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It is 6:30 a.m. in the rural village of Andolofotsy, a six-hour drive from Madagascar’s capital, Antananarivo. Léa Harilalao opens the door and looks across the road to the thatched shelter where a dozen or so people have already begun to congregate. “The dispensary is only meant to open at 7,” she laughs softly, “but, as you can see, people come early.” So, often—when she is not hosting visitors—her day also starts early.