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This article considers the long-term ramifications of biomedical technology transfer in Uganda. It tells the story of the procurement of a radiotherapy machine through a partnership with the International Atomic Energy Agency (IAEA) in the early 1990s. This radiotherapy machine was seen as “rugged,” “simple,” “affordable,” and capable of quickly and cost-effectively treating cancer patients. By the late 2000s, this machine had a reputation for frequent disruptions of service due to breakdowns large and small. In addition, the Cobalt-60 source was severely depleted and in need of replacement. The article highlights the constellation of efforts and decisions made by Ugandan physician-scientists, mechanics, and technocrats to keep radiotherapy services going. The article suggests that the history of the radiotherapy machine offers a much-needed perspective on the half-life of technology transfer, the darker side of repair, and the politics of responsibility.