Clutching an umbrella, medical records and her 2-year-old daughter, Kani Fall negotiated the brown puddles lapping at the hospital gate, the final hurdle in a two-hour, rain-soaked journey to her nearest vaccination clinic in western Gambia.

Fall waited with dozens of mothers and babies in the flooded courtyard of Bundung Hospital. Then a doctor emerged with bad news. The hospital had run out of measles vaccines, and it wasn¡¯t clear when they would receive more.

¡°They told me there was no vaccine. But I am coming back,¡± said Fall, 27, who had closed her catering business for the day to make the trip. ¡°It¡¯s for my daughter, it¡¯s for her health,¡± she added, fighting back tears of frustration.