease
on basil in a Havana organopónico.

GPC Operations
A similar pattern of work was maintained for many years under
the diagnostic and advisory service. People sent us samples from
overseas and we would isolate fungi, bacteria, and so on and try to
determine the cause of the problem. The number of samples stayed
more or less the same and the people who sent them were regular
users. We sent back information about control gleaned from CABI
abstracts and from the Crop Protection Compendium. The
information provided was often quite general, more a list of possible
control options rather than specific advice. The information needed
interpretation and local iteration to make it useful to farmers.
As email became more widely
available, people sent us photos.
This was sometimes less useful
than a sender had planned. When
we received clear photos with
unequivocal symptoms it was
often easy to diagnose the
problem (though we still received
a major part of a tea plant
covered with Phellinus noxius
from Sri Lanka after identifying it
Fig. 4. How to send samples of Melia from a photo). More tricky to
yellows, a phytoplasma disease, collected diagnose were the blurred, poorly
in Cochabamba in Bolivia. composed photos (of which there
are rather too many), often of
dead rather than dying plants, or simply showing equivocal
symptoms. We often request samples, though these too are of
variable quality. The heart sinks as you unwrap dried up and dead
material. Equally disappointing are the plant samples that someone
has collected and dispatched … in a plastic bag. There’s not much
you can do with a festering mess of plant sample.
These problems aside, scientists plus a small group of users from
commercial companies regularly sent us samples. Drawn from over
60 countries, users were pleased that someone could help them.
Finding a laboratory that could help and receive samples from
overseas was and remains a major challenge for many potential
users. Once the samples had arrived there was an expectation that
a result would quickly follow. We explained that a diagnosis might
take weeks rather than days because the quality of samples varied
(a much neglected reason) and because of the challenges of dealing
with a wide variety of crops and diseases (you try it!).
I mentioned early that plant clinics perform different functions.
Some are simply diagnostic laboratories and do not make
recommendations. The US is one of the few countries I know where
extension and research are regularly integrated around a clinic (e.g.
North Carolina State University). A more common model is to have
a ‘clinic’ staffed by experts in different types of pathogens (rarely all
groups) often with little or no knowledge of growing crops. It would
be more accurate to call them diagnostic laboratories. It highlights a
lack of clarity and distinction between identification of pest
organisms, diagnosis and advice. (Not so in human health, where
pathologists analyse and offer a diagnosis but cannot, at least in the
UK, treat patients — even then it is confusing, since pathology labs
include clinicians who are also scientists and can treat patients.)
When the diagnostic and advisory service was part of IMI the
institute was best known for its taxonomic expertise in mycology.
There was an uneasy relationship with plant pathology which only
improved when CABI Bioscience was created. As the development
focus became stronger so it became easier to develop a more
integrated US-style clinic, as we now have with the GPC.
Advisory work is usually associated more with extension than
research. Extension and research co-exist well in the US but in
many countries and among many scientists it would be fair to say
that advisory work has an image problem. It appears less
glamorous compared to research, with a suggestion that it requires
less effort. That was the impression I had when doing my Ph.D in
an Agricultural Sciences Department at Leeds University. Now I see
advisory work as a highly skilled job and have deep admiration for
those who do it well.
At CABI, we wanted to know what happened to the advice we
gave, but despite repeated efforts we rarely received feedback. At
first I thought this was because of poor correspondents, but later
the same people happily adopted email, suggesting that the real
reason for poor feedback was weak contact with farmers. Under the
diagnostic and advisory service it was scientists who were sending
the samples to us, not the extension agents and agronomists who
work regularly with farmers. These were the two groups that
needed better access to our service. We needed to improve the way
we worked.
 Fig. 5. Marvin Isidro digs up a sick coffee
plant at the request of the plant doctors
from nearby Jalapa in Nicaragua. They
explain the importance of examining roots
for swellings (possible nematod attack)
and well-defined internal staining
(possible fungal attack).

Changing the GPC: Plant Health Service Initiatives

The pressures to change the diagnostic and advisory service
were gradual but persistent. The major impetus eventually came
because our funders, the UK Department for International
Development (DFID), changed. The customer, in this case DFID,
knows best.
The nearest equivalent to DFID in the United States is USAID.
Both pursue similar aims. The change that ultimately shaped the
GPC of today began with the election of the Labour party in 1997,
led by Tony Blair. The new government announced an increased
importance and seriousness about international development.
Previous governments had been enthusiastic about international
development but never, to my mind, very serious about it. Then
DFID published a white paper with a stark title: Eliminating World
Poverty. It announced a radical change of policy, one matched by
increased funds to support a much wider range of activities.
This created some unease amongst scientists who read the white
paper and found little overt mention of science. Up until 1997 there
had been a sizeable chunk of UK government money for agriculture
research and hence plant pathology. This shrank as health and
education, for example, took on greater importance. Further
impetus for change came in 2000 when the millennium
development goals were published and strongly supported by the
UK government. The millennium development goals set targets for
improvements to be met after 15 years.
The diagnostic and advisory service continued its work at CABI
while the policy debate about international development flourished,
but already we were re-thinking what we should do next. The GPC
identity started to emerge. A review in 2000 praised what we were
doing, yet standing still was not a sensible option given the new
thinking and importance of international development in the UK and
elsewhere. I found the policy changes at DFID enlivening and it
helped me rethink priorities. The most significant change was when
we started to run plant health clinics. At first we weren’t quite sure
what these should be, but six years of testing and observing
different approaches has helped to mould a model for plant
healthcare that is proving attractive to many people.
Collaborations with colleagues Mick Blowfield, Paul Van Mele and,
most importantly, Jeffery Bentley, an agricultural anthropologist,
helped me learn more about farmers and agriculture, and to see the
implications for the GPC. The truth was that I didn’t know much
about either farmers and agriculture, despite having lived in
Bangladesh and Indonesia for ten years. The resistance to making
more use of social scientists in agriculture (usually by natural
scientists) never made sense to me. The posturing and (unspoken)
interchange of brickbats – “you don’t know anything about plant
diseases” (pathologist to anthropologist) and “you ignore what
farmers need” (vice versa) – is unhelpful, though thankfully has
disappeared over time. A good medical doctor is someone with good
social and clinical skills. The same applies to plant doctors.

Fig. 6. Daniel Vasquez (front left)

interviews a peach farmer in Sucre,
Bolivia about the health of her trees. Jeff
Bentley (right) takes notes.

The main effect of learning more about farmers and agriculture

was to work closer with extension agents, giving rise to a new
extension method called Going Public [(6), Research 4
Development, and Agriculture 21]. Other innovations include a
method for writing fact sheets on plant diseases (and other topics)
which are peer-reviewed by farmers, and a new method for self-
evaluation of technology projects. The GPC still does research on
specific plant diseases, though it is limited to major problems
supported by additional projects. Examples include Napier grass
stunt at Rothamsted Research, and banana xanthomonas wilt at
CABI and more recently CSL.
The GPC works in developing countries in Africa, Latin America,
and Asia. We now spend about 60% of our time collaborating,
encouraging and training colleagues in key countries. Uganda,
Bangladesh, and Bolivia were the first three countries where we set
up “plant health services initiatives.” The centre of these initiatives
is the plant health clinic (originally called mobile plant clinics, a
phrase still in use), a new focal point for receiving farmer demands
and meeting them.
The GPC continues to provide an expert laboratory diagnostic
service for all diseases on all crops, but access to the service is
difficult for many in developing countries, even though plant health
clinics have improved the sending of samples from growers,
particularly poor ones. The cost of sending samples, plus getting
permits and other bureaucratic barriers adds to persistent
difficulties in collecting suitable material (paying for fuel is a
frequent problem). We continue to work on improving access,
particularly by making better use of national laboratories. But we
have also taken a new approach to better diagnosis by training
people in field diagnosis. This is where causes are deduced from
symptoms and other information obtained from the growers and
direct observations.
Field diagnosis is the most common method for determining the
cause of a plant health problem. It works surprisingly well in many
cases though there is little if any formal training on how to do a
“field diagnosis.” When the GPC began to support plant health
clinics in Bolivia and Bangladesh, we saw that the agronomists who
ran them were good at diagnosing common diseases and pests but
they struggled when people brought crops they were unfamiliar with
or presented vague symptoms. Plant doctors have to deal with all
types of problems and it was this realisation that prompted the GPC
to provide training in field diagnosis.
The early emphasis on field diagnosis training was questioned by
many plant doctors. They wanted more training in “control.” Later
we saw the need to produce extension materials. A curriculum for
training plant doctors has been steadily developed over the last
decade and now consists of three modules (training courses), each
lasting 2 to 3 days. The first module shows how to do a field
diagnosis and run a plant health clinic. (The aim is to get clinics
running as quickly as possible. Learn on the job.) The second
module looks at plant “healthcare,” a term I deliberately use to
make further analogies with human health, and which includes crop
protection and IPM technologies. The third module is on preparing
extension messages (mainly writing fact sheets) and how to deliver
them to farmers.
A key lesson from the first training courses in Uganda and
Kenya, was to separate recognition of symptoms from their
interpretation (the diagnosis). People were eager to label a rot as
“fusarium” or a leaf spot as “anthracnose”, perhaps because it
sounded more scientific and decisive. It suggested that distinct
symptoms were present where on closer examination there was
often room for doubt – and a lack of supporting evidence from
laboratory analyses.
 Fig. 7. Edwin García of UNAG helps to run
the Puesto para Plantas in San Juan del
Río Coco in northwest Nicaragua. He's
comparing possible anthracnose on coffee
with similar symptoms on yam from the
CABI Crop Protection Compendium. The
two diseases are caused by the same
fungus but there's no picture of coffee
anthracnose available. Comparing
symptoms with photographs is a common
way of diagnosing problems. It's clumsy
and prone to inaccuracy, but it may be the
only way available to plant doctors in
remote regions.

The first training module in “how to become a plant doctor” uses

group exercises to compare what people see on sick plants before
offering an “expert” opinion on a sample. This is a standard
teaching method we use: people first do a simple exercise, then
compare results between themselves before the teacher offers
“expert” advice. Courses are attended by extensionists, scientists
and farmers and confidence is often shaky at first, hence the need
to begin gently and avoid emphasising what people don’t know or
get wrong. The interpretation (diagnosis) of symptoms begins with
a simple distinction between biotic and abiotic before proceeding to
particular causes. We include arthropod pests as well as all major
pathogens and non-pest causes. One of the key messages is that a
field diagnosis proceeds by elimination and that it is usually easier
to say what is not causing symptoms before suggesting a likely
cause.

In the Beginning: Bolivia

Jeffery Bentley and myself first started talking about plant health
clinics in Bolivia in the late 1990s, when we were starting to explore
local knowledge of plant health problems (9). The idea was to hold
clinics in markets, where people could “walk-in” without prior
appointment. In 2001 we began a short project to promote practical
tests to help growers diagnose plant health problems. One of the
tests was to detect potato nematode cysts in soil: curl a sheet of
newspaper inside a drinking glass, add soil, then water, and swirl.
Cysts adhere to the paper and are visible to the naked eye when
the paper is withdrawn.
We discussed the test with Juan Almanza, an expert técnico
(extension agent) who works for PROINPA, and the possibility of
doing a public demonstration. Jeff and I were staying at PROINPA’s
experimental station in Toralapa and the next day (Friday) there
was a weekly market at nearby Tiraque. In one of those inspired
moments, Juan suggesting doing the demonstration in the back of
the pickup in the market. The event is described in Bentley et al.
(5) and has given rise to a new
extension method called “Going
Public.”
Tiraque market was my first
experience of improvising an
extension exercise on plant
health. Juan began his
demonstration and repeated it
several times over three hours
for new audiences as people
moved on and others took their
place. Jeff an I witnessed an Fig. 8. Juan Almanza of PROINPA is
“unfolding conversation” (4), with skilled at holding the attention of a shifting
Juan patiently answering crowd in the weekly market at Tiraque in
questions about the test and the Bolivia. He demonstrates a quick test that
shows if soil is infected with nematode
cysts (he had a microscope to cysts This was the first ever Going Public
reveal the contents and got event and a precursor of plant health
people to draw what they saw). clinics everywhere.
Juan did this all with great skill
and in a natural way that
astounded me. Until then, I thought that extension had to be
planned, with farmer meetings and fields days, training and
demonstration events. Juan’s performance was an amazing
demonstration of how good extension agents can be. It was very
rewarding to observe, though perhaps not something everybody is
willing or able to do. Outsiders are good at suggesting new things
for others to do but often they need permission first.
Around the same time as the Tiraque event, a community plant
health clinic (LADIPLANTAS) was established by CIAT Santa Cruz in
Comarapa, Bolivia (7). This arose from another project (MIP-PAPA)
on integrated pest management of potato pests and diseases.
LADIPLANTAS is located in offices in the town and is open most
days of the week. Farmers can bring in samples or have them
collected in the field by técnicos working for CIAT and other
organisations.
I then requested Jeff to hold a short workshop on behalf of the
Global Plant Clinic with the aim of starting a plant health clinic in
Tiraque (5). The first ever Posta para Plantas began in September
2003 and has been held regularly since, faithfully attended by Ing.
René Pereira and staff from Toralapa. From the beginning we
emphasised the similarity between clinics for plants and those for
people (Posta de Salud): to offer advice on (plant) health problems.
With support from the GPC and Javier Franco at PROINPA, the
Tiraque clinic has continued. Over 400 people presented queries in
the first year. The early publicity for the clinic concentrated on
telling researchers and extension workers about their popularity and
new ways of interacting with farmers. PROINPA now run clinics in El
Puente, Colomí, Punata, and Tiraque, a good example of how a
successful clinic well publicised encourages other clinics to start.
A striking difference between
running a clinic and doing plant
pathology research is the variety
of problems you have to deal
with. I always imagined that
clinics would be run by
extensionists and agronomists,
people familiar with local
agriculture and already known to
many farmers. Others have
suggested that clinics should be
staffed by plant pathologists with
Fig. 9. Ntozi works for ISAR, the
expert knowledge in all disease
Rwandan agricultural research
organisation, and is asking about a causes. Extensionists make good
problem that affects this lady’s crops doctors, at ease with farmers.
during a pilot plant clinic run in the market The best ones have the
place in Miheto, near Ruhengeri. A good confidence to admit they don’t
interview asks few and short questions know something but they will find
and allows a person to tell their story.
out more. Scientists also make
good plant doctors, though
attending a clinic each week is difficult. Others are uneasy about
diagnosing from symptoms and giving advice on the spot. They are
reminded that this is what medical doctors do all the time.
When clinics start the plant doctors soon realise the challenge of
giving advice. They are not used to a farmer who returns to say
that ‘your advice did not work’ or to ask ‘what is the name of the
resistant variety and where do I buy it’. Plant doctors are encourage
to say when they don’t know – and that they will try to find an
answer. The best advice is often not to do something. For example,
a plant doctor can advise to not use an insecticide because she has
diagnosed a fungus disease. Feedback from farmers and regular
monitoring of clinics helps to improve diagnoses and the quality of
advice.
After Bolivia, we turned our attention to Bangladesh and Uganda,
two countries where CABI and the GPC already had good contacts.
As of October 2007 there are eight countries with over 60 clinics
running regularly (Table 1). We have run pilot clinics in other
countries, such as Colombia, Benin and Cuba though none have
become regular. The biggest clinic scheme is Nicaragua, and that is
what I will now discuss in more detail.

Table 1 Plant health clinics around the world.

Country No. Started Managed by

Bangladesh 25 2004 RDA Bogra, AAS, and Shushilan

Bolivia 7 early 2004 CIAT Santa Cruz, PROINPA, and UMSS

DR Congo 8 March 2006 Université Catholique du Graben, Butembo

India 2 August GB Pant University of Agriculture and

2006 Technology

Indonesia 2 October University of North Sumatera (USU)

2007

Nicaragua 14 March 2005 Farmer organisations, NGOs, INTA, and others.

Supported by PASA II (danida) and other
donors.

Uganda 4 July 2006 Socadido, SG2000, Caritas and MAAIF

Vietnam 2 June 2007 SOFRI

Puestos para Plantas: Nicaragua

In 2004 Dr. Solveig Danielsen took up a post in Nicaragua, as an
advisor to FUNICA, an organisation created to manage technology
projects and provide a missing link between government institutes
and the private or informal sector, where non-governmental
organisations (NGOs) and farmer organisations operate. Soon after
arriving, it became clear that a lack of reliable and regular services
was hampering progress. Solveig knew about the plant health
clinics in Bolivia and suggested that the GPC be invited to try them
out in Nicaragua.
In March 2005 I went with Dr. Jeffery Bentley to test clinics in
Las Segovias. It was a tough assignment since none of us had a
clear idea of who was going to run the clinics. We had useful leads
and the strong support of PROMIPAC, a donor-funded project on
integrated pest management which was run by Zamorano
University. Julio López played a vital part in creating openings for
the clinics and has been an invaluable colleague in supporting their
expansion and growing influence.
Our first two attempts to get clinics started were only partly
successful. We ran one pilot but it was unclear whether it would
continue. Then we met Yamileth Calderón of UNICAM, a “campesino
university.” Yami is an agronomist and knows local farmers and
agriculture well. She is out-going and enthusiastic. She liked the
sound of clinics and agreed to run one at very short notice.
On the 11 March 2005 the first ever Puesto para Plantas in Estelí
took place, our second pilot clinic in Nicaragua. It was rudimentary
— a table, some diseased plants, a microscope (which we didn’t
use, and I’m not sure impressed any potential clients), a hand-
written sign, and two enthusiastic plant doctors: Yamileth and María
Rosa Herrera of ISNAYA. The stall (puesto) was placed at the end of
a row of vendors who make up the weekly mercadito verde, an
organic market for vegetables, fruits, and other products. We had
14 queries in under two hours, and we all felt pleased about the
results. The users included people passing in the street and market
traders that Yamileth knew.
 Fig. 10. Yamileth Calderón (right) is the
plant doctor at the weekly Puesto in
Estelí, Nicaragua. She was the first
person to start a clinic and has been an
inspiration to many others who have since
started their own clinics.

Jeff, Solveig, and myself were now much more optimistic that
this Puesto would continue, and it has. The key to success,
however, has been Yamileth. (I also want to mention the support of
Edgar Castellón of UNICAM, who has allowed Yamileth to spend the
time running the clinic. The employers of plant doctors make
important contributions which need to be discussed and agreed
from the outset.) Yamileth turns up each week at the same time,
sometimes with colleagues or with students from UCATSE.
Two years on from the successful Puesto in Estelí there are 14
operating in Nicaragua. The Estelí Puesto was soon joined by new
Puestos in El Jícaro, Jalapa, and San Juan del Río Coco. The GPC
helped to spread news about the first Puestos, so that others might
be inspired by the efforts of fellow Nicaraguans. We produced
photosheets of the clinics and made a logo. Monthly meetings
organised by FUNICA staff helped create a group identity with a
shared purpose from an early stage.
Since 2005 Jeffery Bentley and I have jointly made seven visits
with a final visit scheduled for late in 2007. During this time we
have trained plant doctors and refined a curriculum on “how to
become a plant doctor.” I want to stress, however, that the true
expansion of the clinics and the emergence of a network of
diagnostic laboratories (see later) and other initiatives have come
from within Nicaragua. These events have been carefully nurtured
by Solveig Danielsen, whose role in the successful development of
the clinics has been vital (11).
Plant pathologists rarely reflect on human behaviour, yet looking
back over an intensive period of activity around the Puestos, it has
been the interaction between extension agents and farmers, and
extension agents and researchers that has helped the Nicaraguan
scheme achieve its momentum and expand from the original three
clinics in mid-2005 towards a planned 33 clinics in 2008.
As the clinics gathered strength and became better known,
Nicaraguan scientists saw the need for a network of diagnostic
laboratories. Bringing together universities and official government
bodies, the “red de diagnosticadores” is a Nicaraguan initiative, an
encouraging sign of how the Puestos have prompted scientists to
take action.
Access to diagnostic
laboratories (clinics) in many
countries is difficult and this is
particularly true for poor farmers.
Their contact with extension is
weak and sending samples for
analysis is impossible. The arrival
of the Puestos and the creation of
the diagnostic laboratory network
meant that poor farmers in
Nicaragua could send samples for
Fig. 11. Liliam Lezana (right) with Solveig the first time. First we needed to
Danielsen. Liliam is the coordinator of the figure out who was going to pay
“red de diagnosticadores” and one of a for the samples. The cost of a
dedicated group of Nicaraguans who
have worked hard to make the Puestos diagnosis is around US$6, a lot of
effective. money to a poor farmer. Donors
have made funds available for
now but in the future all or some of this money will have to be paid
by users of the diagnostic service.
In 2007 we began training trainers and by the end of this year
Nicaragua will begin its own programme for producing new plant
doctors. Around 40 people have taken the three training modules
that constitute the ‘how to become a plant doctor’ course. Module 2
explains how to select the plant part and how to package it
correctly. The quality of samples has improved, though it requires
constant attention and dialogue between plant doctors and
scientists.
The Puestos have strengthened links between groups of people
who had few opportunities before to talk about shared interests in
plant health problems: farmers who want answers, extension
agents who want possible solutions, and scientists who can
diagnose problems and develop new technologies. These three key
groups – growers, extension staff, and researchers – have all
benefited from Puestos, encouraging them to create a single vision
of plant healthcare. A DVD has been produced on the Puestos para
Plantas and copies of publications, factsheets, and more can be
found on the FUNICA website.
Pesticide use dominates discussions about plant health in many
countries and Nicaragua is no exception. Yet while no one disputes
the need to reduce pesticide use and ensure the safe application in
the right circumstances, a focus on pesticides has distracted
attention from a much simpler issue (Science and Development
Network). How do you advise growers on the best method for
managing their plant health problems? The Puestos are a new way
of tackling this persistent question and providing a platform for
promoting IPM technologies.
The ultimate goal is to establish plant health services for farmers
that are available year-round. We want plant clinics to operate in
more areas and to do so each week. We want laboratories to
respond quickly and decisively when they receive samples, helping
plant doctors give advice that is “safe, sound, and suitable.” We
want the government of Nicaragua to recognize that a new support
system for farmers has emerged in response to local demand and
local initiative. What began as a tentative pilot scheme in 2005 has
become a de facto system of plant healthcare serving the needs of
hundreds of poor farmers. For that system to continue it needs
official recognition and incorporation into government policy. This is
what we will be discussing in late 2007 when all major groups with
an interest in plant health will be represented.

The Future of Plant Health Clinics

From 2005-2006 nine Puestos received 1175 queries from more
than 700 users. Since over half of the Puestos were not in operation
until late 2005, that is an impressive measure of the demand for
services. As more Puestos start to operate, and existing ones
improve their current operations, demand will increase. An essential
part of running a Puesto is to maintain a register of users, their
queries and the outcomes. This is essential information when
explaining why national and local governments should invest in the
Puestos. Donor funds will eventually end and we need to discuss
other sources of financial support and how much growers should
pay for the service. We argue that Puestos are a public service, and
like hospitals and schools, have public benefits. The challenge is to
convince elected officials and for them to commit funds that keep
the Puestos going once donor funds are no longer available.
We are optimistic this will happen, if only because the numbers
who have used the clinics are clear evidence of their value. At the
same time, we also need to strengthen ties between the weekly
clinics and the regular work carried out by extension agents, so that
we know more about how recommendations made by the plant
doctors help growers. Nicaragua has provided inspiration to other
countries that have plant clinics. With India planning to introduce
clinics in all 40 states, the stage is set for providing poor farmers
with better advice that helps them grow healthy crops with reduced
risk and lower costs.

Acknowledgments
The work I have described is the result of many peoples’ efforts,
including colleagues in Bolivia, Bangladesh, and Uganda. I thank
them all for their contributions. I particularly want to acknowledge
ideas, inspirations, and stimulating discussions with Jeffery Bentley
and Solveig Danielsen and fellow GPC staff at CABI, Rob Reeder and
Paula Kelly, and the support of Julie Flood and John Lucas. Julian
Smith, Rick Mumford, Val Harju, and Wendy Monger at CSL and
Yaima Arocha at Rothamsted have provided excellent diagnostic
services while Phil Jones, now retired, has been an invaluable
colleague for many years. I’d also like to thank Jim Waller and Tom
Preece, two mentors who have encouraged me for many years and
gave me ideas that are now blossoming thanks to a growing band
of people around the world. Healthy plants for healthy people!
Literature Cited
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Cambridge Univ. Press, Cambridge, UK.

2. Aitchison, E. M., and Hawksworth, D. L. 1993. IMI: Retrospect and

Prospect. A Celebration of the Achievements of the International
Mycological Institute 1920-1992. CAB Int., Wallingford, UK.

3. Bennett, C. P. A., Hunt, P., and Asman, A. 1985. Association of a

xylem-limited bacterium with Sumatra disease of cloves in Indonesia.
Plant Pathol. 34:487-494

4. Bentley, J., Velasco, C., Rodríguez, F., Oros, R., Botello, R., Webb, M.,
Devaux, A., and Thiele, G. 2007. Unspoken demands for farm
technology. Int. J. Agric. Sust. 5:70-84

5. Bentley, J. W. 2003. Starting a Plant Health Clinic in the Organized

Chaos of a Bolivian Farm Fair. Global Plant Clinic, CABI. (Available
from: e.boa@cabi.org).

6. Bentley, J. W., Boa, E., Van Mele, P., Almanza, J., Vasquez, D., and
Eguino, S. 2003. Going Public: A New Extension Method. Int. J. Agric.
Sust. 1:108-123.

7. Bentley, J. W., and Boa, E. R. 2004. Community Plant Health Clinic: An

Original Concept for Agriculture and Farm Families. Online. Global Plant
Clinic, CABI, Wallingford, UK.

8. Bentley, J. W., Thiele, G., Oros, R., and Velasco, C. 2004. Cinderella's
slipper: SONDEO surveys and technology fairs for gauging demand.
Online. Network Paper No. 138, Agric. Res. & Ext. Network, Overseas
Development Institute (ODI AgREN), London, UK.

9. Boa, E. R., Bentley, J. W., and Stonehouse, J. 2001. Standing on all

three legs: The técnico as a cross-cultural occupational group. Econ.
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10. Brunt, A. A., and Kenten, R. H. 1971. Viruses infecting cacao. Rev.
Plant Pathol. 50:591-602.

11. Danielsen, S., Boa, E., and Bentley, J. 2006. Puestos para Plantas in
Nicaragua. Online. Global Plant Clinic, CABI, Wallingford, UK.

12. Harrison, N. A., and Jones, P. 2004. Lethal yellowing. Pages 39-41 in:
Compendium of Ornamental Palm Diseases and Disorders. M. L. Elliott,
T. K. Broschat, J. Y. Uchida, and G. W. Simone, eds. American
Phytopathological Society, St. Paul, MN.

Video Links
Available from Eric Boa's channel on YouTube.
Plant health clinic Rwanda. The clinic
has just started. It's late afternoon but
around 90 people attend in less than
two hours. 15 people present queries.

Samples for clinics. Plant clinic in

Berastagi, North Sumatra. Delima and
Rob Harling help a confused user
obtain the right sample.

Remember to look inside plants. This

impromptu video of internal staining is
given by Fen Beed of IITA and is one
way of explaining how to sample
material for people who live a long
way from clinics. The host is the fever
tree or cinchona and the disease
Phytophthora stripe canker. Location
is near Butembo in North Kivu, DR
Congo. Next time we'll use a proper
knife (as recommended in the
commentary).

Training plant doctors. A short

exercise, part of training course
module 1, to develop interview
techniques for plant doctors. Taken on
a 2007 course at the Université
Catholique du Graben in Butembo,
North Kivu, DR Congo.
 Young plant doctors. Schoolchildren in
Butembo describe symptoms on
plants with the help of Ange, who has
just completed module 1 of 'how to
become a plant doctor'. The
suggestion is that schools run mini-
clinics once a week. Every family in
Butmebo, N Kivu, DR Congo. has a
garden and grows crops.

© Copyright 2007 by The American Phytopathological Society

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