Focus On Health: Child Soldiers

By CUNY SPS Nursing student Gemma Rapsing, RN, BSN 

Children represent innocence, joy, and hope.  Loving parents wish to see their children grow up to fulfill their aspirations.  Environment, security, support, and education play a crucial role for this to happen.  They must involve a positive framework to produce positive outcomes.  As heartwarming as this sounds, the rightful storyline must be addressed.  The bad news is that there are extreme cases that this hope does not see the light of day.         

There is no greater atrocity than robbing children of their childhood.  This is what happens to child soldiers.  The proper definition is “A child associated with an armed force or armed group refers to any person below 18 years of age who is, or who has been, recruited or used by an armed force or armed group in any capacity, including but not limited to children, boys and girls, used as fighters, cooks, porters, spies or for sexual purposes” (United Nations, n.d., p. 1).  This occurs mainly in high-conflict and war-torn countries.  The exact number of child soldiers is not known.  Although, “Between 2005 and 2018, a total of 65,081 children are verified to have been recruited and used by armed forces and groups, but actual numbers are likely much higher” (Save the Children, 2021, para. 4).  There are numerous ways children can end up in this terror.  Some are lured, abducted, forced, or “are driven by poverty, compelled to generate income for their families…others associate themselves for survival or to protect their communities” (Unicef, 2020, p. 1).  According to Wyness (2016), “Many join up to escape the poverty in a country ravaged by war…The only people guaranteed not to starve in Congo are those with guns” (p. 350).  To understand what these children go through, one must be able to stomach their horrifying stories.  To learners, they are stories.  To these children, they are gut-wrenching, inhumane experiences they lived through. 

Child soldiers caught in a 20-year civil conflict in Uganda “endured extreme acts of violence, including physical torture, severe deprivation, and sexual abuse. Further, they were forced to commit atrocities against each other and their own communities including killing family members and other civilians; raids on villages; and looting” (Murphy, Elklit, Dokkedah, & Shevlin, 2017, p. 323).  Girls lives are destroyed during and after this experience.  They are “subjected to sexual abuse and exploitation, while some are forced into child marriage as “brides” for fighters…are frequently abandoned, divorced or left widowed, if they’re not killed or maimed themselves” (Save the Children, 2021, para. 6).  The violence and abuse these children endure have dire effects on many levels.   

This population suffers from many health issues.  Psychological trauma is at the forefront.  It can take a lifetime to recover if it is even possible.  A War Trauma Screening Scale is one of the instruments used as a diagnosis for Post Traumatic Stress Disorder.  In a study, it was determined that “re-experiencing symptoms were the most commonly endorsed experiences,” and that “child soldiers reported significantly higher war experiences, feelings of shame and guilt, and higher PTSD scores” (Murphy et al., 2017, p. 326).  Another psychological disorder they face is depression.  Since they are exposed to unsafe and unsanitary living conditions as well as denied access to nutritious meals, they suffer from malnutrition.  This makes them vulnerable to diseases such as malaria, cholera, and yellow fever (World Health Organization, 2021, p. 1).  Female child soldiers are subject to sexual assault.  Some can become pregnant and can suffer from traumatic fistula.  “Obstetric fistula is also a problem. We see many girls who are too young to give birth requiring surgical procedures” (World Health Organization, 2021, p. 1).  Sexually Transmitted Infections run rampant as girls and boys are sexually assaulted.  HIV/AIDS is the most common (World Health Organization, 2021, p. 1).  One of the most atrocious things these children face is disfigurement.  They suffer from war-like injuries like gunshot wounds and stab wounds.  The World Health Organization (2021) stated that “A child that gets sick in a war zone does not get the treatment he or she might otherwise receive…Generally speaking [the children] are not arriving wounded…They may have the scars of bullet and knife wounds, but these have usually healed” (p. 1).  Another issue child soldiers face is backlash from their communities.  “Some children who attempt to reintegrate are viewed with suspicion or outright rejected…families and communities may be coping with their own challenges and trauma from conflict, and have trouble understanding or accepting children who return home” (Unicef, 2020, p. 1).  It is especially difficult for girls who bore children from soldiers while in captivity.  Some families refuse to take them back in. 

There are numerous organizations worldwide that are taking part in fighting back.  They include the United Nations International Children's Emergency Fund (UNICEF), the World Health Organization (WHO), War Child, Save the Children, and even specialists like pediatricians.  The bigger organizations partner with governments around the world.  UNICEF reintegrates child soldiers back to civilian life, reunites them with their families if they have them, and provides programs that focus on psychosocial support, education, and training (United Nations, n.d., p. 1).  They provide child soldiers medical treatment, rehabilitation, and counseling.  They also created laws and policies to protect children from this unspeakable situation.  “Recruiting and using children under the age of 15 as soldiers is prohibited under international humanitarian law – treaty and custom – and is defined as a war crime by the International Criminal Court” (United Nations, n.d., p. 1).  Campaigns such as “Children, Not Soldiers” were created.  Countries that continue to participate in this heinous crime are placed on the shame list.  UNICEF and WHO are part of and are funded by the United Nations.  Organizations like War Child and Save the Children rely on donations for funding.  Both echo UNICEF in that they help to reunite, reintegrate, and provide the necessary resources.  War Child provides “safety and appropriate care while their families are being traced or a long-term solution found. Otherwise there’s a serious risk of abduction or re-recruitment” (War Child, 2018, p. 1).  Save the Children is “the global leader in child-focused humanitarian response, including protecting child soldiers and other children from the physical and emotional wounds of war, and ensuring their recovery and rehabilitation” (Save the Children, 2021, p. 12).   

There are human rights laws against recruiting children under the age of eighteen for military purposes.  Countries that continue to participate are placed on the shame list and exposed to the world.  There are currently fourteen countries on the list.  They are the Democratic Republic of Congo, Myanmar, Somalia, South Sudan, Sudan, Syria, Yemen, Cameroon, Libya, Nigeria, Afghanistan, Iraq, and Mali (Becker, 2020, p. 1).  Some of these countries are considered repeat offenders.  In the United States, the Child Soldiers Prevention Act “aims to hold governments accountable,” making them ineligible for key US military assistance programs, unless they receive a waiver from the White House” (Becker, 2020, p. 1).  The problem is that the U. S. continues to provide aid to some countries.  In 2019, “waivers allowed Afghanistan, Democratic Republic of Congo, Iraq, Mali, and Somalia to receive $17 million in military training and assistance” (Becker, 2020, p. 1). 

According to Save the Children (2021), there are “149 million children – double the number of all children in the U.S. – live in high-intensity conflict zones, areas experiencing thousands of battle-related deaths each year” with a “170% rise in the number of reported grave violations committed against children in conflict,” and that “a total of 65,081 children are verified to have been recruited and used by armed forces and groups between 2005 and 2018” (p. 1).  “Girls make up an estimated 10 to 30 percent of child soldiers used for fighting and other purposes” (DoSomething, n.d., p. 1).  According to United Nations (n.d.), “Each year, the UN receives reports of children as young as 8 or 9 years old associated with armed groups” (p. 1).  In the United Kingdom in 2018, “the number of under-18 army recruits was 2290, making up 21% of all army recruits” (Abu-Hayyeh & Singh, 2019, p. 1).  UNICEF has responded to the needs of more than 13,000 child survivors in 2018 (UNICEF, 2020, p. 1). 

More research and statistical data are needed about this population.  Information about their health status would allow organizations to find better ways to tend to their needs.  Due to the conflicted regions and dangerous situations, this may have been or may continue to be a challenge.  More health care professionals are needed in centers where child survivors are temporarily placed.  An array of specialists experienced in psychological trauma, physical trauma, pediatrics, obstetrics, and more would be of great help to these children.  As mentioned before, due to the dangerous regions, their political stance, and overall situation, this may pose the biggest challenge.  It is apparent that these children need more advocacy.  More influential voices need to speak out, whether they stand on a political, humanitarian, or a medical platform.  Abu-Hayyeh and Singh (2019) stated that “Clinicians occupy positions of voice and power…Paediatricians are committed to a policy of advocacy for a healthy lifestyle in children and young people and for the protection of their rights…Medact will continue to publish research on this, alongside the scrutinizing of past and current recruitment…Paediatricians are encouraged to join…for further training around advocacy skills to be able to better represent patient interests” (p. 2).  Governments need to provide aid and resources to centers.  Most importantly, they need to fully support the cause by publicly denouncing the recruitment of children into armed groups.  Being on a global shame list is not enough.  The listed countries must be tried in international court for violating human rights laws.  The U. S. must also stick to principles.  “The State Department should use its diplomatic influence to press all countries on the list to end their involvement in child soldiering. The White House will not make its waiver decisions until September, but it should send a clear message: if you want US military aid, you can’t use children as soldiers” (Becker, 2020, p. 1).  Prevention is key.  Global organizations, humanitarians, medical professionals, influential leaders, and perhaps even child survivors who emerged into completely recovered adults, must come together and push for more ways of prevention.  All initiatives can be funded the same way: governments, organizations, and private donations.  Continuous research along with accurate data can measure its effectiveness.  It is all a long shot, but no child deserves to have his or her childhood taken away.  A prominent figure and an advocate for children’s rights, Graça Machel, stated that “children are a unifying force capable of bringing people to common ethical grounds” and that they are “both our reason to struggle to eliminate the worst aspects of warfare, and our best hope for succeeding at it” (United Nations, n.d., p. 1).  Children are the future, and mankind must do everything they can to protect them.  
 

References 

Abu-Hayyeh, R., and Singh, G. (2019). Adverse health effects of recruiting child soldiers. BMJ Paediatrics Open, 3, 1-3. 

Becker, J. (2020, June 29). Record number of countries on US child soldier blacklist.   

DoSomething. (2021). 11 facts about child soldiers.

Murphy, S., Elklit, A., Dokkedah, S., and Shevlin, M. (2017). Anger, guilt and shame as mediators in the relationship between war experiences and PTSD: Testing the moderating role of child soldier status. Journal of Child & Adolescent Trauma, 10, 323–331.  

Save the Children. (2021). Child soldiers: The tragic end of childhood for boys and girls in conflict. 

Unicef. (2020, September). Children recruited by armed forces.  

United Nations. (n.d.). Child recruitment and use. 

United Nations. (n.d.). Graça Machel and the impact of armed conflict on children.  

War Child. (2018, April 4). The effects of being a child soldier can last a lifetime.  

World Health Organization. (2021). Healing child soldiers.    

Wyness, M. (2016). Childhood, human rights and adversity: The case of children and military conflict. Children & Society, 30, 345–355.