It is an unsettling fact that in a country of 30 million people, there are fewer than 100 heart operations performed annually. There is an epidemic of Rheumatic heart disease there and this affects young people in their 20s to 40s and hundreds of people currently do not survive their condition. In Kumasi, the second city of Ghana, 22% of admissions are due to heart failure from rheumatic heart disease and the average age of those admitted is only 29 years old. 29% of ll deaths in this hospital are due to heart failure. And yet in the west, we know that a heart valve replacement would cure every patient. These unsettling facts have inspired the team from James Cook University Hospital led by Dr Enoch Akowuah to organise a series of heart surgery missions to Ghana.