Counting fish and children
On Sumba's south coast, the clinic arrives by boat once a month. The village register decides who gets seen first — and it is not negotiable.
The clinic boat leaves at four in the morning, when the swell is kindest, and reaches the first of twelve villages as the fish boats come in. The crew has learned to set up the tent between the catch and the tide: midwife's table first, vaccines in the cooler under it, the growth scale on a board across two crates.
Every child under five gets screened — 210 on a good visit — and the numbers go into the village's own register, a hardback book that lives with the village midwife. The program's team copies a single summary line per month and leaves the book where it is.
“The register stays in the village. We copy one line a month. That rule is why the book is honest.”
"The register stays in the village," explains Daniel Okonkwo, partnerships lead. "We copy one line a month. That rule is why the book is honest. A village that owns its numbers has no reason to round them up for us."
The boat schedule was negotiated at a harbour meeting that took most of a day and is still posted, laminated, on the fish market wall. Villages traded slots so that market day and clinic day never compete — a logistics decision made entirely by the people it affects, which the crew credits for a 96% appointment rate.
Next year the district health office takes over the route funding. The transition plan runs to eleven pages and ends with the same sentence as the program page: the boat stays, whoever signs for the fuel.