- One in six children in the world live in a conflict zones and are seven times more likely to die from blast injuries than adults involved in fighting according to UNICEF
- Hundreds of CT scans from war zones made newly available
- Improved knowledge sharing – better coordination and joined-up thinking announced
Dr Michael von Bertele, of the Paediatric Blast Injury Partnership, Save the Children and former Director General of the British Army Medical Services, announced an ambitious new Partnership Initiative at the 2019 World Extreme Medicine Conference in Edinburgh, that will incorporate organisations including WHO, ICRC, MSF, Red Cross, Red Crescent, The David Knott Foundation, Humanity and Inclusion, researchers from Radboud (NL) Linköping and Karolinska (Sweden), Stanford University (USA) and a variety of UK academic Institutions including Imperial College.
Speaking on Day 2 of the conference in a dedicated session ‘Improving the Care of Children in Conflict’, he described how this vital new Partnership Initiative plans to tackle the challenges of treating children who have been maimed and injured by explosive weapons and by explosive remnants (such as mines and IOD’s) of war in conflict environments around the world.
As an example, in Syria in recent years, 82% of child deaths were caused by landmines, unexploded ordinance, air strikes, and other explosives, and prompted medics working in the region to plead for help in treating injured children. That help must take account of how children differ from adults, and must address their physical, psychological and social needs at different stages of development. Without highly specialised knowledge, sub-optimal care leaves many children with terrible disabilities, and often intractable pain for life.
As a result, last year the Paediatric Blast Injury Partnership launched the first ever Field Manual for treating blast injured children. This vital tool – which has now been translated into Arabic and is constantly being updated, has become an invaluable resource for medics in war and conflict zones, enabling them to provide the best possible care with limited resources and equipment.
Michael von Bertele is now heading a major new initiative to bring together the many organisations around the world who work in conflict zones and treat children, to try to identify where there are gaps in knowledge and capability, and to stimulate the research that will improve that care. There is currently very little systematic research in this field, and very little sharing of data, experience and knowledge.
New CT scan “bank”
Another example of where the Partnership is breaking new ground is in a detailed study of several hundred CT scans of injured children collected by military medical services in Iraq and Afghanistan. They will be used to describe and understand exactly how those children were injured and whether their treatment was right. This valuable collection has not previously been available for use in this way.
Dr. Michael Von Bertele said:
“We know there’s a huge capability and knowledge gap in the understanding and treatment of conflict related injuries of all types in children at different ages. In particular we need to involve local workers and medics in identifying those gaps – and provide support and training to them – not just to western aid organisations.
There is also a real lack of information about how many children have actually been injured, how they have been treated, and what has happened to them. Very few get any follow up to see what their needs are as they grow up. A child suffering from malnutrition has a good chance of recovering if fed. A child who has lost a limb or been badly burned in an explosive event may require many revisions of an amputation or scarring as he or she grows, but in most countries, will never receive that care and will live with a lifelong disability, often on the margins of society.
So many children are being treated in an ad hoc way – and their needs are not just physical, hundreds of thousands of children also suffer from the psychological consequences of being exposed to such violence in their communities as a result of war.
We are looking at taking a very pragmatic approach, trying to identify what we can do to help here and now – not at some vague time in the future. We can draw on the extensive knowledge and experience of military and humanitarian experts in the partnership, and kick start a research collaboration that will generate the knowledge, skills and will to make a real difference to the lives of these children wherever they are in the world. Of course, it would be better if children were not being caught up in these wars but for as long as they are, we plan to make sure they get better care than they do now. That is their right, and our responsibility.
Prof. Mark Hannaford, founder of World Extreme Medicine added
“We are so pleased to be able to provide a platform for Michael to announce this truly critical initiative – and I’m sure it will provoke a great deal of feedback from our audience. It is tragic that increasing numbers of innocent children are getting caught up in the horrors of war these days.
Most medics have been trained to look after adults, so the continuation of last years’ first steps to address dealing with children is a great leap forward.”
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