Roya, a 40-year-old mother of nine, is the sole provider for her children. She works throughout the day to bake the distinctive Afghan flatbread known as naan in a windowless room. Her face is swaddled in a covering both white with flour and dark with soot.

Abdul Hadi has been farming for almost 10 years in his Southern Kandahar village. Tending his crops, however, was always a struggle because of the decrepit irrigation infrastructure available to the area. “Less than half of the farmers could afford to irrigate their farmland by water-pumps and the rest of the lands were left barren. Even some of the farmers were obligated to leave their villages”, Hadi asserted during a rare break from surveying his crops. The winter is particularly difficult for Hadi because like most area farmers, he cannot grow and is forced to purchase imported vegetables from Pakistan.

One morning in 2015, a mother brought her 9-month-old daughter to the Vumilia Dispensary, a health clinic in Tanzania’s Tabora region. Tecra Chubwa, the nurse who oversees the facility, remembers the infant and her mother, and even remembers weighing the girl herself. But when she later reviewed the day’s vaccination records, she discovered the child had not received the measles-rubella vaccine she was due for that day.