assumed that communities have maintained the cohesiveness that characterised the rural areas in the past, and hence it may be necessary to assume that a degree of community re-building will need to take place. There will be need to integrate healing approaches with peace building approaches, and an important first step will be careful mapping of the churches, NGOs and civil society organizations that are doing peace building and healing within the communities. This mapping can then lead to the development of a strategy that accords with the principles outlined earlier. State psycho-social support for victims of organized violence and torture Any community approach will need to interface with the formal health system in the end, so that the more serious cases can be referred on to professional help. However, it seems relevant to point out that both approaches can develop in parallel: improving, or even creating the capacity of, the formal health system to manage the needs of survivors, can develop alongside the development of community-based assistance. Experience with Zimbabwean survivors in recent years has shown considerably that they have more resilience than might have been expected from the literature, and hence there is reason to be optimistic that low-cost, para-professional approaches may go a considerable way to meeting the needs of the many thousands of survivors. However, there will still be need for referral systems for the more damaged individuals, some of which may be provided by churches and NGOs, but there will remain the crucial need for the formal mental health system to provide support. Below are some suggestions for a strategy to develop a responsive mental health systemx. Identification of victims It is evident that no treatment can be efficacious if the correct diagnosis is not found, and here it is extremely important to note the very low rates of detection by health workers. Detection of psychological disorders is generally very poor, even amongst doctors, and the survivors of torture are no exception to this finding. The remedy for poor detection is training of health workers in detection skills, and training can be easily done, and can have immediate benefits. All health staff at the primary care and secondary care levels should be trained in the identification of psychological disorders, including disorders due to torture and organized violence. Assessment Disorders due to torture and organized violence present special difficulties in assessment for health workers, and will thus require the combined efforts of a team rather than single worker. Here it is important to stress that the fundamental aim of all assessment must be to facilitate treatment or rehabilitation, although assessments may also be used to determine compensation. The current state of the medical services and the enormous morbidity due to violence may preclude the development of a specialist service for this client group, but a minimum service can be developed. It is therefore recommended that assessment of torture survivors be carried out at the District level by a team comprising doctor, psychiatric nurse, rehabilitation technician, and social worker. This team should be supported by either referral to centrally-based specialists, or, better, the regular attendance of these specialists at the District level. Treatment Treatment must operate from the understanding that full cure may be impossible for most survivors of torture and organized violence, and thus rehabilitation may be the only goal. Furthermore, there must be the acceptance that rehabilitation may have to continue for the duration of a survivor’s life, and thus must be continuously available. There probably should be compilation of a register of survivors locally in order that the continuous care needed by torture survivors can be continually monitored. Treatment must be holistic, dealing with the physical, the psychological, and the social. Treatment should stress equally the individual, the family and the community, and thus will require a team approach. Survivors of torture and organized violence must be offered counselling, both individual and family, physical therapy, and community development in order to maximize their fullest possible recovery.