Trauma and Complex Emergencies The term ―complex emergency‖ is increasingly being used to describe situations of disaster, frequently political in origin and process, which result in the massive destabilization of a state‘s capacity to care for its citizensi. As Richard Mollica and his associates have put this, ―A complex emergency is a social catastrophe marked by the destruction of the affected population‘s political, economic, socio-cultural, and health care infrastructures‖ii: no better description could characterize Zimbabwe today. Now complex emergencies can quite clearly occur as a consequence of natural events, as in the recent tsunami in Japan or the effects of Hurricane Katrina on New Orleans, but they can also occur as a consequence of human intervention, what may be termed ―organized violence and torture‖. A distinction should therefore be made between accidental harm causing trauma, as in natural disasters, and deliberate infliction of harm as is seen in wars, civil wars, low intensity conflict, genocide, and widespread political repression. However the distinction is a conceptual one. In the case of Zimbabwe, human intervention, in the form of organized violence and torture, occurs alongside the natural complex emergency, in the form of the HIV epidemic and its associated mass deaths and cumulative, complex grief. It is now evident that organised violence and torture [OVT] is a very significant cause of morbidity, with one study arguing that OVT may have affected as much as one billion people in recent decades iii. In the case of Zimbabwe, we do not have clear figures for the numbers of people affected, directly or indirectly, by violence and torture. The true scale of the problem will not be known until an enabling political and legal infrastructure is in place to facilitate the research needed to generate accurate figures. The most obvious effects are physical, seen in illnesses and injuries, which may be shortlived, but also may lead to long-term disability. However, the most persistent consequences will be psychological, and especially if the trauma was deliberately inflicted, as in torture, for exampleiv. .The most probable long-term consequence of experiencing organized violence and torture is development of a psychological disorder. It should also be clear that this is not a necessary connection (exposure to violence does not always equal psychological disorder), and people affected by complex emergencies involving mass violence are also frequently more resilient that is conventionally assumed. We should also note that cross cultural research has long known that psychological injury and distress is most likely to manifest in somatic symptoms.v , The probability of psychological disorder increases with the number of exposures to trauma such as organized violence and torture. Whilst men are probably the most common primary victims of OVT, women and children are disproportionately the most common secondary victims, and certainly secondary victims are much more common than primary victims. The comment should also be made that it is well-established that psychological disorder due to violence can be caused by physical injury or torture, but equally that mere psychological exposure, as in witnessing violence, or even living in situations of very common physical violence, such as a war can also cause psychological disorder. It is now clear that exposure to Potentially Traumatic Events [PTE‘s] results in increased probability of depressionvi, so we would do well not to focus exclusively on the physical consequences of OVT, and the primary victims, but pay careful attention to the secondary victims, and especially women and children. It should also be pointed out that the clinical/medical language used in the reporting of research evidence included in the first section of this report which indicates high levels of ―common mental disorders‖ and ―psychological distress‖ should not mislead us into thinking that the responses needed are all, or even primarily,in the realm of psychology or therapy. Seen through a different lense, the responses to questionnaires used demonstrate a high level of distress, which could be described as normal given the abnormality of the ongoing situation in Zimbabwe. There clearly are people who need individual treatment and provision has to be made for this through development of mental health services within the existing health system. At the same time,it is argued here that healing interventions of quite a different kind, focusing on communities and the social/political context, will consititute the majority of the work that needs to be done. Furthermore it is also well established