Ancient lampposts lean at all angles in the central reservation, drunken reminders of a colonial past as we head out of Kananga at 8.00am, but suddenly the road surface quite literally drops away.

Looking to the side there is a line of asphalt four feet above us - another reminder of what used to be. Soon even that is gone and we bounce along on the mixture of baked clay, mud, pothole and fissure that counts as a good road most places in Democratic Republic of Congo.

Yesterday, during a briefing meeting, one of the Congolese doctors working with the International Rescue Committee (IRC) in this remote province rolled up his trouser leg to show me an ugly looking graze, the latest injury he'd incurred flying off his motorbike during a regular day's work. The road we are on today is a highway compared to the paths he must negotiate to reach the outlying communities under his care.

Kananga in Kasai Occidental is a very long way from anywhere.

Midway between Lubumbashi in Katanga and the capital Kinshasa, south of the tropical rain forests, it is a mining area which has seen its fair share of conflict.

However, it has never grabbed the headlines like the eastern provinces of South Kivu or Orientale - renowned for violence - and the IRC is pretty much on its own providing assistance in the area.

We are here rebuilding or refurbishing health centres as part of a primary healthcare programme funded by Britain's Department for International Development which we are running in partnership with the Congolese Ministry of Health.

The IRC's mortality survey in 2004 showed that 1200 Congolese people were dying every day from preventable causes, 50 percent of them under five, mainly the result of a lack of access to healthcare after the decade of conflict that had wracked the whole country. This programme is helping address that problem

At Kasasa, a health centre catering to 16,000 people spread across in 11 villages, my attention is drawn to a very pregnant young woman sitting quietly amongst the new mothers and their babies. She is waiting for the arrival of her second baby. Her first died of a fever and she is taking no chances waiting at home for this one.

Next door a father sits anxiously by the side of his 10 year old daughter as she tosses and turns in a malarial fever, rambling to herself, her arm attached to a drip. They were working in the fields this morning when she got sick and he rushed here, the nearest health centre, for treatment. I ask him about the rest of his family and he tells me another of his children also has malaria but is in a centre closer to home.

I discover that it is not uncommon for a child to have malaria four or five times a year.

Further up the road, mothers and babies line up in the shade outside a functional tin-roofed brick building in Nsapu Kumuamba, waiting for treatment at the refurbished health centre.

Inside there are six new arrivals, babies whose mothers chose to have them in the safety of the centre. All have mosquito nets which, as part of the programme, they will get to take home, some protection from the constant threat of malaria.

Marthe, a local volunteer community health worker, has worked here for three years. She isn't qualified to dispense drugs but she checks 10 to 15 families in the village at least once a month, making sure that the children are up to date with their vaccinations and on the lookout for early signs of malnutrition or acute respiratory infections.

The health centre staff tell me their concerns - they need electricity, they need running water and by the way they would prefer not to have to spend three hours walking the 15 kilometres (10 miles) to work from their homes in Kananga.

Soon the road disappears altogether and we hurtle along no more than a footpath, the grass and bushes crashing against our sides.

I feel like an off-piste skier, wondering what might lie beneath the greenery. Our driver shows no such concerns.

Another stop, this time at an unrefurbished health centre in Luyamba. Just its size distinguishes it from all the other thatched huts in the village.

Nurse Francois Gakamba is still proud to show us around. It might be pitch dark and primitive but he keeps the pharmacy and delivery room as clean as mud floors and wattle walls allow.

Finally, we are back on the apology for a main road heading back to town and I have time to think more about what I have seen and the determined optimists I've met - the Congolese doctors and nurses, the local health committees, the community volunteers and the villagers themselves.

Setting up a viable primary healthcare system in this huge country, which the pilot of the small plane in which I travelled out to Kananga described as a giant Petri dish, is an enormous task.

Read more from IRC's Lydia Gomersall in Congo:

Why are Congo's babies dying?

How does a Congolese village decide what to do with $30,000?

What do Congo's women really want?

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