This is some sort of a spin on some famous political science work — and it is true here. All knowledge is *incredibly* local. For example, even when I was running in the very neighborhood where my backpackers was located in Livingstone, but I was one street off, no one knew where the mzungus stayed, where Jollyboys was, or even what direction to send me in. This did not frustrate me (although I was nearing the end of 8 miles and CRAVING something to drink!) — it more informed my understanding that people know what is near to them, and that is what is most important. The implications for this in terms of health care and implementing policy is hugely important: in order to have success, local leadership, family, and community must be brought on board.