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The impact of explosive violence on the sensory health of children

Explosive weapons are more likely to cause sensory injuries in children than any other conventional weapon – irreversibly damaging a child’s sensory organs, causing lifelong blindness and deafness. This article briefly explores the impact of explosive weapons on the sensory health of children, and why such impact needs to be prioritised in the provision of victim assistance.

Sensory injury from explosive weapons
Every mechanism of blast injury, from the supersonic high-pressure blast wave to the ballistic penetrating fragments, heat and toxic fumes, has the potential to cause life-changing and irrevocable damage to a child’s sensory health.

Children injured by explosions are 2.5 times more likely to have facial injuries compared to those injured by gun-shot wounds (29.8% versus 11.8%), greatly increasing the likelihood of sensory injuries. This is likely because of a child’s lower height compared to adults, meaning they will be more impacted from shrapnel emanating from ground level.
A 2005 study using the Israeli Trauma Registry found that children suffered 4.4 times as many eye injuries (13.2%) from explosive weapons as opposed to gun-shot wounds (3%).

In a blast, children are more susceptible to sensory harm than adults. Loss of vision, for instance, occurs in around 21% of children and 10% of adults. This is largely due to a child’s propensity to sustain head injuries- 80% of paediatric blast patients suffer from head injuries in comparison to 31% of adults. Landmines are of particular risk to a child’s eyes due to the “high directionality of the explosive particles towards the face in children”. Tragically, a child’s natural curiosity also means that they are likely to pick up and play with objects, increasing the probability of face and eye injuries from seemingly innocent unexploded ordnance (UXO).

Compounding harm of explosive violence
Children with pre-existing disabilities are much more vulnerable to the violence of explosive weapons. Anecdotal evidence shows that children who have been made deaf by airstrikes cannot hear bombs dropping, and children who have been made blind by landmines cannot see where they walk. Human Rights Watch identified children with sensory impairments are at greater risk of additional harm in conflict zones and, at times of extreme panic, have even been known to be left behind by their families and carers. Pre-existing disabilities of child casualties are rarely recorded, so the impact of explosive violence on children with ‘Special Educational Needs’ and other complex medical requirements is largely missing from the literature.

Action on Armed Violence is working with the University project Disability Under Siege to address this shortfall in research.

Long-term effects
A sensory injury at a critical stage in a child’s development makes them vulnerable to both academic and social underachievement; it can make it difficult for them to earn a living and make an economic contribution to their communities, potentially placing them in further risk of exploitation and abuse.

Hearing loss, for example, is the most common primary blast injury and can be either temporary or permanent, but there is currently no cure for blast-related deafness, and hearing aids do not help. John Oghalai, a specialist in diseases of the ear at Stanford University in California, described to AOAV how IEDs blast produces an airwave of extreme force and as a result of the massive air pressure, the inner ear structures are unable to withstand it.

75% of early learning occurs through vision and hearing is essential to the early development of language, literacy, and social skills. Save the Children has found that damage to the eye in infancy leads not only to visual impairment, but also prevents eyes developing and can lead to visual defects.

Displaced children with sensory disabilities are much less likely to attend school. Refugee parents have reported that schools do not put in enough effort to accommodate their disabled children, and that the fees are often prohibitive. A study of Syrian refugees in Jordan and Lebanon revealed that illiteracy was highly prevalent in refugee children with disabilities above the age of 13, as many had never been enrolled in education. Indeed, many of the children aged between 6 and 12 with disabilities were found to have never been enrolled in school or dropped out as a result of their disability.

According to a 2018 report by Syria Relief, four out of five children living with disabilities in Syria reported not having access to education. Similar studies in Iraq found that only 16% of displaced children with disabilities living in camps and 10% living in urban areas were attending schools around Domiz, Northern Iraq. Prior to displacement, 29% of the children with disabilities living in camps were attending school.

In addition to life-long visual impairments and hearing loss, sensory harm from explosive violence initiates a cycle of reverberating effects, disrupting the support networks and services that are required to allow children to cope with sensory disabilities. Syria Relief’s 2018 report identified over 10,000 children with disabilities in Syria living without access to the most necessities. 88% of the children surveyed required medical rehabilitation services; for 68% of these children these services were not available in their area.

The destruction of rehabilitation services and social support centres is often overlooked and compromised in conflicted areas. Hearing aids, for example, are expensive, but the cost is compounded by their maintenance and the follow-up treatment required. During times of conflict financial assistance accessed by people with disabilities is scarce and the services that do exist tend to be fragmented.

Injuries to a child’s sensory organs leads to barriers in accessing services and information. “It takes you away from communication”, said Oghalai on hearing loss, “It takes you away from society. When you can’t communicate with people, even if you could see them and whatever, it’s not the same as being an active participant in communication”. Loss of sensory faculties inhibits communication and can create a sense of isolation from society. In armed conflict, children with disabilities can face increased discrimination and seclusion.

Conclusion
Child sensory injuries require long-term rehabilitation, far beyond immediate care after a blast.Loss of vision and hearing are not insurmountable stumbling blocks, but children displaced by explosive weapons, or those living in post-conflict countries are unlikely to receive adequate support. A sensory impairment can translate to future social and economic challenges for both the individual and society.

Research support provided by Maram Abdulkader