A/HRC/39/25
or other illnesses, and lack of access to food or health-care facilities. The response
necessary was therefore not only medical. As seen recently in the Syrian Arab Republic and
Yemen, health-care facilities, hospitals and humanitarian convoys were increasingly
targeted to destabilize areas, and children faced the long-term consequences of trauma,
including post-traumatic stress disorder, anxiety and depression, even after the conflict had
ended.
34.
Jérôme Pfaffmann, a child health specialist at UNICEF, delivered a presentation on
community health in emergencies. He explained that emergencies, conflict and
humanitarian crises were among the greatest threats to realizing children’s right to health.
There was a need for a detailed understanding of the challenges in each emergency to
ensure an appropriate response. He stressed the importance of community health workers
embedded in the local population, and of integrated primary health-care systems. He
referred to UNICEF case studies from experience in Guinea, Liberia and South Sudan,
highlighting how community health workers had been able to continue their work even
when formal health system services had been disrupted. Community health workers needed
ongoing support in order to operate effectively throughout crises and emergency situations.
Greater investment was needed in predicting crises and in planning effective responses,
including tools for applying a human rights-based approach.
35.
David Southall of Maternal Child Health Advocacy International (United Kingdom
of Great Britain and Northern Ireland) delivered a presentation on the topic of protecting
children from the health consequences of armed conflict. He stated that the nexus of
security, insecurity and health must take precedence in crisis settings; international law
was, however, ignored in conflict, and the situation was worsening globally. Attacks
against health facilities and health workers were endemic (as in for example Somalia); the
Security Council, in its resolution 2286 (2016), urged States to address such attacks and to
take action to ensure accountability for perpetrators. He noted that, in May 2017, the
Safeguarding Health in Conflict Coalition published a report documenting the current
situation and showing that such attacks were continuing globally, not only in the Syrian
Arab Republic and Yemen, but also in Afghanistan and elsewhere. The proliferation of
arms — including those manufactured by States Members of the Security Council — was a
primary contributing factor to conflict, and proposed the development of a targeted global
health protection system, funded and managed by the United Nations.
36.
Nour Alnirabia of the Syrian American Medical Society Foundation in Aleppo made
a presentation on her experience of addressing newborn and child mortality in the Syrian
Arab Republic. She stated that children in conflict zones had heightened needs owing to
displacement, injuries and lack of health care due to the destruction of medical centres and
the lack of adequate personnel, facilities and equipment to cover the population. In the
Syrian Arab Republic, for each physician there were 6,000 children needing care.
Newborns, particularly premature babies, were at greatest risk of mortality; nonetheless,
300 babies were delivered daily in areas where hospitals did not have the means to provide
care. Patients had no access to facilities being targeted by bombings and from which
children were removed for safety reasons, even though they needed treatment. Chemical
attacks were committed in areas where children could not be treated, and a lack of
vaccination coverage in Syrian conflict areas had recently led to a polio epidemic. Children
needed support through education, orphanages and centres to recover from the
psychological trauma and stress of living through conflict, and also safe schools, which
could help to build the next generation.
37.
During the discussion, participants pointed out that attacks on health facilities in
conflict were one of the six grave violations of children’s rights that the Human Rights
Council had been mandated to address. While minimum standards existed for humanitarian
responses, they did not exist for children in emergency situations. There was a need to
address how children’s health was prioritized in humanitarian response planning; an interagency subcluster could be considered. More detailed understanding was needed in order to
respond to non-medical factors, including underlying determinants, such as malnutrition.
Participants noted the large number of abortions and premature births due to the exposure
of pregnant women to conflict situations, and that conflicts of interests of States were an
obstacle to bringing about effective responses to conflict.
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