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APHA Scientific Session and Event Listing

Recorded presentation

Emmanuel D'Harcourt, MD, MPH, Health Unit, International Rescue Committee, 122 East 42nd Street, New York, NY 10168, 212-551-3178, harcourt@theirc.org and Richard Brennan, MD, International Recue Committee, 122 East 42nd Street, Nyc, NY 10168-1289.

Events in the last decade demonstrate that conflict is a major killer of children, and that children, particularly young children, suffer disproportionately from war and displacement. We review data and experience from the Democratic Republic of Congo and other countries showing the scale of the problem and ways to address it. An early 2004 nationwide mortality survey in DR Congo estimated 3.9 million people had died since the country's civil conflict started in 1998. Nearly half those deaths occurred in children under five, whose relative risk of dying was four times that of older children and adults. Young children were fifty percent more likely to die in areas directly affected by conflict compared to areas less directly affected. The vast majority of the excess child deaths were attributable to untreated disease due to the collapse of the health system, rather than to direct violence. The International Rescue Committee has established a variety of programs to improve child health in DR Congo and other conflict-affected countries. A key lesson from those programs is that implementation strategies must be adapted for conflict countries, however the adapted strategies should retain key elements used in stable, non-conflict areas. In particular, health work in conflict countries should focus on community development, capacity-building, and systems-building, rather than on the exclusive provision of material inputs and emergency aid. Community-based and community-delivered services offer particular promise as ways to overcome infrastructure limitations, begin rebuilding shattered civil societies, and achieve immediate and substantial impact on child health.

Learning Objectives:

• Identify 2 key elements of stable, non-conflict health work that should carry through to health programs designed for conflict-affected areas.
• Recognize principal reasons that children under five suffer disproportionately from war and displacement.

Keywords: Child Health, International Public Health

Presenting author's disclosure statement:

Not Answered

Recorded presentation