Designing ICT systems in the developing world is perceived to be a challenge. But is this really a challenge if we use state-of-the-art development methods? Will the fact that most standards and heuristics are made in the western world render them useless as tools of making modern computer software for the underdeveloped world? In this thesis I will analyze the findings of a software development project I did for my employer, National Center for Fetal Medicine (NCFM) at St. Olav’s Hospital in Trondheim, Norway. In this project we used a user centered development process as defined in ISO 9142-210 to make and test the prototype of an ultrasound help system. We tested the system using two different user groups: midwives in KwaZulu-Natal participating in an ultrasound teaching and training program held by NCFM and midwives in Trondheim, Norway, receiving a post-qualification course in ultrasound diagnostics also held by NCFM at the Norwegian University of Science and Technology (NTNU) in Trondheim. I will analyze the test results and then do an evaluation of the methods used – both the user-centered design process and the usability methods to see if the methods have worked in my project.