In development settings in low and middle-income countries (LMIC), trauma and rehabilitation capacity are often already highly deficient, 9 10 rendering an effective response to the onset and continuation of humanitarian crises extremely challenging. Physical trauma in any setting often occurs suddenly, causing life-threating and life-altering injuries which can require extensive measures for survival and a range of subsequent rehabilitation services aimed at improving quality of life, sustaining and maintaining functionality and developing adaptive capacity.

6 Even long after a conflict has ended, children are particularly vulnerable to injuries from land mines and ERWs, often mistaking them for toys, or picking up scrap metal to sell for cash. 2 5 The Landmine Monitor, an initiative that provides systematic monitoring and assessment of the international community’s response to the issues caused by land mines, cluster munitions and other explosive remnants of war (ERW), reported that in 2017, children accounted for 47% of all civilian casualties where the age was known, and women and girls made up 13% of all casualties where the sex was known. 4 Children suffer immensely from the consequences of these brutal trends, and almost one-fifth of children worldwide are now living in areas affected by armed conflict. 1–3 In 2017, 92% of civilian deaths and injuries by explosive weapons were reported to occur in populated areas.

As the nature of conflict is changing, acts of violence in the context of contemporary armed conflict are increasingly occurring in urban areas among civilian populations leading to deaths and life-changing injuries as a result of trauma.

Children and women in armed conflicts