In Afghanistan’s remote and mountainous Nuristan province, children are highly vulnerable to polio and other deadly diseases due to multiple, intersecting needs that stem from long-standing isolation and multiple deprivations.

Nestled against her grandfather’s folded legs, Roqia looks solemnly at the strangers who have come to visit. Above them, the window opens onto steep-sided mountains, where the last of the morning’s rain clouds still linger, sticking to the highest trees. In February when the two-year-old developed a fever and weakness in her left leg, her grandfather made the two-hour journey down to the district hospital on foot, carrying his granddaughter in his arms. The lab results came back positive: Roqia had polio.