I built the system for almost a year before I really understood what it was for.

For all that time, the babies were three letters. SVN. Small and Vulnerable Newborns. That is what they were called in the system I was building, and that is all they were to me: a field on a form, a row in a database, a record to be registered, tracked, and followed home. I knew the workflow by heart. I had never stood in the same room as the thing it was for.

The work was the digital backbone of a Kangaroo Mother Care program: the system frontline workers used to find preterm or low-birth-weight newborns, register them, guide every visit, and track each baby through the fragile first weeks of life, along with the in-app training that taught the workers the method before they ever began. I built it for several partners. Some were home based, where frontline workers went door to door. Others were hospital based, where the nurses themselves were the workers.

Then I visited one of the hospital based sites, in a small rural town in India.

The first place they took me was the NICU. I am not sure what I had imagined, but it was not this. A clean, sealed room. No parents, no visitors, just machines and babies. Hours old, some so small they did not look finished yet, each one alone, kept alive by tubes, fighting for the most ordinary thing in the world: the next breath. No mother was holding them. They were far too fragile for even that. They were doing the fighting entirely on their own.

It was in the other wards, the ones with the more stable babies, that I finally saw the program I had built actually happening. There were the women. Mothers, grandmothers, neighbours, the women of each family, taking turns holding a tiny newborn against a bare chest. Skin to skin. That is the whole, almost unbelievably simple idea of Kangaroo Mother Care. A mother’s body regulates the baby’s temperature, steadies its heart, feeds it, keeps it alive, in places where an incubator is a scarce luxury and the trip back to a hospital can cost a life. Done consistently it can cut newborn deaths by up to 40%. And still, fewer than 5% of the babies who need it ever receive it.

I could not speak their language, not really. A few words, a lot of gestures. I expected that to be a wall. It was not. You do not need a shared language to understand a woman holding a child to her chest and willing it to live. That is its own grammar, and every woman in that ward was fluent in it.

Somewhere between those two rooms, the abstraction I had lived inside for a year fell apart. Every record I had designed was one of these babies. Every follow-up reminder was a worker reaching one of them in time.

I had built the program first on CommCare, and later helped carry the whole thing onto Connect, Dimagi’s newer platform, the one that walks a worker through each visit step by step, records what happens, and pays them only once the care is verified as delivered. On my screen that was architecture. In that hospital it was the difference between a baby who got followed home and one who slipped through.

The system I helped build has since tracked more than 5,000 of these newborns across India, Kenya, Nigeria, and Uganda, for around $36 a baby. But that is not the number I remember. I remember the room.

Of everything I have built, this is the work I am proudest of. Not because it was the most technically complex thing I have done. It was not. Because it is the work where I could stand in a building and watch software turn into survival. We rarely get to see what we make actually land. I got to watch this one land.

It changed how I build. You are always building for someone you will never meet, and that is not a reason for distance but the reason for care. A confusing form is not a small annoyance out in the field; it is a tired nurse getting something wrong beside an incubator.

But the thing I actually carried out of that hospital was not a lesson about software.

I think about the NICU often. I think about it most when I am at my lowest, when the work feels too heavy, when the rejections stack up, when I want to stop. Because I saw what those babies did. Hours old, with nothing. No strength, no size, no family in the room, no promise of tomorrow. Alone, on tubes, and still fighting for every single breath. Nobody told them to. They had no idea anyone was watching.

If they could fight like that, what excuse do I have?

I must not stop.