Caring for small children and the family in Burkina Faso is hard work. Although the health infrastructure in Burkina Faso is weak and many citizens feel neglected by the state, Fragile Futures shows that the state continues to play an important role in people’s engagements and hopes for a better future. Based on more than twenty years of research engagement with Burkina Faso, it is an ethnography of how rural citizens address ambiguities of sickness and care and try to secure a decent future for themselves and their families.