The hidden crisis: Armed conflict and education Impact of Conflict on Children’s Health and Disability

Armed conflicts have changed in complexity and nature over the past few decades magnifying health challenges for children. Conflict impacts children's health in four important ways. First, conflict‐driven displacement increases child death and injury, mainly through increased susceptibility to infectious disease from unsanitary living conditions. A case study on Southern Sudan illustrates that conflict reduces sanitation, clean water, and health services making it difficult to stop the spread of neglected tropical diseases, such as visceral leishmaniasis and trachoma. Second, children have a higher risk of food insecurity and malnutrition during times of conflict. The country case of Chad illustrates that food insecurity is heightened by the resettlement of displaced people leading to higher rates of malnutrition. Third, children, especially girls, are subjected to an increased risk of sexual violence from armed combatants during conflict. Rape has been a prevalent component of armed conflict in the Democratic Republic of Congo causing increased risk of psychological trauma, unwanted pregnancy, and susceptibility to sexually transmitted infections. Fourth, conflict induces long‐term physical and psychological disability in children, especially among child soldiers. In Afghanistan, rehabilitation and educational interventions are critical in improving the health outcomes of children. Introduction Contemporary armed conflicts are frequently complex, with protracted duration, and fought by irregular armed combatants. Armed conflict involves the intentional use of illegitimate force with arms or explosives against a person, community or state (Geneva Declaration 2008) and is generally characterized by at least 1,000 conflict‐related deaths per year. Armed conflict is the fourth leading cause of death for people between the ages of 15 and 44 worldwide (Geneva Declaration 2008). Armed conflict now involves massive civilian casualties and injuries. The 20th century revealed dramatic increases in violence against civilians during armed conflict. 19% of casualties were civilians during World War I, and nearly half of World War II casualties were civilian. In the 1980s and 1990s, the majority of casualties (80%) were civilians (Bhutta, Yousafzai et al. 2010). In addition to increased prevalence of violence against civilians, conflict is also inextricably linked to poverty. 90% of the 150 conflicts post‐World War II have occurred in developing countries (Pollard, Finn et al. 2005). Asia and Africa have the largest concentration of violent conflict where both regions account for over 75% of global conflicts (Project Ploughshares 2009). Many Sub‐Saharan African countries are poverty stricken during times of peace, and armed conflict deepens civilian vulnerability, diminishes safety networks, and …