nce a week, early in the morning, community health worker Kiden Josephine Francis Laja mounts her bicycle and pedals as far as 10 miles away from her small village in South Sudan. Some weeks Laja is doing outreach, spending her day educating a community about which vaccines she can provide and what diseases they prevent. “It’s my responsibility to tell the mothers to bring the children for vaccination,” she says. She answers their questions and lets them know she’ll be back, usually the following week, to vaccinate their children. Late in the evening she mounts her bike and heads home.

When Laja returns with the vaccines, kept in a cooler with ice packs, she will spend the day immunizing anywhere from a few to 200 children against a range of diseases: polio, tetanus, diphtheria, pertussis, hepatitis B, influenza, bacterial meningitis, tuberculosis and, more recently, COVID. Most people in high-income countries haven’t seen these diseases in decades, but the people of South Sudan know them well. Many have seen family and friends die from them.

During the rest of the week Laja works […]

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