Founded in 1865, the Sindh Institute for Psychiatry in Hyderabad, Pakistan is one of the largest and oldest institutions of its kind in Asia. At present, the institute is having 476 stationary patients, including 25 women. Some of the patients are already more than 15 years at this place. The institute is run on government funding. The management and staff is dedicated to their work, but without more support, little can be done to improve the living conditions of the patients, residing in buildings that are over 100 years old. Some friends of the management arranged my visit today to this facility. As much as I was impressed by the positive attitude of the staff, I was appalled by the primitive living conditions.