Paediatric Blast Takes Off 

As part of our commitment as a movement to scale up our efforts to protect children in conflict, and against a backdrop of worsening grave violations and the stunning statistic that 1 in 5 children live in parts of the world affected by conflict, the nascent Paediatric Blast Injury Partnership (PBIP) goes from strength to strength.

I always say that for this underdeveloped field of medicine to be given its prominence is a sad reflection of the state of the world for children, yet it also should give us hope that dynamic coalitions of concern are forming to address these challenges.

Formed in December of 2018, PBIP has brought together academics, scientists and practitioners from the military and humanitarian space who all agreed that children have unique vulnerabilities to the weapons of modern war.

The Paediatric Blast Injury Field Manual

At the request of Syrian medic Dr Malik, the world’s first ever Paediatric Blast Injury Field manual was developed and launched in May of this year. It is an open source tool that has found itself in ten countries already including Libya, Nigeria and Myanmar. Whilst our colleagues in Afghanistan have it and are looking to translate it into Dari and Pashtu, this week saw our partners the World Innovation Summit for Health (WISH) translate and print the first Arabic edition which was launched in Doha.

This Arabic edition will soon find its way to medics in Iraq and Yemen, but there are still a host of next steps that the PBIP is looking to explore around tools that can save the lives of children injured by blast.

One challenge is that with so many children at potential risk of being hurt by blast is how to spread the knowledge and guidance of the manual as far and wide as possible. Old fashioned distribution and training – like that given to Syrian medics by the manual’s lead author – Dr Paul Reavley – can only reach small numbers of people and are logistically expensive.

We need to think about moving away from assets that are ‘pushed’ onto small numbers of people and imagine how the life saving techniques can be ‘pulled’ quickly by those who come across injured children. Trained first responders may be nowhere near the site of an incident, so we need to prepare ‘zero responders’ for stepping up to try and save a child’s life.

“Siri – help me save the life of this severely injured child”

‘Stop the Bleed’ packs could be pre-positioned in sensitive locations like schools. Smartphones could host a app version of the manual that responds to voice command. A zero responder describing the injuries could receive critical advice as to applying tourniquets, stemming the bleeding or securely stabilising an injured child before more trained support arrives.

With operations being guided by Google glass and telemedicine developing leaps and bounds this isn’t such a crazy concept. Just as James Bond has a team of medics back at HQ ready to advise him if he’s been poisoned, so could the connectivity of those needing advice to those best placed to give in within the PBIP be a tool of the future.

The Vienna Conference

As the Arabic Field Manual was being launched in Doha over in Vienna my colleague Amanda Brydon was delivering our intervention at a major conference on protecting civilians in urban warfare. With some 132 States in attendance the conference is part of a sustained effort, led by a core group of states including Ireland and Austria, to develop a declaration to avoid the use of explosive weapons with wide area effects in urban areas.

It appears that we are at a crossroads as to awareness of the harm of modern conflict on children and that we have at our fingertips the tools and methods to reduce that harm. We must keep up this momentum as only then will we truly stop the war on children.

Dr Malik, Lead Syrian Paediatrician - Paediatric Blast Injury Partnership / Syria Relief
Dr Malik, Lead Syrian Paediatrician – Paediatric Blast Injury Partnership / Syria Relief


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