The International Development Studies Alumni Association of Utrecht University

Lessons from the Banana Republic

Uganda, the pearl of Africa. First time on the continent, and what a different world. After lazing about in Kamapala for a while, I was on my way to Kisiizi. A small village in the South of Uganda, amongst the hills with terraces where people grow their crops. The journey to Kisiizi was beautiful, and the landscape slowly changing from Savanna to Tropical Forests. At every stop, salesmen and mostly saleswomen try to sell you their goods through the open windows. Pancakes made from banana, handpicked grasshoppers, cassava sweets, and all the random things you can imagine, like calculators and swimsuits.

Kisiizi was the place where I would do most of my research, that focused on health insurance. My aim was to interview clients of a large health insurance programme targeting informal workers. Health insurance is still something of rarity in many parts of Africa, and something that people could greatly benefit from for their development. Agriculture makes up for a large part of the informal economy in Uganda and like in most of Africa it is mainly subsistence farming. But a sick farmer cannot yield any crops. Prevention, going to a doctor on time, or going to a doctor at all, were all possible benefits of the programme. The question was, does it work? The answer wouldn’t be as simple as the question.

Landscape South Uganda

Many people in the villages don’t have a birth certificate, so their chance of getting a formal health insurance was none. The pogramme centered around the Kisiizi hospital, the only hospital in the region. With a premium of six dollars per year for the whole family, it was reasonably affordable. One of the hardest things was that most people hadn’t a clue what insurance really meant. Or some people that clearly did have a clue and shared their insurance card with the extended family. In a place where passports are rare, how can you identify if your client is really your client? Finally, a common practice was that people were overusing the possibility to see a doctor, just because the insurance covered it, which was driving up the costs.

In the South, there are almost no Muzungu, Swahili for white people. Everybody is interested to find out what you are doing in their village. I was eager to answer their questions, and they mine. Some of the children had never seen a Muzungu before and their reactions ranged from curiosity to downright horror. There must be something terribly wrong with you, hardly having any pigment! The phrase Muzungu however, is always accompanied by a big smile and a heartwarming friendliness. An even bigger roar of enthusiasm occurred during the Sunday mass in church, when I introduced myself to the village and mentioned which football team I support. People love to come together to watch football on the only TV in the village, the one in the school building. My research went well, I travelled through the beautiful region by motorbike together with a translator and I felt a welcoming and friendly attitude everywhere.

The insurance company tried to educate people as much as they could. The clients benefitted without a doubt, but the programme was operating at a loss, through misuse and the fact that the premium could not be increased: people would simply not be able to afford it.

''Education was necessary, one of the most potent drivers of development as we had learned during our studies. This became blatantly apparent during my research.''

On the way back to Kampala I saw so many banana trees, that while I feel asleep in the bus I dreamt that Uganda was a banana republic. People love their banana in Uganda, where it is called Matooke. It’s cooked and baked in many ways, eaten in so many dishes. It is preferred over potatoes, rice, and sometimes even over meat. As a ‘thank you’ for visiting Kisiizi I received a big bunch of Matooke, which was a humbling experience. Those who barely grow enough to feed their families, wanted to share with me their most beloved crop. It may never become my favorite dish, but it symbolizes a country of friendliness, hospitality, a warm smile, it symbolizes hope. 

''If all the countries in the world have a little banana republic in them, 

the world would be a friendlier place.'' 

Even the Malaria that I got as a final souvenir from Kisiizi, could not take that feeling away.