The Disproportionate Surgical Burden Borne by Children in Regions of Armed Conflict

Background: Modern warfare disproportionately affects children, severely impacting their mental, physical, social, and economic well-being. Specifically, children in areas of conflict bear a significant surgical burden. We aim to review literature to better understand the surgical needs of children attributable to conflict and the challenges faced in receiving surgical care in conflict zones. Methods: A review of literature and primary data sources was conducted to examine the impact of war on the surgical burden faced by children in six countries facing active conflict: the Democratic Republic of Congo, Syria, Yemen, Ukraine, Sudan, and Gaza. Results: There is limited data directly documenting the surgical needs of children in war zones; however, extensive displacement and evidence of unprecedented grave violations against children, including maiming, indicates the gravity of the situation. On average, 50% of hospitals are rendered nonoperational due to conflict; the rise in demand for surgical care due to conflict is thus paralleled by a decrease in health system capacity, creating a worsening cycle of unmet need. Conclusions: There is an urgent need for systematic data collection documenting the health, and specifically surgical burden faced by children in conflict-affected areas. Evidence can drive advocacy for improved services and the enforcement of conventions protecting children in conflict.