My first experience of working in Africa was as a registrar before I had commenced higher training in geriatrics.  Having always been interested in working in low and middle income countries (LMICs), I undertook the Diploma in Tropical Medicine and Hygiene (DTM&H) at the Liverpool School of Tropical Medicine (LSTM) in 1989 and having learnt all about infectious diseases, and nothing about non-communicable disease in the tropics, took up a post as senior medical registrar employed by ODA (Overseas Development Administration) in the Royal Victoria Hospital (RVH), Banjul, The Gambia.