Natural disasters and complex emergencies create new types of vulnerability by disorganizing families and disrupting communities, causing death and injury, and forcing people from their homes. In February of this year the World Health Organization estimated that 20-40% of the people affected by the Tsunami might suffer from short-lasting mild psychological distress. WHO also estimated that another 30-50% would experience moderate to severe psychological distress that might resolve with time, or mild distress that could become chronic.8 In June it reported that half the affected population were actually experiencing psychological problems, 5-10% of which might require treatment.9 In the Maldives, the Ministry of Health in one of its early reports suggested that as many as 7000 people, primarily women and children, might have been traumatized by the Tsunami.10 A WHO-funded study by the University of Indonesia reported that 20-25% of children affected by the Tsunami in Aceh required professional treatment for psychosocial problems.11 The UN Office for the Coordination of Humanitarian Affairs also reported that in January a quarter of children in Thailand were not attending school because of fear and distress.12 Additionally, a dramatic increase in the demand for counselling and psychological care, including tertiary-referral specialized care, was registered in the entire country.13 In Indonesia too the Tsunami precipitated a spate of referrals for psychological troubles, with a reported 15-20% increase in outpatients with anxiety and depression.14 A corresponding increase was registered in the number of drugs prescribed for psychological distress.1 Not all these were people who had been directly affected; some were people in nearby areas who vicariously shared the trauma of the Tsunami and worried about the possibility of new waves. Previous studies in Bosnia3 have shown how the psychosocial impact spreads far beyond those who have suffered directly.