“Infrastructural ephemera” as a set of spontaneous affective relations critical to the success of large-scale projects of urban governance in the urban South are examined. The deep contradictions underscoring the labours of women employed as community health workers in Lyari Town, Karachi, at a time of intense gang violence, are explored. Drawing on two years of field research as a polio vaccinator in Lyari, the reach (and limits) of daptability, skills, and labour (physical, mental, and emotional) involved in the maintenance and repair of a fragile public health infrastructure are explored. Maintaining “community health” also involves dealing mortal and aspirational death to those that provide infrastructural labour to the project of giving life.