FREETOWN, April 16, 2018 - Sister Hannah B. Palmer pulls on her boots, getting ready to set out on the latest field-level investigation of 2018. Her job is not easy. She is a Midwife Investigator in Koinadugu, one of the most remote and geographically dispersed districts of Sierra Leone. Much of the landscape here is steep and mountainous, and the district has one of the lowest densities of health workers and clinics, both relative to its population numbers, and the size of its geographical terrain.