Introduction and Aims: Much of the world faces life without affordable health care. The burden of affordable specialist care has fallen, in large part, on visiting medical volunteers. However, culturally and resource-appropriate patient care is possible. Surgical specialties such as orthopaedic surgery can be developed by providing seed knowledge and skill and developing indigenous skills.

Method: This presentation is based on personal experience in developing countries, specifically the Sihanouk Hospital Centre of HOPE.

Results: Surgical and orthopaedic training has been developed in this resource-poor environment and the individual challenges have been met. A graduate approach to instruction and training is needed and this takes longer than would be the case in a more developed setting.

Conclusion: Surgical training programs, which respect local attitudes and culture, can be set up in resource-poor settings.