This week Save the Children joined some 2,000 delegates from 116 countries at the fourth ‘World Innovation Summit on Health’ (WISH) held in Doha, Qatar.
The summit brought together a global community of health reformers to try and tackle some of the defining issues of the modern era. These included a critically important focus on healthcare in conflict.
The problem statement around this issue is grim.
In modern war some 90% of casualties are civilian and an average of 20 people are displaced every minute of every day by conflict or persecution. Across the globe some 357 million children, that’s one in six of all children, live in countries affected by conflict.
Opening the summit Lord Darzi of Imperial College London, explained that “where once medics were protected by the laws of war, that can no longer be said”. His introduction was followed by David Miliband of the IRC who stated that “none are more at risk in the world today than children in conflict”. Dr Mukesh Kapila bemoaned how “conflict has become a way of life for millions of people on this planet” and how tragically “it’s safer to be a solider than a civilian”.
The paediatric blast injury field manual
We attended the summit to preview an innovative new method of better protecting children in conflict; a paediatric blast injury field manual.
This is the product of the work of a long list of determined medical, academic and humanitarian experts coming together under the banner of the ‘Paediatric Blast Injury Partnership’ co-conveyed by Save the Children and Imperial College London.
This manual is a response to the changing nature of conflict. It is becoming more urban, protracted and fought by more numerous non-state actors – the dynamics constraining our humanitarian response – attacks on healthcare and the denial of aid – and the particular physiological vulnerabilities of children themselves.
The need for such a manual stemmed from a request from Syrian medical partners of ours in December 2017, when they explained that a lack of paediatric specialists and the limited access to outside help meant that indigenous Syrian health teams and first responders needed a practical resource that could bring together best practice in treating children injured in the fighting.
When explosive weapons are used in built up urban areas children are particularly vulnerable.
Heat, pressure and fragmentation from these weapons can wreck havoc on their young and not fully formed bodies. The field manual covers the continuum of care from the point of injury, including first response, pre-hospital care, transport and en-route care, intensive care, anaesthesia, surgery, limb and tissue salvage, prosthetics, burns management, ward care, rehab and physiotherapy, and psychosocial support.
Improving the conduct of conflict
Children injured in conflict often require different equipment, differing levels of fluids and medication and a different approach in terms of bedside manner. As the manual states ‘paediatric casualties distress everyone in the trauma team and this can be detected by the child’.
After workshops with Syrian medics held in November we hope to have the manual finalised and printed and in use early in the new year. We will then turn our attention to broadening the scope of the field manual’s users to places like Yemen and DRC as well as using evidence from it to engage in a debate with States around how they can improve the conduct of conflict to ensure that children don’t pay such a heavy price.
I’d like to thank the organisers of WISH for giving us the platform to talk about this track of work which has allowed us the chance to bring in more expertise into the Partnership and find new allies who are committed to doing everything they can to protect children in conflict.