Children In Disaster And Conflict

Question 1

Learning Objectives

Answer 1

• Learn the Perspective beyond acute medical care
• What make children different from grown ups
• What are the Priorities
• Where do you fit in this?

Question 2

List the bare essentials that children need

Answer 2

• Clean water
• Ordinary care

Question 3

Provide an overview of the world population with reference to the number of children

Answer 3

• World population 8.1 bn
• Roughly- 1+1+1.4+4.7 Americas-Europe-Africa- Asia
• <15 year old – 2.4bn
• A quarter of these children (600 million) live in a country affected by conflict or disaster

Question 4

List the figures of children’s health released by the world health organisation

Answer 4

• Under-5 deaths worldwide have declined from 12.8 million in 1990 to 4.9 million in 2022 (59%vdrop).
• Leading causes of death in children <5 years are preterm birth complications, pneumonia, birth asphyxia, diarrhoea and malaria.
• Nearly half of these deaths are in newborns.
• Children in sub-Saharan Africa are >14 times more likely to die before the age of 5 than children in high income countries.

Question 5

Which continent is home to the largest number of children

Answer 5

Sub-Saharan Africa is home to nearly three-quarters – 393 million – of the children living in countries affected by emergencies, followed by the Middle East and North Africa where 12 % of these children live.

Question 6

List some statistics released by UNICEF worldwide

Answer 6

• 1 in 4 children live in conflict or disaster-stricken countries
• There were 31 million displaced children globally by the end of 2018
• Decision making: 60% of young people believe their views are ignored when important decisions are made

Question 7

What’s the difference between children and adults in disaster and conflict?

Answer 7

• Physiological differences between children and adults
• Prioritise the important things in crisis.
• To form strategies for the prevention of long-term effects.
• Preventing separation from the parents

Question 8

List the anatomical differences between children and adults

Answer 8

• Children have a large head and small neck
• Making them more susceptible to head injuries

Question 9

List the physiological differences between children and adults

Answer 9

• Circulation Blood volume- Neonates 90/kg, Adults 70/Kg
• Increased basal oxygen requirement 6 ml/kg/min (adults 3.5); the presence of Hbf shifts the oxygen dissociation curve to the left.
• Cardiac output 200ml/kg (100ml/kg in adults), Lesser myocardial contractility
• CNS- Open fontanelle, immature BBB, Poorly myelinated nervous system- more pain and excitable nervous system
• Excretion- reduced GFR

Question 10

What’s the difference in breathing between children and adults? (PART 1)

Answer 10

• Large tongue, floppy epiglottis, narrow and short trachea- more laryngospasm and bronchospasm
• Up to 6 months, obligate nose breather, blocked nose may worsen the respiratory failure
• Infants are abdominal breathers who rely primarily on the diaphragm muscles; abdominal distension can lead to respiratory problems.

Question 11

What’s the difference in breathing between children and adults? (PART 2)

Answer 11

• Toxins heavier than air will affect more to children as they are close to the ground
• Gases such as sarin and chlorine have a high vapour density and are heavier than air, which means that they settle close to the ground in the airspace used by children.
• The total amount of water is 75-80 % of body weight in childhood and 60 % in adults
• Neonates and infants lose heat more rapidly than adults

Question 12

List some further anatomical and physiological differences between children and adults

Answer 12

• Larger body surface to-mass ratio, making them more vulnerable to chemical agents, smoke inhalation, and radiation.
• A smaller fluid reserve and increased insensible water loss due to faster breathing- dehydration and shock.
• Increased heart and respiratory rates- increasing their susceptibility to airborne chemical and biological agents that will quickly spread throughout the circulatory system

Question 13

What is a disaster as stated by the UNSDR?

Answer 13

“Disaster a natural process or phenomenon that may cause loss of life, injury or other health impacts, property damage, loss of livelihoods and services, social and economic disruption, or environmental damage”

Question 14

List the different types of Hazards

Answer 14

• Technological
• Natural
• Environmental degradation

Question 15

List the different types of natural disasters

Answer 15

• Hydrometerological: Floods, Cyclones, Storms, Droughts and extreme temperatures
• Geological: Earthquakes, Tsunamis, Volcanic eruptions and Landslides
• Biological: Epidemics

Question 16

How many children had sided from preventable diseases in 2018?

Answer 16

• 6.2 million children under 15 years died, mostly from preventable causes
• Of these deaths, 5.3 million occurred in the first 5 years, with almost half of these in the first month
• Leading causes of death in children under 5 are Pneumonia, Diarrhoea and Premature birth

Question 17

How do infections cause death?

Answer 17

• Diarrhea and chest infections are major killers
• Sanitation, clean water and ORS are life saving
• Crowding makes it easier to spread transmission of infections through water, food, personal contact, and vectors.
• Measles, Bacterial and viral pneumonia
• Tuberculosis

Question 18

Why is children being separated from their families a problem?

Answer 18

• Children have the right to be with their families.
• Better protected and have less emotional disturbance
• Children rely on adults to ensure their safety, if such as a parent, is injured or dies the child is left feeling vulnerable and alone
• Separation can be prevented by involving NGOs, military agencies, particularly United Nations units who may be involved in the initial care of displaced populations

Question 19

How many deaths is pneumonia accountable for?
How can it be treated?

Answer 19

• Pneumonia accounts for almost one million deaths every year, 922,000 in 2015 which is 16% of total deaths
• Oral amoxicillin is the most effective treatment for both fast breathing and chest indrawing pneumonia

Question 20

How much children die each year despite having availability to simple effective treatment?

Answer 20

• Over 1,300 young children dying each day, or about 480,000 children a year, despite the availability of simple effective treatment
• Plans have been created focusing on Reducing, protection, Prevention and treatment

Question 21

List another major killer

Answer 21

• Sepsis, Tuberculosis, Viral rashes
• Identify
• Treat early - Oxygen, Fluids, Antibiotics
• Priorities

Question 22

How do you work to keep a child alive?

Answer 22

• ABC
• Severe trunk injuries are best treated early if possible.
• Paediatric field hospital set up within the week of the event needs to be prepared for the management of crush syndrome and acute renal failure.

Question 23

What are the problems for children during/after wars?

Answer 23

• Slave workers, sex workers & soldiers
• Child abuse increases after natural disasters

Question 24

List the accidental and non accidental injuries that could occur to children

Answer 24

• Same rules apply in disaster for physical injuries
• ABC
• Pediatric-sized emergency equipment is needed to properly treat children
• Head and neck trauma and lower extremity injuries are common
• Although head injuries are the most common injury in explosions, usually minor and contribute to lower mortality
• Injuries to the chest and abdomen have higher overall mortality rates

Question 25

What are the effects of the poor economy

Answer 25

• Malnutrition, poor hygiene- infections
• Poor social and emotional environment, Exploitation, child labour
• Poor healthcare system

Question 26

What is the definition of poverty

Answer 26

A condition characterised by severe deprivation of basic human needs, including food, safe drinking water, sanitation facilities, health, shelter, education and information. It depends not only on income but also on access to services.

Question 27

Conclusion

Answer 27

• Children need separate planning in disasters and for following
• Infection control and clean water is a priority
• Reunion with family
• Psychological support
• Rehabilitation planning
• Safeguarding