There is a place where herds of camels circle by the side of the road, where large land turtles drink from roadside puddles, and the distant hills are Ethiopia. This land has known years of war and even now in peace the outside world offers very little help. Basically, this is a place unrecognized by the Western world. There are medical students training under less than optimal circumstances here, where only a few years ago they might only get one lecture per week. My colleagues here at Kijabe Hospital have made a commitment to help these students and I recently spent a week lecturing and doing patient care with fifth year students. At the same time my surgeon friends were doing scores of surgeries; one of my friends did 36 surgeries, 15 of them gallbladders. There is no one in this country who can take out a gallbladder if our team is not in town. Open fractures stay open for months, until we can fix them. Every day in clinic there are at least 2 or 3 large goiters that haven’t been assessed or treated for years. There is slow progress being made and most of it comes from indigenous efforts and money from the diaspora. The entire medical infrastructure is in slow creation, out of rubble and chaos. To be a small part of this building process was amazing.