Aim. This paper is a report of a study to describe Emergency Mobile Unit team members' and healthcare professionals' perceptions of a disaster preparedness and response project and to explore the elements of participation that could support its sustainability. Background. Many developing countries have limited preparedness for disaster response. There is a need to better understand the role of national and local participation, and their interplay. We also need to consider the moderation and eventual planned withdrawal of international humanitarian organizations' support. Afghanistan is one example of a country in postdisaster development where the opportunity arose for an in-depth study of disaster preparedness and response. Method. Data were collected in Finland and Afghanistan in 2004 using an ethnographic approach, with seven thematic interviews (n = 8) and two focus groups (n = 7). The participants were Afghan healthcare professionals and expatriates who had facilitated Emergency Mobile Unit training. Findings. Constraints in the project arose from uncoordinated implementation and poor job satisfaction, in addition to intrinsic characteristics of the situation. A second theme to emerge was that participation was a positive response to health emergencies. Thirdly, a need for further development and overall support for Emergency Mobile Units was clearly evident. Conclusion. Improved coordination and measures to increase job satisfaction for national aid workers are needed, and a more positive knowledge-based response system and continued overall support for emergency mobile teams. Involving disaster-affected people and the local community, especially women, in health development projects will help to ensure both success and sustainability.