Afghan Children Pay the Price of Brutal War

This blog by César Chelala highlights the issues that children are facing in Afghanistan, which heavily impact their health, education and overall well-being. The post is a part of Wikichild's series on under-5 mortality rates, along with it's spotlight on the recent Save the Children report "State of the World's Mothers 2013: Surviving the first day".

Decades of insecurity and war in Afghanistan have provoked a heavy toll on children’s lives and well-being. An under-5 mortality rate of 199 per 1,000 live births as reported by UNICEF is among the highest in the world. That means that more than one out of every five children is dead by the time they are five. In addition, health and education systems suffer from lack of funds and qualified professionals, a situation worsened by the security situation.

The statistics are frightening. More than 60% of all child deaths and disabilities are due to respiratory and intestinal infections, and of vaccine-preventable diseases such as measles. Diarrhea kills tens of thousands of children every year. Many also die from severance of breast-feeding before time. An estimated 7.5 million children and adults are at risk from hunger and malnutrition, the latter affecting children's growth in particular.

According to United Nations statistics, malnutrition among children has increased by 50 percent or more countrywide when compared to 2012. This is happening despite billions of dollars in humanitarian aid by Western governments. One of the most affected places is the malnutrition ward at Bost Hospital, in war-torn Helmand Province, but a similar situation can be found even at Indira Gandhi Children’s Hospital in Kabul.

Although it is difficult to pinpoint the causes for the increase in malnutrition levels, experts indicate several factors that contribute to it such as widespread poverty, difficulties in the implementation of feeding and therapeutic programs, and lack of breastfeeding. Despite low incomes, many mothers are lured by the beautiful pictures on milk cartons, and tend to believe that this milk provides better nutrition for their children.

Children in Afghanistan can also be affected by polio, since Afghanistan is one of only four countries in the world where the disease is still endemic. Despite high vaccination rates, however, there were 47 documented cases of polio in the country.

Some cities, such as Jalalabad, the largest city in eastern Afghanistan, located at the junction of the Kabul and Kunar rivers, are high risk areas for polio due in large part to the massive and continuous population movements from and into polio infected areas. In South Asia in 2000, over 40 percent of the confirmed cases of polio occurred in Pakistan and Afghanistan.

To control the spread of disease, UNICEF and the Department of Public Health in Nangarhar, one of Afghanistan’s 34 provinces, have launched the “Women Courtyard” initiative, aimed at providing local women with information about polio and other vaccine-preventable diseases, as well as such related issues as hygiene and waterborne illnesses.

While this is an important initiative, certain popular traditions still constitute a hindrance to its successful implementation. One such tradition is that babies cannot leave their homes before the 40th day after birth, a tradition which prevents many newborns from being vaccinated at the appropriate time.

To make matters worse, deadly attacks have targeted schools and impeded access to critical health care. According to Daniel Toole, UNICEF Regional Director for East Asia and the Pacific, “We have had attacks on villages and on schools by both anti-government elements as well as by coalition forces and international troops that have hit civilians."

Just in the first four months of 2013 over 400 children were killed and maimed as a result of the protracted conflict. Statistics seem to show that 2013 may well have been the second most deadly year since 2001.

The result of this conflict is that not a single child growing up in Afghanistan today has known peace in his/her lifetime. Deteriorated mental health is one of the consequences of a permanent state of war. A UNICEF study has found that the majority of children under 16 years of age in Kabul suffer from psychological trauma resulting in serious mental health problems including psychiatric disorders and post-traumatic stress syndrome.

Children in Afghanistan are exposed not only to violence related to acts of war but also to violence resulting from accidents, beatings by close relatives or neighbors, or seeing close relatives being beaten or executed. A study published in the Lancet has pointed out, “In Afghan children’s lives, everyday violence matters just as much as militarized violence in the recollection of traumatic experiences.”

Daniel Toole remarked at a press briefing in Geneva, “Afghanistan today is without doubt the most dangerous place to be born,” a sad commentary on the beleaguered country.

- César Chelala

César Chelala, MD, PhD, is an international public health consultant and the foreign correspondent for the Middle East Times International (Australia). He also is a co-winner of an Overseas Press Club of America award for an article on human rights.

This blog first appeared 11 January, 2014 on The WIP blog site. 

See related articles:

Levels and Trends in Child Mortality 
Childhood Under Fire: The impact of two years of conflict in Syria

UNICEF Child Well-being measure

UNICEF - Towards a Post-2015 World Fit for Children

UNICEF Report Card 10: Measuring child poverty

Children and Malnutrition

Can good governance solve youth unemployment?

This article by Robbie Lawrence, highlights how young people are very much part of the solution to youth unemployment. This post is part of the Wikiprogress Governance and Civic Engagement Series

“Education is our top priority but, once educated we want to be trained, enabled – and funded – to take action to address the challenges faced by our generation through youth-led development. We want, in Gandhi’s words, to ‘be the change’ we want to see in the world…” World Youth Congress, Hawaii, 1999

On the same day that the Bank of England upgraded its economic forecast, stating that inflation is expected to drop within the next two years, the Trades Union Congress reported that UK unemployment figures grew by 15,000 in the first three months of 2012 to 2.52 million. Rising employment numbers in the latter months of 2012 had offered a level of respite for the British government following a bruising financial year, however, today’s findings show that joblessness is still extensive.

The issue remains embedded among young people, with jobless rates soaring towards the one million mark and standing at 21.2% across the country. The TUC is concerned that while employment prospects for older workers have been improving, those for young people are far worse, and have deteriorated further since mid-2010. The damaging effects of unemployment on young people are well documented, and there is an increasing risk that the UK’s current 15-24 year olds will suffer lasting damage to their earnings potential and job prospects throughout their lives.

Global figures are equally gloomy. Over the last few years we have been inundated with statistics on the deteriorating situation in Europe (particularly Spain) for young job seekers and in Africa well over half of 15-24 year olds are currently out of work. According to a UN led report released last week, the weakening world wide recovery has further aggravated the youth job crisis and as a result the problem will continue growing over the next five years. The International Labour Organization’s ‘Global Employment Trends forYouth 2013: A generation at risk’ estimates that 73.4 million young people (12.6 percent) are expected to be out of work in 2013, and by 2018, this will have reached 12.8 percent.

Graph taken from ILO Report 2013

The report stipulates that young people face persistent unemployment, a proliferation of temporary jobs and growing discouragement in advanced economies; and poor quality, informal, subsistence jobs in developing countries:

“The economic and social costs of unemployment, long-term unemployment, discouragement and widespread low-quality jobs for young people continue to rise and undermine economies’ growth potential,” ILO - Global Employment Trends for Youth 2013 report.

Despite vocal concern around the issue, it seems that governments and organisations have struggled to find an effective means of combating youth unemployment. The recent World Economic Forum in Davos touched upon the subject on a number of occasions with some leaders suggesting that a global fund for unemployment be implemented. Yet there have been murmurings among critics that such steps are simply inadequate when faced with the ‘tidal wave’ of jobless young people sweeping the world’s nations. Lynda Cratton of the London Business School believes that in a similar way to global warming, the sheer complexity of the challenge renders it almost impossible to solve.

Following the release of ‘A generation at risk’ the ILO’s assistant director-general for policy José Manuel Salazar-Xirinachs stated, ‘These figures underline the need to focus policies on growth, massive improvements in training systems and targeted youth employment actions’. 

Two recent Wikichild Spotlight reports look at tackling youth unemployment through effective governance.

- Developed by UNICEF and Save the Children, Children's Rights and Business Principles provides a comprehensive framework for understanding and addressing the impact of business on the rights and well-being of children. The Children’s Rights and Business Principles are built on existing standards and practices and helps to explain the opportunities for business of investing in children.  

- First published in Nairobi last year, UN-HABITAT’s State of the Field in Youth Development sheds light on how youth are positively impacting communities around the world. As part of wider series, this particular report stresses how young people can be beneficial to communities, and how local, national and international governments can implement, engage and support youth and youth led initiatives.

Both reports look to brand young people as ambassadors of change. ‘Children’s Right’s and Business Principles’ recognizes that children are among the most marginalised members of society, yet when provided with the agency to participate, they have shown that they can offer vital alternative viewpoints and make effective contributions. Similarly, ‘State of the Field’ emphasizes the need to have faith in the power of young people to contribute constructively to the good of society. It seems that both publications hope to change the attitude of governing bodies towards young people by showing that they themselves have placed youths at the center of their own projects. The ‘State of the Field’ report lists countless examples of how initiatives led by young people have positively benefited society.

Youth unemployment is undoubtedly one of the greatest challenges facing governments this century and will worsen as populations swell and education becomes more readily available. However, the two publications featured provide hard facts about how the integration of young people in a country’s workforce can catalyse economic prosperity. With the development of more projects similar to the ones mentioned in the ‘State of the Field’ it seems that we can go someway to combating the problem.   

Robbie Lawrence 

Wikichild Coordinator 

Governance Week in Review

This Week in Review by Robbie Lawrence is part of the Wikiprogress Governance Series

‘Good governance is the foundation on which a society is built, and thus it is indispensable for the development of a country.’ Dirk Niebel, German Minister for Economic Cooperation and Development

As you all know we are focusing on Governance this month, so today’s Week in Review will provide you with an insight into a number of key reports (and a video!) related to the subject. The article includes overviews of the current Wikichild Spotlight, UN Habitat’s State of the Field in Youth-Led Development, UNDP’s Global Consultation on Governance and the Post 2015 framework and Beth Noveck’s Ted Talk, ‘Demand a more open-source government’.  

First published in Nairobi last year, UN-HABITAT’s State of the Field in Youth Development sheds light on how youth are positively impacting communities around the world. As part of wider series, this particular report stresses how young people can be beneficial to communities, and how local, national and international governments can implement, engage and support youth and youth led initiatives. ‘State of the Field’ then goes further and identifies youth led organizations that need more support, financial and otherwise, that could in the future make the most difference. This framework of initiatives was first put in place at the World Youth Congress in October 1999 and since then has expanded to a global form of youth led participation.

Developed by UNICEF and Save the Children, Children's Rights andBusiness Principles provides a comprehensive framework for understanding and addressing the impact of business on the rights and well-being of children. While most businesses are aware that 'children are our future,' the voices of young people are often ostracized when it comes to the corporate sustainability movement. The Children’s Rights and Business Principles are built on existing standards and practices and help to explain the opportunities for business of investing in children.  

The UNDP is currently running a global thematic consultation on governance in the lead up to the post-2015 framework. Similar to Wikiprogress, Wikigender and Wikichild online discussions, this is an open forum for individuals, policy makers, NGOs, UN staff and other stakeholders to discuss how governance can be used to tackle the most pressing issues (inequality etc) facing the post-2015 panel.  Make your voice heard!

The Human Development Report 2013 examines the noticeable transition in global dynamics catalysed by the fast-rising new powers of the developing world and its long-term implications for human development. The report series provides an overview of health, education and basic living standards across the world so that governments and decision makers can make more accurate and comprehensive decisions to boost progress.

What can governments learn from the open-data revolution? In this striking talk (below), Beth Noveck, the former deputy CTO at the White House, shares a vision of practical openness - connecting bureaucracies to citizens, sharing data and creating a truly participatory democracy.

We look forward to bringing you more Governance related articles in the coming weeks!

The Wikiprogress Team

A Promising Future for Child Nutrition?

This ProgBlog article by Robbie Lawrence, Wikichild Coordinator, is part of the Wikiprogress Health Series.

"In June, the Prime Minister will host the Nutrition and Growth event ahead of the G8; we hope Mr Cameron takes this timely opportunity to pledge significant investment in nutrition programmes and show real leadership in improving children’s futures, as well as those of their communities and their countries.” David Bull, UNICEF UK

Wikichild is currently focusing on nutrition as part of the wider Wikiprogress spotlight on health this month. On Monday, UNICEF released ‘Improving Child Nutrition: The achievable imperative for global progress’ which reports that significant advances have been made in the fight against stunting – the long term effect of hunger and malnutrition. Citing successes in eleven countries - Ethiopia, Haiti, India, Nepal, Peru, Rwanda, the Democratic Republic of the Congo, Sri Lanka, Kyrgyzstan, Tanzania and Vietnam, the report shows that stunting and other forms of undernutrition can be brought down by improved understanding of the problem and the implementation of practical measures that target pregnant mothers and children in the first two years of their life.

According to UNICEF, one in four of all children suffer from stunting because they haven’t had the right nutrients in the critical 1,000-day window following conception. Malnutrition, through lack of both macronutrients and certain micronutrients has long-term negative impacts on brain and nerve development and function, including mental activity, and the acquisition of skills needed to interact well socially. This impairment is often reflected in lower IQs and poorer performance at school (Save the Children). The damage done to a child’s body and brain by stunting is irreversible. It brings down performance at school and later at work, and heightens children’s risk of dying from infectious diseases.

‘Improving Child Nutrition’ builds on UNICEF’s earlier report ‘Tracking Progress on Child and Material’ by highlighting new developments and showing that attempts to improve nutrition programs are working. An estimated 80 per cent of the world’s stunted children live in just 14 countries spanning across Africa and Asia, and by working in communities within these nations, UNICEF and other organizations have reduced stunting by applying a series of steps including, improving women’s diet, early and exclusive breastfeeding and providing minerals and appropriate food to new mothers.

These programs all have common elements: political commitment, national policies and the presence of trained community workers to deliver information and aid. To use two examples of their success; we can look at Ethiopia, where stunting has been cut from 57 percent to 44 percent in the first decade of this century through the implementation of a national nutrition program, and at the Maharashtra state in India where the percentage of stunted children fell from 39 percent in 2005 to 23 percent in 2012 due to the support of frontline workers. 

Such progress is undoubtedly promising, and presents a unique opportunity for future global frameworks to further alleviate the problem of undernutrition. UNICEF itself acknowledges that there is still a great amount of work to be done if the World Health Assembly’s new global target of reducing the number of stunted children under the age of five by forty percent by 2025 is to be achieved. 

More recently, inequality has been a hot topic on the Wikichild, Wikiprogress and Wikigender platforms so we are well versed in the hidden realties that large, all encompassing goals such as this can mask, but it is encouraging that new approaches are targeting individual countries and communities, allowing accurate data systems to be developed that can describe and monitor changes in the circumstances of different population groups.

Furthermore, tools like the Hunger and Nutrition Commitment Index (released last week) provide greater transparency and public accountability by measuring what governments achieve, and where they fail, in addressing hunger and undernutrition. Even Duncan Green has commended the HANCI, stating that ‘it could become one of the more useful annual league tables’, as it forces governments to be ‘slapped’ if they underperform. 

Nutrition should remain at the center of the global development agenda leading up to Post 2015. The evidence laid out in UNICEF’s report and the momentum generated by their successes shows that improving child and maternal nutrition is an achievable necessity for global progress.

Robbie Lawrence

Wikichild Coordinator

Protecting Children in Conflict Zones

This ProgBlog article, will focus on the destructive affects of conflict on children and the need  the issue to be a priority when the final post-2015 framework is put in place. The article is part of the Wikiprogress Post 2015 series.

"Millions of children inside Syria and across the region are witnessing their past and their futures disappear amidst the rubble and destruction of this prolonged conflict," Anthony Lake, UNICEF Chief

Since the Syrian Civil War erupted mid way through March 2011, 70,000 people have died, millions are said to be displaced and the battle scarred country has been segmented into areas controlled by Bashar al-Assad’s regime and those who oppose him. Through articles, photos, tweets, Youtube videos, interviews, documentaries, and reports, the world has been witness to genocide in, second by second detail, experiencing the hopeless situation in all the exactitude that modern information engines provide.

To mark the two year anniversary of the conflict, UNICEF and Save the Children have released up to date reports on the war’s devastating affect on Syria’s children. UNICEF notes that nearly half of the four million people in need of aid are under the age of 18 and 536,000 of them are children under the age of five. Furthermore, some 800,000 below the age of fourteen have been internally displaced, while more than 500,000 are spread across neighboring nations as refugees.

Similarly, Save the Children’s report 'Childhood Under Fire' details the impact of the war on children, showing that many are starving, living in pitiful conditions and are losing out on the chance of an education. Citing new research carried out in refugee camps by Bahcesechir University of Turkey, the report reveals that children have been specifically targeted in the war, with one in three children claiming to have been hit, kicked or shot. Instead of going to school, girls are being forced to marry early as a form of protection against the threat of sexual violence and the armed militias are using boys as porters, runners and human shields. One man, Safa, said:

‘I don’t think there is a single child untouched by this war. Everyone has seen death, everyone has lost someone. I know no one who has not suffered as we have. It is on such a scale.’

Save the Children warns that the conflict had brought about ‘a collapse in childhood’ echoing UNICEF’s caution that Syria’s children risk becoming ‘a lost generation’. We need only look at how the lengthy conflict in Somalia catalyzed a collapse in the country’s education system to know how war can curb the development of a country’s child population.

Both reports emphasize the necessity for governments to deliver the $1.5 billion pledged to the humanitarian appeal for Syria, which is designed to target aid both inside the decimated country and to refugees living on its borders and beyond. While STC and UNICEF scramble to acquire these funds, it is arguable that the international community must take a step back and readdress how it can better prevent the fallout of war and disasters.

The brutalities being enacted on Syria’s children is a strong example of why governments must try and find new solutions to deal with the changing nature of modern conflict, which, according to the Minister of International Development of Finland, Heidi Hautala, usually features child- and gender- based violence. On March 13^th, more than 100 delegates from over 20 countries met in Helsinki to urge the Post 2015 panel to make conflict prevention, violence reduction, peace building and disaster resilience an integral part of the final framework. The UN convened discussion agreed that despite the relative success of the Millennium Development Goals, they have not managed to fully encompass the vision of the Millennium Declaration, particularly in relation to human rights, justice and equality. In a similar vein, a statement from the Civil Society Core Group stipulated that ‘supporting change in conflict affected and fragile states is now a central challenge in international development.’ The document made a concise and practical list of suggestions for how the Post 2015 development agenda should prevent violent conflict in all societies and concluded with a call for the panel to:

‘build on the vision of the Millennium Declaration and upholds the right of all people to enjoy peace, security and human rights as essential elements of sustainable development.’

Only the coming years will tell if this grandiose statement can be realistically implemented, and if we are to turn our eyes back to Syria, its people will find little comfort in such words. However, it seems essential that in the future, financial aid programs must be supported by a more far-reaching framework that will go some way to preventing such atrocities from happening again.    

Robbie Lawrence

Wikichild Coordinator

@Wiki_child