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Children in emergencies and conflicts constitutes the effects of situations that pose detrimental risks to the
health Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
, safety, and well-being of children. There are many different kinds of conflicts and emergencies, for example, violence, armed conflicts,
war War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regular o ...
, natural disasters, etc. Approximately 13 million children are displaced by
armed conflicts War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regul ...
and
violence Violence is the use of physical force so as to injure, abuse, damage, or destroy. Other definitions are also used, such as the World Health Organization's definition of violence as "the intentional use of physical force or power, threatened ...
around the world.UNICEF. 2010. ''The State of the World's Children Report, Special Edition''. New York, UNICEF. Where violent conflicts are the norm, the lives of young children are significantly disrupted and their families have great difficulty in offering the sensitive and consistent care that young children need for their healthy development. Studies on the effect of emergencies and conflict on the physical and
mental health Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental hea ...
of children between birth and 8 years old show that where the disaster is natural, the rate of
PTSD Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that can develop because of exposure to a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on ...
occurs in anywhere from 3 to 87 per cent of affected children.Shannon, M. P., Lonigan, C. J., Finch, A. J. and Taylor, C. M. 1994. Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles. ''Journal of American Academy of Child and Adolescent Psychiatry'', Vol. 33, pp. 80-93. However, rates of PTSD for children living in chronic conflict conditions varies from 15 to 50 per cent as evidenced in the following countries:
Iran Iran, officially the Islamic Republic of Iran, and also called Persia, is a country located in Western Asia. It is bordered by Iraq and Turkey to the west, by Azerbaijan and Armenia to the northwest, by the Caspian Sea and Turkmeni ...
,
Iraq Iraq,; ku, عێراق, translit=Êraq officially the Republic of Iraq, '; ku, کۆماری عێراق, translit=Komarî Êraq is a country in Western Asia. It is bordered by Turkey to the north, Iran to the east, the Persian Gulf and K ...
,
Israel Israel (; he, יִשְׂרָאֵל, ; ar, إِسْرَائِيل, ), officially the State of Israel ( he, מְדִינַת יִשְׂרָאֵל, label=none, translit=Medīnat Yīsrāʾēl; ), is a country in Western Asia. It is situated ...
,
Kuwait Kuwait (; ar, الكويت ', or ), officially the State of Kuwait ( ar, دولة الكويت '), is a country in Western Asia. It is situated in the northern edge of Eastern Arabia at the tip of the Persian Gulf, bordering Iraq to the nort ...
,
Lebanon Lebanon ( , ar, لُبْنَان, translit=lubnān, ), officially the Republic of Lebanon () or the Lebanese Republic, is a country in Western Asia. It is located between Syria to Lebanon–Syria border, the north and east and Israel to Blue ...
, Palestine, Rwanda,
South Africa South Africa, officially the Republic of South Africa (RSA), is the Southern Africa, southernmost country in Africa. It is bounded to the south by of coastline that stretch along the Atlantic Ocean, South Atlantic and Indian Oceans; to the ...
, and Sudan.One or more of the preceding sentences incorporates text from the free content work


Impact of emergency and conflict experiences

In sum, emergency and conflict may impact on children's development in the following manner: * Physical: exacerbation of medical problems, headaches, fatigue, unexplained physical complaints. * Cognitive: trouble concentrating, preoccupation with the traumatic event, recurring
dream A dream is a succession of images, ideas, emotions, and sensations that usually occur involuntarily in the mind during certain stages of sleep. Humans spend about two hours dreaming per night, and each dream lasts around 5 to 20 minutes, althou ...
s or nightmares, questioning spiritual beliefs, inability to process the event. * Emotional: depression or sadness, irritability, anger, resentfulness, despair, hopelessness, feelings of guilt, phobias, health concerns,
anxiety Anxiety is an emotion which is characterized by an unpleasant state of inner turmoil and includes feelings of dread over anticipated events. Anxiety is different than fear in that the former is defined as the anticipation of a future threat wh ...
or fearfulness. * Social: increased conflicts with family and friends, sleep problems, crying, changes in appetite, social withdrawal, talking repeatedly about the traumatic event, refusal to go to school, repetitive play.


Impact on pregnancy

Research shows that environmental factors and experiences can alter the genetic make-up of a developing child. Exposure to prolonged stress, environmental
toxin A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849 ...
s or nutritional deficits chemically alter genes in the
foetus A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal develo ...
or young child and may shape the individual's development temporarily or permanently. Violence and maternal depression may also impair child development and mental health. When trauma occurs at critical times of development for the foetus or young child, the impact on specialized cells for organs such as the
brain A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a ve ...
,
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
, or
kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blo ...
can result in underdevelopment with lifetime implications for physical and mental health. For instance, a study on Iraq showed the rate of
heart defects A congenital heart defect (CHD), also known as a congenital heart anomaly and congenital heart disease, is a defect in the structure of the heart or great vessels that is present at birth. A congenital heart defect is classed as a cardiovascular ...
at birth in Fallujah to be 13 times the rate found in
Europe Europe is a large peninsula conventionally considered a continent in its own right because of its great physical size and the weight of its history and traditions. Europe is also considered a subcontinent of Eurasia and it is located entirel ...
. And for birth defects involving the nervous system the rate was calculated to be 33 times that found in Europe for the same number of births. Prolonged stress during pregnancy or early childhood can be particularly toxic and, in the absence of protective relationships, may also result in permanent genetic changes in developing brain cells. Evidence has shown that toxins and stress from the mother cross the
placenta The placenta is a temporary embryonic and later fetal organ that begins developing from the blastocyst shortly after implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between the physically separate mate ...
into the
umbilical cord In placental mammals, the umbilical cord (also called the navel string, birth cord or ''funiculus umbilicalis'') is a conduit between the developing embryo or fetus and the placenta. During prenatal development, the umbilical cord is physiologi ...
, leading to
premature Premature may refer to: * ''Premature'' (2014 film), an American comedy film * ''Premature'' (2019 film), an American romantic drama film * '' PREMature'', a 2015 British television drama miniseries See also * Premature aging, of an organism * ...
and low birth weight babies. Likewise, conflict trauma can affect pregnant women and the subsequent emotional health of their children. In addition, babies of severely stressed and worried mothers are at higher risk to be born small or prematurely.


Impact on child development

Children's reactions to emergencies fluctuate depending on age, temperament, genetics, pre-existing problems, coping skills and cognitive competencies, and the dose of the emergency. Although most children are said to recover over time, if emergency reactions are left untreated, they can have a significant adverse impact on children's social, emotional, behavioural and physical development.


Age 6 and younger

In conflict-affected countries, the average mortality rate for children under 5 is more than double the rate in other countries. On the average, twelve children out of a hundred die before their fth birthday, compared with six out of a hundred. Common reactions among this age group are severe separation distress, crying, clinging, immobility and/or aimless motion, whimpering, screaming, sleeping and eating disorders, nightmares, fearfulness, regressive behaviours such as thumb-sucking, bed-wetting, loss of bowel/bladder control, inability to dress or eat without assistance, and fear of darkness, crowds and being left alone. During an investigation of the relationship between exposure to day raids and shelling and behavioural and emotional problems among Palestinian children, aged 3–6, in the
Gaza Strip The Gaza Strip (;The New Oxford Dictionary of English (1998) – p.761 "Gaza Strip /'gɑːzə/ a strip of territory under the control of the Palestinian National Authority and Hamas, on the SE Mediterranean coast including the town of Gaza.. ...
, children demonstrated sleeping problems, poor concentration, attention-seeking behaviour, dependency, temper tantrums and increased fear. Mothers of Palestinian kindergarten children reported severely impaired psychosocial and emotional functioning in their children. Thabet et al. examined the behavioural and emotional problems of 309 Palestinian pre-schoolers, and found that direct and indirect exposure to war trauma increased the risk of poor mental health. Zahr et al., in a study on the effect of war on Lebanese pre-school children, found more problems in children aged 3–6 years exposed to heavy shelling over a 2-year period than in a control group living without this threat. According to Yaktine, 40 mothers of different socio-economic backgrounds during the civil war in
Beirut Beirut, french: Beyrouth is the capital and largest city of Lebanon. , Greater Beirut has a population of 2.5 million, which makes it the third-largest city in the Levant region. The city is situated on a peninsula at the midpoint o ...
reported that their pre-school children became more anxious and fearful about bombardments and explosions. After Scud missile attacks, displaced Israeli pre-school children demonstrated aggression, hyperactivity and oppositional behaviour and stress. This was compared with non-displaced children and, despite a continuous decrease in symptom severity, risk factors identified shortly after the
Gulf War The Gulf War was a 1990–1991 armed campaign waged by a Coalition of the Gulf War, 35-country military coalition in response to the Iraqi invasion of Kuwait. Spearheaded by the United States, the coalition's efforts against Ba'athist Iraq, ...
continued to exert their influence on children five years after the traumatic exposure.


Ages 6 to 11

Common symptoms in this age bracket include disturbing thoughts and images, nightmares, eating and sleeping disorders, noncompliance, irritability, extreme withdrawal, outbursts of anger and fighting, disruptive behaviour, inability to pay attention, irrational fears, regressive behaviour, depression and anxiety, feeling of guilt and emotional numbing, excessive clinging, headaches,
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
and visual or hearing problems. Traumatic events experienced before the age of 11 are three times more likely to result in serious emotional and behavioural difficulties than those experienced later in life. According to the Palestinian Counseling Centre,
Save the Children The Save the Children Fund, commonly known as Save the Children, is an international non-governmental organization established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic ...
, even six months after the demolition of their homes, young Palestinian children experienced withdrawal, somatic complaints, depression/anxiety, unexplained pain, breathing problems, attention difficulties and violent behaviour. They were afraid to go to school, had problems relating to other children and greater attachment to caregivers. As a result, parents reported deterioration in educational achievement and ability to study. Al-Amine and Liabre revealed that 27.7 per cent of Lebanese children aged between 6 and 12 developed symptoms of PTSD, as well as from problems sleeping, agitation, difficulties in concentrating and excessive awareness of events related to the 2006 Lebanese-Israeli war. Many children in Sudan and northern
Uganda }), is a landlocked country in East Africa. The country is bordered to the east by Kenya, to the north by South Sudan, to the west by the Democratic Republic of the Congo, to the south-west by Rwanda, and to the south by Tanzania. The sou ...
who were forced to witness family members being
torture Torture is the deliberate infliction of severe pain or suffering on a person for reasons such as punishment, extracting a confession, interrogational torture, interrogation for information, or intimidating third parties. definitions of tortur ...
d and murdered exhibited stunting, PTSD and other trauma-related disorders.


Disabilities

Children with disabilities are disproportionately affected by emergencies, and many become disabled during disasters. Children with disabilities may suffer due to loss of their assistive devices, loss of access to medicines or rehabilitative services and, in some cases, loss of their caregiver. In addition, disabled children tend to be more vulnerable to abuse and violence.
UNICEF UNICEF (), originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing humanitarian and developmental aid to ...
research indicates that violence against children with disabilities occurs at annual rates at least 1.7 times greater than their non-disabled peers. Young children with disabilities living in conflict are more vulnerable and the consequent physical, psychological or emotional problems are higher. They are also more likely to develop emotional and mental health problems during emergencies because of lack of mobility, treatment, and medication or through starvation. The
Inter-Agency Standing Committee The Inter-Agency Standing Committee (IASC) is an inter-agency forum of United Nations and non-UN humanitarian partners founded in 1991 to strengthen humanitarian assistance. The overall objective of the IASC is to improve the delivery of humanitaria ...
(IASC) recognizes that children with pre-existing disabilities are more vulnerable to mistreatment, discrimination, abuse and destitution. Children with mobility, visual and hearing disabilities or intellectual impairments may feel particularly vulnerable if an emergency leads to the relocation of school and the learning of new daily routines. During emergencies, long unsafe distances to school, the lack of buildings with adequate facilities and equipment and teachers with minimum qualifications, are likely to be overwhelming challenges for young children with disabilities to be enrolled in day care and early education.


Gender differences

Some research shows that girls exhibit higher levels of distress than boys in relation to stressful situations and are considered at higher risk in situations of war and terror. Other research has found that girls express more worry, anxiety and depressive disorders, and PTSD symptoms while boys show more behavioural problems in the aftermath of a disaster. However, pre-school girls exposed to
earthquake An earthquake (also known as a quake, tremor or temblor) is the shaking of the surface of the Earth resulting from a sudden release of energy in the Earth's lithosphere that creates seismic waves. Earthquakes can range in intensity, fr ...
s in Sultandagi (Turkey) displayed more problematic behaviours than boys in the same educational category. Additionally, Wiest, Mocellin, and Motsisi contend that young children, especially girls, may be vulnerable to
sexual abuse Sexual abuse or sex abuse, also referred to as molestation, is abusive sexual behavior by one person upon another. It is often perpetrated using force or by taking advantage of another. Molestation often refers to an instance of sexual assa ...
and exploitation. Garbarino and Kostelny reported that Palestinian boys developed more psychological problems than girls when exposed to chronic conflict. In another study, Palestinian boys were more susceptible to effects of violence during early childhood and girls during adolescence. In general it appears that boys take longer to recover, displaying more aggressive, antisocial and violent behaviour while girls may be more distressed but are more verbally expressive about their emotions.


Educational consequences

In all conflict-affected countries, 21.5 million children of primary school age are out of school. Over the past decade, the problem of out-of- school children has been increasingly concentrated in conflict-affected countries, where the proportion increased from 29% in 2000 to 35% in 2014; in Northern Africa and Western Asia, it increased from 63% to 91%. Quality education alleviates the psychosocial impact of conflict and disasters by giving a sense of normalcy, stability, structure and hope for the future. However, emergency and conflict situations often undermine the quality of educational services. They result in shortages of materials, resources and personnel, thereby depriving young children of the opportunity to receive quality early education. In most conflicts, education infrastructure is usually a target. Pre-schools and schools are often destroyed or closed due to hazardous conditions depriving young children of the opportunity to learn and socialize in a safe place that provides a sense of routine. Young children living under emergencies are less likely to be in primary school and more likely to drop out. Primary school completion in poorer conflict-affected countries is 65 per cent while it is 86 per cent in other poor countries. According to the 2000 UNICEF MICS report, information from Iraq, for example, confirms the lack of Early Childhood Development programmes within the formal educational system. Only 3.7 per cent of children aged from 36 to 59 months were enrolled in nurseries or kindergartens. Low enrollment rates in early education programmes decrease the opportunity for young children to find a safe space where they flourish and release the stress and tension resulting from the emergency. In countries with ongoing emergencies, researchers have found a full range of symptoms that may be co-morbid with trauma, including
attention deficit hyperactivity disorder Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inap ...
, poor academic performance, behavioural problems, bullying and abuse, oppositional defiant disorder, conduct disorder, phobic disorder and negative relationships (Terr, 1991; Streeck-Fischer and van der Kolk, 2000). A study using the Young Lives data in
Ethiopia Ethiopia, , om, Itiyoophiyaa, so, Itoobiya, ti, ኢትዮጵያ, Ítiyop'iya, aa, Itiyoppiya officially the Federal Democratic Republic of Ethiopia, is a landlocked country in the Horn of Africa. It shares borders with Eritrea to the ...
found that young children whose mothers had died were 20 per cent less likely to enroll in school, 21 per cent less likely to be able to write, and 27 per cent less likely to be able to read. Dybdahl found that 5- to 6-year-old war-traumatized Bosnian children showed lower levels of cognitive competence. Pre-school and school age Palestinian children exposed to severe losses, wounding and home destruction had impaired cognitive capacity for attention and concentration. Severe trauma has been found to be associated with inexcitable and narrowed attention and problem-solving strategies. Since both physical and mental health are linked to
language Language is a structured system of communication. The structure of a language is its grammar and the free components are its vocabulary. Languages are the primary means by which humans communicate, and may be conveyed through a variety of ...
and cognitive development, it is reasonable to assume that violent conflict has a negative effect on these areas of development.


Supporting young children during emergency and conflict situations

Early childhood care and education (ECCE) is a multisectoral field that holistically addresses children's multiple needs. During emergencies ECCE supportive services may address a range of issues including
prenatal care Prenatal care, also known as antenatal care, is a type of preventive healthcare. It is provided in the form of medical checkups, consisting of recommendations on managing a healthy lifestyle and the provision of medical information such as materna ...
,
immunization Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an infectious agent (known as the immunogen). When this system is exposed to molecules that are foreign to the body, called ''non-se ...
, nutrition, education, psychosocial support and community engagement. Coordinated services of health and nutrition, water sanitation and hygiene, early learning, mental health and protection are considered essential in supporting young children living under emergencies and conflicts. Many programmes and strategies, whether in the formal or
non-formal education Non-formal learning includes various structured learning situations which do not either have the level of curriculum, syllabus, accreditation and certification associated with ' formal learning', but have more structure than that associated ...
sector, have proved to be very supportive to the well-being and recovery of young children living in areas of conflict. Child Friendly Spaces (CFS) programmes have been found valuable in creating a sense of normality and providing coping skills and resilience to children affected by emergencies. Child Friendly Spaces help children develop social skills and competencies such as sharing and cooperation through interaction with other children. They also offer opportunities to learn about risks in their environment and build life skills, such as
literacy Literacy in its broadest sense describes "particular ways of thinking about and doing reading and writing" with the purpose of understanding or expressing thoughts or ideas in written form in some specific context of use. In other words, hum ...
and non-violent conflict resolution, and provide a useful means of mobilizing communities around children's needs. In an effort to strengthen community systems of
child protection Child protection is the safeguarding of children from violence, exploitation, abuse, and neglect. Article 19 of the UN Convention on the Rights of the Child provides for the protection of children in and out of the home. One of the ways to e ...
, Christian Children's Fund (CCF) established three centres for internally displaced young children in Unyama (Uganda) camp that provided a safe, adult-supervised place for young children between 3 and 6 years of age. War Child established six 'safe spaces' in schools in northern Lebanon for displaced Syrian children where counsellors used
art Art is a diverse range of human activity, and resulting product, that involves creative or imaginative talent expressive of technical proficiency, beauty, emotional power, or conceptual ideas. There is no generally agreed definition of wha ...
and
music therapy Music therapy, an allied health profession, "is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music t ...
to help young children express their emotions in a healthy way. Several studies show that children who have participated in quality education programmes within schools tend to have better knowledge of hazards, reduced levels of fear and more realistic risk perceptions than their peers. In such contexts, psychosocial intervention programmes for young children and their families are considered to be vital. Interventions such as storytelling,
singing Singing is the act of creating musical sounds with the voice. A person who sings is called a singer, artist or vocalist (in jazz and/or popular music). Singers perform music (arias, recitatives, songs, etc.) that can be sung with or with ...
, jumping rope, role-play activities, team sports and writing and drawing exercises helped to reduce psychological distress associated with exposure to conflict-related violence in
Sierra Leone Sierra Leone,)]. officially the Republic of Sierra Leone, is a country on the southwest coast of West Africa. It is bordered by Liberia to the southeast and Guinea surrounds the northern half of the nation. Covering a total area of , Sierr ...
for children aged 8 to 18. Studies in Eritrea and Sierra Leone revealed that children's psychosocial well-being was improved by well-designed educational interventions. In
Afghanistan Afghanistan, officially the Islamic Emirate of Afghanistan,; prs, امارت اسلامی افغانستان is a landlocked country located at the crossroads of Central Asia and South Asia. Referred to as the Heart of Asia, it is bordere ...
, young children and adolescents gained a sense of stability and security after their involvement in constructive activities (e.g. art, narrative, sports) which took place in neutral safe places within their communities.Dawes, A. and Flisher, A. 2009. Children's mental health in Afghanistan. ''Lancet'', Vol. 347 (9692), pp. 766-767.


See also

* Declaration on the Protection of Women and Children in Emergency and Armed Conflict * Children in the Israeli–Palestinian conflict * Education in emergencies and conflict areas *
Save the Children The Save the Children Fund, commonly known as Save the Children, is an international non-governmental organization established in the United Kingdom in 1919 to improve the lives of children through better education, health care, and economic ...
* Inter-Agency Network for Education in Emergencies *
Military use of children Children (defined by the Convention on the Rights of the Child as people under the age of 18) have been recruited for participation in military operations and campaigns throughout history and in many cultures. Children in the military, includ ...
* Mobile learning for refugees *
UNICEF UNICEF (), originally called the United Nations International Children's Emergency Fund in full, now officially United Nations Children's Fund, is an agency of the United Nations responsible for providing humanitarian and developmental aid to ...
*
Trafficking of children Trafficking of children is a form of human trafficking and is defined by the United Nations as the "recruitment, transportation, transfer, harboring, and/or receipt" kidnapping of a child for the purpose of slavery, forced labour and exploitation. ...
* International child abduction *
Refugee children Nearly half of all refugees are children, and almost one in three children living outside their country of birth is a refugee.Emily Garin, Jan Beise, Lucia Hug, and Danzhen You. 2016. “Uprooted: The Growing Crisis for Refugee and Migrant Childr ...


References

Attribution: * *{{Free-content attribution , title = Creating sustainable futures for all; Global education monitoring report, 2016; Gender review , author = UNESCO , publisher = UNESCO , page numbers = 20 , source = UNESCO , documentURL = http://unesdoc.unesco.org/images/0024/002460/246045e.pdf , license statement URL = http://www.unesco.org/ulis/cgi-bin/ulis.pl?catno=246045&set=005915672A_2_228&gp=1&lin=1&ll=1 , license = CC-BY-SA IGO 3.0 , Editors = Humanitarian aid Children in war