Surgical disease has recently become recognized as an important determinant of global health. Pediatric neurosurgery has generally been neglected in international surgical initiatives. In Haiti, the poorest country in the Western hemisphere, neurosurgical needs are currently unmet. Project Medishare and Haiti Healthy Kids have treated more than 1400 children with hydrocephalus and congenital disorders for a 10-year period. To develop a sustainable model for improved neurosurgical health, a neurosurgical training program is currently being developed and implemented.