I first learned how the mentally ill were treated in Africa from a cousin, a gynecologist practicing in Paris, who had done a residency in Senegal. She was so shocked by what she observed, people, including women in labor, chained, that later it became one of the reasons she became a psychiatrist. Part of her research was triggered by her observation that so often the mentally ill in Africa, in this case, women, had been so traumatized by difficult lives, it’s as if they took refuge in mental illness. That was years ago and people are still chained, and in some cases placed in camps, usually in abject conditions, and sadly women, sometimes men, can still be traumatized by how they live. Several non-profit groups, in Asia as well as in Africa, have now stepped in, in such a way that the delivery of mental health care is now done by nurses on motorized bikes. They use generic drugs, which are even cheaper there, only have a few, however, which they prescribe with much more liberality and less questions than is done in the US. They also foster and use community support systems. Those nurses are thus able to help mental health patients without clinics or doctors. One problem is that the system is not uniform and those who receive care are considered the lucky ones. The need far out spaces the availability of both nurses on motorized bikes and mainly drugs. The care is obviously not on par with what people in the developed world would receive, but in those cases where they have been able to intervene, it is enabling men and women to lead productive lives, and be part of their family again and experience a modicum of happiness. These little and relatively few successes may be but small steps in view of the need, but are nevertheless quite big for those who are helped.