Huw Thomas graduated in history from Birmingham University in 1960, before joining the National Health Service. In the mid 1960s he worked for two years as provincial hospital secretary in Nyzana and Western Provinces in western Kenya. He returned to the UK, but always nursed a wish to return to work in a less developed country. He retired as Chief Executive of Gwynedd Health Authority in North Wales, and became Programme Director of the Aga Khan Health Service in Tajikistan from 1999 to 2003, based in Khorog, capital of the Pamirs. He has returned frequently to Tajikistan from his home in Bangor, North Wales. He was elected as a Fellow of the Royal Geographical Society in 2009, in recognition of his published work on Tajikistan.