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How do you innovate? Tiraque fair on the 7 December 2001 gave suggestions on what to do. The first vague thoughts were that we needed to join forces with new groups of people and be innovative or undertake 'fresh thinking that creates new value', to quote a pithy definition from the business world. But change was needed, because DFID published a landmark policy statement on eliminating poverty in 1997 and a consensus on Millennium Development Goals appeared in 2000.

Up till then CABI had provided a 'diagnostic and advisory service' to developing countries, supported by the UK Department for International Development (DFID), for over thirty years. The Tiraque fair is where the Global Plant Clinic (GPC) began to take shape. It has a big potato market and lorry loads of onions, broad beans and other agricultural produce regularly come and go. The town comes alive every Friday when a busy agricultural fair attracts many people (mostly farmers) from nearby and buyers and traders from further afield. Tiraque is a small town in Bolivia, about two hours from Cochabamba on the road to Santa Cruz de la Sierra. AlthoughFFSreachessmallaudienceswhichthen fail to pass information on to their neighbours, this intimate audience contact makes FFS an exciting tool for participatory research. There are other extension methods, including radio, video, television, promoters (villagers trained to pass a message on to others through practical demonstrations), written material, workshops, extension agents, picture songs, going public (Bentley et al., 2003) and plant clinics, among others.Whilethesemethodsdeservemorecreativity and thoughtful evaluation, it is clear that radio especially can reach enormous audiences at low costs in local languages. If those people do not or cannot convey their new knowledge to others, then most of the farming community learns little about IPM thus other extension methods would probably reach more people, and so be more appropriate and democratic. FFS is a high-quality, face-to-face method which reaches few people. This is sobering, since FFS can reach about 25 people per community per season. The studies agree that FFS graduates do not teach what they have learned to their neighbours. FFS farmers are often chosen from among the wealthiest farmers, confounding comparisons with others. The more quantitative studies tend to show the fewest benefits. spend less money while reaping larger harvests), although not all of the studies replicate these results. Some studies show that FFS graduates farm more profitably than their neighbours (e.g. FFS graduates learn about pest ecology, and often decrease their insecticide use. Some of these show that farmers like FFS and change their attitudes as a result of it. However, there has now been time for detailed evaluations (reviewed in Bentley, 2009). It caught the imagination of many IPM specialists and spread to various countries. From its start in Indonesia in the 1980s, FFS was creative, ecologically sensitive and peoplefriendly. Field schools meet weekly to observe and discuss pests in the field, from seed to harvest. In recent years, farmer field school (FFS) has been the dominant method for IPM extension.

The alternative, integrated pest management (IPM) depends on conveying the right message (a technology and its background information) in the clearest way to as much of the target audience as is possible (method). Pesticide abuse among tropical smallholders is one of the greatest challenges to sustainable agriculture today. Not only is the original report (written by Jeff Bentley) revealing about the benefits of plant health clinics, but allows the reader to learn more about the genesis and thinking behind plant health clinics. The results were published in a peer-reviewed journal (Bentley et al.) so valuable things were discovered.

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Yet, looking back after some years this is a valuable account of how to approach an impact assessment with limited resources and time. The team behind this report had at the time just learnt about 'randomised control trials' and the whole palaver of attributing outcomes to a particular intervention.

Fumbling is not meant in a pejorative or negative way. Hence this report, a first fumbling attempt at an 'impact assessment'. Ultimately we wanted to know what this all meant and to do so succinctly. Over the next years we (the Global Plant Clinic of CABI and a happy band of collaborators in Bolivia - who did all the hard work) expanded the network, ran training courses and learnt more and more about what it takes to succeed at providing regular advice to farmers. Plant health clinics started in Bolivia in 2000/2001.

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