June 1st is celebrated in several countries as Children’s Day. ICRC medical adviser Dr Robin Coupland explains how armed conflict and other emergencies affect children's health disproportionately and can prevent the safe delivery of health care.

How does conflict affect children's health?

The impact of conflict and lack of security on children's health is disproportionate. This is because in any population, children are the most vulnerable to a variety of illnesses. This vulnerability is compounded in conflict because attacks on health-care workers and facilities disrupt essential health programmes. In addition, a parent may be unable to take her or his child to a clinic when fighting gets too intense. Health programmes such as vaccination campaigns carried out by both local health authorities and international organisations are often put on hold when the security situation deteriorates.

The sad truth is that child health programmes are most needed at times when it is most difficult to implement them. If we want to ensure the health of children in areas suffering from conflict, the international community needs to come up with solutions to ensure the safe delivery of health care.

What infectious diseases plague children in conflict-affected areas?

Children caught up in conflict are at risk from a number of important infectious diseases. There are clear links between conflict and cholera outbreaks. Measles is a particular threat to children's health when they and their families are forced into refugee camps. Recent data show that polio eradication may not be achieved in a number of countries where hundreds of thousands of children cannot be reached by vaccination teams because of a lack of security. It is a tragedy that today we have lifesaving medical technologies at low cost that cannot benefit children's health because of the lack of security that comes with conflict.

What can be done to improve the situation?

Responsibility for the lack of security of health-care programmes that ultimately has such a major impact on children's health in areas of conflict does not lie with the health-care community. It lies with those who are in a position to ensure the security of health care and uphold its sanctity. This is an overriding issue; it means states, armed forces, and other weapons' bearers must ensure that health programmes can be safely accessed by the population, even in times of conflict.

For major public health programmes, this may even mean negotiating ceasefires to let vaccination teams do their work. In terms of numbers of people affected, this is one of the largest humanitarian concerns that the ICRC is facing in today's conflicts.