In current armed conflicts around the world, over 90 per cent of casualties are civilians. This article reviews medical and anthropological evidence of the psychosocial effects of extreme experiences such as torture, mutilation, rape, and the violent displacement of communities. The consequences for women and children are considered in particular. The author argues that the social development programmes of NGOs should be extended to support social networks and institutions in areas of conflict, and ends by giving guidelines for mental health promoters working in traumatised communities.