Abstract In the global context of modern medicine, even a paediatrician in a remote area has to practice with a global view. Since I have a little experience in international circumstances, I have been trying to keep abreast of the global update. In Pakistan I was involved in a high-level care centre, especially in NICU. There, however, I learned the tendency in the international assistance field of those days; more public health oriented projects rather than high-level curative medicine. At that time UNICEF and WHO were very keen on promoting issues such as breast feeding, vaccination, ORS and ARI. These issues should be given more attention in the public health sector in Japan. In Mongolia I had the opportunity to participate in a public health project. There I was able to learn more about environmental health issues and immunization in a less populated area. In Akita, where I am now based, there are many hamlets that are remote from populated local centres. I have experienced many adult re-infection cases of mumps, varicella, and other viral infections that have been believed to be fully immunized after the first infection. Therefore, we were able to discuss relevant issues in promoting immunization in less populated areas last year when we invited a Mongolian counterpart to our town health center. Also, for several years I have been invited to Pakistan to give lectures on Neonatal Resuscitation in a course named “Safe management of newborn infants”, in which we use the well-documented neonatal life support programme by AAP and AHA. In our setting in Japan, I find some difficulty in communication with patients. And I believe this is quite similar to the difficulties that I experienced in Pakistan or in Mongolia. I should like to say that future assistance projects should be up to the international standard. An arbitrary project that is not based on a neutral way of thinking and global evidence must be discouraged.