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36-year-old Miriam told me she first noticed a change in her right breast two years ago. There was a firmness in the upper outer por- tion of her breast. She thought nothing of it, since it was not stopping her from going about her daily work. Faced with the demands of car- ing for five children, in addition to the daily two-hour commute from her village to sell cassava roots in the nearby township of Ijebu-Jesa in Osun State, Nigeria, taking time out to have her breast examined was not an option. While there was a women’s health clinic at the local community centre, the resident doctor had recently left for the United Kingdom (UK), and Miriam was not sure if they would see her for this problem. Visiting a private doctor would cost her two months’ worth of income. Almost no one she knew had health insurance; in fact, most had not heard it existed.