Clinical Review ABC of conflict and disaster

The special needs of children and women

BMJ 2005; 331 doi: (Published 30 June 2005) Cite this as: BMJ 2005;331:34
  1. John Seaman, independent consultant in overseas development,
  2. Sarah Maguire (, independent human rights consultant
  1. Kent

    The special needs of children

    Children are more vulnerable to communicable diseases and environmental exposure than adults, have special dietary needs, and are generally dependent on their family for their material and emotional support.

    Many of the most severe emergencies occur in poor countries. Poverty tends to exacerbate the impact of emergencies of all types: poor people live in low quality, damage-prone housing, often on marginal land at risk of landslide or flood. The children of the poor tend to have low nutritional status, increased exposure to communicable disease, low immunisation rates, high levels of intestinal parasites, and limited access to health care.

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    Queuing outside a clinic in Sudan

    Earthquakes, floods, and other physical shocks

    Trauma in these events may affect children disproportionally. In the 1976 Guatemala earthquake child mortality was generally higher than that of adults, but low in those less than 1 year old, attributed to the fact infants slept with their mother and were thus protected. Serious injury increased steadily with age, an effect assumed to result from the greater susceptibility to injury with increasing age.

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    Risk assessment for humanitarian emergencies

    In the 1971 Bangladesh cyclone children aged less than 10 years made up about a third of the population but accounted for half of all deaths. Many people survived this storm by clinging to trees. Mortality was particularly high in young children and in women older than 15 years, probably because of women trying to protect small children, the relative physical weakness of these groups, and the effects of exposure as the cyclone continued for many hours.

    Economic consequences of disasters

    The economic impact on families affected by disasters may be considerable. Houses, standing crops, domestic food stocks, livestock, and goods may be lost.

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    Malnourished child and mother in a Nepalese clinic

    Crop failure and an increase in the price of food may lead to famine. The initial damage is often …

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