Civilian suffering from civil war extends well beyond the period of active warfare. We examine longer-term effects in a cross-national analysis of World Health Organization data on death and disability broken down by age, gender, and type of disease or condition. We find substantial long-term effects, even after controlling for several other factors. We estimate that the additional burden of death and disability incurred in 1999 alone, from the indirect and lingering effects of civil wars in the years 1991-1997, was nearly double the number incurred directly and immediately from all wars in 1999. This impact works its way through specific diseases and conditions, and disproportionately affects women and children.