As efforts are made to make Emergency Medicine and the Journal of Emergency Medicine more international, the different systems of medical education and practice trends in other countries should be considered when making suggestions. This article is a personal perspective of a surgeon who has been involved in emergency care in both the United States and South Africa. The system in the United States can be defined as "mature." Although the system in South Africa has been defined as "underdeveloped," efforts are underway to establish Emergency Medicine as a separate, independent discipline. Some of the differences in medical education, postgraduate training, and disease prevalence are highlighted. A significant number of South Africans use the services of traditional healers, and a brief review of their services is included.