The paper describes the development of a com- munity oriented mental health care system in the Region of Huancavelica (Peru), after a devastating earthquake in 2007. The area is also one of the most inaccessible and disadvantaged areas of Peru. Collaborative e¡orts by health personnel in the area, the Regional Directorate of Health and the international organization Me¤ dicos del Mundo ^ Espan‹ a, led to a wide range of activities such as: 1) the revitalisation of a dysfunctional Community Mental Health Centre; 2) the development of a Regional Mental Health Plan, through an participatory process; 3) a pilot action research project in the com- munity to identify people with severe mental health disorders who did not receive psychiatric care; 4) the training of general health personnel in mental health and 5) support a mental health reparations programme for survivors of political violence. The authors argue that emergencies and disasters can be an opportunity for funda- mental changes in the mental health care that would be very di/cult to implement at other times. The ¢rst six months of reconstruction after a disaster represent a privileged time for non- governmental organisations to assess the local mental health care systems, and work hand in hand with survivors and the authorities to elab- orate longer term projects and mobilise the necessary support.