It has become very evident that task shifting is necessary at this time in Africa’s development, if the nationals are going to be recipients of safe health care. Consequently, Dr. Gyampfi, KBTH Anesthesiologist, is serving in Sierra Leone at present, supporting the development of nurse anesthetists for the country. Not long ago, they had eight for all of Sierra Leone! With tremendous effort, they now boast 80 and are continuing to pursue a few hundred over the next few years. These nurses must serve as staff nurses for three years and have midwifery training prior to being eligible for anesthesia training. Some non-nurse university graduates are also being considered for training, largely due to the insufficient numbers of eligible nurses.