When is enough, enough? Humanitarian rights and protection for children in conflict settings must be revisited
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj-2024-081515 (Published 04 September 2024) Cite this as: BMJ 2024;386:e081515- Zulfiqar A Bhutta, Robert Harding chair in global child health1 2 3,
- Georgia B Dominguez, research assistant1,
- Paul H Wise, Richard E Behrman professor of child health and society4
- 1Centre for Global Child Health, Hospital for Sick Children, Toronto, ON, Canada
- 2Center of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
- 3Institute for Global Health and Development, Aga Khan University,
- 4Department of Paediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Correspondence to: Z A Bhutta zulfiqar.bhutta{at}sickkids.ca
The rules of war and existing regulations have become increasingly unable to protect civilians from harm in conflicts around the world. The large death toll among children in Gaza continues to provide the most tragically prominent example of this reality. More broadly, international institutions and humanitarian norms have remained impotent in preventing mass civilian casualties in various settings, including Ukraine, Sudan, and Tigray.123 Much has been said on the genesis of the Gaza conflict and other conflicts, and the tactics being employed by the combatant parties,4 but here we examine the Gaza conflict’s humanitarian effect on children and its implications for the protection of children in other conflict settings around the world.
The attack on Israel by Hamas on 7 October 2023 triggered a devastating military response by Israel that is still ongoing in September 2024. Over the past 10 months in Gaza, the protections afforded civilians in international humanitarian law have been largely ineffective.5 The 1994 genocide in Rwanda is estimated to have killed between 500 000 and 1 million people,6 but other than this there have not been as many civilian deaths in such a short period. The UN Office for the Coordination of Humanitarian Affairs (OCHA) reports that 40 534 Palestinians were killed from 7 October 2023 to 28 August 2024, many of them women and children.7 The reliance on the Gaza Ministry of Health for casualty figures has been questioned, particularly as these numbers do not well distinguish between civilian and combatant deaths and cannot distinguish between the number killed and those who remain listed as missing. Nevertheless, independent …
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