Abstract
The authors describe an international project to improve quality of electroconvulsive therapy (ECT) provision in a low- to middle-income territory. Shortcomings in professional training and delivery of clinical care had been identified, including staffing limitations, outdated ECT machines and use of unmodified treatment. The UK Royal College of Psychiatrists, the charity Medical Aid for Palestinians and the Palestinian Ministry of Health collaborated to provide new equipment, deliver specialist training and develop a modern service protocol. The resulting improvements, such as the introduction of electroencephalogram monitoring and stimulus dosing, are detailed, along with obstacles encountered, lessons learnt from the project and aspirations for the future.