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We believe it is important to address three aspects of the timely policy statement on the effects of armed conflict on children.
First, the statement fails to make the necessary distinctions among children actually settled in developed countries, simply hosted in developing countries or, sadly, still living in countries in conflict. This distinction is important to address acute and chronic effects of armed conflicts among children most effectively. For example, children who live in hostile environments are lacking access to basic services and rights, constantly exposed to life threatening situations, and at high risk for being recruited and exploited by various armed groups. In contrast, children and their families who are hosted or settled in other nations are struggling with other challenges such as uncertainties about their future and status, assimilating and adapting to new cultures and navigating health systems due to language and other barriers.
Second, while the authors highlight the value of the children’s rights–based approach, the fraught history of children’s rights in armed conflicts and political upheaval suggests that new approaches to the definition and application of children’s rights are necessary. 1 In such settings, there are many challenges for providing health services, both physical and mental/behavioral. Challenges include inadequate facilities and workforce; frequent attacks on health facilities and professionals; the lack of safety...
Second, while the authors highlight the value of the children’s rights–based approach, the fraught history of children’s rights in armed conflicts and political upheaval suggests that new approaches to the definition and application of children’s rights are necessary. 1 In such settings, there are many challenges for providing health services, both physical and mental/behavioral. Challenges include inadequate facilities and workforce; frequent attacks on health facilities and professionals; the lack of safety and security for families seeking services in conflict zones; and the lack of culturally tailored health services. 2,3
Third, distressingly, very little progress has been made regarding the ending of the participation of children younger than 18 years of age in armed conflicts. Both state and non-state actors are hard to hold accountable for their committed violations against this vulnerable population during and in the aftermath of atrocities. Furthermore, the statement missed the opportunity to address how this population is at high risk for recruitment and radicalization by various groups and then propose measures to prevent it.
Three suggestions, would strengthen the statement. First, there should be clarity about the various settings, the population and their different needs and priorities and available resources. Second, despite governments and various concerned agencies’ calls and investments to stop violations committed against children during armed conflicts, its continuation calls for urgent innovative and practical effective solutions and approaches more than ever. Finally, it would add credibility if pediatricians and other professionals directly experiencing this unacceptable violence were explicitly engaged in the development of and authorship of this important statement.
1. International Committee of the Red Cross (ICRC). The geneva conventions of 12 august 1949.
2. Jaff D, Singh K, Margolis L. Targeting health care in armed conflicts and emergencies: is it underestimated? Med Confl Surviv. 2016;32(1):21-29. doi:10.1080/13623699.2016.1205784.
3. Jaff D and Margolis L. Violence, Armed Conflict and the Burden of Mental Illness in the Middle East and Beyond. (Chapter in Societies Emerging from Conflict: The Aftermath of Atrocity). 1st edition. Cambridge Scholars Publishing (UK), 2017. p. 168 – 191.
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