Three years ago the Royal Society held a two-day discussion meeting entitled ‘Technologies for Rural Health’. The meeting was well attended, the choice of subject appeared to meet a need and many of those who spoke expressed a wish that another such meeting might take place in a few years’ time. The Society has responded and today and tomorrow we shall be discussing ‘More technologies for rural health’. This is not, however, merely a repeat performance by popular demand. It is an attempt to focus on the dominant points that emerged from the 1976 discussions in seeking to alleviate the burden of ill-health, disease and malnutrition among the three-quarters of the world’s population who live in rural areas. Early in the programme we have placed water and sanitation, and agri culture and nutrition - the same priority as was given in the 1976 meeting, but during the 3 years that have elapsed the solving of the relevant problems has become more urgent and, in many cases, the problems have themselves become more complex. An example of a specific complexity is that of refugees. The forces creating refugees have rarely been absent but, in recent months, these forces have been especially active in Central America, in Africa and in Asia. I introduce this complexity to the problems of rural health with particular feeling. I have just returned from a visit to south-east Asia and was in Bangkok when the Prime Minister of Thailand announced that he had changed his mind about his country’s policy with regard to the refugees on their border with Kampuchea. The Thailand frontier would now be open to the tens of thousands of refugees seeking sanctuary, a decision obviously putting humanitarian motives before the interests of national security and public health.