In beginning and running every program there is an issue which must be overcome. In the developing world there seems to always be a missing link which creates an untenable situation.
In beginning the second Safe Motherhood mobile clinic at Boko the issue was getting the donated ambulance going so that staff could get there and so that the ambulance could provide a place to see patients. In this case the missing link was spark plugs which are only available in the US. We were lucky to learn the problem and access the spark plugs. The ambulance is going.
Having antiretrovirals is good, but not being able to test in order to use them is not. This is the reason for beginning the HIV/AIDS testing program.
Lack of materials of all sorts is an ongoing issue at all times. Simple things like money for examination gloves, or pencils make a big difference. Bigger things like equipment can make it possible to open another operating room which sits unused. Lack of material creates untenable situations in all areas of education and health care.