The purpose of this presentation is to describe an American plastic surgery resident's experience working for an academic year in a district-level general hospital in rural Kenya. The operative experience, educational value, and cultural adaptation over the custom-designed year are discussed. Furthermore, the logistics and ethics of picking a location, adjusting to the milieu, and treating patients are evaluated. The importance of a qualified, supportive, and perceptive mentor is emphasized. International volunteerism in plastic surgery beyond the more typical 1- or 2-week short-term trips can be extremely beneficial to a resident's experience, although long-term benefit to the served population should not be overestimated. A careful understanding of plastic surgery in relation to the global burden of disease highlights the fact that plastic surgery, although valuable, is limited in its role within international medical volunteerism. Not unexpectedly, obstetric, orthopedic, and general surgical skills are vital in the management of the most common surgical maladies.