A call comes in at 4:58 p.m. The night shift hasn’t yet started, so the day team that has been working since 7 in the morning goes out. We leave at 5:30. There’s no explicit rush. The 11-year-old isn’t bleeding.

Mary Elias, of Laje village in Malawi’s southern Zomba district, speaks in metaphors. “We are carrying both water cans,” she says of the situation for single mothers in drought-ridden Malawi—meaning that women with children but without partners are solely responsible for feeding, clothing, and educating their progeny. Already a Sisyphean task in a country the United Nations Development Program regularly ranks in the top 20 poorest on earth, this has become nearly impossible in the past few years.