The Konso villagers, for instance, own and control their pumps. Elected committees set fees, which cover maintenance. No one seeks to recoup the installation costs or to make a profit. Villagers told me that, after a few weeks, they realized paying a penny per jerry can is actually cheap, far less than what they were paying through the hours spent hauling water—and the time, money, and lives lost to disease.

How would Aylito Binayo's life be different if she never had to go to the river for water again? Deep in a gorge far from Foro, there is a well. It is 400 feet deep. During my visit it was nothing much to look at—aboveground it was only a concrete box with a jerry can inverted over it for protection, surrounded by a pyramid of bramble bushes. But here's what was to happen by March: A motorized pump would push the water up the mountain to a reservoir. Then gravity would carry it back down to taps in local villages—including Foro. The village would have two community taps and a shower house for bathing. If all went well, Aylito Binayo would have a faucet with safe water just a three-minute stroll from her front door.

When I ask her to imagine this easier life, she closes her eyes and reels off a long list of chores. She will go the fields to help her husband, collect grass for the goats, make food for her family, clean the compound. She will be with her sons, instead of leaving a grave little four-year-old in charge of his younger brothers for hours on end. "I don't know whether to believe it will work. We are on top of a mountain, and the water is down below," she says. "But if it works, I will be so happy, so very happy."

I ask her about her hopes for her family, and her answer is heartbreaking in its modesty: to get through the new hunger brought on by the drought, to get through this new wave of disease—to scramble back to the meager life she had known before. She doesn't dream. She has never dared think that someday life could change for the better—that there could arrive a metal spigot, out of the end of which gushed dignity.