The Most Vulnerable Groups During Conflicts
Photo by Mufid Majnun on Unsplash
Armed conflicts /wars often place people at an increased risk of discrimination and/or abuse, especially vulnerable groups such as children, women, older people and those with existing disabilities or chronic health conditions. They may include particular ethnic or religious minorities, individuals who identify as lesbian, gay, bisexual, transgender, or queer (LGBTQ), victims of human trafficking or sexual violence. However, young people and women are disproportionately impacted by conflict, as violence disrupts their education and diminishes their job prospects and limit their access to civic spaces. Children are particularly vulnerable in times of conflict and crisis.[1]
The collection of health and population data for conflict-affected communities are notoriously scarce. Yet it is increasingly vital for the orientation of humanitarian work and the allocation of aid and resources. Donors, humanitarian service providers and host governments need to understand the impact of their assistance. Proper evaluation, ideally in the form of validated data collected using sound and transparent methods, is essential. Local authorities may have too few resources for such non-urgent tasks, but donors often recognize the benefits of having insights into trends in the communities they are serving.
Comunities that experience armed conflict are frequently among the poorest in the country. Families that belong to these communities always need to be prepared for evacuation at a moment’s notice whenever fighting erupts. At the same time, schoolchildren in these areas are either forced to suspend or quit schooling, which leaves their learning stunted and options for the future limited.
While some contributing factors to this vulnerability may be intrinsic, most commonly they are due to environmental or societal factors that pre-date the disaster and conflict. These groups are not homogenous, and the risks they face vary from individual to individual, depending on the interaction of both personal and environmental factors. [1]
Children[2]:
As the frequency and intensity of disaster events increase around the globe, children are among those most at risk for the negative effects of a disaster. They represent a significant portion of those who endure the devastating long-lasting consequences of disasters. Children are a highly vulnerable group, particularly infants and young children, who are partially or totally dependent on adults.
Older children and adolescents are psychologically and physically vulnerable and may develop post-traumatic stress disorder or related symptoms. They experience death, injury, illness, and abuse and often must cope with disruptions or delays in their educational progress in the aftermath of a disaster. Systems that protect children and young people, including family and community structures, are often impacted during disasters and conflicts. Children may be separated from their families and this situation places them at increased risk of injury, abuse and exploitation, including trafficking or being recruited by armed groups. According to The Peace Research Institute Oslo (PRIO) in 2022 out of world child population:
· Approximately 468 million children (18.8%) were living in a conflict zone.
· Around 96 million children were living in high-intensity conflict areas.
· Close to 41% of all children exposed to conflict lived in an area that experienced more than 25 battle-related deaths within a 50 km radius.
· Africa was the world region with the highest total number of children living in conflict zones (183 million children). The total number in Asia was 145 million.
· The Middle East continued to have the highest share of children living in conflict zones relative to the total child population (with as many as 39%, or more than one third of all children in the region)
Moreover, in post-disaster and conflict settings, the voices of children are often not heard and, as a result, children’s rights and needs are frequently under-addressed. This creates adverse long-term consequences for them and their communities. The negative effects of disaster and conflict include a decline in children’s physical health and emotional and intellectual well-being in both the short- and long-term.
Women[3]
It is not surprising that women are generally more likely than men to suffer injuries or to be killed during disasters and that violence against women and girls may be exacerbated during emergencies. Women also face an increased burden of care tasks, such as the provision of food and water, and caring for the sick and injured following disasters and conflicts, which further impacts their participation.
50 percent of refugees, internally displaced, or stateless populations are women and girls. Of the over 100 million people who have been forced into displacement, over half are women and girls.
The 1979 Convention on the Elimination of All Forms of Discrimination Against Women protects the rights of women during disasters. Women and girls must have following assistance during disasters and conflicts:
· Unimpeded access to health care, despite prevailing insecurity, financial or cultural constraints.
· Should be treated by all healthcare personnel not only by females
· Should not become vulnerable to, trafficking or sexual violence when trying to reach or benefit from health care.
· Child-care facilities must be made available for women seeking health care
· Women must be directed to health education programmes, including family planning
Older Persons[4]
The United Nations defines the older person as anyone 60 years and above. According to the World Health Organization (WHO), there are 600 million persons aged 60+ years in 2000, with that number expected to rise to 1.2 billion by 2025 and 2 billion by 2050, with a significant and growing number of those affected by humanitarian crises.
Pre-existing conditions and positions exacerbated by a crisis and specific issues and risks created by the emergency itself are the main challenges and factors that impact on the older person in humanitarian crises. These can be found at the individual, community and structural levels. Older age often compounds other forms of vulnerabilities or inequalities, such as gender, race, education level, income, health status, or access to justice, that accumulate during a lifetime. When older persons do not enjoy their rights fully in regular times, their vulnerability to emergencies is likely to increase. Older persons generally have following vulnerabilities which have been shown to have an increased likelihood to be severely injured or killed as a result of disasters and conflicts:
· Pre-existing conditions including mobility, sensory and communication difficulties
· They are likely to be neglected in both disaster risk reduction strategies and emergency responses, and are not prioritized to receive medical and rehabilitation services
· Social isolation and reduced access to care support can result in greater difficulty accessing basic needs, including food, water, shelter, latrines and face higher risks associated with safety, protection and dignity and vulnerable to violence and exploitation. These factors can also contribute to deteriorating health during disasters and conflicts.
· Older people may also face a range of protection issues that arise from the disaster and conflict directly including human rights violations perpetrated by states, armed groups, or other international or national actors, or may result from problems at individual, family or community levels. While supporting older persons during disasters and conflicts, following points must be taken care of:
· Elderly persons must not have difficulty reaching health care and should not be confined to their homes.
· Information must be collected as to how health care for elderly people has been affected by the armed conflict or other emergencies.
Persons with a Disability[5]
Over a billion people in the world today are estimated to live with some form of disability, which corresponds to about 15% of the world's population, or one in seven people. Between 110 million (2.2%) and 190 million (3.8%) people 15 years and older have significant difficulties in functioning, while some 93 million children or one in 20 of those under 15 years of age live with moderate or severe disability.
Since the adoption of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), the disability has been firmly established as a human rights and development issue. There is an increasing body of evidence highlighting that people with a disability experience worse socioeconomic outcomes and poverty than persons without disabilities. All necessary measures be ensured for the protection and safety of persons with disabilities in situations of risk, including situations of armed conflict, humanitarian emergencies and the occurrence of natural disasters. People with disabilities may be disproportionately affected by disasters and conflicts, with evidence suggesting that mortality rates for people with disabilities (2.06%) are double, or even up to four times that seen for the general population (1.03%) in disaster settings. In emergency responses, people with disabilities may also be more likely to be left behind, lose essential assistive devices such as spectacles, hearing and mobility aids and/or medications or fail to benefit from humanitarian services due to a range of environmental, physical and social barriers. They may also have greater difficulty accessing basic needs. Traditional caring mechanisms within the community are also interrupted and the capacity of caregivers and care settings to provide for and support people with disabilities are often reduced, further increasing vulnerabilities and risks for people with a disability. Persons with a disability during disasters and conflicts may have following issues:
· Difficulty reaching health care or rehabilitation services and may be confined to their homes
· May not have transport available for them
· There may be limited institutions providing services for people with disabilities
· There may be impending danger for people with disabilities as a result of the insecurity created by the armed conflict or other emergencies
Armed Conflicts- Global Context[6]
The Peace Research Institute of Oslo (PRIO) reports 59 armed conflicts took place worldwide in 2022, led by the wars in Ukraine and Gaza. Twenty-eight of the conflicts were in Africa, followed by Asia with 17 and the Middle East with 10. Just three conflicts were recorded in Europe and a single example in the Americas. Overall, the past three years saw more conflict-related deaths than any time in the past three decades. They were driven by the civil war in Ethiopia’s Tigray region, the Russian invasion of Ukraine and the assault on Gaza. Global conflicts killed three times as many children and twice as many women in 2023 than in the previous year, as overall civilian fatalities swelled 72%. The world is facing the highest number of violent conflicts since the Second World War and 2 billion people — a quarter of humanity — lives in places affected by such conflict. At the end of 2023, an estimated 117.3 million people worldwide were forcibly displaced due to persecution, conflict, violence, human rights violations and events seriously disturbing the public order. Based on operational data, United Nations High Commissioner for Refugees (UNHCR) estimates that forced displacement has continued to increase in the first four months of 2024 and by the end of April 2024 is likely to have exceeded 120 million. One in every 69 people, or 1.5 per cent of the entire world’s population, is now forcibly displaced. [7]
According to data, with the continuation of Russia’s invasion of Ukraine, the latest war between Israel and Hamas and political violence elsewhere in the world, more than 170,000 lives have been lost to war and violent conflicts throughout 2023. Approximately half of all fatalities tracked by Armed Conflict Location & Event Data Project (ACLED a crisis monitoring group based in the U.S.) were in a violent interaction between two politically organized armed groups at a particular time and location. Explosions and instances of remote violence (includes attacks with bombs, improvised explosives, mortars and missiles that are not tied to specific battles) made up nearly 30% of the year’s death toll, with the Palestinian territories, and particularly Gaza, seeing the largest share of fatalities of this type.
According to a study, more armed conflicts took place in 2023 than in any other year since the end of World War II. Analyzing the intensity, frequency, and form of violent events allows for further investigation into different levels of conflict. As per available date, estimated 14 per cent of world population exposed to conflict. Of all violent conflict deaths in 2023, 1 in 5 were instances of violence against civilians, defined as when “an organized armed group deliberately inflicts violence upon unarmed non-combatants. Following are the few deadliest countries and territories in conflict in 2023, meaning they had the highest death tolls attributable to conflict according to data collected by collected by the Armed Conflict Location & Event Data (ACLED) Project a crisis monitoring group based in the U.S.
In Ukraine the estimated death toll is 30,700. Nearly 1 in 5 of the world’s total conflict fatalities occurred in Ukraine in 2023. The war in Ukraine has caused over 6 million refugees to flee the country and created a new humanitarian emergency in Europe.
Gaza has experienced conflict over the decades, but the most recent catastrophic instance began in October of 2023, resulting in death, displacement, and hunger. Since the war erupted in Palestine, more than 120,000 people in Gaza, overwhelmingly women and children, have been killed or injured and almost one million Palestinians have been forcibly displaced, while aid delivery and humanitarian access deteriorated further.
Sudan has experienced its share of internal conflict. Most recently in 2023, ongoing fighting has continued, killing 13,900 people and displacing 8.1 million people mainly women, children, old aged and disabled. Sudan was already facing hunger due to poverty and climate disasters, but the conflict has plunged millions more into hunger. Due to rising food costs and disrupted infrastructure due to the conflict, over 20 million people are now facing food insecurity.
As the conflict in Yemen enters its seventh year, it has caused the deaths of nearly a quarter of a million people. Millions of Yemenis continue to face the largest humanitarian crisis in the world, with more than half of the country’s population facing acute levels of food insecurity.
Practically it is hard to track, the number of homeless people mainly due to armed conflicts which continues to increase each year. The authorities who work to address and reduce the impact of war on these people including children need to support the development of more systematic knowledge on the various ways in which they are affected by armed conflict. There is an urgent need to protect them by adopting the following measures:[8]
· Support high-quality peacekeeping operations in conflict-affected areas.
· Specifically address these people’s needs in peace negotiations as early as possible in the peace process
· Create safe spaces for them in conflict affected areas.
· Design and uphold credible sanctions against armed groups during conflicts to reduce all grave violations against them particularly women and children.
· Increase aid to conflict-affected countries in order to rebuild infrastructure, education and health systems that benefit these homeless people.
Sufficient evidence exists about the devastating effects of armed conflict on the health of women and children. The number of women and children affected by conflict has increased since 2000, partly due to population growth, a increasing number of armed conflicts, the urbanization of conflict, and a growing number of refugees and internally displaced people. Armed conflicts increase indirect mortality among children and women. Food security is threatened during conflict, and it increases the number of children affected by acute malnutrition. Less evidence exists for the effect of conflicts on morbidity from infectious diseases. Eroded water and sanitation capabilities, crowding, mobility, and breakdown of immunization services putatively increase the risk of contagions. Visible local effects (eg, cholera and typhoid fever) and global effects (eg, polio virus and Ebola virus disease outbreaks) are common concerns in conflict-affected areas. The evidence on Non Communicable Diseases(NCDs) remains limited, but effects on mental health, especially post-traumatic stress disorder, depression, and anxiety disorders have been widely documented. Sexual violence against women and children is common. In most conflict-affected areas, data about the health of women, children, old aged and disabled persons are inadequate.
References
1. Pettersson T, Wallensteen P. Armed conflicts 1946–2014. J Peace Res. 2015; 52: 536–50.
2. Slone M, Mann S. Effects of war, terrorism and armed conflict on young children: a systematic review. Child Psychiatry Hum Dev. 2016; 47: 950–65.
3. Boerma T, Tappis H, Saad-Haddad G, et al. Armed conflicts and national trends in reproductive, maternal, newborn and child health in sub-Saharan Africa: what can national health surveys tell us? BMJ Glob Health. 2019; 4 (suppl 4) e001300
4. UNECEF. Policy Brief on Ageing - Older Persons in Emergency. No. 25 November 2020
5. World Health Organization and UNICEF. Guidance Note on Disability and Emergency Risk Management for Health. World Health Organization, UNICEF, Geneva, Switzerland. 2013. Available at: http://www.who.int/hac/techguidance/ preparedness/ disability/en/
6. Internal Displacement Monitoring Centre. Global Report on Internal Displacement 2019. https://www.internal-displacement.org/global-report/grid2019/
7. Peek L. Children and Disasters: Understanding Vulnerability, Developing Capacities, and Promoting Resilience - An Introduction. Children Youth and Environments. 2008 Jan 1;18(1):1-29.
8. United Nations. Political Declaration and Madrid International Plan of Action on Ageing. 2002. Available from: www.un.org/en/events/pastevents/pdfs/Madrid_plan.pdf