Community consequences Gross human rights violations, especially when they are part of a discriminatory political system such as apartheid, have profound and widespread effects beyond the narrow effects of torture. This was clearly part of the aim of the Truth and Reconciliation Commission: to describe the broad effects of apartheid. In studies in Zimbabwe, work with survivors of gross human rights violations such as torture clearly indicated that the survivors were suffering from a wider range of handicaps than merely the medical or psychological, and a number of studies were carried out to examine these additional areas of suffering. The findings from the most reliable of these studies are briefly reported belowxl. Survivors and their families were compared with their nearest neighbours in a detailed interview study. Firstly, there were a number of differences in social and economic factors between the survivors and their neighbours, such as greater illiteracy, higher unemployment, spending more money on health care, greater potential indebtedness, poorer housing, and many other factors indicative of chronic poverty. Secondly, the survivors showed many signs of having less self-esteem and greater apathy than their neighbours: More likely to see war as a reason for poverty; Less optimistic that the situation can be changed; In need of humanitarian assistance. There is a substantial anthropological literature on the engagement between victimized individuals and communities and sources of material aid. It has been pointed out in more than a few well studied cases that the demand for practical help (and the eager and acquisitive engagement with sources of financial aid) is itself a sign of trauma, healing and empowerment in local communities.xli The first group of differences represents real and substantial differences in the social and economic well-being of the two groups. The survivors were markedly less well-off than their neighbours in many areas, and it seems fair to conclude that survivors had greater social adversity than other groups in the same community. This is probably not surprising, and would be found for other disabled populations. However, it does mean that survivors are more vulnerable to ongoing stresses, which will in turn exacerbate their medical and psychological problems. It is noteworthy that this was exactly the interpretation that was given by the survivors themselves, and it was indeed their preoccupation with the practical problems of their lives that originally alerted workers to the significance of social adversity. This is likely to have even greater effects for the current population of survivors, where the overall socio-economic climate is considerably worse than it was in the mid1990s. It should be noted here that there are many critics of an overly medical approach to dealing with torture and PTEs, viewing the problem in more holistic terms.xlii Even within medical paradigms the concept of trauma as pathology has come under serious criticism, particularly from medical history and anthropology.xliii The second group of findings speaks to the psychological consequences of OVT and the social adversity. The survivors had low self-efficacy, and this seemed due in part to the original violence and in part to the failure to overcome the social adversity. It is endlessly demonstrated by studies on individuals that OVT creates powerlessness and a lack of self-efficacy, and many commentators point out that this is replicated in the social and political arena. These findings speak to the heart of this problem: survivor‘s trauma results in feelings and beliefs of powerlessness, which can make them perform less well in the many tasks of life, and the failure compounds and reinforces the lack of selfefficacy. It takes little imagination to see how this then translates into community, social and political apathy, and provides severe problems for the development of rural areas and also of poor urban communities.