The delivery of high-quality health care to all on the Planet is the responsibility of those trained in its procurement. For Surgeons who have had the benefit of working in modern facilities common to the developed World, there is an expectation that the experience, judgement and skills acquired are shared with those in developing countries battling to provide good standards of care to their own peoples. It is to our immediate neighbours in the South Pacific that Australian and New Zealand Surgeons bear this responsibility. Generations of RACS Fellows have shared in this endeavor over many years. There are a variety of avenues through which this can be channeled today, and a few select ones are described. Under the umbrella of RACS Global Health Grants and Partnership division, International scholarships are offered that match South Pacific Surgeons to mentors in Australasian training centres, travel grants are available to provide short term training opportunities, and financial support to South Pacific Surgeons in training can be sourced. The RACS Pacific Clinical Services Health Workforce Improvement Program (PCSHWIP), under the auspices of its Global Health program, provides Visiting Medical Teams (VMT) for volunteer service to 11 countries in the Asia-Pacific region. Nauru is among them, and its Ministry of Health has identified vascular access surgery on its dialysis population as a high priority. Into its second phase, PCSHWIP has sent teams to Nauru in the past two years, and personal experience on one of these trips is described. The Fiji Vascular Project was a collaborative endeavour shared between Fijian and Australian colleagues, was undertaken preCovid, and has provided the impetus for development of an endovascular service in country.