The burden of war-related mental disorders is well documented among US veterans (Nature 477, 390–393; 2011), but not among civilians in Iraq. This oversight must be rectified so that adequate medical support can be provided to the Iraqi people.

US combat troops will soon depart Iraq, leaving Iraqis to cope with the consequences of the 2003 invasion. Although the number of violent deaths is falling, civilians have been killed almost every day this year, most of them in coordinated bomb attacks. Roadside blasts cause long-term disabilities and societal effects among injured civilians. However, these have been largely neglected by the media and no systematic surveillance has been undertaken.

Despite Iraq's damaged health-care system, primary repairs of many injuries are being carried out with acceptable results. But some patients require advanced procedures that are not available in the country. For international aid organizations that are unable to work safely inside Iraq, one operational model is to treat patients outside the country.

Médecins Sans Frontières (MSF; also known as Doctors Without Borders) started a surgical programme in Amman, Jordan, in 2006 to provide functional reconstructive surgery and psychosocial support for Iraqi civilians. Although MSF has managed progressively to increase the capacity of its programme, it can still accommodate only a small fraction of the Iraqi civilians in desperate need of advanced surgical care.

Development of standardized data-collection tools would greatly improve future monitoring of mental health and of explosion injuries. Culturally adequate interventions and tailored support networks are needed to alleviate the long-term physical and psychological repercussions of exposure to war-related trauma. Above all, efforts must concentrate on improving security for civilians.