When Simeon first entered the health center in Gashora, Rwanda, 20 years ago, he had a bothersome fungal infection on his foot and wanted treatment. Back then, the place did not look that much different from today: inadequate rooms, a bare-bones staff (about four nurses to serve a population of 20,000), no running water, no electricity, and little in the way of pharmaceuticals. The nurse on duty sent him home with no idea of what to do and no ability to do a follow-up.

Over the years, Simeon’s foot enlarged as the fungal infection spread. He made an annual pilgrimage to the health center but always received the same response: there’s nothing we can do about it. Earlier this year, a member of my team found Simeon in agony at the local hospital. His foot was nearly as large as his torso and the emanating smell was nauseating. As his skin cracked, puss oozed through the surface, threatening additional infections. Given the size of his foot and the severity of his problem, we were all amazed that he’d made it to the hospital at all: he’d walked there from his home, a distance of more than 10 miles.

With a few photos sent over the internet to experts at the World Health Organization we had a likely diagnosis: chromoblastomycosis. The drug of choice was astronomically expensive and would have a slim chance of success but we managed to obtain a donation. Six months later, though the foot has not visibly changed, Simeon reports he can walk on it a bit better. Experts agree that in spite of what may be minor progress, amputation is the best option. Simeon is happy to proceed and finally have closure.

Martin is a 14-year-old who has grown up in Bugesera District. Seven years ago a venomous snake bit him on the foot, the muscles atrophied, and he was left with a persistent skin lesion and a permanently outstretched foot that could not fit into any shoe.

Earlier this year he learned that some of the medical staff at Mayange health center had arranged surgeries to help other kids with deformities. In spite of the lack of telecommunication and the distances involved, Martin singlemindedly pursued the nurse coordinating the surgeries, sometimes walking on his lame foot 15 miles to see her for help and consultation.

His persistence has paid off. Today, Martin has undergone two surgeries and his foot is at a 90-degree angle for the first time since he was seven years old. His lesion is gone, and he’s looking forward to running for the first time in years.

Though their cases have turned out very differently, both Simeon and Martin share striking similarities. Both grew up in and live in Bugesera District. Both struggled with medical conditions that hobbled them in every sense. Both showed indomitable persistence and perseverance in the face of their misfortune.

Martin was luckier. He lives near a health center that has been improved in significant ways. The facility is small, but it has made a huge difference in the lives of people in the villages surrounding Mayange.

Would Simeon’s foot have recovered if Gashora’s health center had earlier undergone the transformation that Bugesera’s has? It’s impossible to say. So much time was lost in his case and the course of his disease went untracked and unchecked. The Gashora Center’s shortcomings will soon be addressed, but there are other places just like it in Rwanda, with patients who cannot wait. The consequences of taking too long are clear.

At a time when all eyes continue to look at Africa as a continent riddled with mass pandemics of malaria, AIDS and tuberculosis, it’s easy to write off the mass health challenges as too difficult to tackle. While it will take decades, at best, to eradicate those scourges, these stories show how efforts in the meantime can improve one life at a time.