26 August 1996

Original: ENGLISH

Fifty-first session
Item 108 of the provisional agenda*


Impact of armed conflict on children

Note by the Secretary-General

1. The Secretary-General has the honour to transmit herewith to the General Assembly the study on the impact of armed conflict on children, prepared by Ms. Graça Machel, the expert appointed by him on 8 June 1994, pursuant to General Assembly resolution 48/157 of 20 December 1993. The study was undertaken with the support of the United Nations Centre for Human Rights and the United Nations Children's Fund, as provided for in the resolution, and is the fruit of extensive and wide-ranging consultations.

2. In the study, the expert proposes the elements of a comprehensive agenda for action by Member States and the international community to improve the protection and care of children in conflict situations, and to prevent these conflicts from occurring. The study demonstrates the centrality of these issues to the international human rights, peace and security and development agendas, and should serve to promote urgent and resolute action on the part of the international community to redress the plight of children affected by armed conflicts.

3. The Secretary-General trusts that the General Assembly will give thorough consideration to this study and to the mechanisms required for following up and monitoring the implementation of the conclusions and recommendations it will adopt on this important subject.


Report of the expert of the Secretary-General, Ms. Graça Machel, submitted
pursuant to General Assembly resolution 48/157




A. The attack on children 1 - 8
B. Course of the study and its methodology 9 - 21
C. Patterns and characteristics of contemporary armed conflicts 22 - 28

A. Child soldiers 34 - 62
1. Recruitment 36 - 43
2. How child soldiers are used44 - 48
3. Demobilization and reintegration into society 49 - 57
4. Preventing future recruitment 58 - 61
5. Specific recommendations on child soldiers 62

B. Refugees and internally displaced children 63 - 90
1. Vulnerability of children in flight 67 - 68
2. Unaccompanied children 69 - 74
3. Evacuation 75 - 76
4. Children in camps 77 - 80
5. The situation of internally displaced children 81 - 83
6. Asylum and the right to identity and nationality 84 - 86
7. Returning home and durable solutions 87 - 89
8. Specific recommendations for refugee and internally displaced children 90

C. Sexual exploitation and gender-based violence 91 - 110
1. Gender-based violence: a weapon of war 91 - 95
2. Child victims of prostitution and sexual exploitation 96 - 102
3. Ending impunity 103 - 106
4. Preventing gender-based violence 107 - 109
5. Specific recommendations on sexual exploitation and gender-based violence 110

D. Landmines and unexploded ordnance 111 - 126
1. The threat to children 113 - 118
2. Mine clearance, mine awareness and rehabilitation 119 - 122
3. The need for an international ban 123 - 125
4. Specific recommendations on landmines and unexploded ordnance 126 38

E. Sanctions 127 - 135
1. Humanitarian exemptions 128 - 130
2. The need for child impact assessments and monitoring 131 - 134
3. Specific recommendations on sanctions 135

F. Health and nutrition 136 - 165
1. Communicable diseases 140 - 142
2. Reproductive health 143 - 144
3. Disability 145
4. Destruction of health facilities 146 - 148
5. Protecting health services and health workers . 149 - 151




The attack on children

1. Millions of children are caught up in conflicts in which they are not merely bystanders, but targets. Some fall victim to a general onslaught against civilians; others die as part of a calculated genocide. Still other children suffer the effects of sexual violence or the multiple deprivations of armed conflict that expose them to hunger or disease. Just as shocking, thousands of young people are cynically exploited as combatants.

2. In 1995, 30 major armed conflicts raged in different locations around the world.
1/ All of them took place within States, between factions split along ethnic, religious or cultural lines. The conflicts destroyed crops, places of worship and schools. Nothing was spared, held sacred or protected - not children, families or communities. In the past decade, an estimated two million children have been killed in armed conflict. Three times as many have been seriously injured or permanently disabled, many of them maimed by landmines. 2/ Countless others have been forced to witness or even to take part in horrifying acts of violence.

3. These statistics are shocking enough, but more chilling is the conclusion to be drawn from them: more and more of the world is being sucked into a desolate moral vacuum. This is a space devoid of the most basic human values; a space in which children are slaughtered, raped, and maimed; a space in which children are exploited as soldiers; a space in which children are starved and exposed to extreme brutality. Such unregulated terror and violence speak of deliberate victimization. There are few further depths to which humanity can sink.

4. The lack of control and the sense of dislocation and chaos that characterize contemporary armed conflicts can be attributed to many different factors. Some observers point to cataclysmic political upheavals and struggles for control over resources in the face of widespread poverty and economic disarray. Others see the callousness of modern warfare as a natural outcome of the social revolutions that have torn traditional societies apart. The latter analysts point as proof to many African societies that have always had strong martial cultures. While fierce in battle, the rules and customs of those societies, only a few generations ago, made it taboo to attack women and children.

5. Whatever the causes of modern-day brutality towards children, the time has come to call a halt. The present report exposes the extent of the problem and proposes many practical ways to pull back from the brink. Its most fundamental demand is that children simply have no part in warfare. The international community must denounce this attack on children for what it is - intolerable and unacceptable.

6. Children can help. In a world of diversity and disparity, children are a unifying force capable of bringing people to common ethical grounds. Children's needs and aspirations cut across all ideologies and cultures. The needs of all children are the same: nutritious food, adequate health care, a decent education, shelter and a secure and loving family. Children are both our reason to struggle to eliminate the worst aspects of warfare, and our best hope for succeeding at it.

7. Concern for children has brought us to a common standard around which to rally. In the Convention on the Rights of the Child, the world has a unique instrument that almost every country has ratified. The single most important resolve that the world could make would be to transform universal ratification of this Convention into universal reality.

8. It was this challenge, of turning good intentions into real change for children, that led the United Nations Committee on the Rights of the Child in 1993 to recommend to the General Assembly, in accordance with article 45 (c) of the Convention on the Rights of the Child, that it request the Secretary-General to undertake a comprehensive study on the impact of armed conflict on children.

Course of the study and its methodology

9. At its forty-eighth session, the General Assembly adopted resolution 48/157, entitled "Protection of children affected by armed conflicts", in which it requested the Secretary-General to appoint an expert to undertake a comprehensive study with the support of the Centre for Human Rights and the United Nations Children's Fund (UNICEF). The expert was asked to make recommendations in five areas: (1) the participation of children in armed conflict; (2) the reinforcement of preventive measures; (3) the relevance and adequacy of existing standards; (4) the measures required to improve the protection of children affected by armed conflict; and (5) the actions needed to promote the physical and psychological recovery and social reintegration of children affected by armed conflict.

10. In accordance with the resolution, the expert submitted progress reports to the forty-ninth and fiftieth sessions of the General Assembly (A/49/643 and A/50/537). The expert, Ms. Graça Machel, hereby transmits her final report on the impact of armed conflict on children, pursuant to resolution 48/157. The report sets out the findings and recommendations of the expert, who used the Convention on the Rights of the Child throughout her work as a guiding source of operative principles and standards. The Convention on the Rights of the Child represents a new, multidisciplinary approach to protecting children. It demonstrates the interdependence of all children's rights, and the relevance of those rights to the activities of a whole host of actors at all levels. In accordance with the Convention on the Rights of the Child, this report uses the term "child" to include everyone under the age of 18.

11. In the process of her work, the expert identified a number of particular concerns in addition to those identified in paragraph nine of resolution 48/157, including: the changing patterns of conflict; specific impacts on girls and the children of minority and indigenous groups; economic embargoes; rape and other forms of gender-based violence and sexual exploitation; torture; the inadequate provision of education, health and nutrition and psychosocial programmes; the protection and care of refugee and internally displaced children and other children at particular risk; and the inadequate implementation of international human rights and humanitarian law. Accordingly, with the cooperation of relevant inter-governmental and non-governmental organizations and individual experts, a programme of research into these issues was undertaken through the preparation of twenty-five thematic papers and field-based case studies.

12. Six regional consultations were held to determine regional priorities relating to children in armed conflict and to draw these issues to the attention of Governments, policy makers and opinion leaders. The following consultations took place: First Regional Consultation on the Impact of Armed Conflict on Children in the Horn, Eastern, Central and Southern Africa: Addis Ababa, 17-19 April 1995 (co-convened with the Economic Commission for Africa); Second Regional Consultation on the Impact of Armed Conflict on Children in the Arab Region: Cairo, August 1995 (co-convened with the Economic and Social Commission for Western Asia and UNICEF); Third Regional Consultation on the Impact of Armed Conflict on Children in West and Central Africa: Abidjan, 7-10 November 1995 (co-convened with the African Development Bank, the Economic Commission for Africa and UNICEF); Fourth Regional Consultation on the Impact of Armed Conflict on Children in Asia and the Pacific: Manila, 13-15 March 1996 (co-convened with UNICEF); Fifth Regional Consultation on the Impact of Armed Conflict on Children in Latin America and the Caribbean: Bogota, 17-19 April 1996 (co-convened with the Government of Colombia, Save the Children UK, the Fundación para la Educación Superior de Colombia, and UNICEF); and Sixth Regional Consultation on the Impact of Armed Conflict on Children in Europe: Florence, Italy, 10-12 June 1996 (co-convened with the Government of Italy, the Italian National Committee for UNICEF, the Istitutó degli Innocenti and UNICEF International Child Development Centre).

13. The consultations included Governments, military authorities and legal experts. They also involved human rights organizations, the media, religious organizations, eminent leaders from civil society and women and children directly involved in armed conflicts.

14. The expert personally conducted field visits to areas affected by armed conflicts. Visits were made to Angola, Cambodia, Colombia, Northern Ireland, Lebanon, Rwanda (and refugee camps in Zaire and the United Republic of Tanzania), Sierra Leone and various places in the former Yugoslavia. During these visits, she met with Government representatives, non-governmental organizations, community organizations, women's organizations, religious groups, agencies, national institutions and other interested parties, as well as with children and their families. This direct contact has helped ensure that the present report and its recommendations are firmly based on conditions and priorities within countries. It also ensures that the report reflects not only the experience of those most involved in the care and protection of children, but also the immediate concerns of the affected families and children themselves.

15. The expert received guidance from a group of eminent persons representing a variety of political, religious and cultural backgrounds. The members of the group are: Belisario Betancur (Colombia), Francis Deng (Sudan), Marian Wright Edelman (United States of America), Devaki Jain (India), Julius K. Nyerere (United Republic of Tanzania), Lisbet Palme (Sweden), Wole Soyinka (Nigeria) and Archbishop Desmond Tutu (South Africa). In addition, the expert received analysis and guidance from an advisory group of technical experts. The members of the advisory group include: Thomas Hammarberg, Chair (Sweden), Philip Alston (Australia), Rachel Brett (United Kingdom of Great Britain and Northern Ireland), Victoria Brittain (United Kingdom of Great Britain and Northern Ireland), Maricela Daniel (Mexico), Helena Gezelius (Sweden), Jim Himes (United States of America), Duong Quynh Hoa (Viet Nam), Elizabeth Jareg (Norway), Helga Klein (United States of America), Salim Lone (Kenya), Jacques Moreillon (Switzerland), Vitit Muntarbhorn (Thailand), Olara A. Otunnu (Uganda), Sadig Rasheed (Sudan), Everett Ressler (United States of America), Jane Schaller (United States of America), Anne Skatvedt (Norway) and Jody Williams (United States of America). The special advisers are: Ibrahima Fall (Senegal), Kimberly Gamble-Payne (United States of America), Stephen Lewis (Canada) and Marta Santos Pais (Portugal).

16. In all of her undertakings, the expert has enjoyed widespread support from Governments, regional bodies, intergovernmental and non-governmental organizations, as well as from United Nations bodies, especially the United Nations Children's Fund (UNICEF), the Centre for Human Rights and the Office of the United Nations High Commissioner for Refugees (UNHCR). Inter-agency consultations convened periodically in Geneva and New York were attended by representatives of the following major international bodies: the Centre for Human Rights, the Department of Humanitarian Affairs, the Food and Agriculture Organization of the United Nations (FAO), the International Committee of the Red Cross (ICRC), the International Federation of Red Cross and Red Crescent Societies (IFRC) and their National Societies, the International Labour Organization (ILO), UNICEF, the United Nations Educational, Scientific and Cultural Organization (UNESCO), UNHCR, the United Nations Research Institute for Social Development (UNRISD), the World Food Programme (WFP) and the World Health Organization (WHO).

17. Working groups on children and armed conflict of international non-governmental organizations (NGOs), particularly the Working Group on Children in Armed Conflict of the New York-based NGO Committee on UNICEF and the SubGroup on Refugee Children and Children in Armed Conflict of the Geneva-based NGO Group on the Convention on the Rights of the Child, provided substantial contributions to the expert's research and mobilization activities. Other international, regional (including the Forum of African Voluntary Development Organizations and the African Network on Prevention and Protection Against Child Abuse and Neglect) and national NGOs also contributed to these activities.

18. Seminars were convened on the role of religious communities in protecting children in situations of armed conflict (in Geneva, in cooperation with the World Conference on Religion and Peace) and on the impact of low intensity conflicts on children (in Belfast, in cooperation with Save the Children Fund-UK and Rädda Barnen (Save the Children Fund-Sweden)). A third seminar was held on landmines, child soldiers and rehabilitation (convened in Stockholm in cooperation with the Swedish National Committee for UNICEF, the Swedish Foreign Policy Office, Rädda Barnen, the Swedish Red Cross and other Swedish NGOs).

19. Beyond collecting information, the expert undertook a widespread and unusual process of sensitization and mobilization. This facilitated the development of new networks and coalitions organized both nationally and regionally, and helped to place the concerns addressed in the present report on political and development agendas. The collaborative nature of this undertaking created an opportunity to develop unique new partnerships across disciplines and interest groups. For example, following the First Regional Consultation in Addis Ababa, a new alliance of children's NGOs was set up to coordinate action on child rights and development in eastern, central and southern Africa; following the Third Regional Consultation in Abidjan, a regional initiative was developed to promote the role of women in peace-building, and another proposal is currently being negotiated to provide child rights and protection training for African Chiefs of Defence Staffs; following the Second Regional Consultation in Cairo, a selected bibliography on children and war in the Arab region was published; and following the field visit to Cambodia, UNICEF was requested to assist the Ministry of Social Affairs in training its personnel in the concrete implementation of the rights of children.

20. The expert wishes to acknowledge the considerable support and financial contributions received from national committees for UNICEF and from Redd Barna (Save the Children Fund-Norway), without which this work would not have been possible. Specifically, she wishes to thank the UNICEF National Committees of Germany, Greece, Hong Kong, Japan, the Netherlands, Portugal, Spain, Sweden, Switzerland, the United Kingdom of Great Britain and Northern Ireland and the United States of America.

21. While the present report is formally submitted for the consideration of the United Nations General Assembly and its Member States, it is also addressed to regional institutions, United Nations bodies, specialized agencies and other competent bodies, including NGOs, relevant special rapporteurs and working groups, intergovernmental bodies and civil society.

Patterns and characteristics of contemporary armed conflicts

22. Violent conflict has always made victims of non-combatants. The patterns and characteristics of contemporary armed conflicts, however, have increased the risks for children. Vestiges of colonialism and persistent economic, social and political crises have greatly contributed to the disintegration of public order. Undermined by internal dissent, countries caught up in conflict today are also under severe stress from a global world economy that pushes them ever further towards the margins. Rigorous programmes of structural adjustment promise long-term market-based economic growth, but demands for immediate cuts in budget deficits and public expenditure only weaken already fragile States, leaving them dependent on forces and relations over which they have little control. While many developing countries have made considerable economic progress in recent decades, the benefits have often been spread unevenly, leaving millions of people struggling for survival. The collapse of functional Governments in many countries torn by internal fighting and the erosion of essential service structures have fomented inequalities, grievances and strife. The personalization of power and leadership and the manipulation of ethnicity and religion to serve personal or narrow group interests have had similarly debilitating effects on countries in conflict.

23. All of these elements have contributed to conflicts, between Governments and rebels, between different opposition groups vying for supremacy and among populations at large, in struggles that take the form of widespread civil unrest. Many drag on for long periods with no clear beginning or end, subjecting successive generations to endless struggles for survival.

24. Distinctions between combatants and civilians disappear in battles fought from village to village or from street to street. In recent decades, the proportion of war victims who are civilians has leaped dramatically from 5 per cent to over 90 per cent. The struggles that claim more civilians than soldiers have been marked by horrific levels of violence and brutality. Any and all tactics are employed, from systematic rape, to scorched-earth tactics that destroy crops and poison wells, to ethnic cleansing and genocide. With all standards abandoned, human rights violations against children and women occur in unprecedented numbers. Increasingly, children have become the targets and even the perpetrators of violence and atrocities.

25. Children seek protection in networks of social support, but these have been undermined by new political and economic realities. Conflict and violent social change have affected social welfare networks between families and communities. Rapid urbanization and the spread of market-based values have also helped erode systems of support that were once based on the extended family.

26. Unbridled attacks on civilians and rural communities have provoked mass exoduses and the displacement of entire populations who flee conflict in search of elusive sanctuaries within and outside their national borders. Among these uprooted millions, it is estimated that 80 per cent are children and women.

27. Involving children as soldiers has been made easier by the proliferation of inexpensive light weapons. Previously, the more dangerous weapons were either heavy or complex, but these guns are so light that children can use them and so simple that they can be stripped and reassembled by a child of 10. The international arms trade has made assault rifles cheap and widely available so the poorest communities now have access to deadly weapons capable of transforming any local conflict into a bloody slaughter. In Uganda, an AK-47 automatic machine gun can be purchased for the cost of a chicken and, in northern Kenya, it can be bought for the price of a goat.

28. Moreover, the rapid spread of information today has changed the character of modern warfare in important ways. While the world surely benefits from ready access to information, it will pay a price if it fails to recognize that information is never entirely neutral. International media are frequently influenced by one or another of the parties to a conflict, by commercial realities and by the public's degree of interest in humanitarian action. The result of these influences are depictions that can be selective or uneven, or both. Whether a story is reported or not may depend less on its intrinsic importance than on subjective perceptions of the public's appetite for information and on the expense of informing them. For example, while coverage of the conflicts in Bosnia and Herzegovina and Somalia was extensive, very little has been reported about the conflicts in Afghanistan and Angola. The media is capable of effectively galvanizing international public support for humanitarian action, as it did for Indo-Chinese refugees in the late 1970s and for Somalia in 1992. The threat of adverse international publicity may also be positive, holding the potential for keeping some gross violations of human rights in check. Ultimately, however, while reports of starving children or overcrowded camps for displaced persons may be dramatic, they do little to support efforts for long-term reconstruction and reconciliation.


29. Armed conflicts across and between communities result in massive levels of destruction; physical, human, moral and cultural. Not only are large numbers of children killed and injured, but countless others grow up deprived of their material and emotional needs, including the structures that give meaning to social and cultural life. The entire fabric of their societies - their homes, schools, health systems and religious institutions - are torn to pieces.

30. War violates every right of a child - the right to life, the right to be with family and community, the right to health, the right to the development of the personality and the right to be nurtured and protected. Many of today's conflicts last the length of a "childhood", meaning that from birth to early adulthood, children will experience multiple and accumulative assaults. Disrupting the social networks and primary relationships that support children's physical, emotional, moral, cognitive and social development in this way, and for this duration, can have profound physical and psychological implications.

31. In countless cases, the impact of armed conflict on children's lives remains invisible. The origin of the problems of many children who have been affected by conflicts is obscured. The children themselves may be removed from the public, living in institutions or, as is true of thousands of unaccompanied and orphaned children, exist as street children or become victims of prostitution. Children who have lost parents often experience humiliation, rejection and discrimination. For years, they may suffer in silence as their self-esteem crumbles away. Their insecurity and fear cannot be measured.

32. This section of the report documents some of the most grave impacts of armed conflict on children. The presentation is not intended to be exhaustive, but to signal major concerns and to suggest practical steps for improvement. It attempts to demonstrate that the impact of armed conflict on children cannot be fully understood without looking at the related effects on women, families and communities. It strives to illustrate how children's well-being is best ensured through family and community-based solutions to armed conflict and its aftermath, and that those solutions work best when they are based on local cultures and drawn from an understanding of child development. This section also emphasizes the importance of considerations of age - in particular, that adolescents have special needs and special strengths. Young people should be seen in that light; as survivors and active participants in creating solutions, not just as victims or problems.

33. The discussion that follows necessarily includes specific examples. It is not an effort to single out specific groups, Governments, or non-state entities. Countries are named representatively and on the basis of what is widely known. In reality, the impact of armed conflict on children is an area in which everyone shares responsibility and a degree of blame.

Child soldiers

34. One of the most alarming trends in armed conflict is the participation of children as soldiers. Children serve armies in supporting roles, as cooks, porters, messengers and spies. Increasingly, however, adults are deliberately conscripting children as soldiers. Some commanders have even noted the desirability of child soldiers because they are "more obedient, do not question orders and are easier to manipulate than adult soldiers".

35. A series of 24 case studies on the use of children as soldiers prepared for the present report, covering conflicts over the past 30 years, indicate that government or rebel armies around the world have recruited tens of thousands of children. Most are adolescents, though many child soldiers are 10 years of age or younger. While the majority are boys, girls also are recruited. The children most likely to become soldiers are those from impoverished and marginalized backgrounds and those who have become separated from their families.

1. Recruitment

36. Child soldiers are recruited in many different ways. Some are conscripted, others are press-ganged or kidnapped and still others are forced to join armed groups to defend their families. Governments in a few countries legally conscript children under 18, but even where the legal minimum age is 18, the law is not necessarily a safeguard. In many countries, birth registration is inadequate or non-existent and children do not know how old they are. Recruiters can only guess at ages based on physical development and may enter the age of recruits as 18 to give the appearance of compliance with national laws.

37. Countries with weak administrative systems do not conscript systematically from a register. In many instances, recruits are arbitrarily seized from the streets or even from schools and orphanages. This form of press ganging, known in Ethiopia as "afesa", was prevalent there in the 1980's, when armed militia, police or army cadres would roam the streets picking up anyone they encountered. 
4/ Children from poorer sectors of society are particularly vulnerable. Adolescent boys who work in the informal sector, selling cigarettes or gum or lottery tickets, are a particular target. In Myanmar, whole groups of children from 15 to 17 years old have been surrounded in their schools and forcibly conscripted. 4/ Those who can subsequently prove they are under-age may be released, but not necessarily. In all conflicts, children from wealthier and more educated families are at less risk. Often they are left undisturbed or are released if their parents can buy them out. Some children whose parents have the means are even sent out of the country to avoid the possibility of forced conscription.

38. In addition to being forcibly recruited, youth also present themselves for service. It is misleading, however, to consider this voluntary. While young people may appear to choose military service, the choice is not exercised freely. They may be driven by any of several forces, including cultural, social, economic or political pressures.

39. One of the most basic reasons that children join armed groups is economic. Hunger and poverty may drive parents to offer their children for service. In some cases, armies pay a minor soldier's wages directly to the family. 
5/ Child participation may be difficult to distinguish as in some cases whole families move with armed groups. Children themselves may volunteer if they believe that this is the only way to guarantee regular meals, clothing or medical attention. Some case studies tell of parents who encourage their daughters to become soldiers if their marriage prospects are poor. 6/

40. As conflicts persist, economic and social conditions suffer and educational opportunities become more limited or even non-existent. Under these circumstances, recruits tend to get younger and younger. Armies begin to exhaust the supplies of adult manpower and children may have little option but to join. In Afghanistan, where approximately 90 per cent of children now have no access to schooling, the proportion of soldiers who are children is thought to have risen in recent years from roughly 30 to at least 45 per cent. 

41. Some children feel obliged to become soldiers for their own protection. Faced with violence and chaos all around, they decide they are safer with guns in their hands. Often such children join armed opposition groups after experiencing harassment from government forces. Many young people have joined the Kurdish rebel groups, for example, as a reaction to scorched earth policies and extensive human rights violations. In El Salvador, children whose parents had been killed by government soldiers joined opposition groups for protection. In other cases, armed forces will pick up unaccompanied children for humanitarian reasons, although this is no guarantee that the children will not end up fighting. This is particularly true of children who stay with a group for long periods of time and come to identify it as their protector or "new family".

42. In some societies, military life may be the most attractive option. Young people often take up arms to gain power and power can act as a very strong motivator in situations where people feel powerless and are otherwise unable to acquire basic resources. In many situations, war activities are glorified. In Sierra Leone, the expert met with child soldiers who proudly defended the number of "enemies" they had killed.

43. The lure of ideology is particularly strong in early adolescence, when young people are developing personal identities and searching for a sense of social meaning. As the case of Rwanda shows, however, the ideological indoctrination of youth can have disastrous consequences. Children are very impressionable and may even be lured into cults of martyrdom. In Lebanon and Sri Lanka, for example, some adults have used young people's immaturity to their own advantage, recruiting and training adolescents for suicide bombings. 
8/ However, it is important to note that children may also identify with and fight for social causes, religious expression, self-determination or national liberation. As happened in South Africa or in occupied territories, they may join the struggle in pursuit of political freedom.

How child soldiers are used

44. Once recruited as soldiers, children generally receive much the same treatment as adults - including the often brutal induction ceremonies. Many start out in support functions which entail great risk and hardship. One of the common tasks assigned to children is to serve as porters, often carrying very heavy loads of up to 60 kilograms including ammunition or injured soldiers. Children who are too weak to carry their loads are liable to be savagely beaten or even shot. Children are also used for household and other routine duties. In Uganda, child soldiers have often done guard duty, worked in the gardens, hunted for wild fruits and vegetables and looted food from gardens and granaries. Children have also been used extensively in many countries as lookouts and messengers. While this last role may seem less life-threatening than others, in fact it puts all children under suspicion. In Latin America, reports tell of government forces that have deliberately killed even the youngest children in peasant communities on the grounds that they, too, were dangerous. 

45. Although the majority of child soldiers are boys, armed groups also recruit girls, many of whom perform the same functions as boys. In Guatemala, rebel groups use girls to prepare food, attend to the wounded and wash clothes. Girls may also be forced to provide sexual services. In Uganda, girls who are abducted by the Lord's Resistance Army are "married off" to rebel leaders. 
10/ If the man dies, the girl is put aside for ritual cleansing and then married off to another rebel.

46. A case study from Honduras illustrates one child's experience of joining an armed group:
"At the age of 13, I joined the student movement. I had a dream to contribute to make things change, so that children would not be hungry ... later I joined the armed struggle. I had all the inexperience and the fears of a little girl. I found out that girls were obliged to have sexual relations 'to alleviate the sadness of the combatants'. And who alleviated our sadness after going with someone we hardly knew? At my young age I experienced abortion. It was not my decision. There is a great pain in my being when I recall all these things ... In spite of my commitment, they abused me, they trampled my human dignity. And above all, they did not understand that I was a child and that I had rights." 

47. While children of both sexes might start out in indirect support functions, it does not take long before they are placed in the heat of battle. Here, their inexperience and lack of training leave them particularly exposed. The youngest children rarely appreciate the perils they face. A number of case studies report that when the shelling starts the children get over-excited and forget to take cover. Some commanders deliberately exploit such fearlessness in children, even plying them with alcohol or drugs. A soldier in Myanmar recalls: "There were a lot of boys rushing into the field, screaming like banshees. It seemed like they were immortal, or impervious, or something, because we shot at them but they just kept coming." 12/

48. The progressive involvement of youth in acts of extreme violence desensitizes them to suffering. In a number of cases, young people have been deliberately exposed to horrific scenes. Such experience makes children more likely to commit violent acts themselves and may contribute to a break with society. In many countries, including Afghanistan, Mozambique, Colombia and Nicaragua, children have even been forced to commit atrocities against their own families or communities.

Demobilization and re-integration into society

49. Clearly one of the most urgent priorities is to remove everyone under 18 years of age from armed forces. No peace treaty to date has formally recognized the existence of child combatants. As a result, their special needs are unlikely to be taken into account in demobilization programmes. In Mozambique, for example, where recruitment of children was well known, child soldiers were not recognized in demobilization efforts by the Resistência Nacional de Moçambique (RENAMO), the Government or the international community. Official acknowledgement of children's part in a war is a vital step. Peace agreements and related documents should incorporate provisions for the demobilization of children; without this recognition, there can be no effective planning or programming on a national scale.

50. The process of reintegration must help children to establish new foundations in life based on their individual capacities. Former child soldiers have grown up away from their families and have been deprived of many of the normal opportunities for physical, emotional and intellectual development. As article 39 of the Convention on the Rights of the Child emphasizes, recovery and reintegration should take place in an environment that fosters the health, self-respect and dignity of the child.

51. Reintegration programmes must re-establish contact with the family and the community. Even children who are successfully reunited with their families, however, have little prospect of smoothly taking up life as it was before. A formerly cheerful 12-year-old may return home as a sullen 16-year-old who feels newly assertive and independent. Reunification may be particularly difficult for girl soldiers who have been raped or sexually abused, in part because cultural beliefs and attitudes can make it very difficult for them to stay with their families or to have any prospects of marriage. With so few alternatives, many children have eventually become victims of prostitution.

52. In many cases, reunification is impossible. Families may have perished in the conflict or may be untraceable. For some children, a transitional period of collective care may be necessary. Institutional approaches have proven ineffective, but one way to provide such care is through peer-group living arrangements that are strongly integrated into communities.

53. Effective social reintegration depends upon support from families and communities. But families are also worn down by conflict, both physically and emotionally, and face increased impoverishment. The field visits and research for the present report repeatedly stressed the importance of links between education, vocational opportunities for former child combatants and the economic security of their families. These are most often the determinants of successful social reintegration and, importantly, they are the factors that prevent re-recruitment.

54. Education, and especially the completion of primary schooling, must be a high priority. For a former child soldier, education is more than a route to employment. It also helps to normalize life and to develop an identity separate from that of the soldier. The development of peer relationships and improved self-esteem may also be facilitated through recreational and cultural activities. A difficulty to be faced is the likelihood that former combatants may have fallen far behind in their schooling, and may be placed in classes with much younger children. Specific measures may be required, such as establishing special classes for former child soldiers who can then progressively be reintegrated into regular schools.

55. Many teachers and parents may object to having ex-combatants enrol in schools, fearing that they will have a disruptive effect. Programmes must address these wider community concerns. In some African cultures, strong spiritual convictions hold that anyone who has killed is haunted by the evil spirits of the victims. Thus, to accept a former child soldier into one's village is to accept evil spirits. In such a context, programmes for re-entry into the community have effectively involved traditional healers in "cleansing" and other processes.

56. For older children especially, effective education will require strong components of training in life-skills and vocational opportunity. Preparing older children to find employment will not only help them survive, but may also facilitate their acceptance at home and provide them with a sense of meaning and identity.

57. Child soldiers may find it difficult to disengage from the idea that violence is a legitimate means of achieving one's aims. Even where the experience of participating in "the cause" has been positive, as was often the case for youth who identified with and drew meaning from their part in the struggle against apartheid, the transition to a non-violent lifestyle will be difficult. This is particularly true where the frustrations of poverty and injustice remain. The challenge for Governments and civil society is to channel the energy, ideas and experience of youth into contributing in positive ways to the creation of their new, post-conflict society.

Preventing future recruitment

58. The research conducted for this study uncovered many practical steps to be taken to prevent future recruitment. First, Governments should work for the finalization and rapid adoption of the draft optional protocol to the Convention on the Rights of the Child on involvement of children in armed conflicts. Next, Governments must pay much closer attention to their methods of recruitment, and in particular, they must renounce the practice of forced recruitment. They should ensure that all children are registered at birth and receive documentation of age. To be certain that these measures succeed, Governments must establish effective monitoring systems and back them up with legal remedies and institutions that are sufficiently strong to tackle abuses. For example, in Guatemala in May and June of 1995, the human rights ombudsman's office intervened in 596 cases of forced recruitment of youth. As a result, 148 children under the age of 18 were released.

59. The recruitment of children can be minimized if local communities are aware of national and international laws governing the age of recruitment and if they are sufficiently organized and determined. In El Salvador, Guatemala and Paraguay, ethnic groups and the mothers of child soldiers have formed organizations to pressure authorities for the release of under-age soldiers. NGOs, religious groups and civil society in general have important roles in establishing ethical frameworks that characterize children's participation in armed conflicts as unacceptable. In Peru, it has been reported that forced recruitment drives have declined in areas where parish churches have denounced the activity. Another important preventive measure is the active and early documentation and tracing of unaccompanied children.

60. The United Nations and other international organizations also have important roles in reporting child conscription, raising the issue with those in authority and supporting local groups in their work for the release of children. In Myanmar, protests from aid agencies led to the return of men and boys who had been forcibly recruited from a refugee camp.

61. Armed opposition groups are less amenable to external or formal pressure than government-sponsored armies. Even with such groups, however, Governments and international organizations can exert influence. When Governments ratify the international humanitarian conventions that apply to internal conflicts, then international law holds all armed groups within those countries accountable. In Sudan, humanitarian organizations have negotiated agreements with rebel groups to prevent the recruitment of children. The human rights component within the United Nations Observer Mission in El Salvador (ONUSAL) supported local groups investigating complaints of forced recruitment of minors and raised the issue with authorities. In many cases, United Nations intervention secured the release of the minors involved.

Specific recommendations on child soldiers

62. The expert submits the following recommendations on the question of child soldiers:

(a) Building on the existing efforts of the Committee on the Rights of the Child, Rädda Barnen, the Friends World Committee for Consultation (Quakers), UNICEF, UNHCR and the International Committee of the Red Cross (ICRC), the International Federation of Red Cross and Red Crescent Societies (IFRC) and their National Societies, a global campaign should be launched, led by those same organizations, aimed at eradicating the use of children under the age of 18 years in the armed forces. The media, too, should be encouraged to expose the use of child soldiers and the need for demobilization;

(b) United Nations bodies, specialized agencies and international civil society actors should begin to pursue quiet diplomacy with Government and non-state forces and their international supporters to encourage the immediate demobilization of child soldiers and adherence to the Convention on the Rights of the Child;

(c) All peace agreements should include specific measures to demobilize and reintegrate child soldiers into society. There is an urgent need for the international community to support programmes, including advocacy and social services programmes, for the demobilization and re-integration into the community of child soldiers. Such measures must address the family's economic security and include educational, life-skills and vocational opportunities;

(d) States should ensure the early and successful conclusion of the drafting of the optional protocol to the Convention on the Rights of the Child on involvement of children in armed conflicts, raising the age of recruitment and participation in the armed forces to 18 years.

Refugees and internally displaced children

63. Armed conflict has always caused population movements. During full-scale conflicts, whether or not they cross national boundaries, people flee in large numbers. Their destinations determine whether those who flee will become internally displaced people 
13/ in their own countries or refugees 14/ who have crossed national borders. Africa and Asia have been most affected by massive population upheavals but no region has escaped either the phenomenon itself or its ramifications. Wherever it occurs, displacement has a profound physical, emotional and developmental impact on children and increases their vulnerability. Except where otherwise distinguished in the present report, refugees and internally displaced persons, as well as persons in refugee-like situations, are referred to collectively as displaced persons.

64. At the beginning of the 1980s, there were 5.7 million refugees worldwide. By the end of the decade, the number had increased to 14.8 million, and today there are more than 27.4 million refugees and "persons of concern" to UNHCR, that is, some returnees and people living in "safe havens". 

65. According to the report of the Representative of the Secretary-General on Internally Displaced Persons (E/CN.4/1996/52/Add.2), the number of internally displaced people has also escalated in recent years, now reaching an estimated 30 million - more than the number of refugees. The protection and assistance needs of the internally displaced are similar to those of refugees in nearly all respects, and yet their situation can be worse. While refugees have often moved outside the war zone, internally displaced persons usually remain within or close to the scene of conflict and they are often likely to be displaced repeatedly.

66. At least half of all refugees and displaced people are children. At a crucial and vulnerable time in their lives, they have been brutally uprooted and exposed to danger and insecurity. In the course of displacement, millions of children have been separated from their families, physically abused, exploited and abducted into military groups, or they have perished from hunger and disease.

Vulnerability of children in flight

67. To flee from one's home is to experience a deep sense of loss, and the decision to flee is not taken lightly. Those who make this decision do so because they are in danger of being killed, tortured, forcibly recruited, raped, abducted or starved, among other reasons. They leave behind them assets and property, relatives, friends, familiar surroundings and established social networks. Although the decision to leave is normally taken by adults, even the youngest children recognize what is happening and can sense their parents' uncertainty and fear.

68. During flight from the dangers of conflict, families and children continue to be exposed to multiple physical dangers. They are threatened by sudden attacks, shelling, snipers and landmines, and must often walk for days with only limited quantities of water and food. Under such circumstances, children become acutely undernourished and prone to illness, and they are the first to die. Girls in flight are even more vulnerable than usual to sexual abuse. Children forced to flee on their own to ensure their survival are also at heightened risk. Many abandon home to avoid forced recruitment, only to find that being in flight still places them at risk of recruitment, especially if they have no documentation and travel without their families.

Unaccompanied children

69. Unaccompanied children are those who are separated from both parents and are not in the care of another adult who, by law or custom, has taken responsibility to do so. 
16/ Children are often separated from parents in the chaos of conflict, escape and displacement. Parents or other primary care-givers are the major source of a child's emotional and physical security and for this reason family separation can have a devastating social and psychological impact. Unaccompanied children are especially vulnerable and at risk of neglect, violence, military recruitment, sexual assault and other abuses. An essential goal of relief programmes must be to provide assistance to families to prevent separations.

70. The first priority of relief programmes is to identify a child as unaccompanied and to ensure their survival and protection. The next priorities are documenting, tracing and - whenever possible - reunifying families. Most unaccompanied children are not orphans and, even when both parents are dead, often have relatives, bound by custom and tradition, who are willing and able to care for them. In all cases, it is essential to keep siblings together. In the Great Lakes region of Africa, a vast tracing programme was set up in 1994 by ICRC, IFRC and their National Societies, UNHCR, UNICEF, the Save the Children Fund and other NGOs. More than 100,000 children were registered as unaccompanied, both inside and outside their countries of origin. According to UNHCR, by May 1996, more than 33,000 of these children had been reunited with family members. This positive outcome resulted largely because identification and tracing activities were implemented from the outset of the emergency, and because agencies had committed themselves to cooperate together. Many traditional and non-traditional tracing methods were used, including photo tracing programmes.

71. While families are sought, procedures must be set up to prevent further separation and to provide each unaccompanied child with continuous alternative care. Alternative care is most appropriately found with the extended family, but when this is not possible, it can come from neighbours, friends or other substitute families. Nevertheless these arrangements need careful supervision. Many foster families take excellent care of a child, but where economic and social situations have been undermined by war, children may be at risk of exploitation. The situation of a child in a foster family should therefore always be closely monitored through a community-based system. Initiatives of this kind in the Great Lakes region have produced positive results. These programmes have resulted in closing down unaccompanied children's centres and returning children into the refugee community, combining family mediation and projects to support vulnerable families, enabling them to keep their children.

72. Centres for unaccompanied children, such as orphanages or other institutions, cannot fully meet the emotional and developmental needs of children. And there is always the risk that temporary centres may become permanent. The creation of centres may also in itself generate higher numbers of unaccompanied children. During her visit to the Great Lakes region, the expert was deeply concerned that, as a result of media attention, many centres had been created as a way of profiting from humanitarian aid. Such centres may be attractive to parents who are having difficulty feeding their families and who might easily think it best to leave their children where they will be provided with food and health care. This underlines the need to prevent family separation by ensuring that vulnerable families are supported in caring for their children.

73. In response to the many protection and care problems facing unaccompanied children, UNICEF and UNHCR, in consultation with ICRC, IFRC and their National Societies and some specialized NGOs, have jointly developed an emergency kit to facilitate coordination and to enhance the quality of response to the needs of unaccompanied children. The tools included in the kit, such as registration forms and Polaroid cameras, are derived from experiences gained from earlier emergencies. The kit also comes with guidelines on the protection and care of unaccompanied children, and it is essential that these are widely disseminated among and followed by relief workers.

74. At the height of a conflict, tracing is particularly difficult. Precisely because that is the case, unaccompanied children should not be considered available for adoption. Adoption severs family links permanently and should not be considered unless all family tracing efforts have been exhausted. This principle is safeguarded by a recommendation adopted in the Convention on Protection of Children and Cooperation in respect of Inter-country Adoption signed at The Hague on 29 May 1994. 


75. Parents living in zones of armed conflict can become so concerned for the safety of their children that they decide to evacuate them, sending them to friends or relatives or having them join large-scale programmes. To parents, evacuation may appear at the time to be the best solution, but this is frequently not the case. In Bosnia and Herzegovina, for example, evacuations were often hastily organized with little documentation. Evacuation also poses a long-term risk to children, including the trauma of separation from the family and the increased danger of trafficking or of illegal adoption. On her visit to Bosnia and Herzegovina, the expert was concerned to learn that some evacuations had been organized by groups intent on exploiting adoption markets. In the case of medical evacuations, difficulties often arise when the foster family, thinking the child will have better opportunities in the host country, does not want to allow the child in their care to return to the original family.

76. As is stressed in the Convention on the Rights of the Child, with articles 9 and 10 regarding family unity being of particular note, all such decisions must be based on the best interests of the child and take her or his opinions into account. If evacuation is essential, whole families should move together, and if this is not possible, children should at least move with their primary care-givers and siblings. Great care should also be taken to ensure that any evacuation is properly documented, and that arrangements are made for the effective reception and care for children and for maintaining contact with other family members, as well as for early reunification. Guidelines on these criteria are supported by UNHCR, UNICEF, ICRC, IFRC and their National Societies. Evacuations are sometimes essential, as international agencies concluded in the Great Lakes region when orphanages were being targeted for purposes of ethnic cleansing. In 1992, UNHCR/UNICEF issued a publication on considerations and guidelines on evacuation of children from conflict areas. These require wide dissemination.

Children in camps

77. Ideally, camps for refugees or the internally displaced should be places of safety, offering protection and assistance. However, displaced populations are complex societies that often reproduce former divisions and power struggles. At the same time their traditional systems of social protection come under strain or break down completely and there are often high levels of violence, alcohol and substance abuse, family quarrels and sexual assault. Women and adolescent girls are particularly vulnerable and even the youngest children can be affected when they witness an attack on a mother or a sister. The UNHCR guidelines on sexual violence against refugees outline practical protection measures such as careful lighting, arrangement of latrines and the organizing of people into groups for tasks such as gathering firewood.
18/ These and the UNHCR guidelines on the protection and care of refugee children should be applied to all internally displaced women and children.

78. One important aspect of relief that particularly affects women and children is the distribution of resources such as food, water, firewood and plastic sheeting. Control of these resources represents power. Men are usually in charge of distribution and often abuse their power by demanding bribes or sexual favours. This puts women at risk and especially female heads of households. As recommended in the UNHCR
Guidelines on the Protection of Refugee Women, UNHCR and WFP should be in the forefront of ensuring that women are the initial point of control in distribution systems and that appropriate support systems are established for female-headed households.

79. The first days and weeks of a mass displacement of people usually result in high mortality rates for children. Among displaced children, measles, diarrhoeal diseases, acute respiratory infections (ARI), malaria and malnutrition account for 60 to 80 per cent of reported deaths. Factors contributing to high mortality include overcrowding and lack of food and clean water, along with poor sanitation and lack of shelter. Pregnant and lactating women require particular attention, as do displaced children living with disabilities. Children coming from armed conflict are likely to have injuries that require special medical attention. In these circumstances, only a multi-sectoral approach to health and nutrition can protect young children.

80. Camp environments are often highly militarized. In some instances, children have been taken, either forcibly or fraudulently, from camps to a third country for "political education" or military training. In several cases, host Governments have recruited refugee children for military service.

5. The situation of internally displaced children

81. Children who are displaced but remain in their own countries face perilous circumstances. They are often worse off than refugees, since they may lack access to protection and assistance. There are an increasing number of situations where families and communities are chronically displaced due to localized, continued armed conflict. Surveys have shown that the death rate among internally displaced persons has been as much as 60 per cent higher than the death rate of persons within the same country who are not displaced.
20/ Even when internally displaced families are housed with relatives or friends, they may not be secure, eventually facing resentment from their hosts because of the limited resources to be shared.

82. Another acute problem for internally displaced children is access to health and education services. In contravention of humanitarian law, the access of internally displaced persons to humanitarian assistance is often impeded. Flight can put them beyond the reach of existing Government or NGO programmes. Even if schools exist, the children may not be able to enrol because they lack proper documentation, are not considered residents of the area or are unable to pay school fees. Feelings of exclusion, as well as the struggle for survival and protection, may lead children to join parties to the conflict or to become street children.

83. While some organizations such as UNHCR, ICRC, IFRC and their National Societies and the International Organization for Migration (IOM) have specific mandates with regard to internally displaced persons, at present there is no clear institutional responsibility for their protection and assistance needs. Organizations with mandates to protect and care for children affected by armed conflicts such as UNICEF, UNHCR and WFP, do not consistently ensure the protection and care of internally displaced children. The expert supports the call of the Representative of the Secretary-General on Internally Displaced Persons for the development of an appropriate legal framework and institutional arrangements to clearly establish assistance and protection responsibilities. The legal framework should be based on the report of the Representative on the compilation and analysis of legal norms applicable to internally displaced persons (E/CN.4/1996/52/Add.2).

Asylum and the right to identity and nationality

84. Statelessness is a risk for refugee children as they may have difficulty in establishing their identity and nationality. As article 7 of the Convention on the Rights of the Child provides, all children should be registered and receive citizenship at birth. In the case of refugee children, only the host State is in a position to register the child. It is particularly important for a refugee child, especially if unaccompanied, to be provided with clear documentation concerning the identity of parents and place of birth.

85. Families who reach a border are still very exposed, and young girls and women who have been separated from their families are particularly vulnerable to exploitation and abuse from border guards and others. Even those who succeed in crossing a border have no guarantee of asylum. The 1951 Convention and the 1967 Protocol relating to the Status of Refugees may not fully cover those fleeing armed conflict. In cases of mass exodus from countries like Afghanistan and Viet Nam, many Governments were sufficiently flexible to grant temporary refuge. However, since the end of the cold war, many Governments have been more reluctant to grant asylum and have even sought to prevent asylum seekers from reaching their borders. As a minimum, Governments should grant temporary asylum pending the identification of a durable solution.

86. One consequence of current policies is that a number of asylum seekers, including children, are detained while their cases are considered. Seeking asylum cannot be considered an offence or a crime, yet in some cases women and children are incarcerated with criminals. Countries that determine refugee status on an individual basis should under no circumstances refuse access to unaccompanied children seeking asylum. The Statement of the Sixth Regional Consultation on the Impact of Armed Conflict on Children in Europe stressed that unaccompanied children should have access to asylum procedures regardless of age. Bearing in mind the critical development needs of children, long-term solutions should be found as quickly as possible. In accordance with the Convention on the Rights of the Child and UNHCR guidelines, children should be fully involved in decisions about their future.

Returning home and durable solutions

87. Long-term solutions for refugees involve voluntary repatriation, local integration or resettlement into new national communities. Whichever is chosen, procedures should be expeditious and carried out in the best interests of the child. The principles relating to voluntary repatriation and reintegration should also be applied to the return of internally displaced persons. These are to ensure that conditions of safety and dignity as well as national protection are available.

88. For refugee or internally displaced families and children returning to their home communities, reintegration may be very difficult. In countries disrupted by many years of conflict, there are often tensions between returnees and residents. For children in particular, one of the most important measures is to ensure education and the opportunity to re-establish family life and productive livelihoods.

89. Another major difficulty is that female heads of households may, on their return, lose property rights and custody of their children. Loss of property rights may also affect child-headed households. These are usually family units of siblings, children of extended family members, or even unrelated children, headed by a minor, usually an adolescent girl. In September 1995, UNICEF and the Rwandan Ministry of Labour and Social Affairs identified 1,939 children living in child-headed households. Their need for legal and social protection is especially acute; lack of land, property and inheritance rights add to their instability. Child-headed households are particularly vulnerable to exploitative labour and prostitution. Dilemmas have arisen in designing appropriate policy and programme responses, especially around the feasibility of foster arrangements. The principle of family unity, even where there are not parents, as safeguarded in the Convention on the Rights of the Child, must be the basis of all support for these children.

Specific recommendations for refugee and internally displaced children

90. The expert submits the following recommendations for refugee and internally displaced children:
(a) As a priority in all emergencies, procedures should be adopted to ensure the survival and protection of unaccompanied children. Family tracing programmes should be established from the outset of assistance programmes;

(b) Unaccompanied children should, wherever possible, be cared for by their extended family and community rather than in institutions. It is essential that donors support this principle. The vast majority of unaccompanied children have some family somewhere. Therefore, no adoptions should be permitted until exhaustive family tracing, including into the post-conflict phase, has been attempted;

(c) Practical protection measures to prevent sexual violence, discrimination in delivery of relief materials, and the recruitment of children into armed forces must be a priority in all assistance programmes in refugee and displaced camps. Such measures should involve women and youth fully in their design, delivery and monitoring and include advocacy and social services to address abuses and violations of children's rights;

(d) The Inter-Agency Standing Committee and its Task Force on Internally Displaced Persons should evaluate the extent to which assistance and protection are being provided to internally displaced children and develop appropriate institutional frameworks to address their needs. In cooperation with the Department of Humanitarian Affairs in its role under the authority of the Emergency Relief Coordinator, and in consultation with other major humanitarian agencies, in each emergency, a lead agency should be assigned overall responsibility for the protection and assistance of internally displaced persons. In collaboration with the lead agency, UNICEF should provide leadership for the protection and assistance of internally displaced children;

(e) The General Assembly, the Commission on Human Rights, as well as regional organizations, should support the work of the Representative of the Secretary-General on Internally Displaced Persons to develop an appropriate legal framework to increase protection for internally displaced persons and to give particular emphasis to the specific concerns of children;

(f) Intergovernmental bodies, UNHCR, the United Nations Development Fund for Women (UNIFEM) and other organizations should support Governments in strengthening national legislative frameworks challenging any aspect of discrimination against women, girls and child-headed households with particular respect to custody, inheritance and property rights;

(g) The expert urges that UNICEF, UNHCR, FAO and ILO give urgent attention to the situation of child-headed households, and develop policy and programme guidelines to ensure their protection and care.

Sexual exploitation and gender-based violence

Gender-based violence: a weapon of war

91. Rape poses a continual threat to women and girls during armed conflict, as do other forms of gender-based violence including prostitution, sexual humiliation and mutilation, trafficking and domestic violence. While abuses such as murder and torture have long been denounced as war crimes, rape has been downplayed as an unfortunate but inevitable side effect of war. Acts of gender-based violence, particularly rape, committed during armed conflicts constitute a violation of international humanitarian law. When it occurs on a massive scale or as a matter of orchestrated policy, this added dimension is recognized as it was at the most recent International Conference of the Red Cross and Red Crescent, as a crime against humanity. Recent efforts to prosecute rape as a war crime, however, have underscored the difficulties in applying international human rights law and humanitarian law.

92. Women of all ages may be victims of violence in conflict, but adolescent girls are particularly at risk for a range of reasons, including size and vulnerability. Their vulnerability is even greater in some localities where they are considered less likely to have sexually transmitted diseases and the HIV/AIDS virus. Characteristics such as ethnicity, class, religion or nationality may be factors that determine which women or girls are subjected to violence. Women and girls are at risk in all settings whether in the home, during flight or in camps to which they have fled for safety. Children affected by gender-based violence also include those who have witnessed the rape of a family member and those who are ostracized because of a mother's assault.

93. Most child victims of violence and sexual abuse are girls, but boys are also affected and cases of young boys who have been raped or forced into prostitution are under-reported. In Bosnia and Herzegovina, sons and fathers have been forced to commit sexual atrocities against each other. In some cases, boys traumatized by violence have also subsequently been the perpetrators of sexual violence against girls.

94. Rape is not incidental to conflict. It can occur on a random and uncontrolled basis due to the general disruption of social boundaries and the license granted to soldiers and militias. Most often, however, it functions like other forms of torture and is used as a tactical weapon of war to humiliate and weaken the morale of the perceived enemy. During armed conflict, rape is used to terrorize populations or to force civilians to flee.

95. Often, gender-based violence is practised with the intent of ethnic cleansing through deliberate impregnation. The Special Rapporteur on the situation of human rights in the territory of the former Yugoslavia found that this was the case in Bosnia and Herzegovina and in Croatia.
21/ The thousands of Korean women forced to serve as military sexual slaves during the Second World War is another example of rape being used as a weapon of war. 22/

Child victims of prostitution and sexual exploitation

96. Poverty, hunger and desperation may force women and girls into prostitution, obliging them to offer sex for food or shelter, for safe conduct through the war zone or to obtain papers or other privileges for themselves and their families. Children have been trafficked from conflict situations to work in brothels in other countries, transported from Cambodia to Thailand, for example, and from Georgia to Turkey. In refugee camps in Zaire, the expert heard numerous reports of girls who had been pressured by their families to enter prostitution. Similarly, some parents among the internally displaced communities in Guatemala have been forced to prostitute their children. Other girls have done so in the hope of securing greater protection. In Colombia, for example, there have been reports of girls as young as twelve submitting themselves to paramilitary forces as a means of defending their families against other groups.

97. With time, different forms of gender-based violence experienced during armed conflicts become institutionalized, since many of the conditions that created the violence remain unchanged. Young girls who have become victims of prostitution for armies, for example, may have no other option but to continue after the conflict has ceased. In Phnom Penh, the number of child victims of prostitution continues to escalate with an estimated 100 children sold into prostitution each month for economic reasons.

98. Children may also become victims of prostitution following the arrival of peacekeeping forces. In Mozambique, after the signing of the peace treaty in 1992, soldiers of the United Nations Operation in Mozambique (ONUMOZ) recruited girls aged 12 to 18 years into prostitution. After a commission of inquiry confirmed the allegations, the soldiers implicated were sent home.
23/ In 6 out of 12 country studies on sexual exploitation of children in situations of armed conflict prepared for the present report, the arrival of peacekeeping troops has been associated with a rapid rise in child prostitution.

99. Sexual exploitation has a devastating impact on physical and emotional development. Unwanted and unsafe sex is likely to lead to sexually transmitted diseases and HIV/AIDS, which not only affect immediate health but also future sexual and reproductive health and mortality. In Cambodia, according to a study prepared for the present report, it is estimated that 60 to 70 per cent of the child victims of prostitution are HIV positive. Adolescent girls may nonetheless suffer in silence after the trauma of sexual exploitation; they often fear reprisals from those who attacked them or rejection by their families, not to mention the sheer personal humiliation and anguish which causes so many of them to withdraw into a shell of pain and denial. WHO has found that among rape victims the risk of suicide is high.

100. When a pregnancy is forced, the determination about whether it will be carried to term depends on many local circumstances, including access to and the safety of abortion, community support systems and existing religious or cultural mores. In Rwanda, the expert heard conflicting reports about the numbers of pregnancies that had been terminated or brought to term, abandoned or adopted.

101. All women and young girls who give birth during conflict must contend with the unexpected economic and psychosocial consequences of raising a child without adequate systems of support. The deterioration of public health infrastructure reduces access to reproductive health services, such as family planning, treatment for sexually transmitted diseases and gynaecological complications, and pre- and post-natal care.

102. Complications in pregnancy and delivery are especially likely for children who have children. Owing to their physical immaturity, many pregnant adolescents experience infection as a result of unsafe or incomplete abortion. Victims of repeated rape and young girls who give birth in the absence of trained birth attendants and in unhygienic conditions are at greater risk of chronic pelvic inflammatory diseases and muscle injury that can result in incontinence. Without sensitive, timely and adequate medical care, many of these victims die. Some commit suicide because of the humiliation and embarrassment they suffer.

3. Ending impunity

103. The failure to denounce and prosecute wartime rape is partly a result of its mischaracterization as an assault against honour or a personal attack rather than a crime against the physical integrity of the victim. The International Tribunal established to try war crimes committed in the former Yugoslavia has indicted eight people on specific charges of rape and sexual assault, despite estimates of up to 20,000 victims. This limited result underscores the difficulties in applying international human rights and humanitarian law to rape - difficulties which are reflected both in the codification and interpretation of national, and even international, law.

104. The widespread practice of rape as an instrument of armed conflict and ethnic cleansing must be ended and its perpetrators prosecuted. National and international law must codify rape as a crime against the physical integrity of the individual, national Governments must hold those who commit rape in internal conflicts accountable and must reform their national laws to address the substantive nature of the abuse. Unwanted pregnancy resulting from forced impregnation should be recognized as a distinct harm and appropriate remedies provided.

105. Overall procedures and mechanisms to investigate, report, prosecute and remedy gender-based violations should be reviewed and strengthened, ensuring the protection of victims who report violations. It is encouraging that some organizations are beginning to include trained and qualified personnel in international human rights monitoring, investigation and verification operations to consider issues of gender violence more systematically.

106. As recommended in the Beijing Platform for Action, gender balance must be sought when nominating or promoting candidates for judicial and all relevant international bodies, including the International Tribunals for the former Yugoslavia and for Rwanda, the International Court of Justice and other bodies related to the peaceful settlement of disputes. Both legal and medical programme personnel, including medical and relief personnel, prosecutors, judges and other officials who respond to crimes of rape, forced impregnation, and other forms of gender-based violence in armed conflict, should be trained to integrate a gender-specific perspective into their work.

Preventing gender-based violence

107. Prevention of gender-based violence should include a role for the military, and United Nations peacekeepers in particular. Senior officers often have turned a blind eye to the sexual crimes of those under their command, but they must be held accountable for both their own behaviour and that of the men they supervise. The 12 case studies on gender-based violence prepared for the present report found the main perpetrators of sexual abuse and exploitation to be the armed forces of parties to a conflict, whether governmental or other actors. Military training should emphasize gender sensitivity, child rights and responsible behaviour towards women and children. Offenders must be prosecuted and punished for acts against women and children.

108. Other preventive measures include the construction of shelter, water and sanitation facilities in camps which must be carefully designed to avoid creating opportunities for gender-based aggression against displaced women and children. In situations of armed conflict, all humanitarian assistance must include community-based psychosocial and reproductive health programmes. Higher priority should be given to addressing the needs of children who have witnessed or been subjected to gender-based violence.

109. Humanitarian responses have been largely inadequate. UNHCR, however, has published guidelines on prevention and response to sexual violence against refugees and guidelines on evaluation and care of victims of trauma and violence. These are important efforts to ensure that relief workers are equipped to respond to the special needs of victims of sexual violence. Some effective programmes do exist, such as the "Women Victims of Violence" project in Kenya. This was initiated by UNHCR following the very large number of rapes committed by bandits and local security personnel in the Somali refugee camps of north-eastern Kenya. During a field visit to Bosnia and Herzegovina, the expert visited a number of community-based programmes, such as "Bosfam" and "Bospo" that provide support for women, including victims of sexual violence, in regaining control over their lives through small-scale income-generating activities. Such programmes have been few and far between, however. To be effective, they should provide comprehensive services including economic assistance and psychosocial support, and they should not overtly identify the women as victims. If such initiatives are to succeed, the local community must be involved in their design and implementation.

Specific recommendations on sexual exploitation and gender-based violence

110. The expert submits the following recommendations on sexual exploitation and gender-based violence:

(a) All humanitarian responses in conflict situations must emphasize the special reproductive health needs of women and girls including access to family planning services, pregnancy as a result of rape, sexual mutilation, childbirth at an early age or infection with sexually transmitted diseases, including HIV/AIDS. Equally important are the psychosocial needs of mothers who have been subjected to gender-based violence and who need help in order to foster the conditions necessary for the healthy development of their children;

(b) All military personnel, including peacekeeping personnel, should receive instruction on their responsibilities towards civilian communities and particularly towards women and children as part of their training;

(c) Clear and easily accessible systems should be established for reporting on sexual abuse within both military and civilian populations;

(d) The treatment of rape as a war crime must be clarified, pursued within military and civilian populations, and punished accordingly. Appropriate legal and rehabilitative remedies must be made available to reflect the nature of the crime and its harm;

(e) Refugee and displaced persons camps should be so designed as to improve security for women and girls. Women should also be involved in all aspects of camp administration but especially in organizing distribution and security systems. Increased numbers of female personnel should be deployed to the field as protection officers and counsellors;

(f) In every conflict, support programmes should be established for victims of sexual abuse and gender-based violence. These should offer confidential counselling on a wide range of issues, including the rights of victims. They should also provide educational activities and skills training.

Landmines and unexploded ordnance

111. The spread of light weapons of all kinds has caused untold suffering to millions of children caught up in armed conflict. Many of these weapons have a devastating impact not only during the period of conflict, but for decades thereafter. Landmines and unexploded ordnance probably pose the most insidious and persistent danger. Today, children in at least 68 countries live amid the contamination of more than 110 million landmines. Added to this number are millions of items of unexploded ordnance, bombs, shells and grenades that failed to detonate on impact. Like landmines, unexploded ordnance are weapons deemed to have indiscriminate effects, triggered by innocent and unsuspecting passers-by. 

112. Landmines have been employed in most conflicts since the Second World War, and particularly in internal conflicts. Afghanistan, Angola and Cambodia alone have a combined total of at least 28 million landmines, as well as 85 per cent of the world's landmine casualties. Angola, with an estimated 10 million landmines, has an amputee population of 70,000, of whom 8,000 are children. African children live on the continent most plagued by landmines - there are as many as 37 million mines in at least 19 African countries - but all continents are affected to some extent.

The threat to children

113. Landmines and unexploded ordnance pose a particular danger for children, especially because children are naturally curious and likely to pick up strange objects they come across. Devices like the "butterfly" mines used extensively by the former Union of Soviet Socialist Republics in Afghanistan are coloured bright green and have two "wings". Although they were not designed to look like toys, such devices can still hold a deadly attraction for children. Children are also more vulnerable to the danger of landmines than adults because they may not recognize or be able to read warning signs. Even if they are aware of mines, small children may be less able than adults to spot them: a mine laid in grass and clearly visible to an adult may be less so to a small child, whose perspective is two or three feet lower.

114. The risk to children is further compounded by the way in which mines and unexploded ordnance become a part of daily life. Children may become so familiar with mines that they forget they are lethal weapons. In northern Iraq, children have been known to use mines as wheels for toy trucks, and in Cambodia children have been seen playing "boules" with B40 anti-personnel mines, even beginning their own collections of landmines.
26/ The dangers from unexploded ordnance are very similar, and in many places these weapons are much more numerous. During her field visit to Cambodia, the expert noted that civilians increasingly use mines and other devices for daily activities such as fishing, guarding private property and even settling domestic disputes. Such familiarity dulls awareness of the dangers of these devices.

115. The victims of mines and unexploded ordnance tend to be concentrated among the poorest sectors of society, where people face danger every day when cultivating their fields, herding their animals or searching for firewood. In many cultures, these are the very tasks carried out by children. In Viet Nam, for example, it is young children who look after the family water buffalo, which often roam freely in areas where the ground has been mined or contains unexploded bombs and shells. Many poor children also work as scavengers. In a village in Mozambique in 1995, several children were collecting scrap metal to sell in the local market. When they took it to the market and placed it on a scale, the metal exploded, killing 11 children.
27/ Child soldiers are particularly vulnerable, as they are often the personnel used to explore known minefields. In Cambodia, a survey of mine victims in military hospitals found that 43 per cent had been recruited as soldiers between the ages of 10 and 16.

116. A mine explosion is likely to cause greater damage to the body of a child than to that of an adult. Anti-personnel mines are designed not to kill, but to maim, yet even the smallest mine explosion can be lethal for a child. In Cambodia, an average 20 per cent of all children injured by mines and unexploded ordnance die from their injuries.
28/ For the children who survive, the medical problems related to amputation are often severe, as the limb of a growing child grows faster than the surrounding tissue and requires repeated amputation. As they grow, children also need new prostheses regularly. For young children, this can mean a new prosthesis every six months. The extended medical treatment and psychosocial support that mine injuries demand make them extremely expensive for the families of the victims and for society in general. Girls are even less likely than boys to receive special medical attention and prostheses. The burden and the expense of rehabilitative care should be considered in recovery and social reintegration programmes.

117. Even where children themselves are not the victims, landmines and unexploded ordnance have an overwhelming impact on their lives. Families already living on the edge of survival are often financially devastated by mine incidents. Surveys in Cambodia have revealed that 61 per cent of families with a mine victim to support were in debt because of the accident. Additionally, when a parent is a mine casualty, the lost ability to work can substantially weaken the care and protection available to children. A field survey in Afghanistan reported that unemployment for adult males rose from 6 to 52 per cent as a result of landmine accidents.

118. Indiscriminate weapons also strike at a country's reconstruction and development. Roads and footpaths strewn with landmines impede the safe repatriation and return of refugee and displaced children and their families. Land seeded with millions of landmines and unexploded ordnance is unfit for sowing productive crops, and the threat of mines inhibits the circulation of goods and services.

Mine clearance, mine awareness and rehabilitation

119. Protecting children and other civilians from landmines and unexploded ordnance demands rapid progress in four major areas: a ban on landmines; mine clearance that will eventually remove the problem; mine awareness programmes that help children to avoid injury; and rehabilitation programmes that help children recover. The Department of Humanitarian Affairs of the Secretariat has advanced the relatively new concept of humanitarian mine clearance. The United Nations considers that an area meets safety standards when it is 99.9 per cent free of landmines. Clearing landmines is a long and expensive business: each one takes 100 times longer to remove than to deploy and a weapon that costs $3 or less to manufacture may eventually cost $1,000 to remove. The countries most contaminated by mines are generally among the world's poorest, so there is little prospect that they can afford to finance their own de-mining programmes. Only Kuwait has been able to devote the necessary resources to mine clearance.

120. The United Nations is responding to this problem with the Voluntary Trust Fund for Assistance in Mine Clearance. To date, countries have pledged $22 million of the United Nations goal of $75 million, and so far $19.5 million has been received. 29/ The Department of Humanitarian Affairs, as the focal point for mine-related activities within the United Nations system, is developing the Voluntary Trust Fund and de-mining stand-by capacity as quick response instruments to develop national programmes. Protection from landmines is a shared international responsibility and the costs should be borne by the companies and countries that have profited from the manufacture and sale of mines.

121. Far greater attention must be paid to increasing national capacity to address the consequences of landmines and unexploded ordnance. This requires sustainable financial support for mine-clearance teams and medical rehabilitation programmes. It is essential to establish and support local mechanisms for coordination, the open sharing of information and the development of consistent mine awareness messages. Commercial teams often clear only the major roads and generally follow the priorities of central Government or of businesses such as airports and commercial transportation routes. Too often, children's needs are ignored and the areas around schools or rural footpaths are left uncleared. Mine clearance should be adapted to local knowledge and priorities. In the area of medical rehabilitation, the development of local capacity for prosthetics production is essential. This can provide economic opportunity for victims and contribute to their psychosocial well being.

122. Mine awareness programmes help people to recognize landmines and suspected mined areas and explain what to do when a mine is discovered or an incident occurs. These programmes have been undertaken in a number of countries, but for children, they are not as effective as they need to be, making relatively little use of techniques that are interactive or tailored to the needs of different age groups. Often, mine awareness teams simply enter a community, present information and leave - an approach that does not address the behavioural changes an affected community must make to prevent injury. Recent programmes have been more carefully prepared, not merely telling participants about the issues, but trying to involve them in the learning process. For example, a new programme developed by Save the Children Fund - US for Kabul (a city with more than 1 million mines) emphasizes participants' involvement, child-to-child approaches, multi-media presentations, role playing, survivors as educators and the creation of safe play areas.

The need for an international ban

123. The immense impact of landmines and the damage they will continue to cause for many years to come has stimulated an international campaign to ban their manufacture and use. In 1992, a global coalition of non-governmental organizations formed the International Campaign to Ban Landmines, and there has been considerable progress since. The Secretary-General has strongly advocated an end to the landmine scourge and, in resolution 49/75 D, the General Assembly has called for their eventual elimination. UNICEF and UNHCR have adopted stringent policies against doing any business with companies or subsidiaries of companies that produce or sell anti-personnel mines. Some 41 countries have now stated that they are in favour of banning landmines and some have already taken concrete steps to ban the use, production and trade of the weapons and have begun to destroy their stocks. The expert urges that all States follow the lead of countries like Belgium and enact comprehensive national legislation to ban landmines.

124. Many legal experts believe that landmines are already an illegal weapon under international law and should be prohibited because they counter two basic principles of humanitarian law. First, the principle of distinction holds that attacks may only be directed against military objectives. Landmines do not distinguish between military and civilian targets. Second, the principle of unnecessary suffering holds that, even if an attack is directed against a legitimate military objective, the attack is not lawful if it can result in excessive injury or suffering to civilians. Thus, the military utility of a weapon must outweigh its impact on civil society, and the long destructive life of a landmine is clearly greater than any immediate utility. These principles apply to all States as part of customary international law.

125. The use of landmines is specifically regulated by Protocol II of the Convention on Prohibitions or Restrictions on the Use of Certain Conventional Weapons Which May Be Deemed to Be Excessively Injurious or to Have Indiscriminate Effects. Worldwide pressure resulting from the International Campaign to Ban Landmines led to a call for a review conference on the Convention, which took place between September 1995 and May 1996. While some progress was made in revising Protocol II to the Convention, this legal protection falls far short of even the bare minimum needed to protect children and their families. The expert hopes that the next conference in 2001 will agree on a total ban, at least on anti-personnel mines.

Specific recommendations on landmines and unexploded ordnance

126. The expert submits the following recommendations on landmines and unexploded ordnance:

(a) Governments should immediately enact comprehensive national legislation to ban the production, use, trade and stockpiling of landmines. Governments should support the campaign for a worldwide ban, at least on anti-personnel mines, at the next review conference to the Convention on Conventional Weapons in 2001. In order to reduce the threat of unexploded ordnance, the conference should also make concrete proposals to address the impact on children of other conventional weapons, such as cluster bombs and small-calibre weapons;

(b) In reports to the Committee on the Rights of the Child, States Parties, where relevant, should report on progress in enacting comprehensive legislation. Furthermore, they should report on measures being taken in mine clearance and in programmes to promote children's awareness of landmines and to rehabilitate those who have been injured;

(c) Humanitarian mine clearance should be established as a part of all peace agreements, incorporating strategies to develop national capacity for mine clearance;

(d) Governments must provide sufficient resources to support long-term humanitarian mine clearance. Such funding should be provided bilaterally and through international assistance such as the United Nations Voluntary Trust Fund for Assistance in Mine Clearance;

(e) Countries and companies that have profited from the sale of mines should be especially required to contribute to funds designated for humanitarian mine clearance and mine awareness programmes. Measures to reduce the proliferation and trade of landmines, such as consumer boycotts, should be explored;

(f) A technical workshop on mine awareness should be held by the Department of Humanitarian Affairs, UNICEF, UNESCO and involved NGOs. The purpose would be to assess lessons learned, promote best practice in child-focused mine awareness programmes and improve coordination, assessment and evaluation.


127. The present report focuses on armed conflict, but a closely-related issue that also has a serious impact on children is the imposition of economic sanctions. In recent years, economic sanctions have been seen as a cheaper, non-violent alternative to warfare. In his follow-up report to "An Agenda for Peace" (A/50/60), the Secretary-General of the United Nations recognized that sanctions raise the ethical question of whether suffering inflicted on vulnerable groups in the target country is a legitimate means of exerting pressure on political leaders. Since 1991, under Article 41, Chapter VII of the Charter of the United Nations, the international community has collectively imposed sanctions on Iraq, the Federal Republic of Yugoslavia (Serbia and Montenegro), the Libyan Arab Jamahiriya and Haiti. In addition, countries can and have employed bilateral sanctions. In the post-cold war era, it seems likely that sanctions will play an increasingly important part in international policy. Governments are reluctant to commit troops and funds to international military intervention and see sanctions as a safer recourse that can be applied at lower cost to the embargoing power. While not necessarily the case, sanctions also appear less deadly than military action for the population of the target country.

1. Humanitarian exemptions

128. In theory, most sanctions regimes exempt critical humanitarian supplies from general embargoes. In practice, sanctions have so far proved blunt instruments. Humanitarian exemptions tend to be ambiguous and are interpreted arbitrarily and inconsistently. They often cause resource shortages; disrupt the distribution of food, pharmaceuticals and sanitation supplies; and reduce the capacity of the public health system to maintain the quality of food, water, air, and medicine. Delays, confusion and the denial of requests to import essential humanitarian goods cause resource shortages. While these effects might seem to be spread evenly across the target populations, they inevitably fall most heavily on the poor. Those with power and influence will usually have ways of acquiring what they need, while the general population struggles to survive with what remains. While adults can endure long periods of hardship and privation, children have much less resistance, and they are less likely to survive persistent shortages. Studies from Cuba, Haiti and Iraq following the imposition of sanctions each showed a rapid rise in the proportion of children who were malnourished. In Haiti after 1991, for example, one study indicated that the price of staple foods increased fivefold and the proportion of malnourished children increased from 5 to 23 per cent.

129. Even when exemptions are permitted, the conditions applied may be unacceptable to the Government in power. Indeed, those Governments and authorities against which sanctions are imposed are rarely personally affected and may be precisely those less responsive to the plight of their people. Iraq since 1990 has experienced the most comprehensive regime ever imposed. In order to mitigate some of the effects on health and nutrition, the Security Council adopted resolution 706 (1991) to permit the use of frozen Iraqi funds to purchase food and medicine, stipulating that these supplies had to be purchased and distributed under the supervision of the United Nations. The Iraqi Government considered these conditions unacceptable and only started to discuss them in 1995. Meanwhile, the situation for children has deteriorated. Over the past five years, infant mortality is thought to have tripled.
31/ The "oil-for-food" procedures contained in Security Council resolution 986 (1995) present an opportunity to mitigate the negative impact of sanctions on Iraqi children. To take full advantage of this opportunity, however, all currency generated through oil sales should be dedicated to humanitarian and civilian purposes.

130. In the interests of children, the international community should cease to impose comprehensive economic sanctions without obligatory and enforceable humanitarian exemptions and agreed mechanisms for monitoring the impact of sanctions on children and other vulnerable groups. Any measures taken should be precisely targeted at the vulnerabilities of the political or military leaders whose behaviour the international community wishes to change. These actions could include an arms embargo, the freezing of all corporate and individual overseas assets, the stopping of certain kinds of economic transactions, the suspension of air links and other forms of communication and the isolation of countries from the rest of the world through cultural, academic and economic boycotts.

The need for child impact assessments and monitoring

131. Sanctions should be judged against the standards of universal human rights, particularly the Convention on the Rights of the Child. The primary consideration must always be the potential human impact, which should influence the imposition and choice of sanctions, the duration, the legal provisions and the operation of the sanctions regime. Sanctions should not be imposed without advance assessment of the economic and social structure of the target country and the ability of the international community to sustain continuous monitoring.

132. Monitoring systems make it possible to assess the impact of the embargo on health and well-being. At minimum, such assessments should measure changes in access to essential medicines and medical supplies (especially items that may serve both civilian and military purposes such as chlorine for water purification or lab reagents for health screening and testing), water quality and quantity, the nutritional state of children and the infant mortality rate.

133. When targeted sanctions are imposed, humanitarian exemptions should be formulated with clear guidelines. At the same time, in order to help vulnerable groups, the established agencies should formulate appropriate humanitarian assistance programmes. If essential humanitarian goods are denied to the population, the sanctioning powers have a responsibility to assure new sources of supply. When the Security Council imposes sanctions, it should also simultaneously provide resources to neutral, independent bodies to monitor the situation of vulnerable groups. In the event that the position of children deteriorates, the United Nations should assume responsibility for redressing the situation.

134. Since many of the effects of sanctions, particularly the health impact, may only become evident over a period of years, no sanctions regime should be allowed to continue indefinitely. When the Security Council imposes sanctions, it should also clearly define the circumstances under which they should be lifted. If the sanctions fail to produce the desired result within a predetermined period, they should be replaced by other measures.

Specific recommendations on sanctions

135. The expert submits the following recommendations on sanctions:

(a) The international community should ensure that whenever sanctions are imposed they provide for humanitarian, child-focused exemptions. The international community should establish effective monitoring mechanisms and child impact assessments. These must be developed with clear application guidelines;

(b) Humanitarian assistance programmes of the United Nations specialized agencies and of NGOs should be exempt from approval by the Security Council Sanctions Committee;

(c) A primary concern when planning a targeted sanctions regime should be to minimize its impact on vulnerable groups, and particularly children. Sanctions or other measures taken by the Security Council should be precisely targeted at the vulnerabilities of those whose behaviour the international community wishes to change;

(d) The Security Council Sanctions Committee should closely monitor the humanitarian impact of sanctions and amend sanctions immediately if they are shown to cause undue suffering to children.

Health and nutrition

136. The effects of armed conflict on child development accumulate and interact with each other. The stage of physical, psychosocial, cognitive and moral development that a child has reached directly affects his or her ability to cope with these impacts. Consistent with article 39 of the Convention on the Rights of the Child, obliging States Parties to promote the physical and psychological recovery and social reintegration of children affected by armed conflict, the following three subsections of the report are devoted to health and nutrition, psychosocial well-being and education.

137. Thousands of children are killed every year as a direct result of fighting, from knife wounds, bullets, bombs and landmines, but many more die from malnutrition and disease caused or increased by armed conflicts. The interruption of food supplies, the destruction of food crops and agricultural infrastructures, the disintegration of families and communities, the displacement of populations, the destruction of health services and programmes and of water and sanitation systems all take a heavy toll on children. Many die as a direct result of diminished food intake that causes acute and severe malnutrition, while others, compromised by malnutrition, become unable to resist common childhood diseases and infections.

138. Given their vulnerability, it is no surprise that around 2 million children are estimated to have died as a result of armed conflict in the last decade. 32/ In Mozambique alone, between 1981 and 1988, armed conflict caused 454,000 child deaths, while in Somalia, according to WHO, crude mortality rates increased 7 to 25 times. Some of the highest death rates occur among children in refugee camps. These statistics are in stark contrast to the intent behind article 6 of the Convention on the Rights of the Child, which asserts that States Parties shall ensure to the maximum extent possible the survival and development of the child. Article 24 states that the child has a right to the highest standard of health and medical care available.

139. Many of today's armed conflicts take place in some of the world's poorest countries, where children are already vulnerable to malnutrition and disease, and the onset of armed conflict increases death rates up to 24 times. All children are at risk when conflicts break out, but the most vulnerable are those who are under five and already malnourished.

Communicable diseases

140. Since 1990, the most commonly reported causes of death among refugees and internally displaced persons during the early influx phase have been diarrhoeal diseases, acute respiratory infections, measles and other infectious diseases. Even in peacetime, these are the major killers of children, accounting for some seven million child deaths each year.
33/ Their effects are heightened during conflicts, partly because malnutrition is likely to be more prevalent, thereby increasing chances of infection.

141. Diarrhoea is one of the most common diseases. In Somalia during 1992, 23 to 50 per cent of deaths in Baidoa, Afgoi and Berbera were reported to be due to diarrhoea. Cholera is also a constant threat and, following armed conflicts, it has occurred in refugee camps in Bangladesh, Kenya, Malawi, Nepal, Somalia and Zaire, amongst others. Acute respiratory infections, including pneumonia, are particularly lethal in children and, according to WHO, killing one-third of the children who died in six refugee centres in Goma, Zaire, in 1994. Measles epidemics have been reported in recent situations of conflict or displacement in several African countries - at the height of the conflict in Somalia, more than half the deaths in some places were caused by measles. As tuberculosis re-emerges as a dangerous threat to health the world over, its effect is heightened by armed conflict and disruption. WHO estimates that half the world's refugees may be infected with tuberculosis, as the crowded conditions in refugee camps often promote the spread of tubercular infection. Malaria has always been a major cause of morbidity and mortality among refugees in tropical areas, particularly among people who come from areas of marginal transmission and who move through or settle in endemic areas. Children, as always, are the most vulnerable to these collective assaults on health and well-being.

142. The potential for greater spread of sexually transmitted diseases, including HIV/AIDS, increases dramatically during conflicts. Population movements, rape, sexual violence and the breakdown of established social values all increase the likelihood of unprotected sexual activity and larger numbers of sexual partners. Reduced access to reproductive health services, including education, increases the vulnerability of adolescents in particular. The breakdown of health services and blood transfusion services lacking the ability to screen for HIV/AIDS also increase transmission. NGOs and agencies such as FAO and UNICEF have noted a dramatic increase in the incidence of child headed households as one of the consequences of HIV/AIDS in parts of Africa. This trend is likely to increase. It is essential that agencies design clear strategies to assist children in these situations without disrupting family unity.

Reproductive health

143. In times of conflict, the provision of primary health care in conjunction with interventions to secure clean water, adequate nutrition, shelter and sanitation, will be the priority health agenda. However, reproductive health is also important for the physical and psychosocial well-being of men and women, and particularly of young girls. The reproductive health of pregnant women and mothers is integrally tied to the health of newborns and children. WHO advocates that reproductive health services based on women's needs and demands, with full respect for religious and cultural backgrounds, should be available in all situations. The effects of armed conflicts - family and community breakdown, rapid social change, the breakdown of support systems, increased sexual violence and rape, malnutrition, epidemics and inadequate health services, including poor prenatal care - make it imperative that the right to reproductive health care is given high priority. The problems caused by complications in pregnancy and delivery and by unwanted and unsafe sex can be immediate, as is the case with chronic pelvic inflammatory diseases. They can also adversely effect women's future sexual and reproductive health and that of their children by leading to health conditions such as infertility, paediatric AIDS and congenital syphilis.

144. The insufficient attention paid to reproductive health issues in emergency situations led to the development of the UNHCR/UNFPA
Inter-Agency Field Manual on Reproductive Health in Refugee Situations. Reproductive health programmes that involve women and adolescents in their design, implementation and assessment help to build personal capacities, lead to more relevant programmes and can make important contributions to the health and development of young people and women in situations of armed conflict. In South Africa, for example, UNICEF reports that young people have been involved effectively in the design, testing and implementation of youth health situation analyses, and in Ghana, peer educators in health projects for children living or working in the streets, 34/ have improved their programmes by involving young people in assessments.


145. Millions of children are killed by armed conflict, but three times as many are seriously injured or permanently disabled by it. According to WHO, armed conflict and political violence are the leading causes of injury, impairment and physical disability and primarily responsible for the conditions of over 4 million children who currently live with disabilities. In Afghanistan alone, some 100,000 children have war-related disabilities, many of them caused by landmines. The lack of basic services and the destruction of health facilities during armed conflict mean that children living with disabilities get little support. Only 3 per cent in developing countries receive adequate rehabilitative care, and the provision of prosthetics to children is an area that requires increased attention and financial support. In Angola and Mozambique, less than 20 per cent of children needing them received low-cost prosthetic devices; in Nicaragua and El Salvador, services were also available for only 20 per cent of the children in need. This lack of rehabilitative care is contrary to article 23 of the Convention on the Rights of the Child, which lays out clearly the responsibilities of States Parties for ensuring effective access of disabled children to education, health and rehabilitation services.

Destruction of health facilities

146. In most wars, and particularly in internal conflicts, health facilities come under attack, in direct violation of the Geneva Conventions of 1949. During the armed conflict from 1982 to 1987 in Nicaragua, for example, 106 of the country's 450 health units were eventually put out of service as a result of complete or partial destruction, and a further 37 health posts were closed owing to frequent attacks. The intensity of the war also diverted much of the health service to the needs of immediate casualties. Hospitals maintained low occupancy rates in order to be able to receive the injured at short notice and they were forced either to neglect the regular care of patients or to shift them to health centres. Even health facilities that remain open during a conflict offer very restricted service. In Mozambique, between 1982 and 1990, about 70 per cent of health units were looted or forced to close down and the remainder were difficult to reach because of curfews.

147. A concentration on military needs also means that children injured in a conflict may not get effective treatment or rehabilitation. Effects on general health care can be just as severe. Health services suffer from a shortage of personnel as health workers move to other areas or leave the country. After the Khmer Rouge period, for example, Cambodia was left with only about 30 doctors. Restrictions on travel also hamper the distribution of drugs and other medical supplies, and health referral services, supervision and logistic support break down.

148. For children, one of the most dangerous implications of this breakdown is the disruption of rural vaccination programmes. During Bangladesh's struggle for independence in 1971-1972, childhood deaths increased 47 per cent. Smallpox, a disease that had virtually disappeared prior to the conflict, claimed 18,000 lives. By 1973, in Uganda, immunization coverage had reached an all-time high of 73 per cent. After the fighting started in that country, coverage declined steadily until, according to WHO sources, by 1990, fewer than 10 per cent of eligible children were being immunized with anti-tuberculosis vaccine (BCG), and fewer than 5 per cent against diphtheria, pertussis and tetanus (DPT), measles and poliomyelitis. The situation has improved dramatically, but the lessons are clear.

Protecting health services and health workers

149. In actions at both global and national level, the health sector should continue to promote children's rights to survival and development while doing all it can to prevent and alleviate their suffering. In the midst of armed conflict, WHO urges that health facilities be respected as safe environments for the care of patients and as safe workplaces for health workers. The delivery of medical assistance should not be prevented or obstructed. Moreover, the health care system and the community should work together, using health care wherever possible as an opportunity to gain access to children for other positive purposes.

150. During times of war, health services should emphasize the need for continuity of care and long-term follow-up. Emergency health relief must be linked with long-term development support and planning that not only permit survival, but also bring about long-lasting positive changes in children's lives. Paediatric and gynaecological care must become a regular component of all relief programmes. In the post-conflict phase, health systems must be sustainable, and programmes must be designed with as much involvement as possible from the affected communities. One obstacle to the full enjoyment of health services is that they are often dominated by men, whether expatriate or from the host country. For cultural or religious reasons, many women and girls underutilize the services despite risks to their health. Governments, United Nations bodies and specialized agencies such as WHO, UNHCR and UNICEF should increase the numbers of female health and protection professionals available in emergency situations.

151. Armed conflict is a major public health hazard that cannot be ignored. Any disease that had caused as much large-scale damage to children would long ago have attracted the urgent attention of public health specialists. When armed conflict kills and maims more children than soldiers, the health sector has a special obligation to speak out. Health professionals must be advocates of the rights of the child.



1/ Smith, Chris and D. Henrickson, "The Transformation of Warfare and Conflict in the Late-Twentieth Century", London, Centre for Defence Studies, King's College, 1996, p. 50.

2/ United Nations Children's Fund, State of the World's Children 1996, Oxford, Oxford University Press, p. 13.

3/ Brett, Rachel, Margaret McCallin and Rhonda O'Shea, "Children: The Invisible Soldiers", Geneva, Quaker United Nations Office and the International Catholic Child Bureau, April 1996, p. 88.

4/ Ibid., p. 23.

5/ Ibid., p. 33.

6/ Ibid., p. 34.

7/ Ibid., p. 53.

8/ Ibid., p. 31.

9/ Ibid., p. 52.

10/ Almquist, Kate, Robbie Muhumuza and David Westwood, "The Effects of Armed Conflict on Girls", Geneva, World Vision International, May 1996, p. 21.

11/ Brett, Rachel, Margaret McCallin and Rhonda O'Shea, "Children: The Invisible Soldiers", Geneva, Quaker United Nations Office and the International Catholic Child Bureau, April 1996, p. 84.

12/ Ibid., p. 53.

13/ See E/CN.4/1996/52/Add.2. The Representative of the Secretary-General on Internally Displaced Persons has developed the following working definition of internally displaced persons: "Persons who have been forced to flee their homes suddenly or unexpectedly in large numbers as a result of armed conflict, internal strife, systematic violation of human rights or natural or man-made disasters, and who are within the territory of their own country".

14/ Article 1A, paragraph 2, of the 1951 Convention relating to the Status of Refugees defines a refugee as someone who, "owing to well founded fear of being persecuted for reason of race, religion, nationality, membership of a particular social group or political opinion, is outside of the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country, or who, not having nationality and being outside of the country of his former habitual residence, as a result of such events, is unable or unwilling to return to it".

15/ United Nations High Commissioner for Refugees, State of the World's Refugees 1995: In Search of Solutions, New York, Oxford University Press, 1995, p. 248.

16/ United Nations High Commissioner for Refugees, Refugee Children: Guidelines on Protection and Care. Geneva: UNHCR, 1994.

17/ See also General Assembly resolution 41/85 entitled Declaration on Social and Legal Principles relating to the Protection and Welfare of Children, with Special Reference to Foster Placement and Adoption Nationally and Internationally.

18/ United Nations High Commissioner for Refugees, Sexual Violence Against Refugees: Guidelines on Prevention and Response. Geneva: UNHCR, 1995.

19/ United Nations High Commissioner for Refugees, The Impact of Armed Conflict on Children: The Refugee and Displaced Children Dimension, Geneva, 1996, p. 36.

20/ Ibid., p. 53.

21/ See E/CN.4/1996/63.

22/ See E/CN.4/1996/53/Add.1.

23/ Schade, Ernst, "Experiences with regard to the United Nations Peace-keeping Forces in Mozambique", Norway, Redd Barna, 1995.

24/ Statistics from the United Nations Department of Humanitarian Affairs.

25/ Williams, Jody, "The Protection of Children Against Landmines and Unexploded Ordnance", Washington, D.C., Viet Nam Veterans of America Foundation, p. 1.

26/ Ibid., p. 12.

27/ Ibid.

28/ Ibid., p. 13.

29/ Information obtained from the United Nations Department of Humanitarian Affairs.

30/ Garfield, Richard, "The Impact of Economic Sanctions on the Health of Women and Children", New York, Columbia University, April 1996, p. 9.

31/ Ibid., p. 11.

32/ Ibid., p. 13.

33/ United Nations Children's Fund, State of the World's Children 1995, New York, Oxford University Press, p. 20.

34/ Youth for Population Information and Communication, "Improved Quality of Life, Empowerment and Development for Street Youth in Kumasi", Ghana, Youth for Population Information and Communication, 1996.


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