This photo is showing Dr.Raymond teaching the final year anaesthetic students in the ICU. The value of the anaesthetists contribution to ICU is now becoming established in rural Africa as the curriculum now includes specific items on ICU training. The child was on a ventilator and suspected of having taken a poison that paralysed his muscles. The challenge is to be able to provide low cost intensive care that will be sustainable in rural Africa and available to the poor. Many of these students will return to hospitals that have no capacity at this stage to set up an intensive care unit but seeing the work in St.Mary’s Hospital will plant a seed in their minds for the future.