A research-based project was conducted to introduce structured pain assessment on a surgical ward at a general hospital in Kenya, East Africa. The aim was to improve pain control, and subsequently patients' recovery and satisfaction with care. It was agreed that the ultimate aim was to develop and use a common tool for pain assessment throughout the hospital, thereby reducing disparity in various clinical areas, and raising standards of patient care. The project was seen as a pilot, and planned introduction of the pain assessment took place over 1 month. This paper describes the findings in relation to the patient sample, and perceptions of nurses taking part. It also contains reflections about action research, and how it may enter the scene as a way of understanding the whole picture retrospectively.