Developing nations face tremendous challenges in providing care to mothers and children. Uganda has some of the highest maternal and infant mortality rates in the world. The Luwero Triangle in central Uganda is one of the poorest areas of Uganda. In the late 1990s, the ISIS Foundation began developing a neonatal intensive care unit (NICU) in this area. The article describes NICU development and relates the author's experiences in working with the staff of Kiwoko Hospital. The overall goal of this effort has been to assist the hospital to be more self-sufficient using a train-the-trainer approach.