Sixty children out of every 1000 live births die before their 5th birthday in Zambia.  These rates are much better than they were a decade ago but still high compared to the UK (around 4 per 1000 live births).  Many of these deaths could have been prevented the right treatment was given sooner (e.g. fluids for dehydration or antibiotics for severe pneumonia).  An audit at the University Teaching Hospital (UTH) in Lusaka found that two thirds of childhood deaths occurred within the first two days of admission.  Whilst there are often delays getting to hospital (families may live far from the hospital and not be able to afford transport for example) consultant paediatrician at UTH Dr Somwe Wasomwe wondered whether better care at the time of admission might improve outcomes and save lives.  He and colleagues noted that nurses who looked after sick children were not trained to look after children and many had lost their skills once they qualified due to a lack of ongoing training.  One of the results of these observations was the development of the diploma of paediatric nursing.  The other was to develop training in advanced paediatric life support (APLS).  Dr Wasomwe and Professor Paul Seddon, a paediatrician at the Royal Alexandra Children’s Hospital in Brighton, were already working together and started working on this idea.  They successfully applied for funding from the THET Partnership scheme and were able to get a team of APLS trainers from the UK and from South Africa together in Lusaka to develop the programme. The courses were aimed at health care professionals who looked after very sick children at admission and enabled them to resuscitate and treat very sick children soon after arrival at UTH.  A number of more senior practitioners were identified and trained to ruin the APLS course such that the programme was sustainable and continues to run new and refresher courses.y