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Children in war zones – how do we respond?

Author: Sue Boucher and Steve Hynd
29 July 2014

Jon Snow of Channel 4 news appeals to everyone to raise their voices against the war raging in Gaza and talks about the adverse effect this war is having on children and young people. This article asks what the palliative care response should be to the increasing death toll of children in war zones around the world.

In recent days reports have emerged from Gaza of the growing child death rate and the devastating impact this is having on families, friends and the community in the Gaza strip. One such report was that of Channel 4’s Jon Snow. His impassioned account of what he has witnessed during his recent trip to Gaza makes for difficult viewing.

At times clearly moved by what he has experienced, Snow reports on the impact that the bombing is having on children saying:

"Those people who live in Gaza are young. The average age is 17. That means that a quarter of a million is under the age of 10 years,"

He goes on to explain that when a densely populated area such as that of Gaza is targeted, it is inevitable that some of the civilians killed will be children. In the most recent upsurge of violence Snow’s report estimates that 1310 children have been wounded and 166 killed, with these numbers rising every day.

The long-term and short impact this is having on children and their families is almost impossible to quantify.

It is of course not just in Gaza that children are suffering.

From Ukraine to Syria, from the Central African Republic to South Sudan we are increasingly seeing how children are being affected by war. Not only in the death statistics but also through the exposure to the brutality of war we can see the devastating impact on children’s lives that will be felt for a generation to come.

The palliative care response
"How do we respond as a palliative care community to these distressing reports?" asks Joan Marston, CEO of the International Children's Palliative Care Network. "Where there is so much suffering, what are we as the “experts” on death and dying doing to help those in regions that are difficult to reach; and how do we provide and justify palliative care when there are so many other conflicting needs that must be met?" she asks.

Joanna Santa Barbara writes in a 2006 Journal article for the National Center for Biotechnology Information entitled Impact of War on Children and Imperative to End War that listing the effects of war on children is simple. These are:
  • Death
  • Injury
  • Disability
  • Illness
  • Rape and prostitution for subsistence
  • Psychological suffering
  • Moral and spiritual impacts
  • Social and cultural losses
Remedial strategies however are much more difficult to identify and even harder to implement. Some suggestions she makes to make war less damaging to children include:
  • The implementation of an international humanitarian law regarding the protection of children in war.
  • To ban the use of economic sanctions which lead to poverty and starvation.
  • Greater consideration for children refugees which could include the internal layout of camps to prevent attacks on girls, the provision of facilities for education and play and special help for families headed by children.
  • Putting measures in place to reduce sexual exploitation and gender-based violence against girls such as the training of soldiers and peacekeeping forces. 
  • Making organised rape a crime against humanity.
  • The prosecution of perpetrators for such actions as destroying clinics, schools and hospitals. 
  • The inclusion of children's interests in peace agreements. 
Santa Barbara concludes that "It is time for health professionals to define war as a serious global public health problem. The public health imperative is primary prevention – removing the vector of illness or making conditions unfavourable for survival of the vector."

Ignoring war as too political to engage with has never been and is not acceptable. Children are experiencing a desperate need for the support of the palliative care community in these war zones.

The question then is what will our response be?

ehospice would be interested to hear your views and thoughts on this matter. Please feel free to post your comments below this article.
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