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In the post-apocalyptic world, humans have rebuilt themselves and created their own civilization in response to The End that destroyed much of human culture during a global disaster 10 years earlier. Backwater is set at this southern U.S.-based community where travelers roam along crumbling roads with mosquitoes or snakes as companions while protecting mankind from supernatural horrors lurking behind every corner. With the 20-sided die and backbone system, characters must roll under their current Health points to avoid conditions like bleeding for severe damage received in combat situations. Backwatter offers a rich setting that is unique even among southern Gothic horror games with its emphasis on social issues relating fear poverty religion alienation through decaying structures aristocratic families. It also reimagines the genre as more than just American history and our present world, reflecting upon these topics while incorporating supernatural elements to create horrors humans themselves can face in this post-apocalyptic society.