BBC News health reporter
Each year the African country of Malawi trains about 60 nurses.
There are 150,000 disabled children in Malawi
But that figure is dwarfed by the 100 who leave the country annually in search of better wages abroad - many of them heading to Britain.
This autumn, two more nurses will leave Malawi bound for Carlisle, in Cumbria.
But, unlike many of their compatriots, these nurses will be going back.
For they are part of the latest initiative by staff at the Cumberland Infirmary.
They will be trained in the hospital for a couple of weeks before taking their newly acquired skills back to Malawi.
Clare McKenzie, a sister in orthopaedic trauma, said that staff from Carlisle had already been out to help in the new orthopaedic hospital in Blantyre, Malawi, and have, with the help of local companies and businesses, sent out truckloads of equipment.
Clare said she would like to see projects like this extended.
"I think a scheme like this on a bigger scale would address many of the issues in Africa. We have shored up our system with international recruitment."
But she added that Africa was now paying the price as it had too few nursing staff to cope with patients.
Malawi has only three orthopaedic surgeons for a population of 11 million, compared with one to 45,000 in the UK.
There are 150,000 physically disabled children in the country and about 50,000 of these are thought to benefit from corrective orthopaedic surgery.
The Carlisle-Blantyre hospitals link was set up when Jim Harrison, a senior registrar in Carlisle, left to work as the medical director of Malawi's first elective orthopaedic hospital for children - The New Beit Children's United Rehabilitation (CURE) Trust international Hospital.
Since the hospital opened three years ago, Clare and her team have been involved in sending out journals, medical materials and used equipment.
For their Malawian work, Clare and colleague Pauline Stratton were named Nursing Standard's joint national nurses of the year in 2003.
Pauline received her award posthumously having been killed in an elephant stampede on safari while visiting Malawi in May of that year.
Clare said the link had become very important to the Cumberland hospital, particularly the orthopaedic department.
"We visited in October 2002 before the hospital opened and spent three weeks there doing a bit of teaching and helping to set it up. And it grew from there."
Beit CURE Trust International Hospital
She said one of the rewarding things about working in Malawi was the massive difference that could be made in the lives of the children, by enabling many to work again.
"There was a little boy called Willy who had congenital deformities and he could not work. He had nine operations and is now his family's chief fire collector," she said.
And she added the whole experience had been very rewarding.
"I went to give. Instead, I received far more in return."
Jim Harrison, in Malawi, agreed that the operations at the hospital were life changing for the children.
"Surgery is often life-changing, restoring mobility and dignity. For many children it will enable them to go to school and have hope for the future."
Marie Burnham, chief executive of the North Cumbria Acute Hospitals NHS Trust, said the Malawi orthopaedics link had been such a success that the whole trust was thinking of linking with an African hospital later this year.
She said it would be able to share its skills with Africa, but that it would also be able to learn from staff there about dealing with TB management and communicable diseases.