It's six in the morning, and the sun is rising behind Lake Tanganyika. Thick smoke wafts through the air, blown across the lake from distant forest fires in the Congo. I am sitting on the steps of a small medical clinic, staffed by two nurses. Though it's early, there are over seventy women and small children congregating outside its door, their chatter punctuated by frequent coughs and moans. At the women's feet, children giggle as they kick up dust.