In summary all conditions to achieve a good and long relationship appear to be present at KCMC. It is crucial to retain the current residents and thereby create a new staff. The current residents will be the trainers of the future. They are now rotating in Muhimbili hospital for their training. The aim should be to compile a schedule that guarantees the more or less permanent presence (with brief interruptions at most) of one or more Western ENT doctors at the ENT department. Once this has been sufficiently organized, the residents can continue their education at the KCMC. This will involve a thorough training schedule. The American and Dutch model can serve as a basis. If these conditions can be met, it seems a long lasting cooperation can be successful.