Salima, Malawi … One will probably never hear these words as an ox cart hurries along a dusty dirt road in eastern Malawi, but the urgency is there never the less. The ox cart is on the way to the district hospital in Salima, and it is the only means of transportation from the village to the medical facility. It is hard to imagine if the reader is sitting in a comfortable upscale family room, in an upscale neighborhood, in an upscale community, in an upscale nation in the developed world. But in sub-Saharan Africa it is every day all the time. No 911. No Para-medics. No ambulance. No emergency room. No. No. No. It’s just a last minute rush to the hospital in the back of a slow moving, bump crushing, life-threatening wooden wagon being pulled by two ox carts who have all day to get there. Or do they?