Several legal declarations and treaties protect the health of children and health workers and preserve access to health care during armed conflict. As a result, even short-lived armed conflicts affect child health and wellbeing across the life course and through adulthood. 7 Similarly, the adverse effects of population displacement, the destruction of health systems and social infrastructure, environmental damage, and economic sanctions may compromise children’s access to basic necessities, such as food, health care, and education, for decades. Unexploded ordnances, such as landmines and cluster bombs, result in injuries and death for decades after combat has ended. Furthermore, the effects of armed conflict continue long after hostilities have ceased. 6 These changes have led to geographically widespread, complex, and nuanced effects on children’s physical, developmental, and mental health and wellbeing. Combat zones are increasingly widespread, weapons cause destruction on a larger scale, 3, 4 conflicts are more protracted (waxing and waning over lengthier periods of time), 5 and the availability and use of small arms facilitates the use of children as combatants. In this Technical Report, we review the available knowledge on the effects of armed conflict on children and support the recommendations in the accompanying Policy Statement on children and armed conflict.
Armed conflict is both a toxic stress and a significant social determinant of child health. Children and health workers are targeted by combatants during attacks, and children are recruited or forced to take part in combat in a variety of ways. Indirect effects are related to a large number of factors, including inadequate and unsafe living conditions, environmental hazards, caregiver mental health, separation from family, displacement-related health risks, and the destruction of health, public health, education, and economic infrastructure. The direct effects of conflict include death, physical and psychological trauma, and displacement. The effects are both direct and indirect and are associated with immediate and long-term harm. More than 1 in 10 children worldwide are affected by armed conflict.
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