Six month old twins Nkanzo and Pemphero are healthy beneficiaries of Joyful Motherhood. Years before their birth, their Malawian parents moved across the border to Mozambique in search of a better life. They settled there and had five children together. These twins were their sixth and seventh children. Their land provided what they need to sustain their large family but it was located in a remote area, a long journey to the nearest health center. In spite of the distance, their mother made it to the clinic for prenatal care four times during her pregnancy (this is the recommended number of prenatal visits in Malawi). However, when her labor started there was no question that she would labor at home. Without transportation many women deliver their babies at home in rural areas. Given the circumstances, this is a rational decision, and most of the time births are relatively uneventful. Nkanzo and Pemphero each cried spontaneously after being pushed into the world, but within moments their mother began to bleed profusely. The women with her alerted other community members who quickly loaded her in an ox cart to take her to the clinic. But long before their destination sat on the horizon, she died. Rather than returning, the group continued to the woman’s home village in Malawi with her body and her babies. The remainder of the journey was marked by the slow plodding of the ox, a woman’s weeping, and the occasional cries of hungry newborns. Upon reaching the home village, maternal relatives immediately assumed care of the babies and tried to provide for them as best as possible. Without breast milk or formula the babies quickly began to deteriorate. Guardians took the babies to a clinic for treatment and from there they were connected with Joyful Motherhood. The JM nurses recount that they were not optimistic about the survival of the tiny sick babies. Still, they provided medication, formula, and education. And, after several weeks they returned to find the babies improved. Joyful Motherhood has been following the twins over the past several months. At this point the twins are bright and curious little babies who bring joy to those around them. This is another example of the difference we are making together in Malawi.