Paediatric Blast
Injuries
Partnership

Save the Children is proud to partner with Imperial College London and a host of medical and operational experts to support children who’ve been injured in conflict.

Every day, in places like Ukraine, Syria and Yemen, healthcare professionals and frontline responders are working tirelessly to save the lives of children. To help inform and improve the care provided to children caught up in conflict, the Paediatric Blast Injuries Partnership developed the world’s first field manual on paediatric blast injury – a handbook for doctors, surgeons and those providing aftercare for children in war zones.

In 2023, the Centre of Paediatric Blast Injury Studies at Imperial College London was established, with the aim of carrying out research into the impact of conflict trauma on children and developing solutions to the challenges they face.

More children are living in conflict zones than any other time in the last 20 years, with approximately 449 million children – one child out of six globally – living in conflict in 2021.

Those living in areas of extreme conflict face risks of grave violations that endanger their lives and wellbeing. The number of children verified by the UN as killed or maimed has risen drastically in the last 10 years.

In Yemen, explosive weapons were the biggest killer of children between April and June 2022, being responsible for over 75% of all war-related casualties among children.

In Ukraine, of the 1,441 recorded civilian casualties among children in Ukraine, 981 were caused by explosive weapons – with actual numbers expected to be considerably higher. Over 250,000 explosive devices have already been removed and destroyed since March 2022, but millions more persist, presenting a severe threat to thousands of children.

Dr Reavley, lead author of the Paediatric Blast Injury Field Manual, says ‘In Ukraine, all clinicians are now faced with the challenges experienced in conflict zones around the world and will continue to do so for some time. They need support to successfully treat some of the most severely injured children’. 

Central to the Paediatric Blast Injuries Partnership is a practical field manual which Save the Children is distributing to its first responders, doctors and surgeons and those providing aftercare for children in the most dangerous places in the world.

Children injured in war need to be treated differently from adults. In conflict zones, even trained medical staff such as surgeons, nurses and therapists can lack the training and expertise they need to treat children. These experts need to make complex decisions in the horrors of war, like whether to amputate a child’s leg or how best to help a child with a life-changing injury re-integrate back into society. This field manual helps inform these decisions by providing a durable, easy-to-use, illustration-based guide that can be used worldwide.

Doctors in Syria told us that such a guide was needed, and the Paediatric Blast Injury Partnership has been quick to respond. Dr Malik, from our partner Syria Relief, says  ‘I’m a trained paediatrician but I never imagined in a million years that I would have to treat children who have suffered devastating blast injuries. Yet that became the new normal in Syria. 

"This field manual will go some way to address the huge knowledge gap in treating children injured as a result of explosive weapons. Ultimately, I hope this simple tool will save lives.’

Download the field manual in English

Download the field manual in Ukrainian

Download the field manual in French

Download the field manual in Arabic

Download the field manual in Dari

Download the field manual in Pashto

Download the field manual in Russian

See our Report on the Impact of Explosive Weapons on Children in Conflict

The manual is now being expanded upon through the webinar series Support for Ukraine – Paediatric Blast Injury, produced in response to the number of children hurt by explosive weapons in Ukraine over the past year. In this series, the UK’s leading doctors have come together to deliver lifesaving ‘blast injury’ training to Ukraine’s medics.

See the recordings of the Support for Ukraine – Paediatric Blast Injury webinars

The issue of blast injury is increasingly recognised by the international community.  

On the 18th of November 2022, Ireland welcomed delegates from across the world to a high-level international conference in Dublin to adopt the Political Declaration on strengthening the protection of civilians from the humanitarian consequences arising from the use of explosive weapons in populated areas. The hugely successful meeting saw the Political Declaration formally adopted by 83 countries.

The declaration marks the culmination of almost three years of consultations led by Ireland and involving Member States, the United Nations, the International Committee of the Red Cross (ICRC) and civil-society organisations, including the International Network on Explosive Weapons (INEW) which Save the Children is a member of.

The declaration's focus is to address the devastating and long-lasting humanitarian impact of the use of explosive weapons in populated areas.

The Final text of the Political Declaration can be found here

The challenge children in conflict zones face is great – especially so from the threats of explosive weapons. However, the resilience of children and their desire to secure safer, better futures for themselves is a platform upon which states and parties to conflict can, and should, act. Save the Children believes that practical action on the ground and policy change at national and international levels can better protect children from harm. Specifically, and in line with our campaign to Stop the War on Children, we call on states to:

• Uphold international norms and standard
• Ensure perpetrators of violations against children are held to account
• Support and resource practical action to protect children in conflict and enable their recovery.

• Save the Children Press Release: World's First Handbook for Child Blast Injuries Launched in Syria
• Save the Children Report: Stop the War on Children, Protecting Children in 21st Century Conflict 
• Save the Children Report: Blast Injuries: The impact of explosive weapons on children in conflict 
• Imperial College London: Paediatric Blast Injury Partnership
• International Committee of the Red Cross, Humanitarian Law & Policy, Blog: Bombs & Blast Waves: Why Children in Conflict Need Special Care
• Save the Children Press Release: British Doctors Training Ukrainian Medics to Treat Children with Blast Injuries 
• British Orthopaedic Association: Support for Ukraine webinars - Paediatric blast injury

If you have any questions or requests on our work on paediatric blast injuries, please feel free to contact us.