DEATH

These are not necessarily risks familiar to children and their caregivers.
Furthermore, health and emergency services may not be available to respond should an incident occur. Alternatively, they may be overwhelmed,
inadequate and ill-resourced and therefore unable to provide suitable treatment. Children, their families and communities may
not be aware of the availability of facilities even when they are present.
In general terms, the type and number of injuries depend on the nature and context of the emergency.
• n Childhood physical injury is common during and after armed conflicts and natural disasters. 37n
• n Injuries in earthquake settings are numerous. 38n
• n Children are especially at risk of road traffic accidents because their heads, chests, abdomens and limbs aren
all in a state of growth, entailing a relative “softness”. Their smaller physical stature limits their ability to see or be
seen by vehicles. 39 In 2004 road traffic injuries made up 22.3% of total global child injury deaths by cause. 40 n
In Rwanda, for example, more children were evaluated for injuries from road traffic accidents than from landminesn
or interpersonal violence in July 1994, following the large influx of vehicles as part of relief efforts. 41 , 42 In Asia, recent
surveys show that road traffic injuries are one of the five leading causes of disability for children. 43 It is important to
be aware of the risks of drowning and to include water risks in any mapping activities. n
• n The best-documented paediatric injuries associated with conflicts are those due to landmines. See annex 4n
for a detailed case study.
WHICH CHILDREN ARE MOST VULNERABLE?
Certain groups of children have higher than average rates of injury. These rates may be associated with their specific circumstances and
environment such as refugee status or homelessness. 44 On a global scale in all settings, the proportion of children who die as a result
of injury increases with age, accounting for over 40% of deaths among those aged 15 to 19. 45 Data from Syria indicates that boys aged
13-17 years old are four times more likely to be injured or killed than girls of the same age. 46 Once injured, unaccompanied and separated
young children are especially unlikely to know where to go for help and assistance and gain access to any humanitarian services available.
Their injuries are therefore likely to cause greater long-term issues.
URGENCY OF RESPONSE
There is a need for medical support within hours of the incident. Sphere 47 states that in many cases wounds are not presented for
treatment within six hours meaning that instances of wound infection and preventable excess mortality increase. Mine Risk Education,
and the referral of children to health services are both recognized as life-saving activities under the CERF Life-saving criteria. 48
23 A MATTER OF LIFE AND DEATH: CHILD PROTECTION IN EMERGENCIES