More than 520 million children – or, one in five children globally – live in an area affected by armed conflict, according to Save the Children’s 2025 Stop the War on Children report.
Children are being killed and maimed, denied food and unable to develop cognitively and emotionally. Community bonds and family structures are being destroyed, and young people’s agency as participants in society is being lost. Infants are dying or becoming trapped in a cycle of undernutrition and acute sickness due to infectious disease, with severe consequences for their future growth and development.
Medical-humanitarian organization Medecins Sans Frontières (MSF) brings medical care to people affected by conflict, disasters, epidemics and social exclusion, where, tragically, more than 60% of their patients are under 16 years of age. To ensure that health care professionals and humanitarians can meet the ever-growing needs of children living amid conflict and to constantly adapt to provide the highest quality medical care in some of the world’s most challenging contexts, MSF brought together child health experts and front-line humanitarians in a two-day Paediatric Days conference in Amman late November.
Participants attested to the harsh reality our world is facing: an ever-increasing number of protracted conflicts, where "advancements" in modern warfare have led to higher civilian death rates, leaving those living in horrific conditions with increased physical, emotional and psychosocial trauma. And this is happening against the backdrop of global aid cuts: the United Nations humanitarian assistance budget, for example, has had to shrink its prior $44 billion target by 34% to just $29 billion this year.
This conflagration of factors means more people will suffer, and more mothers, babies and children will die preventable deaths.
The cascading number of regional conflicts has decimated access for many communities to adequate health care. In October alone, nearly 4,000 children in Gaza were still on a waitlist for medical evacuation, according to the World Health Organization. MSF is making inroads in treating those injured during conflict in the region. Since 2006 in Amman, MSF has run a program providing complex surgical reconstruction and long-term psychosocial and rehabilitative care for war-wounded adults and children from Iraq, Syria, Yemen, and now Palestine.
Yet only a small percentage of those in need make it to a highly skilled reconstruction hospital to receive treatment.
Children’s needs have too often been neglected in conflict, but at the Paediatric Days, we were collectively energized by innovative interventions working to mitigate the impacts of conflict and trauma on children, and which have the potential to be adopted more broadly. These are low-cost, high-impact interventions that embed prevention, community action and psychosocial support, such as grassroots promotion of early breastfeeding, therapeutic play and community first aid. Not only do these interventions protect and nurture children today and save lives, but they also promise to reverberate generationally, inspiring hope for a future beyond war.
Initiating breastfeeding within the first hour of birth can reduce newborn deaths by up to 20%, and maintaining exclusive breastfeeding extends lifesaving effects for both the mother and her child. But this is not easy in the face of ongoing conflict, forced displacement, precarious living conditions and food insecurity in places like the Gaza Strip, which can all affect a mother's capacity to breastfeed.
Despite virtually insurmountable odds, organizations are doing what they can. The Gaza Infant Nutrition Alliance (GINA) was started in April 2024 to support breastfeeding women and to help them provide a continuous supply of breast milk for their babies. Their innovative approach involves networks of community volunteers, who have succeeded in establishing a nurturing environment for breastfeeding women, in-person and virtually via messaging groups, enabling babies to grow with greater safety in their mother’s embrace.
Play is essential for a child’s well-being. It supports physical health, cognitive functioning and children’s linguistic, social and emotional development. Through play, a child discovers the world and is helped to develop trusting relationships with others. But children living amid conflict – often encountering death, destruction, grief and a sense of hopelessness – do not play like my children played when they were young, in safe and stable environments and being hospitalized can exacerbate their trauma.
MSF has developed a play therapy "toolkit," equipping health care providers with practical strategies so that they can integrate trauma-informed therapeutic play into their care. Through small, consistent moments of play, children can learn to regulate their emotions, express fear, and regain agency. The costs are minimal, but the benefits are truly transformative for their recovery and their future well-being.
A third intervention profiled in Amman and currently being piloted by the HALO Trust, who are expert in mine clearance and risk education, is a community-based first responder training program teaching first aid for traumatic injury. Data released earlier this month says that 46% of at least 6,279 people maimed or killed by landmines or unexploded ordnance (UXO) around the world in 2024 were children. Injuries caused by bombs, landmines and UXO require immediate medical attention to prevent fatal bleeding, which happens faster in children due to their small bodies, before they can reach a hospital.
Humanitarians cannot stop the violence, but we can help prevent its worst effects on women and children. We must create more spaces in health care facilities, work with communities to promote life-saving, health-enabling best practices, and support organizations committed to this work, to ensure children can have the best building blocks for a healthy future, with a mother whose health and well-being are equally safeguarded. And we must bear witness, bringing these issues to the fore, so that every life counts and humanity prevails.
