Rosie has worked for >20 years in a resource constrained setting on the Thailand-Myanmar border contributing to optimizing treatment of malaria and health care in pregnancy and child birth and early childhood. These improvements do not happen by research alone but by investment in care. The closer quality care can be delivered to the population - logically, the greater chance it will be accepted and attended by the population. This requires a significant investment in health care providers - on this particular border opportunities for education of staff has been very limited. Rose remains adamant that credit belongs to the incredible example set by Karen and Burmese health workers and community workers who have lifted their community forwards despite resource constraints. Research within the same context as delivery of humanitarian health care has permitted a strong environment for reflection of problems concerning the population and potential solutions. Rose is indebted to the system of education and institutions that provided her a pathway to work in such an environment.