•Half of all child casualties in 2017 in Nigeria were the result of suicide attacks or IEDs
•Nearly three quarters of child casualties in the world’s five deadliest wars caused by explosives
•As UK doctors launch guide for Syrian medics battling to save children’s lives
The life-saving handbook was compiled at the request of Syrian doctors who were struggling to treat children for horrific injuries they had not come across before in a country where health services have been decimated by eight years of war.
Nearly three quarters of child casualties in the world’s five deadliest wars are caused by explosives such as suicide bombs, landmines, unexploded ordinance and air strikes, aid agency Save the Children said in a report on Thursday.
The charity, which helped produce the manual, calculated at least 5,322 children in Nigeria, Syria, Yemen, Iraq, and Afghanistan were killed or maimed by explosives in 2017.
In some cases, it said children were killed when they picked up unexploded ordnance – which is small and sometimes colourful – to use as toys.
It calculated that nearly three times as many children as adult combatants have died from explosives in Syria, where densely populated towns have been shattered by weapons traditionally meant for open battlefields.
Aid group Syria Relief is distributing the handbook to emergency units across northwest Syria, and there are plans to roll it out in Yemen, Afghanistan and Iraq.
“For more than eight years we’ve seen children dying on the operating table from wounds that adults have survived,” said one Syria Relief paediatrician who asked not to be named.
“The tragedy is these deaths could have been prevented with basic training. This manual … will undoubtedly save lives.”
The book was produced by the Paediatric Blast Injury Partnership (PBIP) – a British coalition of doctors and humanitarians – which plans to translate it into other languages and create a smart phone app.
It said most textbooks on treating blasts were based on research on injured soldiers.
“We know children’s bodies are different. They aren’t just small adults.” PBIP member Michael von Bertele, former head of British Army Medical Services, said in a statement.
Children’s thinner skulls and less developed muscle put them at greater risk of brain injury and internal organ damage.
Future growth also has to be factored in when amputating limbs or children can be left with even worse disabilities and lifelong pain.
One in five children worldwide lives in conflict-affected areas, according to Save the Children.
The charity is hosting a global symposium in The Hague on Thursday – the anniversary of its centenary – to discuss how to protect children in war and end impunity for those who commit atrocities on them.
Read full report:
Blast Injuries: The impact of explosive weapons on children in conflict
Three in four child casualties in world’s deadliest conflicts caused by explosive weapons Suicide bombs, landmines, unexploded ordinance, air strikes and other forms of explosives account for 72% of child deaths and injuries across the world’s deadliest war zones, new analysis by Save the Children reveals today.
The analysis shows children are uniquely and horrifically injured and impacted by explosive weapons compared to adults, and that children exposed to explosive weapons often present with symptoms of post-traumatic stress disorder (PTSD), depression, anxiety and agoraphobia[ii].
The analysis comes from UN data on the five deadliest conflicts for children – Nigeria, Afghanistan, Iraq, Syria and Yemen[iii] – as well as from a new review of child injury data, commissioned by Paediatric Blast Injury Partnership (PBIP), of which Save the Children is a co-convenor.
As a practical response, the partnership has today launched a new ground-breaking field handbook to help doctors and surgeons working with children injured by explosive weapons. The manual is a world-first guide to the unique procedures needed to keep children alive, and help them recover fully, following catastrophic injuries from explosive weapons. It also includes child specific guidance in reducing the mental trauma a child may face during injury and treatment, and coping mechanisms for children and caregivers to support their ongoing physical and mental recovery.
Save the Children’s new analysis on the impact of explosive on children further reveals today:
- In 2017 in Afghanistan, Iraq, Nigeria, Syria and Yemen 7,364 children were killed or maimed in conflict, with an estimated 5,322 of those linked to blasts[iv].
- In Afghanistan, explosive weapons were the cause of death in 84 per cent of child conflict fatalities over a two-year period, compared to 56 per cent of civilian adult deaths. Child casualties were approximately twice as likely to be killed by rockets, mortars and grenades than adult casualties.
- Half of all child casualties in 2017 in Nigeria were the result of suicide attacks or IEDs[vi]
- Children’s bones bend more than those of adults, meaning a higher chance of long-term deformities as a result of blast injury. A child’s skull is also not as thick as that of an adult, meaning their risk of brain injury is higher.
- A child’s natural curiosity can put them in harm’s way. Unexploded ordnance – being small and sometimes colourful – can be easily mistaken for toys.
- Children are not only at grave risk of injury or death from explosives during conflict but also in the aftermath, such as in the Ukraine where 220,000 children in the east of the country were at risk from landmines in 2017[ix].
- In some cases, children in conflict were exclusively killed by blasts, such as in 2014 in Gaza where 100% of all reported child fatalities were the result of explosive weapons
- The physical toll of explosive weapons on children is coupled with a heavy psychological toll, with 84% of adults and almost all children saying that ongoing bombing and shelling was the number one cause of psychological stress in children’s daily lives[xi]. The analysis also illustrates how healthcare systems decimated by years of conflict are poorly resourced to treat ‘unique and unusual’ child blast injuries, lacking essential items like tourniquets designed for children or child-specific transfusion protocols.
A century after Save the Children was founded to protect children affected by conflict, the charity is today launching a new campaign [LINK] urging world leaders to declare children off limits in war.
Major General (Ret) Michael von Bertele, former Director General of British Army Medical Services and member of the Paediatric Blast Injury Partnership (PBIP), said: “The sad reality is most medics just haven’t been trained to treat children injured by blasts. Nearly all the textbooks and procedures we have are based on research on injured soldiers, who are usually fit adults.
“We know children’s bodies are different. They aren’t just small adults. Their skulls are still not fully formed, and their undeveloped muscles offer less protection, so a blast is more likely to damage their brain and lungs or tear apart organs in their abdomen, even when there’s no visible damage. “And when children suffer severe injuries to their legs and arms, it takes highly specialised knowledge to know where to amputate so that you can factor in future growth. Without that, children are left with even worse disabilities, and often intractable pain for life.”
Mahmoud*, 12, lives in Gaza. In 2014 when he was playing in the street, he was hit by an explosive weapon and lost his eye:
“I heard an explosion and I felt something go into my eye. I touched my eye and began to run. I felt blood pouring out. “My eye fell out. I ran to the shop, ‘help me, help me’. They took me to the hospital, and they treated me. I woke up at the hospital. They operated on me. When I woke up from the anaesthetic, they told me that I had lost my eye.”
CEO of Save the Children International, Helle Thorning-Schmidt, said: “International law makes clear that everyone has a responsibility to make sure children are protected in war. Yet explosive weapons continue to kill, maim and terrorise thousands of children every year. Every warring party – from armed groups to governments – must do more to protect children and abide by this important moral principle to protect children.
For those children whose lives are devastated by these weapons, this field manual is a practical tool to help doctors save more children’s lives. But ultimately, the best way of protecting children is to stop using weapons in places that should be safe, like schools and hospitals.
Too often in war today children are seeing and experiencing things that no child ever should. 2019 marks 100 years since Save the Children launched its first campaign to protect children suffering in the aftermath of the First World War, and today we are bringing leaders together at the Peace Palace in the Hague to call for urgent action to stop the war on children.” ENDS
Notes to editors:
- In December 2017, Save the Children and the Centre for Blast Injuries Studies based at Imperial College London convened a pioneering workshop to explore issues around paediatric blast injury. It was the first time experts from diverse fields – including surgery, paediatrics, rehabilitation, prosthetic design, and academia – were brought together to discuss blast injury in children. The workshop issued a communique that created the Paediatric Blast Injury Partnership (PBIP) to deliver practical resources and research. At the request of Syrian medics, the PBIP pooled expertise from doctors, researchers at Imperial College London, and agencies like Save the Children and Humanity & Inclusion, to develop the first comprehensive field manual for paediatric blast injury. Full production credits for the Paediatric Blast Injury Field Manual can be found herehttp://www.imperial.ac.uk/blast-injury/research/networks/the-paediatric-blast-injury-partnership/the-production-credits-for-the-field-manual-/.
- In its centenary year, Save the Children is focusing on the war waged on children. The effects of conflicts are devastating: every day children are killed or maimed, abducted, recruited, sexually abused, they see their schools bombed or aid is being denied to them. In February, Save the Children revealed that some 420 million children, or one in five worldwide, are living in conflict-affected areas.
- On the anniversary of its centenary – 16 May 2019 – Save the Children is hosting an event at the Peace Palace in The Hague to alert the world on the war on children and the ways to protect children in conflict. Experts including Virginia Gamba, Michelle Bachelet and Fatou Bensouda will share their insights on how to better protect children in conflict. If your correspondent wants to join the event in The Hague, please RSVP.
- On 16 May Save the Children is also staging stunts with thousands of children around the world to stand in solidarity with children living in conflict. We invite press to come and cover the stunts. If you would like to cover the stunt, please contact Save the Children in your country.
Credits| Reuters, Relief Web